bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine learning in primary biliary cholangitis: A novel approach for risk stratification
Authors: Gerussi Alessio , Verda Damiano , Bernasconi Davide Paolo , Carbone Marco , Komori Atsumasa , Abe Masanori , Inao Mie , Namisaki Tadashi , Mochida Satoshi , Yoshiji Hitoshi , Hirschfield Gideon , Lindor Keith , Pares Albert , Corpechot Christophe , Cazzagon Nora , Floreani Annarosa , Marzioni Marco , Alvaro Domenico , Vespasiani‐Gentilucci Umberto , Cristoferi Laura , Valsecchi Maria Grazia , Muselli Marco , Hansen Bettina E. , Tanaka Atsushi , Invernizzi Pietro
Published: December 2021

Background & Aims

Machine learning (ML) provides new approaches for prognostication through the identification of novel subgroups of patients. We explored whether ML could support disease sub‐phenotyping and risk stratification in primary biliary cholangitis (PBC).

Methods

ML was applied to an international dataset of PBC patients. The dataset was split into a derivation cohort (training set) and a validation cohort (validation set), and key clinical features were analysed. The outcome was a composite of liver‐related death or liver transplantation. ML and standard survival analysis were performed.

Results

The training set was composed of 11,819 subjects, while the validation set was composed of 1,069 subjects. ML identified four clusters of patients characterized by different phenotypes and long‐term prognosis. Cluster 1 (n = 3566) included patients with excellent prognosis, whereas Cluster 2 (n = 3966) consisted of individuals at worse prognosis differing from Cluster 1 only for albumin levels around the limit of normal. Cluster 3 (n = 2379) included young patients with florid cholestasis and Cluster 4 (n = 1908) comprised advanced cases. Further sub‐analyses on the dynamics of albumin within the normal range revealed that ursodeoxycholic acid‐induced increase of albumin >1.2 x lower limit of normal (LLN) is associated with improved transplant‐free survival.

Conclusions

Unsupervised ML identified four novel groups of PBC patients with different phenotypes and prognosis and highlighted subtle variations of albumin within the normal range. Therapy‐induced increase of albumin >1.2 x LLN should be considered a treatment goal.
Declining incidence of hepatitis C related hepatocellular carcinoma in the era of interferon‐free therapies: A population‐based cohort study
Authors: Innes Hamish , McDonald Scott A. , Hamill Victoria , Yeung Alan , Dillon John F. , Hayes Peter C. , Went April , Fraser Andrew , Bathgate Andrew , Barclay Stephen T. , Janjua Naveed , Goldberg David J. , Hutchinson Sharon J.
Published: December 2021

Background & aims

The impact of interferon (IFN)‐free therapies on the epidemiology of hepatitis C virus (HCV) related hepatocellular carcinoma (HCC) is not well understood at a population level. Our goal was to bridge this evidence gap.

Methods

This study included all patients in Scotland with chronic HCV and a diagnosis of cirrhosis during 1999‐2019. Incident cases of HCC, episodes of curative HCC therapy, and HCC‐related deaths were identified through linkage to nationwide registries. Three time periods were examined: 1999‐2010 (pegylated interferon‐ribavirin [PIR]); 2011‐2013 (First‐generation DAA); and 2014‐2019 (IFN‐free era). We used regression modelling to determine time trends for (i) number diagnosed and living with HCV cirrhosis, (ii) HCC cumulative incidence, (iii) HCC curative treatment uptake and (iv) post‐HCC mortality.

Results

3347 cirrhosis patients were identified of which 381 (11.4%) developed HCC. After HCC diagnosis, 140 (36.7%) received curative HCC treatment and there were 202 deaths from HCC. The average annual number of patients diagnosed and living with HCV cirrhosis was approximately seven times higher in the IFN‐free versus the PIR era, whereas the number of incident HCCs was four times higher. However, the cumulative incidence of HCC was significantly lower in the IFN‐free versus PIR era (sdHR: 0.65; 95%CI:0.47‐0.88; P = .006). Among HCC patients, diagnosis in the IFN‐free era was not associated with improved uptake of curative treatment (aOR:1.18; 95%CI:0.69‐2.01; P = .54), or reduced post‐HCC mortality (sdHR: 0.74; 95%CI:0.53‐1.05; P = .09).

Conclusions

The cumulative incidence of HCC is declining in HCV cirrhosis patients, but uptake of curative HCC therapy and post‐HCC survival remains suboptimal.
Unique igneous textures and shock metamorphism of the Northwest Africa 7203 angrite: Implications for crystallization processes and the evolutionary history of the angrite parent body
Authors: Hayashi Hideyuki , Mikouchi Takashi , Kim Nak Kyu , Park Changkun , Sano Yuji , Takenouchi Atsushi , Yamaguchi Akira , Kagi Hiroyuki , Bizzarro Martin
Published: December 2021

Northwest Africa (NWA) 7203 is a quenched angrite, showing mineralogical features typically not present in other quenched angrites. NWA 7203 exhibits textures whose grain size varies from fine grains (<10 μm) to coarse grains (~3 mm), while other quenched angrites show only single‐sized textures. Fine‐grained and coarse‐grained lithologies have nearly the same bulk compositions. Cooling rates were estimated to be ~80 °C h−1 for fine‐grained lithologies and ~1 °C h−1 for coarse‐grained lithologies. Mg‐rich olivines (~Fo64) were found only in fine‐grained lithologies. Crystallization of NWA 7203 started in the fine‐grained lithologies with Mg‐rich olivine grains acting as seeds for crystallization. Coarse‐grained lithologies were subsequently formed under conditions of slower cooling. NWA 7203 shows clear shock metamorphic textures unlike other quenched angrites except for NWA 1670. We confirm that the oxygen isotopic ratios of NWA 7203 plot on the angrite fractionation line within uncertainty. However, the obtained Pb‐Pb age of NWA 7203 is 4543 ± 19 Ma, younger than the ages of other quenched angrites, which might be a result of disturbance by shock metamorphism. The finding of shock metamorphism of NWA 7203 suggests that some angrites might be derived from asteroids that remained large (>10 km in diameter) during the late heavy bombardment.
Participatory Action Research in Education: Benefits and Tensions Across Contexts
Authors: Sosnowski Jim , Tokunaga Tomoko , Evans Sarah A.
Published: December 2021

This special section examines the enactment of participatory action research (PAR) across three distinct educational contexts: a public library program for teens, an after‐school program in Japan, and a prison‐based adult language and literacy program. This introduction provides an overview of the principles associated with PAR and outlines potential tensions and challenges associated with partnering with the community as co‐researchers. Building on the interest in anthropology to challenge traditional research approaches, these studies emphasize how PAR can provide opportunities to positively impact the communities that are the focus of the research, including how PAR impacts those community members who become co‐researchers. Additionally, these three studies critically examine the challenges and tensions introduced through PAR, challenging romanticized notions of PAR with the reality of the demands that participating in research placed on community members.
Lessons from the 116 years (1902‐2018) of history of the Japanese Society of Neurology in establishing its identity: Secondary publication
Authors: Kuzuhara Shigeki
Published: December 2021

The Japanese Society of Neurology and Psychiatry was founded in 1902 as a joint society of Neurology and Psychiatry, but was renamed the Japanese Society of Psychiatry and Neurology in 1935 because of the stagnation of activities of Neurology and the rise of those of Psychiatry. After World War II, activities of Neurology were restored and the Japanese Society of Neurology (JSN) independent from the Society of Internal Medicine and Society of Psychiatry was established in 1960 after overcoming many difficulties. In 1975, neurology was approved by law as one of the specialized fields of medicine. After that, neurology and JSN developed dramatically, in both research and medical practices. As of 2018, JSN had 9000 members and more than 5500 board‐certified neurology specialists. In 2018, JSN enacted a new policy to upgrade the neurology specialist from a subspecialty of Internal Medicine to an independent major medical field. Lessons of the 116 years of history of the Society would teach us a sensible way to achieve the goals.
Identification of maternal serum biomarkers for prenatal diagnosis of nonsyndromic orofacial clefts
Authors: Wang Xinhuan , Yang Xiaohong , Huang Pei , Meng Xiujiao , Bian Zhuan , Meng Liuyan
Published: December 2021

Nonsyndromic orofacial clefts (NSOFCs) are the most common congenital defects in the oral and maxillofacial regions. It is mainly diagnosed prenatally through fetal ultrasonography. However, the accuracy of ultrasonography for NSOFC is unreliable. Maternal serological screening is a noninvasive method for the diagnosis of fetal malformations. In our study, we sought to identify specific biomarkers in maternal serum for predicting NSOFC prenatally. We quantified the alterations in maternal serum protein profiles between 20 pregnant women with NSOFC fetuses and 20 pregnant women with healthy fetuses by using isobaric tags for relative and absolute quantitation‐based mass spectrometry (MS). The serum levels of 75 elevated and 50 decreased proteins in the NSOFC group were detected. Twenty‐eight candidate biomarkers were selected for further confirmation by multiple reaction monitoring‐MS; of these, 16 proteins were found to be significantly different. More importantly, the levels of three proteins (APOA, HPT, and CRP) were verified by ELISAs to be obviously altered in serum from pregnancies carrying fetuses with NSOFC. Our results indicate that analysis of the maternal serum proteome is a feasible strategy for biomarker discovery of NSOFC, and APOA, HPT, and CRP proteins are potential serum biomarkers for prenatal diagnosis of NSOFC.
Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth‐borne and tooth‐bone‐borne expanders: A randomized clinical trial
Authors: Pasqua Bruno de Paula Machado , André Cristiane Barros , Paiva João Batista , Tarraf Nour Eldin , Wilmes Benedict , Rino‐Neto José
Published: December 2021

Objectives

To compare, using cone‐beam computed tomography, the dentoskeletal changes in rapid maxillary expansion with tooth‐bone‐borne (Hybrid Hyrax) and tooth‐borne (Hyrax) appliances.

Setting and sample population

Forty‐two patients who met the eligibility criteria (aged 11‐14 years; transverse maxillary deficiency, posterior crossbite, and presence of upper first premolars and molars) were screened and allocated into two groups: HHG (treatment with Hybrid Hyrax) and HG (treatment with Hyrax).

Main outcome measures

The primary outcomes included nasomaxillary dimensional changes. CBCT was performed before and 3 months after the activation phase. Measurements were performed using Dolphin®. Baseline data were compared using one‐way ANOVA. For intergroup comparison, ANCOVA was used to analyze the initial age, appliance activations (mm), and mid‐palatal suture maturation data as covariates. Statistical significance was set at 5%.

Results

The premolar region in HHG showed increased skeletal changes than in HG, with the difference being 1.5 mm (0.5; 2.6) in the nasal cavity (P = .004), 1.4 mm (0.3; 2.5) in the nasal floor (P = .019), and 1.1 mm (0.2; 2.1) in the maxilla (P = .022). The molar region in HHG showed increased skeletal changes with the difference being 0.9 mm (0.2; 1.5) in the nasal cavity (P = .005), and 0.9 mm (0; 1.8) in the maxilla (P = .042) than in HG. Premolar inclination was higher in HG.

Conclusion

Hybrid Hyrax showed more skeletal changes and fewer dental side effects, especially in the first premolar region. The amount of activation influenced the higher nasal skeletal changes in the Hybrid hyrax group.
Histopathology of oral lichen planus and oral lichenoid lesions: An exploratory cross‐sectional study
Authors: Lodolo Michele , Gobbo Margherita , Bussani Rossana , Torelli Lucio , Rupel Katia , Ottaviani Giulia , Poropat Augusto , Biasotto Matteo
Published: December 2021

Objective

To better characterize the histopathology of oral lichen planus and oral lichenoid lesions and to highlight the differences between them in order to support the clinician in the diagnostic and therapeutic management of such conditions.

Subjects and Methods

Fifty‐five patients, clinically diagnosed with oral lichen planus (n = 25) or oral lichenoid lesions (n = 30), were consecutively enrolled in the present study. Subsequently, one blind pathologist reviewed all the biopsy specimens of enrolled subjects following a specific protocol to provide a detailed histopathological description. Demographic, anamnestic, and clinical data were also recorded from all the participants. Patients’ data were analysed and compared using the chi‐squared test, to provide distinguishing features between the studied conditions.

Results

We found a higher and statistically significant number of eosinophils in the oral lichenoid lesions compared with the oral lichen planus group (p < 0.01), an equally promising result was seen regarding plasma cells, which were more represented (p = 0.05) in the oral lichenoid lesions than in the oral lichen planus cases. No statistically significant differences were detected in demographic, anamnestic and clinical data.

Conclusion

A mixed lichenoid inflammatory infiltrate, consisting of eosinophils and plasma cells, could be used as reliable histological features for the diagnosis of oral lichenoid lesions, as long as compared with findings obtained from the patients’ history and clinical examination.
Associations of attachment avoidance and anxiety with life satisfaction, satisfaction with singlehood, and desire for a romantic partner
Authors: MacDonald Geoff , Park Yoobin
Published: December 2021

Living single is becoming increasingly common worldwide and understanding within‐group predictors of well‐being among singles is becoming a stronger research priority. Although Pepping, MacDonald, and Davis suggested individual differences in attachment security may be useful for predicting singles' well‐being, there are no published data on the issue. In this research, single participants (N = 1930; 49% men; Mage = 31 years; 75% White) completed measures of attachment security as well as measures of life satisfaction, satisfaction with singlehood, and desire for a romantic partner. The data suggested that higher levels of attachment avoidance and attachment anxiety were both associated with lower levels of life satisfaction as well as satisfaction with singlehood. However, when controlling for life satisfaction, attachment avoidance was not associated with satisfaction with singlehood. We also found that higher levels of attachment avoidance were associated with less desire for a romantic partner whereas higher levels of attachment anxiety were associated with stronger desire for a partner. Our findings suggest that individual differences in attachment security may indeed be useful in predicting well‐being‐related outcomes for singles.
Empowering patients to co‐design Covid‐19 responses: the role of online health communities
Authors: Garcia Martinez Marian , Bezos Daleske Carlos , Benítez León Áurea , Lalanza Rodelgo Simón Moisés , Orive Espinosa Raquel , Rubio López Patricia , de Hoyos Aragoneses Vega
Published: December 2021

Covid‐19 has paved the way for major disruptions to conventional healthcare systems accelerating participatory health enabled by interactive virtual environments. The role of the ‘patient voice’ as a fundamental resource in an effective Covid‐19 response has moved centre stage. In this time of extraordinary crisis and health system disruptions, patient‐centred models offer opportunities for embedding shared decision‐making to improve health outcomes using digital tools. Through an exploratory case study, this paper examines patient action during Covid‐19 and how co‐design methods can be adapted to an online environment in response to Covid‐19 restrictions to improve the Covid‐19 patient and family experience of care. Experienced‐based co‐design was employed to map the care journey of patients with Covid‐19 confined at home in Spain – one of the hardest‐hit countries in the pandemic – to identify quality improvements. Main touchpoint needs were explored in online co‐design workshops leading to improvement projects including the development of a Covid‐19 patient online health community (OHC) to deliver patient‐centred care during the outbreak. The Covid‐19 patient OHC has become an instrument that facilitates Covid‐19 patient’s recovery, especially psychological resilience. OHC participation has clear potential for empowerment and transformative agency as it enables Covid‐19 patients to control the content and flow of the information available to them. This paper offers valuable insights on how co‐design can be adapted to an online format to enable more meaningful patient input to healthcare design when faced with uncertainty and ambiguity during health crises.
Model Identification Via Total Frobenius Norm of Multivariate Spectra
Authors: McElroy Tucker S. , Roy Anindya
Published: December 2021

We study the integral of the Frobenius norm as a measure of the discrepancy between two multivariate spectra. Such a measure can be used to fit time series models, and ensures proximity between model and process at all frequencies of the spectral density—this is more demanding than Kullback–Leibler discrepancy, which is instead related to one-step ahead forecasting performance. We develop new asymptotic results for linear and quadratic functionals of the periodogram, and make two applications of the integrated Frobenius norm: (i) fitting time series models, and (ii) testing whether model residuals are white noise. Model fitting results are further specialized to the case of structural time series models, wherein co-integration rank testing is formally developed. Both applications are studied through simulation studies, as well as illustrations on inflation and construction data. The numerical results show that the proposed estimator can fit moderate- to large-dimensional structural time series in real time, an option that is lacking in current literature.
Latent M. tuberculosis infection is associated with increased inflammatory cytokine and decreased suppressor of cytokine signalling (SOCS)‐3 in the diabetic host
Authors: Masood Kiran Iqbal , Irfan Muhammad , Masood Qamar , Yameen Maliha , Jamil Bushra , Ram Nanik , Rao Shoaib , Rottenberg Martin , Hasan Zahra
Published: December 2021

Tuberculosis (TB) outcomes are worsened by type II diabetes mellitus (DM). Protective immunity against Mycobacterium tuberculosis (MTB) is driven by cytokines. Latent TB (LTBi) is common but its effect on the diabetic host is not well understood. We investigated mycobacterial antigen‐stimulated responses in peripheral blood mononuclear cell (PBMC) isolated from healthy endemic controls (EC), those with LTBi, DM groups with and without LTBi, as compared with TB patients. Cytokines were measured using a Luminex‐based assay. Gene expression was determined by RT‐PCR. In DM‐LTBi cases, PPD‐stimulated proinflammatory cytokines; IFN‐γ, IL‐6, IL‐2, TNF‐α and GM‐CSF and anti‐inflammatory cytokines, IL‐5 and IL‐13 were raised as compared with EC. DM‐LTBi PPD‐stimulated IFN‐γ, IL‐6 and TNF‐α mRNA titres were found raised in DM‐LTBi, whilst suppressor of cytokine signalling (SOCS)‐3 expression was lowered. Within DM cases, stratification based on HbA1c levels revealed raised IFN‐γ but lowered IL‐6 gene expression in those with controlled levels as compared with uncontrolled glycaemic levels. Further, SOCS1 expression levels were found higher in DM cases with controlled glycaemia when compared with EC. Overall, we show that diabetics with LTBi manifest raised levels of inflammatory and anti‐inflammatory cytokines concomitant with reduced SOCS3 mRNA expression. Reduced glycaemic control results in further inflammatory dysregulation impacting conversing impacting IFN‐γ and IL‐6 activation. These results suggest that dysregulated immune activation in diabetes is exacerbated by LTBi, lack of glycaemic control may further compromise immunity against MTB infection.
Issue Ownership and Agenda Setting in the 2019 Swiss National Elections
Authors: Gilardi Fabrizio , Gessler Theresa , Kubli Maël , Müller Stefan
Published: December 2021

The 2019 Swiss national elections were characterized by the unusual prominence of two issues, environment and gender, whereas two staples of Swiss politics, immigration and Europe, were less dominant compared to previous elections. We study how, in this context, the media and party agenda were linked to issue ownership. Specifically, we consider whether political parties that own an issue could lead the media agenda and the agenda of other parties. Our analysis relies on all tweets and press releases of major Swiss political parties from January to October 2019 and 37,225 newspaper articles published during the same period. Results show, first, that the agenda‐setting capacity of parties was restricted to the gender issue, and second, that the link between issue ownership and agenda setting is ambiguous. These findings suggest that during election campaigns, agenda setting may be largely exogenous to both parties and media.
Determination of unacceptable HLA antigen mismatches in kidney transplant recipients
Authors: Ziemann Malte , Suwelack Barbara , Banas Bernhard , Budde Klemens , Einecke Gunilla , Hauser Ingeborg , Heinemann Falko Markus , Kauke Teresa , Kelsch Reinhard , Koch Martina , Lachmann Nils , Reuter Stefan , Seidl Christian , Sester Urban , Zecher Daniel
Published: December 2021

With the introduction of the virtual allocation crossmatch in the Eurotransplant (ET) region in 2023, the determination of unacceptable antigen mismatches (UAM) in kidney transplant recipients is of utmost importance for histocompatibility laboratories and transplant centers. Therefore, a joined working group of members from the German Society for Immunogenetics (Deutsche Gesellschaft für Immungenetik, DGI) and the German Transplantation Society (Deutsche Transplantationsgesellschaft, DTG) revised and updated the previous recommendations from 2015 in light of recently published evidence. Like in the previous version, a wide range of topics is covered from technical issues to clinical risk factors. This review summarizes the evidence about the prognostic value of contemporary methods for HLA antibody detection and identification, as well as the impact of UAM on waiting time, on which these recommendations are based. As no clear criteria could be determined to differentiate potentially harmful from harmless HLA antibodies, the general recommendation is to assign all HLA against which plausible antibodies are found as UAM. There is, however, a need for individualized solutions for highly immunized patients. These revised recommendations provide a list of aspects that need to be considered when assigning UAM to enable a fair and comprehensible procedure and to harmonize risk stratification prior to kidney transplantation between transplant centers.
Identification of two HLA‐C alleles with new amino acid residues in the α‐3 domain, HLA‐C*03:581 and ‐C*05:267
Authors: Bandres Eva , Arnedo Patricia , Jauregui Axier , Balas Antonio , Vicario Jose L.
Published: December 2021

Characterization of two new HLA‐C alleles, C*03:581 and C*05:267.
A Hybrid Method for Lithium-Ion Batteries State-of-Charge Estimation Based on Gated Recurrent Unit Neural Network and an Adaptive Unscented Kalman Filter
Authors: Xu Shuai , Zhou Fei , Liu Yuchen
Published: December 2021

Among the battery state of charge (SOC) estimation methods, the Kalman-based filter algorithms are sensitive to the battery model while the neural network (NN)-based algorithms are decided by hyperparameters. In this paper, a hybrid approach composed of a gated recurrent unit (GRU) NN and an adaptive unscented Kalman filter (AUKF) method is proposed. A GRU NN is first used to acquire the nonlinear relationship between the battery SOC and battery measurement signals, and then an AUKF is utilized to filter out the output noise of the NN to further improve estimation accuracy. The hybrid method avoids the establishment of accurate battery models and the search for optimal hyperparameters. The data of dynamical street test and US06 test are used as training dataset and validation dataset, respectively, while the data collected from the tests under federal urban driving schedules and Beijing driving cycle conditions are taken as testing dataset. As compared with some hybrid methods proposed in other literature, the hybrid method has the best estimation accuracy and generalization for various driving cycles at different ambient temperatures. The root mean square error and the mean absolute error all are less than 1.5%, and the maximum absolute error is less than 2%. In addition, it also exhibits powerful robustness against the abnormal values of the battery signals and can converge to the true value in just 5 s.
Development and Multisite Assessment of a Novel Shoulder Motion Joint Simulator
Authors: Nayak Aniruddh N. , Gabriel Stefan M. , Spenciner David B. , Mason Courtney E. , Jacofsky Marc C.
Published: December 2021

Multiple biomechanical shoulder simulators have been described in the literature, with a trend toward increasing complexity to better simulate clinical scenarios. Our objective was to develop an advanced, novel shoulder joint simulator and compare outcomes at two separate institutions, for a typical shoulder joint motion simulation. Identical shoulder simulators were developed & deployed at both institutions. Eight cadaveric upper extremities were tested by simulating actively controlled, arm elevation in the plane of the scapula for two sequential test conditions (intact and nondestructive simulated cuff-tear), each repeated for a total of five trials. Muscle forces and joint translations were recorded for both conditions. The intact condition was repeated following simulated cuff-tear to assess effect of testing order. Statistical analyses were aimed at assessing repeatability and reproducibility of results within specimens, between specimens, and between institutions. The highest average forces were observed for the middle deltoid (233N or 32.5% body weight (BW)), followed by infraspinatus (99.0N), and posterior deltoid (93.7N) muscles. Differentiation between test conditions was unhindered by variability between repeated trials. Data from testing repeated over time, and between the two institutions were not significantly different. The novel shoulder simulator produced repeatable results with low trial-to-trial variation and outcomes were comparable between the two institutions. The results demonstrated a consistent response in muscle forces and humeral translation for the simulated rotator cuff tear condition. Such advanced shoulder simulators could thus be used for evaluating and optimizing surgical interventions and implant strategies.
Characterization of Nonlinear Rattling Behavior of a Gear Pair Through a Validated Torsional Model
Authors: Donmez Ata , Kahraman Ahmet
Published: December 2021

Dynamic response of a gear pair subjected to input and output torque or velocity fluctuations is examined analytically. Such motions are commonly observed in various powertrain systems and identified as gear rattle or hammering motions with severe noise and durability consequences. A reduced-order torsional model is proposed along with a computationally efficient piecewise-linear solution methodology to characterize the system response including its sensitivity to excitation parameters. Validity of the proposed model is established through comparisons of its predictions to measurements from a gear rattle experimental setup. A wide array of nonlinear behavior is demonstrated through presentation of periodic and chaotic responses in the forms of phase plots, Poincaré maps, and bifurcation diagrams. The severity of the resultant impacts on the noise outcome is also assessed through a rattle severity index defined by using the impact velocities.
A Review of Virtual Assistants’ Characteristics: Recommendations for Designing an Optimal Human–Machine Cooperation
Authors: Gilles Marlène , Bevacqua Elisabetta
Published: December 2021

Designed to improve human–machine interactions, virtual agents and particularly virtual assistants (VAs) are spreading in our daily lives. Presenting a very wide variety of characteristics, studies generally report their own agent with its own characteristics and objective. So we can wonder if some of these characteristics are a consensus for VAs in general. In this study, we aim to identify agents’ characteristics that should be considered when designing a virtual assistant promoting the best communication and cooperation between man and machine. We review the aspects of representation of the agent (embodied or not) and its ability to interact with the human being not only by speech or gestures but also by displaying personality traits. This overview focuses on virtual assistance of any kind embarked on vehicles.
Novel Methodology for Inflection Circle-Based Synthesis of Straight Line Crank Rocker Mechanism
Authors: Shiwalkar P. B. , Moghe S. D. , Modak J. P.
Published: December 2021

Emerging fields like Compact Compliant Mechanisms have created newer/novel situations for application of straight line mechanisms. Many of these situations in Automation and Robotics are multidisciplinary in nature. Application Engineers from these domains are many times uninitiated in involved procedures of synthesis of mechanisms and related concepts of Path Curvature Theory. This paper proposes a predominantly graphical approach using properties of Inflection Circle (IC) to synthesize a crank rocker mechanism for tracing a coupler curve which includes the targeted straight line path. The generated approximate straight line path has acceptable deviation in length, orientation, and extent of approximate nature well within the permissible ranges. Generation of multiple choices for the link geometry is unique to this method. To ease the selection, a trained artificial neural network (ANN) is developed to indicate relative length of various options generated. Using studied unique properties of Inflection Circles a methodology for anticipating the orientation of the straight path vis-à-vis the targeted path is also included. Two straight line paths are targeted for two different crank rockers. Compared with the existing practice of selecting the mechanism with some compromise due to inherent granularity of the data in Atlases, proposed methodology helps in indicating the possibility of completing the dimensional synthesis. The developed solution is well within the design specifications and is without a compromise.
Comparative Study of Tip Injection in a Transonic and Subsonic Compressor
Authors: Wang Wei , Liu Boxing , Lu Jinling , Feng Jianjun , Chu Wuli , Wu Yanhui
Published: December 2021

Discrete tip injection is an effective method to enhance stability of compressors. This study compares the effects of injection parameters on compressor performance and underlying mechanisms in two different compressors. The transonic compressor is studied using unsteady simulations, and the subsonic compressor is mainly investigated with experiments. Results show that tip injection improves stable operating range by 35.6% and 77.9% for the transonic compressor and subsonic compressor, respectively, without decreasing compressor efficiency. The effects of circumferential coverage percentage and injector throat height on compressor stability are similar in the two compressors when the injection velocity is double the velocity of the main flow. The optimal injector throat height which is normalized by the tip clearance size is the same for the two compressors, and the best circumferential coverage percentage for the subsonic compressor is lower than that in the transonic compressor. For the two compressors, the adaption of the main flow to the discrete tip injection is unsteady, and the hysteresis effect that the recovery of tip blockage lags behind the recovery of tip leakage vortex accounts for the improved stability using partial coverage of injection. The injection efficiency, which is defined to quantify the improved quality of the flow field in the injection domain, is proven to determine the stall limits by studying the effects of different injection parameters. The guidelines built in the subsonic compressor can be used in the transonic compressor to design tip injection, but the optimal values of some injection parameters should be reconfirmed.
Aeroelastic Aspects of Axial Compressor Stage With Self-Recirculating Casing Treatment
Authors: Kumar S. Satish , Alone Dilipkumar Bhanudasji , Thimmaiah Shobhavathy M. , Mudipalli Janaki Rami Reddy , Kumar Lakshya , Jana Soumendu , Kandagal S. B. , Ganguli Ranjan
Published: December 2021

For successful implementation of casing treatment designs in axial compressors, apart from the stall margin improvement benefits, aeroelasticity also plays a major role. This manuscript addresses the not often discussed aeroelastic aspects of a new discrete type of passive self-recirculating casing treatment (RCT) designed for a transonic axial compressor stage. Experiments are carefully designed for synchronized measurement of the unsteady fluidic disturbances and vibrations during rotating stall for compressor with baseline solid casing and self-RCT. The modal characteristics of the axial compressor rotor-disk assembly are studied experimentally and numerically. Experimentally it is observed that the rotating stall cells excite the blades in their fundamental mode in a compressor with baseline solid casing at the stall flow condition. In contrast, there is no excitation of the blades in the compressor with self-RCT at the same solid casing stall flow condition. Also, the self-RCT compared to the solid casing can significantly reduce the overall vibration levels of the blades that are excited at the stall flow condition. The casing treatment is able to alter the flow field near the tip region of the rotor blade, and hence influencing the forcing function of the rotating cantilever blades to have the aeroelastic benefit.
Kinematics and structural evolution of the Anziling dome-and-keel architecture in east China: Evidence of Neoarchean vertical tectonism in the North China Craton
Authors: Zhao Chen , Zhang Jian , Zhao Guochun , Yin Changqing , Chen Guokai , Liu Jin , Liu Xiaoguang , Chen Wenliang
Published: December 2021

The debate on the role of vertical versus horizontal tectonism in Archean cratons is intimately linked to the initiation of plate tectonics. The dome-and-keel architecture has been considered as a consequence of vertical tectonism. Although such a structural pattern is documented in some Mesoarchean and older cratons, such as the Kaapvaal and Pilbara cratons, whether it also occurs in Neoarchean cratons is poorly constrained. Determining the kinematics, structural evolution, and the timing of these structures is crucial in understanding how the tectonic behavior operated during the evolution of the early Earth. The North China Craton, especially its eastern part, is a Neoarchean continental block and preserves typical greenstone-granite rock assemblages. Detailed structural mapping reveals that the Anziling area (east China) is characterized by a typical dome structure without significant reworking by later deformation. The dome is in tectonic contact with a supracrustal rock assemblage that is now the dip-slip Shuangshanzi ductile shear zone. In the supracrustal rocks, compositional layers are folded into upright isoclinal folds. Meanwhile, along the shear zone, foliation varies from NNW to SW with sub-vertical dip. Mineral stretching lineations indicate a sinistral shear sense with a slightly oblique-slip component in the north, but show NWW-directed and SW-directed steep dip-slip shear in the west and south, respectively. Kinematic indicators imply that the granitic dome formed through a vertically upward movement accompanied by an uneven clockwise rotation. The supracrustal rocks sank downwards to form the regional keel structure. Structural data suggests that the Anziling area is a typical dome-and-keel structure. U-Pb zircon dating on pre-, syn-, and post-tectonic dykes indicate that the dome-and-keel structure formed at 2530−2500 Ma, and was intimately related to the emplacement of tonalite-trondhjemite-granodiorite granitoids. New data from this study suggest that until the late Neoarchean, the vertical tectonism was still a dominant tectonic regime that was operating in the eastern North China Craton.
Proterozoic–Phanerozoic tectonic evolution of the Qilian Shan and Eastern Kunlun Range, northern Tibet
Authors: Wu Chen , Li Jie , Zuza Andrew V. , Haproff Peter J. , Chen Xuanhua , Ding Lin
Published: December 2021

The Proterozoic–Phanerozoic tectonic evolution of the Qilian Shan, Qaidam Basin, and Eastern Kunlun Range was key to the construction of the Asian continent, and understanding the paleogeography of these regions is critical to reconstructing the ancient oceanic domains of central Asia. This issue is particularly important regarding the paleogeography of the North China-Tarim continent and South China craton, which have experienced significant late Neoproterozoic rifting and Phanerozoic deformation. In this study, we integrated new and existing geologic field observations and geochronology across northern Tibet to examine the tectonic evolution of the Qilian-Qaidam-Kunlun continent and its relationships with the North China-Tarim continent to the north and South China craton to the south. Our results show that subduction and subsequent collision between the Tarim-North China, Qilian-Qaidam-Kunlun, and South China continents occurred in the early Neoproterozoic. Late Neoproterozoic rifting opened the North Qilian, South Qilian, and Paleo-Kunlun oceans. Opening of the South Qilian and Paleo-Kunlun oceans followed the trace of an early Neoproterozoic suture. The opening of the Paleo-Kunlun Ocean (ca. 600 Ma) occurred later than the opening of the North and South Qilian oceans (ca. 740–730 Ma). Closure of the North Qilian and South Qilian oceans occurred in the Early Silurian (ca. 440 Ma), whereas the final consumption of the Paleo-Kunlun Ocean occurred in the Devonian (ca. 360 Ma). Northward subduction of the Neo-Kunlun oceanic lithosphere initiated at ca. 270 Ma, followed by slab rollback beginning at ca. 225 Ma evidenced in the South Qilian Shan and at ca. 194 Ma evidenced in the Eastern Kunlun Range. This tectonic evolution is supported by spatial trends in the timing of magmatism and paleo-crustal thickness across the Qilian-Qaidam-Kunlun continent. Lastly, we suggest that two Greater North China and South China continents, located along the southern margin of Laurasia, were separated in the early Neoproterozoic along the future Kunlun-Qinling-Dabie suture.
Diet and development among children aged 36–59 months in low-income countries
Authors: Bliznashka Lilia , Perumal Nandita , Yousafzai Aisha , Sudfeld Christopher
Published: December 2021

Objective

To assess the associations between diet, stimulation and development among children 36–59 months of age in low-income and middle-income countries (LMICs).

Design

We pooled Demographic and Health Survey data on 12 126 children aged 36–59 months from 15 LMICs. Child diet indicators included dietary diversity score (DDS, range 0–7), minimum dietary diversity (MDD, defined as DDS ≥4) and animal source foods (ASFs) consumption. Child development was assessed using the Early Childhood Development Index and stimulation by the number of stimulation activities (range 0–6). Associations were assessed using generalised linear models.

Results

In our sample, 18% of children met MDD and 50% received ≥4 stimulation activities. The prevalence of suboptimal cognitive, socioemotional, literacy-numeracy and physical development was 24%, 32%, 87% and 11%, respectively. Higher DDS, meeting MDD and consuming ASFs were associated with 8%–13% more stimulation activities. Children who met MDD were slightly less likely to have suboptimal literacy-numeracy development compared with children who did not meet MDD: relative risk 0.97 (95% CI 0.95 to 1.00). DDS, meeting MDD and ASFs consumption were not associated with cognitive, socioemotional or physical development. However, there was evidence of positive associations between MDD and cognitive and literacy-numeracy development among subgroups of children, including those who received ≥4 stimulation activities or attended an early childhood care and education programme.

Conclusions

Child diet was associated with more stimulation activities. However, independent of stimulation, socioeconomic status and other factors, child diet appeared to be a prominent determinant only of literacy-numeracy development among children 36–59 months of age.
Application of machine learning techniques to understand ethnic differences and risk factors for incident chronic kidney disease in Asians
Authors: Lim Cynthia Ciwei , He Feng , Li Jialiang , Tham Yih Chung , Tan Chieh Suai , Cheng Ching-Yu , Wong Tien-Yin , Sabanayagam Charumathi
Published: December 2021

Introduction

Chronic kidney disease (CKD) is increasing in Asia, but there are sparse data on incident CKD among different ethnic groups. We aimed to describe the incidence and risk factors associated with CKD in the three major ethnic groups in Asia: Chinese, Malays and Indians.

Research design and methods

Prospective cohort study of 5580 general population participants age 40–80 years (2234 Chinese, 1474 Malays and 1872 Indians) who completed both baseline and 6-year follow-up visits. Incident CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2in those free of CKD at baseline.

Results

The 6-year incidence of CKD was highest among Malays (10.0%), followed by Chinese (6.1%) and Indians (5.8%). Logistic regression showed that older age, diabetes, higher systolic blood pressure and lower eGFR were independently associated with incident CKD in all three ethnic groups, while hypertension and cardiovascular disease were independently associated with incident CKD only in Malays. The same factors were identified by machine learning approaches, gradient boosted machine and random forest to be the most important for incident CKD. Adjustment for clinical and socioeconomic factors reduced the excess incidence in Malays by 60% compared with Chinese but only 13% compared with Indians.

Conclusion

Incidence of CKD is high among the main Asian ethnic groups in Singapore, ranging between 6% and 10% over 6 years; differences were partially explained by clinical and socioeconomic factors.
Maximum body mass index before onset of type 2 diabetes is independently associated with advanced diabetic complications
Authors: Ozawa Harutoshi , Fukui Kenji , Komukai Sho , Y Baden Megu , Fujita Shingo , Fujita Yukari , Kimura Takekazu , Tokunaga Ayumi , Iwahashi Hiromi , Kozawa Junji , Shimomura Iichiro
Published: December 2021

Introduction

The maximum body mass index (BMI) before onset of type 2 diabetes (MBBO) might be used to estimate a patient’s insulin secretion capacity. There have been few factors that can predict future diabetic complications at the time of diagnosis of diabetes mellitus. This study aimed to clarify the clinical usefulness of MBBO for predicting the development of advanced diabetic microvascular complications.

Research design and methods

This was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 435 patients for whom we could confirm their MBBO. Univariate and multivariate logistic regression analyses were performed to examine whether MBBO or BMI on admission was associated with advanced diabetic retinopathy or nephropathy. To evaluate the predictive performance of these indexes, we performed cross-validation in various models with MBBO or BMI and evaluated the areas under the curve (AUCs) yielded by these analyses.

Results

Univariate analyses suggested that MBBO was associated with advanced retinopathy and nephropathy, while BMI on admission was associated only with advanced nephropathy. In multivariate analyses, MBBO was significantly associated with advanced complications, while BMI on admission was not. For advanced diabetic retinopathy, the AUCs were 0.70–0.72, and for advanced nephropathy, the AUCs were 0.81–0.83. When comparing the AUCs among models, the models with MBBO sustained high predictive performance for diabetic complications.

Conclusions

MBBO was independently associated with advanced diabetic complications, while BMI on admission was not. Diabetic microvascular complications in patients with high MBBO could progress more rapidly. At the time of the diagnosis of diabetes mellitus, MBBO would enable us to predict the progress of diabetic complications.
Durability of effects from short-term economic incentives for clinic attendance among HIV positive adults in Tanzania: long-term follow-up of a randomised controlled trial
Authors: Fahey Carolyn A , Njau Prosper F , Kelly Nicole K , Mfaume Rashid S , Bradshaw Patrick T , Dow William H , McCoy Sandra I
Published: December 2021

Introduction

Conditional economic incentives are shown to promote medication adherence across a range of health conditions and settings; however, any long-term harms or benefits from these time-limited interventions remain largely unevaluated. We assessed 2–3 years outcomes from a 6-month incentive programme in Tanzania that originally improved short-term retention in HIV care and medication possession.

Methods

We traced former participants in a 2013–2016 trial, which randomised 800 food-insecure adults starting HIV treatment at three clinics to receive either usual care (control) or up to 6 months of cash or food transfers (~US$11/month) contingent on timely attendance at monthly clinic appointments. The primary intention-to-treat analysis estimated 24-month and 36-month marginal risk differences (RD) between incentive and control groups for retention in care and all-cause mortality, using multiple imputation for a minority of missing outcomes. We also estimated mortality HRs from time-stratified Cox regression.

Results

From 3 March 2018 to 19 September 2019, we determined 36-month retention and mortality statuses for 737 (92%) and 700 (88%) participants, respectively. Overall, approximately 660 (83%) participants were in care at 36 months while 43 (5%) had died. There were no differences between groups in retention at 24 months (86.5% intervention vs 84.4% control, RD 2.1, 95% CI −5.2 to 9.3) or 36 months (83.3% vs 77.8%, RD 5.6, –2.7 to 13.8), nor in mortality at either time point. The intervention group had a lower rate of death during the first 18 months (HR 0.27, 95% CI 0.10 to 0.74); mortality was similar thereafter (HR 1.13, 95% CI 0.33 to 3.79).

Conclusion

These findings confirm that incentives are a safe and effective tool to promote short-term adherence and potentially avert early deaths at the critical time of HIV treatment initiation. Complementary strategies are recommended to sustain lifelong retention in HIV care.

Trial registration number

NCT01957917