bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving cancer care locally: Study of a hospital affiliate network model
Authors: Gao Xiang , Schroeder Mary C. , Lizarraga Ingrid M. , Tolle Cheri L. , Mullett Timothy W. , Charlton Mary E.
Published: December 2021

Purpose

The University of Kentucky Markey Cancer Center Affiliate Network (MCCAN) increased access to high‐quality cancer care for patients treated in community hospitals across the state by leveraging the American College of Surgeons Commission on Cancer (CoC) standards to improve quality among its member sites. This study describes the network activities and services identified as most helpful or effective to its members, as well as the perceived value of joining MCCAN or pursing accreditation.

Methods

An independent research team conducted in‐depth, semistructured interviews with 18 administrators and clinicians from 10 MCCAN hospitals in 2019. Interviews were transcribed and a thematic analysis was conducted.

Findings

Network affiliation and CoC accreditation were perceived as helpful to improving quality of care. Having both clinician and administrative champions were key facilitators to achieving CoC standards and made mentoring of member sites a critical activity of the Network. Other components identified as valuable and/or key to the Network's success included providing access to specific CoC‐required clinical services (eg, genetic counseling); offering regular performance monitoring and individualized feedback; establishing a culture of quality improvement; and fostering trust within the Network with patient referrals (ie, sending patients back to their local hospital for ongoing care).

Conclusions

Quality improvement in community cancer programs is challenging but several strategies were identified by members as valuable and effective. Efforts to disseminate the MCCAN model should focus on identifying the needs of community hospitals, implementing a quality monitoring system, and fostering site‐level champions who can be influential drivers of change.
Scent, rather than fur pattern, determines predation of mice: an in‐the‐wild experiment with plasticine mouse models
Authors: Bocz R. , Batáry P. , Purger J. J.
Published: December 2021

Wood mouse Apodemus sylvaticus and striped field mouse A. agrarius are the most abundant mouse species in Central Europe coexisting in several habitats not only such as in forests but also in rural and urban areas. Their basic colours are similar, but the striped field mouse has a pronounced black stripe on its back. The biological function of this phenotypic difference is unexplored; therefore, our goal was to study the impact of fur pattern as well as the scent on the survival of these species. In our study, we used plasticine models mimicking wood mouse and striped field mouse. For imitating mouse scent, cotton pads saturated with mouse urine were placed under the models. In spring 2016, 200 plasticine mice divided into four types (non‐striped with scent, non‐striped without scent, striped with scent, striped without scent) were placed randomly in four sampling sites in the mid‐sized city, Pécs, Hungary. During 4 weeks of exposure, we recorded predation on 71 plasticine models. Birds (51%) and large mammals (25%) were the most common predators, and in 24% of the cases, the models disappeared. Considering predation only by large mammals, we found that the daily survival rate of both striped and non‐striped models with scent decreased in comparison to models without scent. Thus, large mammalian predators could discover plasticine models sooner than avian predators, which suggests a strong impact of scent. Despite the high rate of bird predation, we did not detect an effect of fur pattern suggesting that it may not be related to survival but might have other functional roles. With the dummy mouse experiment, we showed that fur pattern may play a minor role in mice detection by predators, thus further studies are needed to discover its ecological function.
The pace of modern life, revisited
Authors: Sanderson Sarah , Beausoleil Marc‐Olivier , O’Dea Rose E. , Wood Zachary T. , Correa Cristian , Frankel Victor , Gorné Lucas D. , Haines Grant E. , Kinnison Michael T. , Oke Krista B. , Pelletier Fanie , Pérez‐Jvostov Felipe , Reyes‐Corral Winer D. , Ritchot Yanny , Sorbara Freedom , Gotanda Kiyoko M. , Hendry Andrew P.
Published: December 2021

Wild populations must continuously respond to environmental changes or they risk extinction. Those responses can be measured as phenotypic rates of change, which can allow us to predict contemporary adaptive responses, some of which are evolutionary. About two decades ago, a database of phenotypic rates of change in wild populations was compiled. Since then, researchers have used (and expanded) this database to examine phenotypic responses to specific types of human disturbance. Here, we update the database by adding 5675 new estimates of phenotypic change. Using this newer version of the data base, now containing 7338 estimates of phenotypic change, we revisit the conclusions of four published articles. We then synthesize the expanded database to compare rates of change across different types of human disturbance. Analyses of this expanded database suggest that: (i) a small absolute difference in rates of change exists between human disturbed and natural populations, (ii) harvesting by humans results in higher rates of change than other types of disturbance, (iii) introduced populations have increased rates of change, and (iv) body size does not increase through time. Thus, findings from earlier analyses have largely held‐up in analyses of our new database that encompass a much larger breadth of species, traits, and human disturbances. Lastly, we use new analyses to explore how various types of human disturbances affect rates of phenotypic change, and we call for this database to serve as a steppingstone for further analyses to understand patterns of contemporary phenotypic change.
A Comparison Between Unstemmed and Stemmed Constrained Condylar Knee Prostheses in Primary Total Knee Arthroplasty: A Propensity Score‐Matched Analysis
Authors: Zhao En‐Ze , Zeng Wei‐Nan , Ding Zi‐Chuan , Liu Zun‐Han , Luo Zhen‐Yu , Zhou Zong‐Ke
Published: December 2021

Objective

To compare and analyze the clinical outcomes between unstemmed and stemmed constrained condylar knees (CCK) in complex primary total knee arthroplasty (TKA) in terms of implant survivorship, change in outcome evaluations, and complications.

Methods

We reviewed 156 consecutive patients who received primary TKA using PFC®SIGMA®TC3 (TC3) of constrained condylar design between January 2009 and January 2017 at our institution. After removing patients who met exclusion criteria, 25 patients were identified as unstemmed TC3 cases and 81 as stemmed TC3 cases. Propensity score matching was used to select 25 stemmed cases as a control group for the unstemmed group with comparable preoperative conditions including preoperative demographics, preoperative diagnosis, preoperative range of motion, main reason to use TC3, ASA score (American Society of Anesthesiologists), and follow‐up duration. Preoperative and postoperative clinical evaluations including Knee Society Score (KSS), Hospital for Special Surgery (HSS) score, the 12‐Item Short‐Form Health Survey (SF‐12), and the range of motion (ROM) were obtained and compared. The instability, periprosthetic fracture, radiolucent lines, polyethylene wear, and heterotrophic ossification were assessed according to the anteroposterior and lateral radiographs of the knee. The complications and implant survivorship between the two groups were also recorded and compared.

Results

3After the index surgery, both groups showed substantial improvement in KSS (knee and function), HSS score, SF‐12, and ROM compared with baseline. There was no significant difference in the mean KSS scores (knee and function), HSS score, SF‐12, and ROM between the unstemmed and stemmed group postoperatively. No statistically significant difference was found in the overall complication rate between the two groups. The overall Kaplan–Meier survivorship was 98.0% (95% confidence interval 94.1%–100.0%) at 7 years. No significant difference was found in the survival rate between the unstemmed group (100.0%) and the stemmed group (96.0%) at 7 years (log rank, P = 0.317). The mean duration of follow‐up was 7.0 years for unstemmed group and 7.7 years for stemmed group.

Conclusions

In patients with adequate bone stock receiving complex primary TKA, unstemmed CCK could achieve similar clinical outcomes at mid‐term follow‐up as stemmed CCK.
Ventilation through small‐bore airways in children by implementing active expiration
Authors: de Wolf Michiel , Enk Dietmar , Jagannathan Narasimhan
Published: December 2021

Management of narrowed airways can be challenging, especially in the smallest patients. This educational review focusses on active expiration through small‐bore airways with the Ventrain (Ventinova Medical, Eindhoven, The Netherlands). Manual ventilation with the Ventrain establishes inspiratory and expiratory flow control: By setting an appropriate flow, the volume of gas insufflated over time can be controlled and expiration through a small‐bore airway is expedited by jet‐flow generated suction, coined “expiratory ventilation assistance” (EVA). This overcomes the inherent risks of emergency jet ventilation especially in pediatric airway emergencies. Active expiration by EVA has been clinically introduced to turn a “straw in the airway” into a lifesaver allowing not only for quick and reliable reoxygenation but also adequate ventilation. As well as managing airway emergencies, ventilating through small‐bore airways by applying EVA implements new options for pediatric airway management in elective interventional procedures. Safe application of EVA demands a thorough understanding of the required equipment, the principle and function of the Ventrain, technical prerequisites, clinical safety measures, and, most importantly, appropriate training.
Public health nurses’ encounters with undocumented migrant mothers and children
Authors: Kvamme Eli , Voldner Nanna
Published: December 2021

Objectives

Undocumented migrant children (UMC) are often affected by policies and practices that do not take their best interests into account. The aim of this study was to describe how public health nurses (PHNs) experienced challenges and dilemmas in ensuring the best interests of the undocumented migrant child.

Design

This study had a qualitative descriptive design.

Sample

Focus group interviews and semi‐structured interviews were conducted with seven PHNs in four different child health centers (CHCs).

Results

Qualitative content analysis was applied. Three main themes were identified: building trust, ensuring the best interests of the child, and dilemmas and challenges in ensuring the best interests of the child. The study revealed examples of immigration policy being prioritized over the best interests of the child. PHNs experienced frustration when the best interests of the child were not taken into account. Strategies for managing these conflicting demands were identified.

Conclusion

Conflicting demands appeared when national immigration policies collided with fundamental human rights and ethical standards. Rules that exclude certain groups are incompatible with PHNs professional ethics.
Collective autonomy: Why groups fight for power and status
Authors: Kachanoff Frank J. , Gray Kurt , Koestner Richard , Kteily Nour , Wohl Michael J. A.
Published: December 2021

People experience “collective autonomy restriction” when they believe other groups want to restrict their own group from freely expressing its social identity and determining its behavior. We review emerging research on the negative consequences of collective autonomy restriction for well‐being, as well as its implications for group members' motivation to fight for their place within social hierarchies. We propose that group members desire two resources tied to having a favorable position within the social hierarchy—structural power (i.e., the ability to influence and resist influence from other groups) and status (being positively valued and perceived as moral by others)—because they believe that having power and status are necessary to secure their group's collective autonomy. We hypothesize that group members anticipate that other groups might restrict their group if they lack the structural power to resist outside influences, or if they are perceived as negative or immoral and worthy of restriction. We apply this power and status perspective of collective autonomy restriction to predict (1) when disempowered groups are most likely to fight against (vs. tolerate) their disadvantaged position and (2) when powerful groups are most likely to relinquish power and acknowledge their transgressions (vs. defensively maintain their privileged position).
Curse of friendship: IMF programme, friendship with the United States and foreign direct investment
Authors: Moon Chungshik , Woo Byungwon
Published: December 2021

How do investors respond when a country participates in an International Monetary Fund (IMF) programme? While there exists some optimism in and around the IMF on the catalytic effect of a Fund programme, empirical research on the catalytic finance reports rather diverse findings; contrary to most theoretical research, empirical studies report both positive and negative effects as well as null effects. This paper revisits the question of whether and how an IMF programme catalyses other finances, focusing on the catalytic effect on foreign direct investment (FDI). We modify the core theoretical logic behind the catalytic finance to identify conditions under which an IMF programme is more likely to catalyse FDI: we highlight the credibility of an IMF programme as a key determinant of any positive catalytic effect it may have and reason that politically motivated lending by the IMF can attenuate a programme’s credibility, depressing the catalytic effect. We empirically capture politically motivated lending by looking at the relationship between a borrowing country and the United States and demonstrate that IMF loans to countries closely aligned with the United States are less likely to catalyse FDI than loans to countries that are not aligned with the United States.
Clinical practice for outpatients that are chronically red cell dependent: A survey in the Netherlands
Authors: Tonino Rik P. B. , Schipperus Martin R. , Zwaginga Jaap Jan
Published: December 2021

Background and Objectives

Limited data are available to guide physicians on how to determine the red blood cell (RBC) transfusion regimen in chronically transfusion‐dependent patients. The lack of clarity on thresholds and targets to be used for transfusion could easily result in either under or over transfusion in these patients. The aim of our survey is to investigate (1) transfusion thresholds; (2) number of RBC units given per transfusion episode; (3) interval between transfusions and (4) patient factors, like decreased cardiac function modulating the former.

Materials and Methods

We sent a web‐based 44‐question survey to members of the Dutch Haematology Association.

Results

Fifty physicians responded between June and October 2020 (response rate 30%), well‐distributed between community and academic hospitals. A wide variation in transfusion strategies was reported: Most patients have transfused 1–2 RBC units (range: 0–3 units) every 2–4 weeks (range: 1–12 weeks) with a median threshold of 8.0 g/dl ranging from 6.4 to 9.6 g/dl. Patient‐specific clinical factors that are most frequently reported to influence the transfusion strategy are angina pectoris, cardiac failure and dyspnoea, softer parameters that are of influence are the quality of life and self‐sustainability.

Conclusion

The results of this survey indicate a broad variation in RBC transfusion strategies in Dutch patients with chronic transfusion dependency. While the current variation in transfusion strategies may be unavoidable in an individualized approach, randomized trials and better defined usable parameters to evaluate the effect of transfusion strategies are required to reach a consensus on how to determine the transfusion strategy.
A Computationally Efficient Lower Limb Finite Element Musculoskeletal Framework Directly Driven Solely by Inertial Measurement Unit Sensors
Authors: Wang Sentong , Hase Kazunori , Ota Susumu
Published: December 2021

Finite element musculoskeletal (FEMS) approaches using concurrent musculoskeletal (MS) and finite element (FE) models driven by motion data such as marker-based motion trajectory can provide insight into the interactions between the knee joint secondary kinematics, contact mechanics, and muscle forces in subject-specific biomechanical investigations. However, these data-driven FEMS systems have two major disadvantages that make them challenging to apply in clinical environments: they are computationally expensive and they require expensive and inconvenient equipment for data acquisition. In this study, we developed an FEMS model of the lower limb, driven solely by inertial measurement unit (IMU) sensors, that includes the tissue geometries of the intact knee joint and combines muscle modeling and elastic foundation (EF) theory-based contact analysis of a knee into a single framework. The model requires only the angular velocities and accelerations measured by the sensors as input, and the target outputs (knee contact mechanics, secondary kinematics, and muscle forces) are predicted from the convergence results of iterative calculations of muscle force optimization and knee contact mechanics. To evaluate its accuracy, the model was compared with in vivo experimental data during gait. The maximum contact pressure (12.6 MPa) in the rigid body contact analysis occurred on the medial side of the cartilage at the maximum loading response. The proposed computationally efficient framework drastically reduced the computational time (97.5% reduction) in comparison with the conventional deformable FE analysis. The developed framework combines measurement convenience and computational efficiency and shows promise for clinical applications aimed at understanding subject-specific interactions between the knee joint secondary kinematics, contact mechanics, and muscle forces.
Modelling of the Cross Angle and its Impact on Pump Performance
Authors: Rambaks Andris , Schmitz Katharina
Published: December 2021

A secondary swash plate angle, also known as a cross angle, has been used in the past to reduce flow ripple with great success. However, for the past two decades, research in this field has been scarce. In this paper, a pressure controlled 9-piston pump is investigated to determine the effects of the cross angle on commutation, acting forces and torques, as well as volumetric flow rate pulsations. A detailed description of the piston kinematics, the simulation model used, and the subsequent simulation results are presented in this contribution.
Analysis of Pressure Response Characteristics and Influencing Factors of the Automatic Pressure Regulating Valve in Electronic-Controlled Pneumatic Braking System of Commercial Vehicle
Authors: Bao Hanwei , Wang Zaiyu , Wei Xiaoxu , Li Gangyan
Published: December 2021

Automatic pressure regulating valve is the core pressure regulating element in electronic-controlled pneumatic braking system of commercial vehicle, its pressure response characteristics directly affect the real-time and rapid pressure regulation. In this paper, the influence of structural parameters of high-speed solenoid valve on its pressure response characteristics is studied. By analyzing the working principle and structure of high-speed solenoid valve, the mathematical model was established by AMESim. Through the combination of simulation and experiment the correctness of the model is verified. Finally, according to the influence law of key structural parameters in high-speed solenoid valve on the pressure response characteristics of automatic pressure regulating valve, a set of optimized parameters are obtained to realize the improvement and optimization of the pressure response characteristics of the automatic pressure regulating valve.
Machine Learning Prediction of Journal Bearing Pressure Distributions, Considering Elastic Deformation and Cavitation
Authors: Hess Nathan , Shang Lizhi
Published: December 2021

This paper presents a machine learning neural network capable of approximating pressure as the distributive result of elastohydrodynamic effects and discusses results for a journal bearing at steady state. Design of efficient, reliable fluid power pumps and motors requires accurate models of lubricating interfaces; however, most existing simulation models are structured around numerical solutions to the Reynolds equation which involve nested iterative loops, leading to long simulation durations and limiting the ability to use such models in optimization studies. This study presents the development of a machine learning model capable of approximating the pressure solution of the Reynolds equation for given distributive geometric boundary conditions and considering cavitation and elastic deformation at steady-state operating conditions. The architecture selected for this study was an 8-layer U-Net convolutional neural network. A case study of a journal bearing was considered, and a 438-sample training set was generated using an in-house multiphysics simulator. After training, the neural network predicted pressure distributions for test samples with great accuracy, and accurately estimated resultant loads on the journal bearing shaft. Additionally, the neural network showed promise in analyzing geometric inputs outside the space of the training data, approximating the pressure in a grooved journal bearing with reasonable accuracy. These results demonstrate the potential to integrate a machine learning model into fluid power pump and motor simulations for faster performance during evaluation and optimization.
An Analysis of the Effects Causing an Asymmetric Behavior of the Lateral Lubricating Films of External Spur Gear Machines
Authors: Lim Kaeul , Zappaterra Federico , Mukherjee Swarnava , Vacca Andrea
Published: December 2021

The torque efficiency and flow efficiency of positive displacement machines for fluid power applications are determined by the behavior of their internal lubricating interfaces. This aspect has motivated the development of tribological simulation tools for the analysis of these interfaces. The level of details these tools can provide allows explaining some counterintuitive aspects that occur in these interfaces. This paper focuses on a significant example, which is the high asymmetric behavior of the lubricating films occurring in pressure compensated external gear pumps. These units are often designed with a symmetric axial balancing compensation system. Notwithstanding, there are differences between the lateral gaps that can be explained only considering the mutual effects of the pressure development in the film and the material deformation.

To study this problem, this paper utilizes the tool Multics-HYGESim developed by the authors’ research team. Two analyses are performed: the first one imposing axial symmetry in the behavior of the gap, which is the common assumption discussed in literature; the second one (referred to as “full configuration”), which holds the asymmetric behavior of the gap. An experimental set-up is used to validate the modeling assumptions based on the measurements of the drain leakage and volumetric efficiency. The main paper findings are on the uneven distribution of these leakages, which indicates an asymmetric behavior of the gap films in the unit.
A Novel Positive Displacement Axial Piston Machine With Bent Cylinder Sleeves
Authors: Mukherjee Swarnava , Masia Antonio , Bronson Mark , Shang Lizhi , Vacca Andrea
Published: December 2021

In this paper, an investigation of a novel positive displacement axial piston machine using a bent cylinder sleeve configuration is presented. The proposed design eliminates the side moments on the piston/cylinder interface, therefore, reduces the frictional loss and improves the total energy efficiency. A multi-physics elastohydrodynamic lubrication model was used to aid the design of the piston/cylinder and the cylinder block/port block interface. Then, a lumped parameter model was used to optimize the port block geometry. Groove geometry was chosen primarily to reduce flow ripple, tilting moment, and cavitation risk. To improve the housing stiffness, the lumped parameter model was combined with a finite element analysis. This ensured safety for the testing. In the end, steady-state experiments were performed on the prototype based on the ISO4409 normative. The unit’s speed was set to 500 rpm, then increased by 500 rpm until it reached 3000 rpm. The supply pressure was set to 20 bar. The outlet pressure was set to 70 bar at first, then increased by 50 bar until it reached 220 bar. The results show a remarkable volumetric efficiency with a peak of 99.5%. It is however noted that due to some of the issues with the initial iteration of the current design, there is a reduction in mechanical efficiency. The causes and possible future solutions to these issues are discussed in the manuscript.
Dynamical Characteristics of a Hydraulic Soft Actuator With Three Degrees of Freedom
Authors: Xie Qing , Wang Tao , Zhu Shiqiang
Published: December 2021

In recent years, increasing attention and expanding research have been devoted to the study and application of soft actuators. Inherent compliance equips soft actuators with such advantages as incomparable flexibility, good environmental adaptability, safe interaction with the environment, etc. However, the highly nonlinear also bring challenges to modeling of dynamics. This study aims to explore the dynamical characteristics of an underwater hydraulic soft actuator. The actuator has three fiber-reinforced elastomer chambers distributed symmetrically inside. By controlling the pressure in the chambers through a hydraulic power system, the actuator can achieve spatial motion with three degrees of freedom. To describe the relationship between the input pressure combination and the actuator movement, a dynamic model considering the nonlinearity of viscoelastic material is developed based on Lagrangian method and constant curvature hypothesis. A series of experiments are carried out, including single-chamber actuation and multi-chamber actuation. The test results verify the effectiveness and precision of the model. Finally, the effects of the geometrical features on dynamic response are investigated through model-based simulation, which can provide guidance to parameter optimization. The proposed dynamic model can also contribute to behavior analysis, performance prediction, and motion control of the hydraulic soft actuator.
Experimentation on a Hydraulic Energy Storage System for Mid-Size Wind Turbines
Authors: Mohr Eric , Mohanty Biswaranjan , Escobar-Naranjo Daniel , Stelson Kim A.
Published: December 2021

Renewable energy resource investment is crucial to mitigating the effects of climate change. One underrecognized method is improving the performance of mid-sized wind turbines. A hydraulic Energy Storage System (ESS) can be added to a midsized wind turbine transmission to improve system reliability and produce more energy. This hybrid system also offers potential ancillary benefits, such as fault ride-through and strong wind pitch and yaw control. In this paper, results of recent improvements on our previously proposed hybrid system are presented. These improvements include a more realistic accumulator model to improve simulation fidelity and the addition of a hydraulic energy storage system to the power regenerative test platform at the University of Minnesota for experimental validation. Losses of the test platform are characterized and used to improve the quality of the simulation results. Wind samples are used to experimentally validate simulation results. The updated simulation is used to create a refined prediction of the benefits of the hybrid system for a 60 kW turbine.
Improving the Efficiency of a Compact Inline Hydro-Mechanical Transmission (i-HMT) at Lock-Up
Authors: Barkei Johnathan (Hans) , Li Perry Y.
Published: December 2021

A hydro-mechanical transmission (HMT) transmits power both mechanically and hydraulically allowing continuously variable transmission ratios and more efficient transmission than hydrostatic transmission. A conventional HMT tends to be costly and bulky since it has a hydrostatic transmission in parallel with a mechanical transmission. An alternative is a compact inline configuration that utilizes a two-shafted pump that is mechanically and hydraulically connected to a motor. This avoids the need for a planetary gear set while providing the HMT functionality. When the pump/motor displacement is zero, all of the power is transmitted mechanically and the transmission ratio is unity, a condition referred to as lock-up that is expected to be very efficient. Previous research however has shown significant losses at this operating condition in experiments. This is thought to be caused primarily by compressibility losses due to the repeated unnecessary opening and closing of the distributor valves. This paper first models the Hondamatic in simulations to confirm that compressibility losses contribute to the low efficiency at lock-up. Second, the paper proposes a solution to reduce these compressibility losses by means of a second cam mode that closes the distributor valves to prevent flow between the piston and the high and low pressure volumes. The performance of the existing inline HMT and the proposed solution at lock-up are modeled in simulations and compared. The results indicate a 10% increase in efficiency at lock-up.
Modeling and Analysis of a Digital Hydraulic Actuator for Flight Control Surfaces
Authors: Lopes R. S. , Nostrani M. P. , Carvalho L. A. , Dell’Amico A. , Krus P. , De Negri V. J.
Published: December 2021

This paper presents the design and modeling process of a flight control actuator using digital hydraulics and a performance analysis that compares the proposed solution and the Servo Hydraulic Actuator (SHA) on a fighter aircraft model. The proposed solution is named Digital Hydraulic Actuator (DHA) and comprises the use of a multi-chamber cylinder controlled by on/off valves and different pressures sources provided by a centralized hydraulic power unit, as proposed in the Fly-by-Wire (FbW) concept. The analyses were carried out using the Aero-Data Model in a Research Environment (ADMIRE), which was developed for flight performance analysis. The actuators were modeled using the software Matlab/Simulink® and Hopsan. They were applied to control the aircraft elevons in a flight mission close to the aircraft limits, to evaluate the actuator’s behavior and energy efficiency. The results show a reduction in energy dissipation up to 22.3 times when comparing the DHA with the SHA, and despite the overshooting and oscillations presented, the aircraft flight stability was not affected.
Characterization of acoustic sources in a corrugated pipe flow with linear stochastic estimation
Authors: Galeron Gaëtan , Amielh Muriel , Mattei Pierre-Olivier
Published: December 2021

The intense whistling of corrugated pipe under flow is related to a coherence between the dynamics of structures developing in the shear layer over cavities and acoustic eigenmodes of the pipe. In order to highlight the coupling between aerodynamics and acoustics, three measurement systems with complementary characteristics in terms of space and time resolutions are synchronized. The simultaneity of the measurements of velocity and acoustic pressure provided by five local probes, as two hot-wires and three microphones, with the velocity fields measured by PIV in the same flow region is used to estimate the velocity fields at frequencies compatible with the space-time characterization of the acoustic sources. The linear stochastic estimation (LSE) is performed to reconstruct these high frequency velocity fields. Two rectangular corrugated pipes with different corrugation geometry are investigated. Thanks to the LSE velocity field reconstruction, the contribution of the flow structures, both jet flapping and vortex shedding, to acoustic level is highlighted.
How to Make Physical Activity Promotion Work in Thai Schools: Perspectives of Multiple Stakeholders
Authors: Amornsriwatanakul Areekul , Noosorn Narongsak , Poonchob Kittipong , Wongwat Rung , Sornprasit Somkiat , Markmee Phataraphon , Rosenberg Michael , Milton Karen
Published: December 2021

Background: This study aimed to determine current practice in physical activity (PA) promotion in Thai schools, explore barriers and facilitators to PA promotion within the school setting, and identify strategies to support schools’ future practice. Methods: A qualitative study design was applied comprising document analysis, focus groups, in-depth interviews, and onsite observations. The focus groups and in-depth interviews were conducted with 144 informants, purposively recruited through 24 schools in 4 regions across Thailand. Inductive content analysis was used. Results: Most schools were promoting PA in the absence of written policies, and without an accurate understanding of PA. Nonalignment of school performance indicators and policies, concerns about children’s academic performance, and lack of budget were raised as barriers to PA promotion, whereas strong partnerships with multiple local stakeholders facilitated school-based PA promotion. Mandated government PA policies and more information support were suggested as strategies to enhance schools’ future practices. Conclusions: For PA promotion to be successful in the school setting, significant challenges will need to be addressed. Results from this study help the government and concerned stakeholders to better understand the situation at the school level, and further strive for achieving the target PA levels specified in the National PA Plan.
Examining Role Stress, Emotional Intelligence, Emotional Exhaustion, and Affective Commitment Among Secondary Physical Educators
Authors: Washburn Nicholas S. , Simonton Kelly L. , Richards K. Andrew R. , Lee Ye Hoon
Published: December 2021

Research on the psychological outcomes of physical education teachers’ perceptions of their work environments and variables that support adaptive coping processes is needed. Purpose: This study examined the relationships among role stress, emotional intelligence, emotional exhaustion (EE), and affective commitment among secondary physical educators in the United States (N = 246). Method: Using participants from a national database, variables were analyzed using multivariate analyses of covariances and structural modeling. Results: Urban teachers reported more role ambiguity than those working in other contexts. Role stress partially predicted emotional intelligence, whereas emotional intelligence predicted EE negatively and affective commitment positively. Role ambiguity influenced EE directly and indirectly through emotional intelligence. Role conflict and overload showed only direct relations. Conclusion: Emotional intelligence may buffer negative effects of role stress on EE while enhancing affective commitment by reappraising stress in manageable ways. Enhancing emotional intelligence may promote adaptive emotional responses.
Population Pharmacokinetics of Intraperitoneal Gentamicin and the Impact of Varying Dwell Times on Pharmacodynamic Target Attainment in Patients with Acute Peritonitis Undergoing Peritoneal Dialysis
Authors: Farkas Andras , Oikonomou Katerina , Ghanbar Mohammad , Villasurda Phillip , Varghese Julie , Lipman Jeffrey , Sassine Joseph , Ranganathan Dwarakanathan , Roberts Jason A.
Published: December 2021

While the use of intraperitoneal (i.p.) gentamicin is common in the treatment of peritoneal dialysis (PD)-related infections, the ability of these regimens to attain pharmacodynamic target indices of interest in blood and dialysate has not been widely reported. Pharmacokinetic (PK) data were obtained and analyzed from a multiple-dose PK study of i.p. gentamicin with 24 patients who received the drug at 0.6 mg/kg dose of body weight.
Echinocandins and Their Activity against Aspergillus terreus Species Complex: a Novel Agar Screening Method
Authors: Lackner Nina , Vahedi-Shahandashti Roya , Jähnig Sonja , Schönherr Lea , Lass-Flörl Cornelia
Published: December 2021

We evaluated the newly proposed agar screening method for echinocandin susceptibility testing of 144
Aspergillus
section
Terrei
isolates compared with the Etest method. Both methods defined the isolates to be wild-type strains for anidulafungin and micafungin, with Etest minimal effective concentrations (MECs) of ≤0.004 mg/L.
Early Use of Sarilumab in Patients Hospitalized with COVID-19 Pneumonia and Features of Systemic Inflammation: the SARICOR Randomized Clinical Trial
Authors: Merchante Nicolás , Cárcel Sheila , Garrido-Gracia José Carlos , Trigo-Rodríguez Marta , Moreno María Ángeles Esteban , León-López Rafael , Espíndola-Gómez Reinaldo , Alonso Eduardo Aguilar , García David Vinuesa , Romero-Palacios Alberto , Pérez-Camacho Inés , Gutiérrez-Gutiérrez Belén , Martínez-Marcos Francisco Javier , Fernández-Roldán Concepción , Pérez-Crespo Pedro María Martínez , Caño Alexandra Aceituno , León Eva , Corzo Juan E. , de la Fuente Carmen , Torre-Cisneros Julián
Published: December 2021

The objective of this study was to investigate the efficacy and safety of early treatment with sarilumab, added to standard of care (SOC), in hospitalized adults with COVID-19. Methods included phase II, open-label, randomized, controlled clinical trial of hospitalized patients with COVID-19 pneumonia and interleukin (IL)-6 levels ≥ 40 pg/mL and/or d-dimer > 1,500 ng/mL.
Distinct Serotypes of Streptococcal M Proteins Mediate Fibrinogen-Dependent Platelet Activation and Proinflammatory Effects
Authors: Palm Frida , Chowdhury Sounak , Wettemark Sara , Malmström Johan , Happonen Lotta , Shannon Oonagh
Published: December 2021

Sepsis is a life-threatening complication of infection that is characterized by a dysregulated inflammatory state and disturbed hemostasis. Platelets are the main regulators of hemostasis, and they also respond to inflammation.
IL-10 Deficiency Protects Hamsters from
Leptospira
Infection
Authors: Xie Xufeng , Lv Tianbao , Wu Dianjun , Shi Haozhe , Zhang Shilei , Xian Xunde , Liu George , Zhang Wenlong , Cao Yongguo
Published: December 2021

Leptospirosis is a global zoonotic disease with outcomes ranging from subclinical infection to fatal Weil’s syndrome. In addition to antibiotics, some immune activators have shown protective effects against leptospirosis. However, the unclear relationship between
Leptospira
and cytokines has limited the development of antileptospiral immunomodulators. In this study, the particular role of interleukin-10 (IL-10) in leptospirosis was explored by using IL-10-defective (IL-10
−/−
) hamsters.
Impact of night travel ban on road traffic crashes and fatalities in Zambia: an interrupted time series analysis
Authors: Hangoma Peter , Moonga-Mukale Kantu
Published: December 2021

Background

The burden of road traffic crashes (RTCs) and road traffic fatalities (RTFs) has been increasing in low-income and middle-income countries (LMICs). Most RTCs and RTFs happen at night. Although few countries, including Zambia, have implemented night travel bans, there is no evidence on the extent to which such policies may reduce crashes and fatalities.

Methods

We exploit the quasi-experimental set up afforded by the banning of night travel of public service vehicles in Zambia in 2016 and interrupted time series analysis to assess whether the ban had an impact on both levels and trends in RTCs and RTFs. We use annual administrative data for the period 2006—2020, with 10 pre-intervention and 4 post-intervention data points. In an alternative specification, we restrict the analysis to the period 2012—2020 so that the number of data points are the same pre-interventions and post-interventions. We also carry out robustness checks to rule out other possible explanation of the results including COVID-19.

Results

The night travel ban was associated with a reduction in the level of RTCs by 4131.3 (annual average RTCs before the policy=17 668) and a reduction in the annual trend in RTCs by 2485.5. These effects were significant at below 1%, and they amount to an overall reduction in RTCs by 24%. The policy was also associated with a 57.5% reduction in RTFs. In absolute terms, the trend in RTFs reduced by 477.5 (Annual average RTFs before the policy=1124.7), which is significant at below 1% level. Our results were broadly unchanged in alternative specifications.

Conclusion

We conclude that a night travel ban may be an effective way of reducing the burden of RTCs and RTFs in Zambia and other LMICs. However, complementary policies are needed to achieve more gains.
Effect of complete adherence to antenatal care guideline during first visit on maternal and neonatal complications during the intrapartum and postpartum periods: a prospective cohort study in Northwest Ethiopia
Authors: Seyoum Tewodros , Alemayehu Mekuriaw , Christensson Kyllike , Lindgren Helena
Published: December 2021

Objectives

To examine the relationship between complete of providers’ adherence to antenatal care (ANC) guideline during first visit and maternal and neonatal complications during intrapartum and postpartum periods.

Design

Prospective cohort study.

Setting

Gondar town public health facilities in Northwest, Ethiopia.

Participants

A total of 832 pregnant women with gestational age <28 weeks who came for first ANC visit were enrolled and followed up to the first 6 hours of the postpartum periods.

Exposure

Providers’ adherence to ANC guideline during first visit was the exposure variable. An 18-point checklist was used to record the level of providers’ adherence. Clients who received care from providers who adhered completely to the guideline constituted the ‘exposed group’, and those who did not receive such care constituted the ‘unexposed group’.

Main outcomes

Maternal and neonatal complications occurred during the intrapartum and postpartum periods.

Data analysis

Negative binomial regression model was used to analyse the data. The adjusted incidence risk ratio (AIRR) with 95% CI was reported in the final model.

Results

A total of 782 pregnant women were followed up and included in the final analysis (254 in the exposed group and 528 non-exposed). Complete adherence to the guidelines during first visit reduced the risk of neonatal complications (AIRR 0.56; 95% CI 0.39 to 0.79). However, complete adherence to the guidelines was not found to have a statistically significant effect on maternal complications (AIRR 0.84; 95% CI 0.67 to 1.05) during the intrapartum and the postpartum periods.

Conclusions

The group that received care from providers who completely adhered to the ANC guidelines during the first antenatal visit showed significantly improved neonatal outcomes. However, it did not show a significant improvement in maternal outcomes. Hence, focusing on safe motherhood programmes like training that gears provider’s conformity to ANC guideline is quite crucial to improve neonatal outcomes.
Cohort profile: The National Colorectal Cancer Cohort (NCRCC) study in China
Authors: Zhu Yingshuang , Hu Yeting , Kong Xiangxing , Xiao Qian , Pan Zhizhong , Zheng Zhaoxu , Wei Ye , Ziqiang Wang , Wang Da , Chen Jiaqi , Chen Kun , Zheng Shu , Wang Meilin , Wu Xifeng , Ding Kefeng
Published: December 2021

Purpose

The National Colorectal Cancer Cohort (NCRCC) study aims to specifically assess risk factors and biomarkers related to endpoints across the colorectal cancer continuum from the aetiology through survivorship.

Participants

The NCRCC study includes the Colorectal Cancer Screening Cohort (CRCSC), which recruited individuals who were at high risk of CRC between 2016 and 2020 and Colorectal Cancer Patients Cohort (CRCPC), which recruited newly diagnosed patients with CRC between 2015 and 2020. Data collection was based on questionnaires and abstraction from electronic medical record. Items included demographic and lifestyle factors, clinical information, survivorship endpoints and other information. Multiple biospecimens including blood, tissue and urine samples were collected. Participants in CRCSC were followed by a combination of periodic survey every 5 years and annual linkage with regional or national cancer and death registries for at least 10 years. In CRCPC, follow-up was conducted with both active and passive approaches at 6, 12, 18, 24, 36, 48 and 60 months after surgery.

Findings to date

A total of 19 377 participants and 15 551 patients with CRC were recruited in CRCSC and in CRCPC, respectively. In CRCSC, 48.0% were men, and the average age of participants at enrolment was 58.7±8.3 years. In CRCPC, 61.4% were men, and the average age was 60.3±12.3 years with 18.9% of participants under 50 years of age.

Future plans

Longitudinal data and biospecimens will continue to be collected. Based on the cohorts, several studies to assess risk factors and biomarkers for CRC or its survivorship will be conducted, ultimately providing research evidence from Chinese population and optimising evidence-based guidelines across the CRC continuum.
STI epidemic re-emergence, socio-epidemiological clusters characterisation and HIV coinfection in Catalonia, Spain, during 2017–2019: a retrospective population-based cohort study
Authors: Sentís Alexis , Montoro-Fernandez Marcos , Lopez-Corbeto Evelin , Egea-Cortés Laia , Nomah Daniel K , Díaz Yesika , Garcia de Olalla Patricia , Mercuriali Lilas , Borrell Núria , Reyes-Urueña Juliana , Casabona Jordi
Published: December 2021

Objectives

To describe the epidemiology of sexually transmitted infections (STIs), identify and characterise socio-epidemiological clusters and determine factors associated with HIV coinfection.

Design

Retrospective population-based cohort.

Setting

Catalonia, Spain.

Participants

42 283 confirmed syphilis, gonorrhoea, chlamydia and lymphogranuloma venereum cases, among 34 600 individuals, reported to the Catalan HIV/STI Registry in 2017–2019.

Primary and secondary outcomes

Descriptive analysis of confirmed STI cases and incidence rates. Factors associated with HIV coinfection were determined using logistic regression. We identified and characterized socio-epidemiological STI clusters by Basic Health Area (BHA) using K-means clustering.

Results

The incidence rate of STIs increased by 91.3% from 128.2 to 248.9 cases per 100 000 population between 2017 and 2019 (p<0.001), primarily driven by increase among women (132%) and individuals below 30 years old (125%). During 2017–2019, 50.1% of STIs were chlamydia and 31.6% gonorrhoea. Reinfections accounted for 10.8% of all cases and 6% of cases affected HIV-positive individuals. Factors associated with the greatest likelihood of HIV coinfection were male sex (adjusted OR (aOR) 23.69; 95% CI 16.67 to 35.13), age 30–39 years (versus <20 years, aOR 18.58; 95% CI 8.56 to 52.13), having 5–7 STI episodes (vs 1 episode, aOR 5.96; 95% CI 4.26 to 8.24) and living in urban areas (aOR 1.32; 95% CI 1.04 to 1.69). Living in the most deprived BHAs (aOR 0.60; 95% CI 0.50 to 0.72) was associated with the least likelihood of HIV coinfection. K-means clustering identified three distinct clusters, showing that young women in rural and more deprived areas were more affected by chlamydia, while men who have sex with men in urban and less deprived areas showed higher rates of STI incidence, multiple STI episodes and HIV coinfection.

Conclusions

We recommend socio-epidemiological identification and characterisation of STI clusters and factors associated with HIV coinfection to identify at-risk populations at a small health area level to design effective interventions.