bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Novel Hybrid Manufacturing Technique for Manufacturing Support Structures Free Complex Parts
Authors: Khan Haris Ali , Ademujimi Toyosi 
Published: November 2019

Abstract
This study unearths a novel approach utilizing conventional subtractive manufacturing technology (5-axis CNC milling center) to realize additively manufactured complex geometries without employing support structures. The proposed approach was based on benefiting from the precision and accuracy of subtractive manufacturing while leveraging the freedom of design of additive manufacturing (AM) process. The desired objectives were achieved in a three-stepped methodology where initially the CNC machine was modified to adapt the 3D printing protocols while in the second step, additional hardware was retrofitted on the conventional CNC machine making it compatible to print 3D parts. A “geometric subsection” approach was adopted as the third step where the desired printed part was divided in different subsections based on the overhang angles and the rotational axes of the CNC machine was then utilized in a manner to eliminate the need for support structures. The manufactured AM part can then be post-processed employing the same machining platform. The proposed approach thereby also served as a next step in evolution of done-in-one processes by printing near-net shape components through additive manufacturing and then promptly acquiring the net shape through subtractive manufacturing techniques.
Microwave-Assisted Processing of Regenerated Silk Fibroin Films
Authors: Abdulhafez Moataz , Cho Se Youn , Tomaraei Golnaz , Bedewy Mostafa 
Published: November 2019

Abstract
Regenerated silk fibroin (RSF) is an emerging material derived from natural silk. Thin RSF films are transparent, biocompatible and biodegradable, which makes them suitable for many applications, such as flexible/conformal and transient electronics, bioresorbable devices, bioresists for lithography, and edible food protective coatings. To realize these applications, controlling and tuning the properties of RSF films is required to fully exploit their unique mechanical, optical, and degradation properties. Here, a new approach for tuning these properties is presented based on inducing rapid molecular structure transformations in fibroins via microwave heating. Transparent RSF films were post-treated by microwave irradiation, resulting in the transition of amorphous silk fibroin structure to a more α-helix dominant secondary structure. By increasing the microwave irradiation duration, an increase of helix secondary structure was observed. We use amide-I band Fourier-transform infrared spectroscopy (FTIR) of the films to characterize the secondary structure of fibroins. Moreover, we show that silicon substrates coated with 100 nm thick RSF films by spin casting, exhibit higher stability in water after microwave irradiation for up to 10 minutes, confirming a conformational change in the RSF secondary structure towards more stable α-helical rich motifs. Our results show that microwave treatment can be a new high throughput approach for tailoring the properties and structure of functional RSF-based films in a scalable and sustainable manufacturing process, when compared to other post processing techniques.
Improved Co-Scheduling of Printing Path Scanning for Collaborative Additive Manufacturing
Authors: Jiang Zhengqian , Psulkowski Sean , Nwodu Arriana , Wang Hui , Dickens Tarik 
Published: November 2019

Abstract
Additive manufacturing processes, especially those based on fused filament fabrication (FFF) mechanism, have relatively low productivity and suffer from production scalability issue. One solution is to adopt a collaborative additive manufacturing system that is equipped with multiple extruders working simultaneously to improve productivity. The collaborative additive manufacturing encounters a grand challenge in the scheduling of printing path scanning by different extruders. If not properly scheduled, the extruders may collide into each other or the structures built by earlier scheduled scanning tasks. However, there existed limited research addressing this problem, in particular, lacking the determination of the scanning direction and the scheduling for sub-path scanning. This paper deals with the challenges by developing an improved method to optimally break the existing printing paths into sub-paths and assign these generated sub-paths to different extruders to obtain the lowest possible makespan. A mathematical model is formulated to characterize the problem, and a hybrid algorithm based on an evolutionary algorithm and a heuristic approach is proposed to determine the optimal solutions. The case study has demonstrated the application of the algorithms and compared the results with the existing research. It has been found that the printing time can be reduced by as much as 41.3% based on the available hardware settings.
Modeling of Material Removal in Atomized Dielectric-Based Electrical Discharge Machining (EDM)
Authors: Tanveer Asif , Kapoor Shiv G. , Mujumdar Soham S. 
Published: November 2019

Abstract
Atomized dielectric-based electrical discharge machining (EDM) is an emerging technology in which the dielectric between the electrodes is supplied in the form of a thin film using a spray atomizer. This novel machining process uses significantly less quantities of dielectric compared to the conventional EDM while resulting in higher material removal rates and better debris flushing. This paper presents a model-based investigation of the atomized dielectric-based EDM to study the effect of the dielectric film flow on material removal. A melt-pool formation and material removal model is developed to predict the material removal in terms of crater shapes during a single EDM discharge. The atomization spray parameters are varied in order to produce different dielectric film velocities. The model accurately captures the asymmetry in crater shapes caused by the dielectric film flow and predicts the crater diameter and depth, however, the model overestimates the crater sizes observed in experiments.
Development of a national Department of Veterans Affairs mortality risk prediction model among patients with cirrhosis
Authors: Koola Jejo David , Ho Samuel , Chen Guanhua , Perkins Amy M , Cao Aize , Davis Sharon E , Matheny Michael E 
Published: November 2019

ObjectiveCirrhotic patients are at high hospitalisation risk with subsequent high mortality. Current risk prediction models have varied performances with methodological room for improvement. We used current analytical techniques using automatically extractable variables from the electronic health record (EHR) to develop and validate a posthospitalisation mortality risk score for cirrhotic patients and compared performance with the model for end-stage liver disease (MELD), model for end-stage liver disease with sodium (MELD-Na), and the CLIF Consortium Acute Decompensation (CLIF-C AD) models.DesignWe analysed a retrospective cohort of 73 976 patients comprising 247 650 hospitalisations between 2006 and 2013 at any of 123 Department of Veterans Affairs hospitals. Using 45 predictor variables, we built a time-dependent Cox proportional hazards model with all-cause mortality as the outcome. We compared performance to the three extant models and reported discrimination and calibration using bootstrapping. Furthermore, we analysed differential utility using the net reclassification index (NRI).ResultsThe C-statistic for the final model was 0.863, representing a significant improvement over the MELD, MELD-Na, and the CLIF-C AD, which had C-statistics of 0.655, 0.675, and 0.679, respectively. Multiple risk factors were significant in our model, including variables reflecting disease severity and haemodynamic compromise. The NRI showed a 24% improvement in predicting survival of low-risk patients and a 30% improvement in predicting death of high-risk patients.ConclusionWe developed a more accurate mortality risk prediction score using variables automatically extractable from an EHR that may be used to risk stratify patients with cirrhosis for targeted postdischarge management.
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study
Authors: Carayon Pascale , Hoonakker Peter , Hundt Ann Schoofs , Salwei Megan , Wiegmann Douglas , Brown Roger L , Kleinschmidt Peter , Novak Clair , Pulia Michael , Wang Yudi , Wirkus Emily , Patterson Brian 
Published: November 2019

ObjectiveIn this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive support to the pulmonary embolism (PE) diagnostic decision-making process in the emergency department. We hypothesised that the application of HF methods and principles will produce a more usable CDS that improves PE diagnostic decision-making, in particular decision about appropriate clinical pathway.Materials and methodsWe conducted a scenario-based simulation study to compare a HF-based CDS (the so-called CDS for PE diagnosis (PE-Dx CDS)) with a web-based CDS (MDCalc); 32 emergency physicians performed various tasks using both CDS. PE-Dx integrated HF design principles such as automating information acquisition and analysis, and minimising workload. We assessed all three dimensions of usability using both objective and subjective measures: effectiveness (eg, appropriate decision regarding the PE diagnostic pathway), efficiency (eg, time spent, perceived workload) and satisfaction (perceived usability of CDS).ResultsEmergency physicians made more appropriate diagnostic decisions (94% with PE-Dx; 84% with web-based CDS; p<0.01) and performed experimental tasks faster with the PE-Dx CDS (on average 96 s per scenario with PE-Dx; 117 s with web-based CDS; p<0.001). They also reported lower workload (p<0.001) and higher satisfaction (p<0.001) with PE-Dx.ConclusionsThis simulation study shows that HF methods and principles can improve usability of CDS and diagnostic decision-making. Aspects of the HF-based CDS that provided cognitive support to emergency physicians and improved diagnostic performance included automation of information acquisition (eg, auto-populating risk scoring algorithms), minimisation of workload and support of decision selection (eg, recommending a clinical pathway). These HF design principles can be applied to the design of other CDS technologies to improve diagnostic safety.
Using standardised patients to assess the quality of medical records: an application and evidence from rural China
Authors: Wu Yuju , Zhou Huan , Ma Xiao , Shi Yaojiang , Xue Hao , Zhou Chengchao , Yi Hongmei , Medina Alexis , Li Jason , Sylvia Sean 
Published: November 2019

BackgroundMedical records play a fundamental role in healthcare delivery, quality assessment and improvement. However, there is little objective evidence on the quality of medical records in low and middle-income countries.ObjectiveTo provide an unbiased assessment of the quality of medical records for outpatient visits to rural facilities in China.MethodsA sample of 207 township health facilities across three provinces of China were enrolled. Unannounced standardised patients (SPs) presented to providers following standardised scripts. Three weeks later, investigators returned to collect medical records from each facility. Audio recordings of clinical interactions were then used to evaluate completeness and accuracy of available medical records.ResultsMedical records were located for 210 out of 620 SP visits (33.8%). Of those located, more than 80% contained basic patient information and drug treatment when mentioned in visits, but only 57.6% recorded diagnoses. The most incompletely recorded category of information was patient symptoms (74.3% unrecorded), followed by non-drug treatments (65.2% unrecorded). Most of the recorded information was accurate, but accuracy fell below 80% for some items. The keeping of any medical records was positively correlated with the provider’s income (β 0.05, 95% CI 0.01 to 0.09). Providers at hospitals with prescription review were less likely to record completely (β −0.87, 95% CI −1.68 to 0.06). Significant variation by disease type was also found in keeping of any medical record and completeness.ConclusionDespite the importance of medical records for health system functioning, many rural facilities have yet to implement systems for maintaining patient records, and records are often incomplete when they exist. Prescription review tied to performance evaluation should be implemented with caution as it may create disincentives for record keeping. Interventions to improve record keeping and management are needed.
A novel faecalLachnoclostridiummarker for the non-invasive diagnosis of colorectal adenoma and cancer
Authors: Liang Jessie Qiaoyi , Li Tong , Nakatsu Geicho , Chen Ying-Xuan , Yau Tung On , Chu Eagle , Wong Sunny , Szeto Chun Ho , Ng Siew C , Chan Francis K L , Fang Jing-Yuan , Sung Joseph J Y , Yu Jun 
Published: November 2019

ObjectiveThere is a need for early detection of colorectal cancer (CRC) at precancerous-stage adenoma. Here, we identified novel faecal bacterial markers for diagnosing adenoma.DesignThis study included 1012 subjects (274 CRC, 353 adenoma and 385 controls) from two independent Asian groups. Candidate markers were identified by metagenomics and validated by targeted quantitative PCR.ResultsMetagenomic analysis identified ‘m3’ from aLachnoclostridiumsp.,Fusobacterium nucleatum(Fn) andClostridium hathewayi(Ch) to be significantly enriched in adenoma. Faecalm3andFnwere significantly increased from normal to adenoma to CRC (p<0.0001, linear trend by one-way ANOVA) in group I (n=698), which was further confirmed in group II (n=313; p<0.0001). Faecalm3may perform better thanFnin distinguishing adenoma from controls (areas under the receiver operating characteristic curve (AUROCs)m3=0.675 vsFn=0.620, p=0.09), whileFnperformed better in diagnosing CRC (AUROCsFn=0.862 vsm3=0.741, p<0.0001). At 78.5% specificity,m3andFnshowed sensitivities of 48.3% and 33.8% for adenoma, and 62.1% and 77.8% for CRC, respectively. In a subgroup tested with faecal immunochemical test (FIT; n=642),m3performed better than FIT in detecting adenoma (sensitivities for non-advanced and advanced adenomas of 44.2% and 50.8% bym3(specificity=79.6%) vs 0% and 16.1% by FIT (specificity=98.5%)). Combining with FIT improved sensitivity ofm3for advanced adenoma to 56.8%. The combination ofm3withFn,Ch,Bacteroides clarusand FIT performed best for diagnosing CRC (specificity=81.2% and sensitivity=93.8%).ConclusionThis study identifies a novel bacterial markerm3for the non-invasive diagnosis of colorectal adenoma.
Inflationary perturbation spectra at next-to-leading slow-roll order in effective field theory of inflation
Authors: Ding Guang-Hua , Qiao Jin , Wu Qiang , Zhu Tao , Wang Anzhong 
Published: November 2019

AbstractThe effective field theory (EFT) of inflation provides an essential picture to explore the effects of the unknown high energy physics in the single scalar field inflation models. For a generic EFT of inflation, possible high energy corrections to simple slow-roll inflation can modify both the propagating speed and dispersion relations of the cosmological scalar and tensor perturbations. With the arrival of the era of precision cosmology, it is expected that these high energy corrections become more important and have to be taken into account in the analysis with future precise observational data. In this paper we study the observational predictions of the EFT of inflation by using the third-order uniform asymptotic approximation method. We calculate explicitly the primordial power spectra, spectral indices, running of the spectral indices for both scalar and tensor perturbations, and the ratio between tensor and scalar spectra. These expressions are all written in terms of the Hubble flow parameters and the flow of four new slow-roll parameters and expanded up to the next-to-leading order in the slow-roll expansions so they represent the most accurate results obtained so far in the literature. The flow of the four new slow-roll parameters, which arise from the four new operators introduced in the action of the EFT of inflation, can affect the primordial perturbation spectra at the leading-order and the corresponding spectral indices at the next-to-leading order.
Modulation of alpha waves in sensorimotor cortical networks during self-motion perception evoked by different visual-vestibular conflicts
Authors: Harquel Sylvain , Guerraz Michel , Barraud Pierre-Alain , Cian Corinne 
Published: November 2019

Visually induced illusion of self-motion (vection) has been used as a tool to address neural correlates of visual-vestibular interaction. The extent to which vestibular cortical areas are deactivated during vection varies from one study to another. The main question in this study is whether such deactivation depends on the visual-vestibular conflict induced by visual motion. A visual motion about the line of sight (roll motion) induces a visual-canal conflict in upright and supine observers. An additional visual-otolith conflict arises in the upright position only, with the graviceptive inputs indicating that the head is stationary. A 96-channel electroencephalogram (EEG) was recorded in 21 participants exposed to roll motion in seated and supine positions. Meanwhile, perceptual state of self-motion was recorded. Results showed a transient decrease in the cortical sensorimotor networks’ alpha activity at the onset of vection whatever the participant’s position, and therefore the visual-vestibular conflict. During vection, an increase in alpha activity over parieto-occipital areas was observed in the upright condition, that is, in a condition of visual-otolith conflict. The modulation of alpha activity may be predictive of the illusion of self-motion but also may reflect the level of inhibition in the sensorimotor networks needed to reduce potential interference from vestibular conflicting inputs.NEW & NOTEWORTHY For the first time, we explored the neural correlates of different visuo-vestibular conflicts induced by visual motion using EEG. Our study highlighted a neuronal signature for illusory self-motion (vection) in the sensorimotor networks. Strong alpha activity may predict successful vection but also reflects the level of inhibition of sensorimotor networks needed to reduce potential interfering vestibular inputs. These findings would be of prime importance for simulator and virtual reality systems that induce vection.
Histone Lysine Methylation Dynamics ControlEGFRDNA Copy-Number Amplification
Authors: Clarke Thomas L. , Tang Ran , Chakraborty Damayanti , Van Rechem Capucine , Ji Fei , Mishra Sweta , Ma Anqi , Kaniskan H. Ümit , Jin Jian , Lawrence Michael S. , Sadreyev Ruslan I. , Whetstine Johnathan R. 
Published: November 2019

AbstractAcquired chromosomal DNA copy gains are a feature of many tumors; however, the mechanisms that underpin oncogene amplification are poorly understood. Recent studies have begun to uncover the importance of epigenetic states and histone lysine methyltransferases (KMT) and demethylases (KDM) in regulating transient site-specific DNA copy-number gains (TSSG). In this study, we reveal a critical interplay between a myriad of lysine methyltransferases and demethylases in modulating H3K4/9/27 methylation balance to control extrachromosomal amplification of the EGFR oncogene. This study further establishes that cellular signals (hypoxia and EGF) are able to directly promote EGFR amplification through modulation of the enzymes controlling EGFR copy gains. Moreover, we demonstrate that chemical inhibitors targeting specific KMTs and KDMs are able to promote or block extrachromosomal EGFR amplification, which identifies potential therapeutic strategies for controlling EGFR copy-number heterogeneity in cancer, and, in turn, drug response.Significance:This study identifies a network of epigenetic factors and cellular signals that directly control EGFR DNA amplification. We demonstrate that chemical inhibitors targeting enzymes controlling this amplification can be used to rheostat EGFR copy number, which uncovers therapeutic opportunities for controlling EGFR DNA amplification heterogeneity and the associated drug response.This article is highlighted in the In This Issue feature, p. 161
Cerebral Venous Thrombosis at High Altitude: Analysis of 28 Cases
Authors: Hassan Wahaj Ul , Syed Maryam J. , Alamgir Wasim , Awan Safia , Bell Simon M. , Majid Arshad , Wasay Mohammad 
Published: November 2019

<b><i>Objective:</i></b> An association between cerebral venous sinus thrombosis (CVST) and high altitude has been previously proposed, but limited published data exist to support this association. We investigated 28 cases of CVST occurring at high altitude and sought to describe patient demographics, altitude and acclimatization, hematological laboratory findings, neuroimaging, treatment, and prognosis in these cases. <b><i>Methods:</i></b> Twenty-eight cases of symptomatic CVST occurring at high altitude were identified between the months of August 2017 and December 2018, in collaboration with Military Hospital, Rawalpindi and Combined Military Hospital, Skardu (Pakistan). Follow-up visits were performed at 1 and 6 months. <b><i>Results:</i></b> Twenty-seven (96%) of the patients were males, and the mean age was 33 years. In total, 32.1% were smokers. The mean NIHSS score on presentation was 5.5. 85.7% of the cases occurred at altitude higher than 8,000 feet. On average 107.8 days were spent at a high altitude prior to CVST. Totally, 71.4% had acclimatized for &#x3e;2 weeks. The mean hemoglobin (Hb) value was 16.7 g/dL and 50% had d-dimer levels higher than 1,000 ng/mL. On MRI, 25% showed signs of hemorrhage and 14.3% showed infarcts. Treatments provided include low-molecular-weight heparin and Rivaroxaban and were associated with good outcomes. <b><i>Conclusion:</i></b> CVST is not uncommon at high altitude (&#x3e;8,000 feet). It is predominantly a male disease. Most patients have high Hb and high D-dimer levels. The overall outcome was good.