bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residual Shank Torque of Bolted Joints: A Numerical Investigation
Authors: Fini Stefano , De Agostinis Massimiliano , Croccolo Dario , Olmi Giorgio , Paiardini Luca , Robusto Francesco 
Published: November 2019

Abstract
During operation, the overall stress state of a screw is a function of the direct stress generated by the axial preload, and the external loads, plus the shear stress due to the residual shank torque. All in all, the higher the residual torque, the lower the direct stress the screw can withstand prior to yielding. The residual shank torque stems from the tightening torque, part of which flows through the shank and it is, only partially, released after wrench removal, thanks to springback phenomena involving both the screw and the joined elements. This phenomenon has been tackled in a previous experimental and analytical work by the authors, which investigated the effect of the stiffness and frictional parameters of the joint on the amount of residual shank torque. Such research was based on a sleevelike specimen, and, in fact, the results were strictly applicable to the case of slender cylindrical joint. The present contribution aims at assessing the effect of the same parameters on the residual shank torque, namely: the ratio between the torsional stiffness of the screw and of the plates, the friction coefficients (underhead and thread). Nonetheless, thanks to a novel three-dimensional finite element model, the parameters have been varied in a much wider range, in order to analyze all the likely operating conditions. The model is capable of predicting the residual shank torque for both the cases of slender and thick joint (plate-like joint). The model has been developed in the Ansys R17 software, but the methodology can be extended to other codes with minimal changes.
Verification of Manual Digitization Methods During Experimental Simulation of Knee Motion
Authors: Hargett Zachary , Gutierrez Manuel , Harman Melinda 
Published: November 2019

Abstract
Cadaveric testing is a common approach for verifying mathematical models used in computational modeling work. In the case of a knee joint model for calculating ligament tension during total knee replacement (TKR) motion, model inputs include rigid body motions defined using the Grood-Suntay coordinate system as a spatial linkage between the tibial component orientation relative to the femoral component. Using this approach requires the definition of coordinate systems for each rigid TKR component (i.e. tibial and femoral) based on fiducial points, manual digitization of a point cloud within the experimental setup, and registration of the orientation relative to the relevant bone marker array. The purpose of this study was to compare the variability between two different manual point digitization methods (a hand-held stylus and pivot tool each calibrated in the optical tracking system), using a TKR femoral component in a simulated cadaver limb experimental setup as an example. This was accomplished by verifying the mathematical algorithm used to calculate the coordinate system from the digitized points, quantifying the variability of the manual digitization methods, and discussing how any error could affect the computational model. For the hand-held stylus method, the standard deviation of the origin and, x-, y-, and z-axis calculations were 0.50mm, 1.31 degrees, 0.51 degrees, and 0.62 degrees, respectively. It is important to note that there is an additional error created using the hand-held stylus from required manual digitization of each rigid marker array. This average additional error was 0.54mm for the origin and 1.70, 1.66, and 0.98 degrees for the x-, y-, and z-axes, respectively. For the pivot tool method, the standard deviation was 0.35mm, 0.37 degrees, 1.27 degrees, and 1.24 degrees for the origin, x-, y-, and z-axes, respectively. It is essential to minimize experimental error, as small errors in alignment can substantially alter model outputs. In this study of cadaver simulation of limb motion, the pivot tool is the better option for minimizing error. Careful definition of fiducial points and repeatable manual digitization of the point cloud is critical for meaningful computational models of TKR motion based on cadaver experimental work.
Trends in HIV testing in the UK primary care setting: a 15-year retrospective cohort study from 2000 to 2015
Authors: Gompels Mark , Michael Skevi , Davies Charlotte , Jones Tim , Macleod John , May Margaret 
Published: November 2019

ObjectivesTo estimate trends in HIV testing, positivity and prevalence in UK primary care for 2000–2015 as part of a wider investigation into reasons for late diagnosis of HIV.DesignRetrospective cohort study using the Clinical Practice Research Datalink (CPRD) which is derived from computerised clinical records produced during consultations in primary care.Setting404 general practices in England.Participants5 979 598 adults aged ≥16 years registered between 2000 and 2015 with 45 093 761 person years of observation.OutcomesAnnual HIV testing rates, proportion of positive tests and prevalence of HIV-infected people recorded in primary care 2000–2015.ResultsHIV testing in primary care increased from 2000 to 2010, but then declined. Testing was higher in females than in males and in those aged 16–44 years compared with older adults. Rates per 100 000 in women aged 16–44 years were 177 (95% CI 167 to 188); 1309 (95% CI 1282 to 1336); 1789 (95% CI 1757 to 1821) and 839 (95% CI 817 to 862) in 2000, 2005, 2010 and 2015, respectively, and for non-pregnant women: 22.5 (95% CI 19 to 26); 134 (95% CI 125 to 143); 262 (95% CI 250 to 275); 190 (95% CI 179 to 201). For men aged 16–44 years rates were: 26 (95% CI 22 to 29); 107 (95% CI 100 to 115); 196 (95% CI 185 to 206); 137 (95% CI 127 to 146). Over the study period, there were approximately two positive results per 1000 HIV tests. Men were eightfold more likely to test positive than women. The percentage of HIV diagnoses among adults recorded in CPRD may be as low as 55% in London and 67% in the rest of the UK.ConclusionsHIV testing rates in primary care peaked in 2010 and subsequently declined. Access to testing was higher for women despite the prevalence of HIV being higher in men.Implications and further research neededOpportunities remain in primary care for increasing HIV testing to prevent costly late diagnoses and decrease HIV transmission. Interventions to improve targeting of tests and increase adherence to HIV testing guidelines are needed in primary care.
How timely is access to palliative care medicines in the community? A mixed methods study in a UK city
Authors: Miller Elizabeth Jane , Morgan Julie D , Blenkinsopp Alison 
Published: November 2019

ObjectiveTo investigate timely access to palliative medicines/drugs (PMs) from community pharmacies to inform palliative care service delivery.DesignMixed methods in two sequential phases: (1) prospective audit of prescriptions and concurrent survey of patients/representatives collecting PMs from pharmacy and (2) interviews with community pharmacists (CPs) and other healthcare professionals (HCPs).SettingFive community pharmacies in Sheffield, UK and HCPs that deliver palliative care in that community.ParticipantsPhase 1: five CPs: two providing access to PMs within a locally commissioned service (LCS) and three not in the LCS; 55 patients/representatives who completed the survey when accessing PMs and phase 2: 16 HCPs, including five phase 1 CPs, were interviewed.ResultsThe prescription audit collected information on 75 prescriptions (75 patients) with 271 individual PMs; 55 patients/representatives (73%) completed the survey. Patients/representatives reported 73% of PMs were needed urgently. In 80% of cases, patients/representatives received all PMs on the first pharmacy visit. One in five had to travel to more than one pharmacy to access PMs. The range of PMs stocked by pharmacies was the key facilitating factor. CPs reported practical issues causing difficulty keeping PMs in stock and playing a reactive role with palliative prescriptions. Confidentiality concerns were cited by other HCPs who were reluctant to share key patient information proactively with pharmacy teams. Inadequate information transfer, lack of CP integration into the care of palliative patients and poor HCP knowledge of which pharmacies stock PMs meant patients and their families were not always able to access PMs promptly.ConclusionsConsistent routine information transfer and integration of pharmacy teams in the care of palliative patients are needed to achieve timely access to PMs. Commissioners of PM access schemes should review and monitor access. HCPs need to be routinely made aware and reminded about the service and its locations.
Protocol for the CREST Choles (Chinese REgistry Study on Treatment of Cholecysto-Choledocholithiasis) study: an ambispective, multicenter, observational, open-cohort study
Authors: Zhu Jie-Gao , Wu Shanshan , Feng Qiushi , Li Fei , Han Wei , Xiu Dianrong , Tan Haidong , Fu Jianzhu , Li Xun , Shang Dong , Liu Houbao , Li Binglu , Yang Li , Kong Yuanyuan , Zhan Siyan , Guo Wei , Zhang Zhong-Tao 
Published: November 2019

IntroductionThe best approach for choledocholithiasis remains a matter of debate. Choledocholithiasis is usually treated with endoscopic sphincterotomy (EST), laparoscopic common bile duct exploration (LCBDE) or laparoscopic transcystic common bile duct exploration (LTCBDE). Data pertaining to the clinical outcomes of these approaches in the management of patients with cholecysto-choledocholithiasis in China are limited. An analysis of the economic burden associated with these treatments is lacking. The Chinese REgistry Study on the Treatment of Cholecysto-Choledocholithiasis (CREST Choles) was designed to address these issues in a real-world setting.Methods and analysisCREST Choles was an ambispective, multicenter, observational, open-cohort study. A total of 2700 patients undergoing one of the three treatments (EST+laparoscopic cholecystectomy (LC), LCBDE+LC and LTCBDE+LC) during the period from 1 January 2013 to 1 December 2018 at participating centres were enrolled in the study. Patients with gallstones and confirmed common bile duct stones were included. Data pertaining to demographics, disease history, procedural details, imaging features and follow-up were collected. Follow-up was conducted at least 6 months after enrolment in the study and annual follow-up will be conducted until December 2020. The primary outcome is the rate of adverse outcomes within 3 years postoperatively. Economic analysis (eg, incremental cost-effectiveness ratio) would be performed to compare expense across treatments.Ethics and disseminationEthical approval was obtained at all participating centres. The registry presented is the first attempt to comprehensively evaluate the cost of treatment for cholecysto-choledocholithiasis in China. Findings are expected to be available in 2020 and will facilitate clinical decision making in such cases.Trial registration numberNCT02554097.
Shanghai Preconception Cohort (SPCC) for the association of periconceptional parental key nutritional factors with health outcomes of children with congenital heart disease: a cohort profile
Authors: Wang Dingmei , Zhang Yi , Jiang Yuang , Ye Ying , Ji Mi , Dou Yalan , Chen Xiaotian , Li Mengru , Ma Xiaojing , Sheng Wei , Huang Guoying , Yan Weili 
Published: November 2019

PurposeThe Shanghai Preconception Cohort (SPCC) was initially established to investigate the associations of parental periconceptional nutritional factors with congenital heart disease (CHD) but has further analysed child growth and development and paediatric diseases.ParticipantsPreparing-for-pregnancy couples who presented at Shanghai preconception examination clinics and early-pregnancy women before 14 gestational weeks were enrolled to comprise the periconceptional baseline study population. General characteristics, routine clinical data and consumption of diet supplements, such as folic acid and multivitamins, were collected. Blood samples were obtained at preconception and early, middle and late gestations using standard procedures. Multiple nutritional factors, including folate, homocysteine, vitamin A, vitamin D, vitamin E and metals, in the blood samples of participants selected using a case–control design were examined. Genomic DNA was extracted.Findings to dateThe baseline population included 8045 preconception couples, 3054 single women and 15 615 early-pregnancy women. Data from 12 402 births were collected, and follow-up of the cohort for other outcomes is ongoing. Currently, 151 cases of CHD were identified after birth. The pilot analysis in a small subgroup showed that approximately 20.0% of preconception women and 44.9% of early-pregnancy women had red blood cell (RBC) folate levels that met the international recommendation for preventing neural tube defects.Future plansOnce a sufficient number of CHD cases are achieved, we will investigate the quantitative association of preconception RBC folate levels with CHD using a nested case–control design. The SPCC will be followed up for 18 years to investigate extensive outcomes of growth, development, obesity, and common and rare diseases during childhood and adolescence according to our plan. Blood nutritional factors will be examined in participants selected for specific aims. The SPCC will also allow for prospective cohort studies on extensive research questions.Trial registration numberNCT 02737644
Cost-effectiveness and value-based prices of the 9-valent human papillomavirus vaccine for the prevention of cervical cancer in China: an economic modelling analysis
Authors: Jiang Y , Ni Weiyi , Wu Jing 
Published: November 2019

ObjectivesTo evaluate the cost-effectiveness of the 9-valent human papillomavirus (HPV) vaccine for the prevention of cervical cancer in China.DesignHealth economic modelling using the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model populated with China-specific data.SettingIndividual cervical cancer prevention in China using the 9-valent HPV vaccine from the perspective of private sector purchasers in relation to receiving other HPV vaccines and not receiving vaccination for 16-year-old girls in China who had not been previously infected with HPV.ParticipantsNot applicable.InterventionsVaccination using the 9-valent, the quadrivalent and the bivalent vaccines.Primary outcome measureIncremental costs per disability-adjusted life year (DALY) prevented.ResultsIn the base case, the incremental costs per DALY prevented were, respectively, US$35 000 and US$50 455 compared with the quadrivalent and the bivalent vaccines, both of which were above the cost-effective threshold of US$25 920/DALY prevented. To be cost-effective in these comparisons, the 9-valent vaccine should be priced at $550 and $450 for the full doses, respectively. To be highly cost-effective, the price thresholds were $435 and $335. The incremental costs per DALY prevented in relation to no vaccination was US$23 012, making the 9-valent vaccine marginally cost-effective. The results were robust in most one-way sensitivity analyses including changing vaccination age to 13 and 26 years.ConclusionsAt the current price, the 9-valent HPV vaccine is not cost-effective compared with the quadrivalent and the bivalent vaccines for young girls in China who had not been previously infected with HPV. Policymakers and clinicians should keep potential vaccine recipients informed about the economic profile of the 9-valent vaccine and carefully consider expanding its use in China at the current price.
ПРОБЛЕМНІ ПИТАННЯ ПРИ ПОВОДЖЕННІ З МЕДИЧНИМИ ВІДХОДАМИ В УКРАЇНІ
Authors: Brezytska D. M. , Guschuk I. V. 
Published: November 2019

Мета: провести аналіз проблем, які виникають при поводженні з медичними відходами, та визначити основні гігієнічні підходи щодо безпечного поводження з ними.
Матеріали і методи. У процесі дослідження використано такі методи: описовий, медико-статистичний, бібліографічний, епідеміологічний, санітарно-гігієнічний.
Результати. Проведено аналіз проблем, які виникають при поводженні з медичними відходами, та визначено основні гігієнічні підходи щодо безпечного поводження з ними. На сьогодні в нашій країні немає досконалої законодавчої бази у вирішенні цього питання. Медичні відходи мають різний ступінь епідеміологічної та екологічної безпеки залежно від їх складу та ступеня контамінації біологічними, хімічними та радіоактивними агентами. Відходи та побічні продукти їх розкладу спричиняють та завдають шкоду не тільки довкіллю, а й життю та здоров’ю населення. Виділено основні ризики, спричинені відходами медичних закладів (інфекційні, хімічні, радіаційні), та ризики, пов’язані з утилізацією відходів. Нині єдиним шляхом подолання цих проблем є впровадження Національної стратегії управління відходами в Україні до 2030 р. Це – перший стратегічний документ державного рівня, який визначає політику управління всіма видами відходів до 2030 р. Стратегія визначає головні напрями державного регулювання у сфері поводження з відходами в найближче десятиліття з урахуванням європейських підходів із питань управління відходами, що ґрунтуються на положеннях Директив ЄС.
Висновки. Основними завданнями, які постають на сьогодні при поводженні з медичними відходами (МВ), є створення основи для впровадження апробованих методів і технологій управління МВ та розробка загальнонаціональної мережі з їх подальшої утилізації, вдосконалення стандартів поводження з відходами з метою зменшення забруднення навколишнього середовища. Впровадження та дотримання цих вимог не тільки вирішить проблему поводження з МВ, а й буде сприяти поліпшенню екологічної ситуації в країні.
Results of CoALL 07-03 study childhood ALL based on combined risk assessment by in vivo and in vitro pharmacosensitivity
Authors: Schramm Franziska , zur Stadt Udo , Zimmermann Martin , Jorch Norbert , Pekrun Arnulf , Borkhardt Arndt , Imschweiler Thomas , Christiansen Holger , Faber Jörg , Schmid Irene , Feuchtinger Tobias , Beron Gerhard , den Boer Monique L. , Pieters Rob , Horstmann Martin A. , Janka-Schaub Gritta E. , Escherich Gabriele 
Published: November 2019

Key Points
Report of the long-term outcome of children with acute lymphoblastic leukemia upon risk-adapted therapy accrued in trial CoALL 07-03. Lack of correlation between in vitro and in vivo drug response as well as a lower predictive value of in vitro drug testing.
Risk of disease transformation and second primary solid tumors in patients with myeloproliferative neoplasms
Authors: Hong Junshik , Lee Ju Hyun , Byun Ja Min , Lee Ji Yun , Koh Youngil , Shin Dong-Yeop , Lee Jeong-Ok , Hwang Sang Mee , Choi Hyoung Soo , Kim Inho , Yoon Sung-Soo , Bang Soo-Mee 
Published: November 2019

Key Points
South Korean MPN patients had a significantly higher risk of developing second primary solid tumors than that of the general population. Patients with SMF had an overall survival comparable to those with PMF with less risk of developing SAML.
Real-life effectiveness of omalizumab in difficult-to-treatversussevere asthma: a national cohort study in Belgium
Authors: Verhamme Katia M.C. , Lucet Catherine , Van Meerhaeghe Alain , Brusselle Guy G.O. , Lambert Marie-Laurence 
Published: November 2019

BackgroundGuidelines recommend omalizumab in patients with uncontrolled severe allergic asthma. We investigated real-life use of omalizumab, the proportion of patients fulfilling eligibility criteria, its costs and its effectiveness.MethodIn a cohort of asthma patients initiating treatment with omalizumab in Belgium between 2010 and 2016, we investigated fulfilment of eligibility criteria (chronic use of high-dose inhaled corticosteroids (ICSs) plus long-acting β2-agonists (LABAs) and ≥2 severe asthma exacerbations in previous year), and compared hospitalisations and systemic corticosteroid consumption in the year before and after omalizumab initiation. We computed healthcare costs in the respective time periods and compared the cost per prevented hospitalisation in patients fulfilling eligibility criteriaversusthose who did not.ResultsBetween 2010 and 2016, omalizumab treatment was initiated in 2068 patients with asthma; only 24% fulfilled the eligibility criteria, mainly due to nonadherence to high-dose ICSs + LABAs. The proportion of patients hospitalised for asthma decreased from 41% to 21% in eligible patients (absolute risk reduction, 20%), whereas the absolute risk reduction was 5% (from 19% to 14%) in noneligible patients. The cost per prevented hospitalisation was €44 238versus€139 495, respectively. Chronic use of systemic corticosteroids was discontinued in 35% of eligible patientsversus15% of noneligible patients.ConclusionIn Belgium, omalizumab is mostly initiated in uncontrolled asthma patients who are nonadherent to ICSs + LABAs. Omalizumab decreases hospitalisations and the use of systemic corticosteroids, but at a high cost. Careful management of patients with difficult-to-treat asthma should be a priority before prescribing omalizumab.
Identifying Cancer genes by combining two-rounds RWR based on multiple biological data
Authors: Zhang Wenxiang , Lei (IEEE member) Xiujuan , Bian Chen 
Published: November 2019

Abstract
Background
It’s a very urgent task to identify cancer genes that enables us to understand the mechanisms of biochemical processes at a biomolecular level and facilitates the development of bioinformatics. Although a large number of methods have been proposed to identify cancer genes at recent times, the biological data utilized by most of these methods is still quite less, which reflects an insufficient consideration of the relationship between genes and diseases from a variety of factors.

Results
In this paper, we propose a two-rounds random walk algorithm to identify cancer genes based on multiple biological data (TRWR-MB), including protein-protein interaction (PPI) network, pathway network, microRNA similarity network, lncRNA similarity network, cancer similarity network and protein complexes. In the first-round random walk, all cancer nodes, cancer-related genes, cancer-related microRNAs and cancer-related lncRNAs, being associated with all the cancer, are used as seed nodes, and then a random walker walks on a quadruple layer heterogeneous network constructed by multiple biological data. The first-round random walk aims to select the top score k of potential cancer genes. Then in the second-round random walk, genes, microRNAs and lncRNAs, being associated with a certain special cancer in corresponding cancer class, are regarded as seed nodes, and then the walker walks on a new quadruple layer heterogeneous network constructed by lncRNAs, microRNAs, cancer and selected potential cancer genes. After the above walks finish, we combine the results of two-rounds RWR as ranking score for experimental analysis. As a result, a higher value of area under the receiver operating characteristic curve (AUC) is obtained. Besides, cases studies for identifying new cancer genes are performed in corresponding section.

Conclusion
In summary, TRWR-MB integrates multiple biological data to identify cancer genes by analyzing the relationship between genes and cancer from a variety of biological molecular perspective.