bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Successive Forming Process for Large Modulus Gears
Authors: Lin Yao , Wu Tao , Wang Guangchun 
Published: October 2020

Abstract
A successive tooth forming process for producing large modulus spur gears (m＞2.5 mm) was firstly proposed in this paper to break the restrictions of large forming load and large equipment structure of traditional plastic forming. It contains the preforming stage and finishing stage. In the first stage, the die with a single-tooth preformed gear teeth one by one through several passes. In the second stage, the other die with multi-teeth refined the preformed teeth into required shape. The influence of total pressing depth and feed distribution in preforming stage on final forming quality was analyzed by numerical simulation and the reasonable process parameters had been presented. Gears without fold defects were well formed both in simulations and experiments, proving the feasibility of this method. The new process has advantages of smaller forming load and simpler tooling set, which shows a good potential for manufacturing large modulus spur gears.
“I Want to Get Better, But…”: Identifying the Perceptions and Experiences of People Who Inject Drugs With Respect to Evolving Hepatitis C Virus Treatments
Authors: Goodyear Trevor , Brown Helen , Browne Annette J. , Hoong Peter , Ti Lianping , Knight Rod 
Published: October 2020

Abstract
Background: The advent of highly tolerable and efficacious direct-acting antiviral (DAA) medications has transformed the hepatitis C virus (HCV) treatment landscape. Yet, people who inject drugs (PWID) – a population with inequitably high rates of HCV and who face significant socio-structural barriers to healthcare access – continue to have disproportionately low rates of DAA uptake. The objective of this study is to explore how PWID with lived experience of HCV perceive and experience DAA treatment, in a setting with universal coverage of these medications since 2018.Methods: Informed by a critical interpretive framework, we thematically analyze data from in-depth, semi-structured interviews conducted between January and June 2018 in Vancouver, Canada, with a purposive sample (n=56) of PWID at various stages (e.g., pre, peri, post) of DAA treatment. Results: The analysis yielded three key themes: (i) life with HCV, (ii) experiences with and perceptions of evolving HCV treatments, and (iii) substance use and the uptake of DAA treatments. First, participants described how health and healthcare conditions, such as the deprioritizing of HCV (e.g., due to being asymptomatic, healthcare provider inaction, gatekeeping) and catalysts to care (e.g., symptom onset, treatment for co40 morbidities) shaped DAA treatment motivation and access. Second, participants described how individual and community-level accounts of evolving HCV treatments, including skepticism following negative experiences with interferon-based treatment and uncertainty regarding treatment eligibility negatively, influenced willingness and opportunities to access DAAs. Concurrently, participants described how peer and community endorsement of DAAs was positively associated with treatment uptake. Third, participants favoured HCV care that was grounded in harm reduction, which included the integration of DAAs 46 with other substance use related services (e.g., opioid agonist therapy, HIV care), and which was often contrasted against abstinence-focused care wherein substance use is framed as a contraindication to HCV treatment access. Conclusions: These findings underscore several equity-oriented healthcare service delivery and clinician adaptations that are required to scale up DAAs among PWID living with HCV, including the provision of harm reduction-focused, non-stigmatizing, integrated, and peerled care that responds to power differentials.
Self-reported Lifestyle Behaviours in Families With an Increased Risk for Type 2 Diabetes Across Six European Countries: the Feel4diabetes-study
Authors: Stappen Vicky Van , Cardon Greet , Iotova Violeta , Chakarova Nevena , Rurik Imre , Lindström Jaana , Kivelä Jemina , Luis Alberto Moreno , Mavrogrianni Christina , Manios Yannis , Ruben Brondeel 
Published: October 2020

Abstract
Background: The current study aimed to describe self-reported lifestyle behaviours by comparing them to current health guidelines in European Feel4Diabetes-families at risk for developing type 2 diabetes across six countries (Belgium, Finland, Spain, Greece, Hungary and Bulgaria). Methods: Parents and their children were recruited through primary schools located in low socio-economic status areas. Parents filled out the FINDRISC-questionnaire, which was used for the risk assessment of the family. Sociodemographic factors and several lifestyle behaviours of both adults and children were assessed by parental questionnaires. To investigate families’ lifestyle behaviours, to compare these levels to health guidelines and to assess potential differences between the countries, multilevel regression analyses were conducted. Results: Most Feel4Diabetes-families at risk (parents and their children) did not comply with the guidelines regarding healthy behaviours, set by the WHO, European or national authorities; less than half of parents and children complied with the physical activity guidelines, less than 15% of them complied with the fruit and vegetable guideline, and only 40% of the children met the recommendations of five glasses of water per day. Clear differences in lifestyle behaviours in Feel4Diabetes-families at risk exist between the countries. Conclusions: Countries are highly recommended to invest in policy initiatives to counter unhealthy lifestyle behaviours in families at risk, taking into account country-specific needs. For future research it is of great importance to focus on families at risk in order to counter the development of type 2 diabetes and reduce health inequity.Trial registration: Name: Feel4Diabetes-study, trial registration number: 643708, data of registration 03/15/2015 (Retrospectively registered), URL: https://clinicaltrials.gov/ct2/show/NCT02393872?term=643708&draw=2&rank=1
Private Health Care Market Shaping and Equity in Childhood Diarrhea Treatment: Evidence From Data Analysis of an ORS&nbsp;and Zinc Scale-up Program in Eight States Across Nigeria&nbsp;
Authors: Braimoh Tiwadayo , Danat Isaac , Abubakar Mohammed , Ajeroh Obinna , Stanley Melinda , Wiwa Owens , Prescott Marta Rose , Lam Felix 
Published: October 2020

Abstract
Background: Nearly 90,000 under-five children die from diarrhoea annually in Nigeria. Over 90% of the deaths can be prevented with oral rehydration salt (ORS) and zinc treatment but coverage nationally was less than 34% for ORS and 3% for zinc with wide inequities. A program was implemented in eight states to address critical barriers to the optimal functioning of the health care market to deliver these treatments. However, it has been argued that initiatives that engage the private sector may worsen inequities due to their profit motive.Methods: Changes in disparities in the coverage of ORS and zinc treatments by socioeconomic strata and geographical location were assessed using data from cross-sectional baseline and endline surveys.Results: At baseline, 28% (95% CI: 22 - 35%) of children with diarrhoea from the poorest wealth quintile received ORS compared to 50% (95% CI: 52 - 58%) from the richest. This inequality reduced at endline as ORS coverage increased by 21%-points (P = 0.000) for the poorest and 17%-points (P = 0.000) for the richest. Zinc coverage increased significantly for both quintiles at endline from an equally low baseline coverage level. Consistent with the findings of the pairwise comparison of the poorest and the richest, the summary measure of disparity across all wealth quintiles showed a narrowing of inequities from baseline to endline. Concentration curves shifted towards equality for both treatments, concentration index declined from 0.1012 to 0.0480 for ORS and from 0.2640 to 0.0567 for zinc. Disparities in ORS and zinc coverage between rural and urban at both time points was insignificant except that the use of zinc in the rural at endline was significantly higher at 38% (95%CI: 35 - 41%) compared to 29% (95%CI: 25 - 33%) in the urban.Conclusion: The results show a pro-rural improvement in coverage and a reduction in coverage inequities across wealth quintiles from baseline to endline. This gives an indication that initiatives focused on shaping healthcare market systems may be effective in reducing health coverage gaps without detracting from equity as a health policy objective.
Phenological Traits, Litterfall Production, and Carbon Sequestration Rates of Major Three Species in the Sundarbans
Authors: Kamruzzaman Md. , Paul Sumonta Kumar 
Published: October 2020

Abstract
BackgroundAttempt to compare the phonological pattern of the three mangrove species: Heritiera fomes, Bruguiera sexangula, and Xylocapus mekongensis in the Sundarbans mangrove forest by observing the litterfall data over 3 years.ResultsAll these three species showed highest litterfall of leaves and stipules in summer and lowest in winter. In case of B. sexangula, it also showed its second peak of leaves litterfall in the rainy season. Branch litterfall for the three species was occurred all over the year without having a distinct seasonal pattern. Flowering was observed in February – June and March - May for H. fomes and X. mekomgensis, respectively. Fruiting was observed for H. fomes and X. mekongensis in between the month of March – May and April – June respectively. Peak of mature fruit or seed litterfall was observed in July and August for both H. fomes and X. mekongensis respectively. Litterfall of flower buds, flowers and propagule for B. sexangula was observed throughout the year and peak flower buds, flowers, and propagule litterfall was found in the month of January, March, and July respectively. Kendall’s coefficient of concordance showed that all the organs of litterfall were concordant during the study period. Autocorrelation coefficient revealed that all the parts of litterfall followed a clear annual cycle except branches. Mean total litterfall was calculated 1014.6±12.7 g m-2 year-1 for H. fomes, 1047.3±21.3 g m-2 year-1 for X. mekongensis and 1640.2±14.1 g m-2 year-1 for B. sexangula of which leaves litterfall contributed more than 50% of total litterfall for all the three species. H. fomes, B. sexangula and X. mekongensis none of them exhibit any correlation between stipules litterfall and reproductive organs litterfall.ConclusionThe findings may contribute to an understanding of vegetative and reproductive phenology, litterfall production, and carbon sequestration rate of the major mangrove species in Sundarbans mangrove forests, and also its role in global C budgets.
Microbial Community Structure and Composition is Associated With Host Species and Sex in Sigmodon Cotton Rats
Authors: Strickland Britton , Patel Mira , Shilts Meghan H. , Boone Helen H. , Kamali Arash , Zhang Wei , Stylos Daniel , Boukhvalova Marina S. , Rosas-Salazar Christian , Yooseph Shibu , Rajagopala Seesandra V. , Blanco Jorge C. G. , Das Suman Ranjan 
Published: October 2020

Abstract
Background: The cotton rat (genus Sigmodon) is an essential small animal model for the study of human infectious disease and viral therapeutic development. However, the impact of the host microbiome on infection outcomes has not been explored in this model, partly due to the lack of a comprehensive characterization of microbial communities across different cotton rat species. Understanding the dynamics of their microbiome could significantly help to better understand its role during when modeling viral infections in this small animal model.Results: We examined the bacterial communities of the gut and three external sites (skin, ear, and nose) of two inbred species of cotton rats commonly used in research (S. hispidus and S. fulviventer) by using 16S rRNA gene sequencing, constituting the first comprehensive catalog of the cotton rat microbiome. We showed that S. fulviventer maintained higher alpha diversity and richness than S. hispidus at external sites (skin, ear, nose), but there were no differentially abundant genera. However, S. fulviventer and S. hispidus had distinct fecal microbiomes composed of several significantly differentially abundant genera. Whole metagenomic shotgun sequencing of fecal samples identified species-level differences between S. hispidus and S. fulviventer, as well as different metabolic pathway functions as a result of differential host microbiome contributions. Furthermore, the microbiome composition of the external sites showed significant sex-based differences while fecal communities were not largely different. Conclusions: Our study shows that host genetic background potentially exerts homeostatic pressures, resulting in distinct microbiomes for two different inbred cotton rat species. Because of the numerous studies that have uncovered strong relationships between host microbiome, viral infection outcomes, and immune responses, our findings represent a strong contribution for understanding the impact of different microbial communities on viral pathogenesis. Furthermore, we provide novel cotton rat microbiome data as a springboard to uncover the full therapeutic potential of the microbiome against viral infections.
Strengthening of Masonry Rings With Composite Materials
Authors: Jasieńko Jerzy , Raszczuk Krzysztof , FRĄCKIEWICZ PIOTR , Kleszcz Kajetan , Bednarz Łukasz 
Published: October 2020

Abstract
The paper presents the results of experimental testing of six masonry rings built to technical scale and strengthened with CFRP strips and sheets and also with an FRCM system with PBO, glass, basalt and carbon fibres. The rings were subjected to tensile loads induced by four hydraulic jacks. The assumption is that the masonry rings are a representative simplification of domes, especially their structural support. Both single layered domes and ribbed domes are exposed to tensile stress in up to one third of their height.During the tests, the following information was collected: loads, displacements, strains of composites and failure modes. In some cases, an initial prestressing of reinforcements was carried out. Recommendations and limitations related to the use of the materials tested for reinforcing round, masonry structures under tensile stresses are discussed. The criterion for choosing the best solution was not only based on comparing the tensile strength of the reinforcement but also its stiffness. A strengthening efficiency index is proposed. The assessment of strengthening effectiveness was carried out, taking into account also heritage building conservation standards.
Anticoagulation Therapy Using Unfractionated Heparin at a Therapeutic Dose for Coronavirus Disease 2019 Patients With Severe Pneumonia: A Retrospective Historical Control Study
Authors: Takayama Wataru , Endo Akira , Otomo Yasuhiro 
Published: October 2020

Abstract
Introduction: Patients with severe coronavirus disease 2019 (COVID-19) pneumonia often have the complications of coagulopathy and thrombotic phenomena, which lead to high mortality. Whether administering systematic anticoagulant therapy is beneficial remains unclear. We report our experience using systemic anticoagulation with unfractionated heparin to treat severe COVID-19.Methods: We conducted a retrospective historical control study of severe COVID-19 patients requiring mechanical ventilation who received prophylactic-dose anticoagulation (April 1–May 20) or therapeutic-dose anticoagulation (May 21–August 20) in the intensive care unit (ICU) of the tertiary emergency critical care medical center in Japan. The primary endpoints were in-hospital mortality and anticoagulation therapy-related adverse events. The secondary endpoints included the administration of veno-venous extracorporeal membrane oxygenation (ECMO), ventilator-free days (VFD), ICU-free days, and the development of multiple organ dysfunction syndrome.Results: Twenty-one patients were in the prophylactic-dose group and 26 patients were in the therapeutic-dose group. Background characteristics between the groups were not significantly different, although the therapeutic-dose group had a lower in-hospital mortality rate [0 (0.0%) patients vs. 4 (19.0%) patients; p = 0.063] and significantly longer ICU-free days (median [interquartile range (IQR)]: 15 days [13-18] vs. 5 days [0-13]; p = 0.014). Hemorrhagic events did not occur during the study period. Compared to the prophylactic-dose group, the therapeutic-dose group tended to have a longer VFD, were not treated with ECMO, and did not experience multiple organ dysfunction syndrome; however, the difference was not statistically significant.Conclusions: Therapeutic-dose anticoagulation may be beneficial for patients with severe COVID-19 pneumonia requiring mechanical ventilation.
Dual antiplatelet therapy in patients with coronary artery disease after percutaneous coronary intervention with drug-eluting stents: A systematic review and network meta-analysis
Authors: Xu Yi , Shen Yimin , Zhao Pengfei , Han Yuanyuan , Jiang Jun 
Published: October 2020

Abstract
Background: This network meta-analysis was committed to evaluating the efficacy and safety of different dual antiplatelet therapies (DAPTs) after percutaneous coronary intervention (PCI) with drug-eluting stents (DESs).Methods: Randomized controlled trials (RCTs) comparing two of the following DAPT strategies: long-term (>12 months) DAPT (L-DAPT), 12-months DAPT (DAPT 12Mo), short-term (≤6 months) DAPT followed by aspirin monotherapy (S-DAPT+ASA), short-term DAPT followed by a P2Y12 receptor inhibitor monotherapy (S-DAPT+P2Y12) were searched. Primary outcomes were all-cause mortality, cardiac death, myocardial infarction (MI), stroke, major bleeding, any bleeding, definite or probable stent thrombosis (ST). This Bayesian network meta-analysis was performed with the random-effects model.Results: Twenty-four RCTs (n=81,376) were included. L-DAPT increased the risk of major bleeding (OR 2.37, 95%CI 1.32-5.03 compared with S-DAPT+P2Y12) and any bleeding (OR 2.95, 95%CI 1.91-4.34 compared with S-DAPT+P2Y12). When compared with L-DAPT, DAPT 12Mo (OR 1.54, 95%CI 1.13-2.02) and DAPT+ASA (OR 1.67, 95%CI 1.22-2.19) were associated with higher rates of MI, but S-DAPT+P2Y12 obtained no statistical difference. The sensitivity analysis revealed that the risks of major bleeding and any bleeding further increased for ≥18 months of DAPT. In the subgroup analysis, short-term DAPT (S-DAPT) presented similar efficacy and safety to DAPT 12Mo for patients with the acute coronary syndrome (ACS), and lower risks of major bleeding and all-cause mortality were observed in S-DAPT+P2Y12 among patients with newer-generation DES.Conclusions: S-DAPT+P2Y12 presented superiority in patients with all clinical presentations, for a lower risk of bleeding and not associated with increased ischemic harm. Besides, prospective research between aspirin monotherapy and P2Y12 monotherapy was required.
Effects of Refractive Power on Quantification Using Ultra-Widefield Retinal Imaging
Authors: Lim Su-Ho , Jeong Seongyong , Ahn Jang Hwan , Hemert Jano van , Sagong Min 
Published: October 2020

Abstract
Background: Ultra-widefiled (UWF) retinal images include significant distortion when they are projected onto a two-dimensional surface for viewing. Therefore, many clinical studies that require quantitative analysis of fundus images have used stereographic projection algorithm, three-dimensional fundus image was mapped to a two-dimensional stereographic plane by projecting all relevant pixels onto a plane through the equator of the eye. However, even with this impressive algorithm, refractive error itself might affect the size and quality of images theoretically. The purpose of this study is to investigate the effects of refractive power on retinal area measurements (quantification) using UWF retinal imaging (Optos California; Dunfermline, Scotland, UK).Methods: A prospective, interventional study comprised 50 healthy eyes. UWF images were acquired first without the use of a soft contact lens (CL) and then repeated with six CLs (+9D, +6D, +3D, -3D, -6D, and -9D). Using stereographically projected UWF images, the optic disc was outlined by 15-17 points and quantified in metric units. We divided the subjects into three groups according to axial length: Groups A (22-24mm), B (24-26mm), and C (≥26mm). The primary outcome was percentage change before and after use of the CLs. Secondary outcome was proportion of subjects with magnification effects, maximal changes >10%. Results: The study population was 6, 28, and 16 eyes in each group. Overall changes for the measured area were not significantly different in the whole study population. Group C had a larger proportion of magnification effects compared to Groups A and B (50.0%, 0%, and 3.6%, P=0.020). Measured area with plus lenses was significantly higher in Group C (P<0.001). Conclusion: The use of CLs might affect quantification of eyes with long axial length when using UWF images. Ophthalmologists should consider refractive error when measuring area in long eyes.
Context Matters: Using A Case Study Approach to Understand Implementing A Patient Centred Rehabilitation Model for Persons With Cognitive Impairment
Authors: McGilton Katherine , Cumal Alexia , Corsi Dana , Gingrich Shaen , Zheng Nancy , Escrig-Pinol Astrid 
Published: October 2020

Abstract
Background: There is a growing number of older adults with cognitive impairment (CI) that require inpatient rehabilitation. Patient centred rehabilitation models exist, yet there is a lack of specific strategies for implementing these models into other contexts. Researchers collaborated with administrators and staff in one rural site to adapt a patient centred rehabilitation model of care in the Canadian province of Ontario. This paper reports on the contextual factors that influenced the implementation of the model of care.Methods: The study takes a case study approach. One rural facility was purposefully selected for its interest in offering rehabilitation to persons with CI. Four focus group discussions were conducted to explore healthcare professionals’ perceptions on the contextual factors that could affect the implementation of the rehabilitation model of care in this facility. Twenty-seven professionals with various backgrounds were purposively sampled using a maximum diversity sampling strategy. A hybrid inductive-deductive approach was used to analyze the data using the Context and Implementation of Complex Interventions (CICI) Framework. Results: Across the domains of the CICI framework, three domains (political, epidemiological, and geographical) and seven corresponding sub-domains were found to have a major influence on the implementation process. Key elements within the political domain included effective teamwork, facilitation, adequate resources, effective communication strategies, and a vision for change. Within the epidemiological domain, a key element was knowing how to tailor rehabilitation approaches for persons with CI. Infrastructure was a key aspect of the geographical domain, which was focused on the facility’s physical layout.Conclusions: The study identified key factors within the context that supported and hindered the implementation of the model of care in a new environment. This work suggests that when implementing a new program of care, strong consideration should be paid to the political, epidemiological, and geographical domains of the context and how these aspects interact and influence one another. The CICI Framework was a useful guide to understand which elements existed and which were still required for successful implementation of the model of care.