bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic Modeling of Aerostatic Spindle With Shaft Tilt Deformation
Authors: Shi Jianghai , Cao Hongrui , Maroju Naresh Kumar , Jin Xiaoliang 
Published: December 2019

Abstract
This paper presents a new dynamic model of aerostatic spindle including the journal and thrust bearings. Reynolds equations are used to model the dynamics of a 4-degree-of-freedom (DOF) aerostatic journal bearing and a 3-DOF aerostatic thrust bearing. Finite element model of the spindle shaft is developed based on the Timoshenko beam theory considering the centrifugal and gyroscopic effects and is coupled with the bearing to construct the dynamic model of the whole aerostatic spindle. The effect of shaft tilt motion due to elastic deformation on the dynamic characteristics of the aerostatic bearing is considered for the first time. The finite difference method is used to determine the load capacity and moments provided by the bearings with changing air film thickness due to shaft vibration, and Newmark-β method is used to obtain the dynamic response of the spindle shaft. The simulated natural frequencies of the aerostatic spindle are verified through impact experiments under static and rotating conditions. Based on the developed model, the effects of tool overhang length, rotating speed, air film thickness, and supply air pressure on the frequency response function of the spindle are investigated comprehensively. The proposed dynamic model of the aerostatic spindle is able to provide useful guidance for structure design and process planning for micro-machining.
Numerical Study on Effect of Dimples on Tribo-Characteristics in Non-Newtonian Thermal Elastohydrodynamic Lubrication Point Contacts With Different Mechanical and Thermal Properties
Authors: Kaneta Motohiro , Matsuda Kenji , Wang Jing , Yang Peiran 
Published: December 2019

Abstract
The transient behavior of tribo-characteristics caused by micro-dimples on point contact surfaces with different mechanical and thermal properties was investigated based on non-Newtonian thermal elastohydrodynamic lubrication (EHL) analysis. The dimples were assumed to exist on both contact surfaces and the surface shapes of the contact bodies were evaluated separately. It is pointed out that surface texturing due to the micro-dimples is not necessarily beneficial in EHL contacts under fully flooded conditions since the micro-dimples provide a high pressure and a thin minimum film thickness as compared with the case of contacts with smooth surfaces, although the friction coefficient of surfaces with micro-dimples is always lower than that of the smooth surfaces. In order to obtain relatively good tribo-characteristics, the velocity of the surface with low thermal conductivity should be faster than that with high thermal conductivity, and the wavelengths of micro-dimples in the direction of motion on both surfaces should be different.
<p><strong><span>The effect of infection of hard ticks </span></strong><em><strong><span>Ixodes ricinus </span></strong></em><strong><span>(L.) and </span></strong><em><strong><span>Ixodes</span></strong></em><span> <em><strong>persulcatus </strong></em><strong>Sch. (Acari: Ixodinae) with the causative agent of Lyme</strong> <strong>borreliosis (</strong><em><strong>Borrelia burgdorferi </strong></em><strong>s.l.) on their host search activity</strong> <strong>(using attractants)</strong></span></p>
Authors: GRIGORYEVA L. A. , MITEVA O. A. , MYASNIKOV V. A. , GOGOLEVSKY A. S. , SHITOVA L. F. 
Published: December 2019

A series of lab experiments with ticks (collected by flagging in the natural biotopes in North-Western Russia) was carried out in order to study tick reaction to attractants imitating the smell of a potential host. All the ticks that showed either positive or negative reactions to attractants in the experiment were individually PCR-tested for B. burgdorferi s.l DNA.The percent of Borrelia - positive specimen among hungry active adult I. ricinus and I. persulcatus ticks was higher than that among hungry passive ones. The discovered infection of I. persulcatus females by B. burgdorferi s. l. was 56% from which 67% were active and 36% were passive ticks. Total infection of adult ticks was 45% (61% active, 24% passive ticks). Infection of I. ricinus females was 60%, 69% in active individuals and 48% in passive, total infection of adult ticks was 56% (70% in active, 43% in passive). Synthetic kyromonas (attractant) composed of 1-octen-3-ol and a mixture of ethyl myristate-methyl salicylate (1:1), simulated the odour of the host in the experiment, attracted up to 70% of adults of I. ricinus and up to 80% of I. persulcatus. It can be assumed that this percent of adult ticks reflect an overall number of individuals searching for a hosts during the season of activity in natural biotopes.
Diet patterns and the incidence of age-related macular degeneration in the Atherosclerosis Risk in Communities (ARIC) study
Authors: Dighe Shruti , Zhao Jiwei , Steffen Lyn , Mares J A , Meuer Stacy M , Klein Barbara E K , Klein Ronald , Millen Amy E 
Published: December 2019

BackgroundAge-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the elderly.ObjectiveThis study aimed to determine the association between dietary patterns and food groups (used to make them) with the 18-year incidence of AMD.MethodsARIC (Atherosclerosis Risk in Communities) participants who showed change in AMD lesions between retinal photographs taken at visit 3 and visit 5 were graded side by side to determine incident AMD (any=144; early=117; late=27). A 66-line item food frequency questionnaire, administered at visit 1 and visit 3, was used to identify 29 food groups. Principal component analysis was used to derive dietary patterns from average food group servings. Logistic regression was used to estimate ORs and 95% CIs for incident AMD (any, early and late) by tertiles of dietary pattern scores, adjusted for age, race, education, total calories and smoking status. P-trend was estimated using continuous scores.ResultsWestern (unhealthy) and Prudent (healthy) dietary patterns were identified. No significant associations were observed between either dietary pattern and incident any or incident early AMD. However, a threefold higher incidence of late AMD was observed among participants with a Western pattern score above, as compared with below, the median (OR=3.44 (95% CI 1.33 to 8.87), p-trend=0.014). The risk of developing late AMD was decreased, but not statistically significant, among participants with a Prudent pattern score above, as compared with below, the median (OR=0.51 (95% CI 0.22 to 1.18), p-trend=0.054).ConclusionsDiet patterns were not significantly associated with incident any or incident early AMD. However, consumption of a Western pattern diet may be a risk factor for development of late AMD.
Effectiveness and cost-utility of a multifaceted eHealth strategy to improve back pain beliefs of patients with non-specific low back pain: a cluster randomised trial
Authors: Suman Arnela , Schaafsma Frederieke G. , van Dongen Johanna M. , Elders Petra J.M. , Buchbinder Rachelle , van Tulder Maurits W. , Anema Johannes R. 
Published: December 2019

ObjectivesTo assess the effectiveness and cost-utility of a multifaceted eHealth strategy compared to usual care in improving patients’ back pain beliefs, and in decreasing disability and absenteeism.DesignStepped-wedge cluster randomised trial with parallel economic evaluation.SettingDutch primary healthcare.ParticipantsPatients diagnosed with non-specific low back pain by their general practitioner or physiotherapist. Patients with serious comorbidities or confirmed pregnancy were excluded. 779 patients were randomised into intervention group (n=331, 59% female; 60.4% completed study) or control group (n=448, 57% female; 77.5% completed study).InterventionsThe intervention consisted of a multifaceted eHealth strategy that included a (mobile) website, digital monthly newsletters, and social media platforms. The website provided information about back pain, practical advice (eg, on self-management), working and returning to work with back pain, exercise tips, and short video messages from healthcare providers and patients providing information and tips. The control consisted of a digital patient information letter. Patients and outcome assessors were blinded to group allocation.Primary and secondary outcome measuresThe primary outcome was back pain beliefs. Secondary outcome measures were disability and absenteeism, and for the preplanned economic evaluation quality of life and societal costs were measured.ResultsThere were no between-group differences in back pain beliefs, disability, or absenteeism. Mean intervention costs were €70— and the societal cost difference was €535—in favour of the intervention group, but no significant cost savings were found. The incremental cost-effectiveness ratio indicated that the intervention dominated usual care and the probability of cost-effectiveness was 0.85 on a willingness-to-pay of €10.000/quality adjusted life year (QALY).ConclusionsA multifaceted eHealth strategy was not effective in improving patients’ back pain beliefs or in decreasing disability and absenteeism, but showed promising cost-utility results based on QALYs.Trial registration numberNTR4329.
COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
Authors: Stienen Martin N , Akeret Kevin , Vasella Flavio , Velz Julia , Jehli Elisabeth , Scheffler Pierre , Voglis Stefanos , Bichsel Oliver , Smoll Nicolas Roydon , Bozinov Oliver , Regli Luca , Germans Menno R 
Published: December 2019

IntroductionOutcomes rated on impairment scales are satisfactory after burr hole trepanation for chronic subdural haematoma (cSDH). However, the surgery leads to bony defects in the skull with skin depressions above that are frequently considered aesthetically unsatisfactory by the patients. Those defects could be covered by the approved medical devices (burr hole covers), but this is rarely done today. We wish to assess, whether the application of burr hole covers after trepanation for the evacuation of cSDH leads to higher patient satisfaction with the aesthetical result at 90 days postoperative, without worsening disability outcomes or increasing the complication rate.Methods and analysisThis is a prospective, single-blinded, randomised, controlled, investigator-initiated clinical trial enrolling 80 adult patients with first-time unilateral or bilateral cSDH in Switzerland. The primary outcome is the difference in satisfaction with the aesthetic result of the scar, comparing patients allocated to the intervention (burr hole cover) and control (no burr hole cover) group, measured on the Aesthetic Numeric Analogue scale at 90 days postoperative. Secondary outcomes include differences in the rates of skin depression, complications, as well as neurological, disability and health-related quality of life outcomes until 12 months postoperative.Ethics and disseminationThe institutional review board (Kantonale Ethikkommission Zürich) approved this study on 29 January 2019 under case number BASEC 2018–01180. This study determines, whether a relatively minor modification of a standard surgical procedure can improve patient satisfaction, without worsening functional outcomes or increasing the complication rate. The outcome corresponds to the value-based medicine approach of modern patient-centred medicine. Results will be published in peer-reviewed journals and electronic patient data will be safely stored for 15 years.Trial registration numberNCT03755349.
Improving data sharing between acute hospitals in England: an overview of health record system distribution and retrospective observational analysis of inter-hospital transitions of care
Authors: Warren Leigh R , Clarke Jonathan , Arora Sonal , Darzi Ara 
Published: December 2019

ObjectivesTo determine the frequency of use and spatial distribution of health record systems in the English National Health Service (NHS). To quantify transitions of care between acute hospital trusts and health record systems to guide improvements to data sharing and interoperability.DesignRetrospective observational study using Hospital Episode Statistics.SettingAcute hospital trusts in the NHS in England.ParticipantsAll adult patients resident in England that had one or more inpatient, outpatient or accident and emergency encounters at acute NHS hospital trusts between April 2017 and April 2018.Primary and secondary outcome measuresFrequency of use and spatial distribution of health record systems. Frequency and spatial distribution of transitions of care between hospital trusts and health record systems.Results21 286 873 patients were involved in 121 351 837 encounters at 152 included trusts. 117 (77.0%) hospital trusts were using electronic health records (EHR). There was limited regional alignment of EHR systems. On 11 017 767 (9.1%) occasions, patients attended a hospital using a different health record system to their previous hospital attendance. 15 736 863 (73.9%) patients had two or more encounters with the included trusts and 3 931 255 (25.0%) of those attended two or more trusts. Over half (53.6%) of these patients had encounters shared between just 20 pairs of hospitals. Only two of these pairs of trusts used the same EHR system.ConclusionsEach year, millions of patients in England attend two or more different hospital trusts. Most of the pairs of trusts that commonly share patients do not use the same record systems. This research highlights significant barriers to inter-hospital data sharing and interoperability. Findings from this study can be used to improve electronic health record system coordination and develop targeted approaches to improve interoperability. The methods used in this study could be used in other healthcare systems that face the same interoperability challenges.
Sexually transmitted infections among high-risk populations that use treatment as prevention or pre-exposure prophylaxis: a protocol for a systematic review
Authors: Coudray Makella , Kiplagat Sandra , Saumell Franklin , Madhivanan Purnima 
Published: December 2019

BackgroundAmong men who have sex with men, pre-exposure prophylaxis (PrEP) reduces the risk of HIV by 95%. Based on the documented benefits, the Centre for Disease Control and Prevention has recommended PrEP as a prevention method for high-risk groups. Moreover, for those HIV-infected individuals, antiretroviral therapy has been shown to serve as both as a treatment and prevention method for HIV.Methods and analysisThis systematic review protocol was reported according to the Preferred Reporting Items for Systematic reviews and Analyses (PRISMA) P framework. Medline (1980–present), Embase (1980–present), CINAHL (1980–present), Cochrane Central Register of Controlled Trials and clinicaltrials.gov will be used to identify relevant articles based on a piloted search strategy. Peer-reviewed observational and experimental studies will be included. A narrative style will be used to describe descriptive data. A meta-analysis will be conducted if heterogeneity is not significant.Ethics and disseminationRecent evidence suggests that there is an increased risk of sexually transmitted infections (STIs) among high-risk persons that use PrEP. Furthermore, there is a paucity of data on the relationship of treatment as prevention and incidence of STIs. The findings of this review will assess this emerging public health phenomenon and serve to inform future public health policy. No formal ethical review is required for this protocol. All findings will be published in a peer reviewed journal.PROTOCOL registration numberCRD42019128720.
Role of patient preferences in clinical practice guidelines: a multiple methods study using guidelines from oncology as a case
Authors: Gärtner Fania R , Portielje Johanneke E , Langendam Miranda , Hairwassers Desiree , Agoritsas Thomas , Gijsen Brigitte , Liefers Gerrit-Jan , Pieterse Arwen H , Stiggelbout Anne M 
Published: December 2019

ObjectiveMany treatment decisions are preference-sensitive and call for shared decision-making, notably when benefits are limited or uncertain, and harms impact quality of life. We explored if clinical practice guidelines (CPGs) acknowledge preference-sensitive decisions in how they motivate and phrase their recommendations.DesignWe performed a qualitative analysis of the content of CPGs and verified the results in semistructured interviews with CPG panel members.SettingDutch oncology CPGs issued in 2010 or later, concerning primary treatment with curative intent.Participants14 CPG panel members.Main outcomesFor treatment recommendations from six CPG modules, two researchers extracted the following: strength of recommendation in terms of the Grading of Recommendations Assessment, Development and Evaluation and its consistency with the CPG text; completeness of presentation of benefits and harms; incorporation of patient preferences; statements on the panel’s benefits–harm trade-off underlying recommendation; and advice on patient involvement in decision-making.ResultsWe identified 32 recommendations, 18 were acknowledged preference-sensitive decisions. Three of 14 strong recommendations should have been weak based on the module text. The reporting of benefits and harms, and their probabilities, was sufficiently complete and clear to inform the strength of the recommendation in one of the six modules only. Numerical probabilities were seldom presented. None of the modules presented information on patient preferences. CPG panel’s preferences were not made explicit, but appeared to have impacted 15 of 32 recommendations. Advice to involve patients and their preferences in decision-making was given for 20 recommendations (14 weak). Interviewees confirmed these findings. Explanations for lack of information were, for example, that clinicians know the information and that CPGs must be short. Explanations for trade-offs made were cultural-historical preferences, compliance with daily care, presumed role of CPGs and lack of time.ConclusionsThe motivation and phrasing of CPG recommendations do not stimulate choice awareness and a neutral presentation of options, thus hindering shared decision-making.
New warfarin anticoagulation management model after heart valve surgery: rationale and design of a prospective, multicentre, randomised trial to compare an internet-based warfarin anticoagulation management model with the traditional warfarin management model
Authors: Zhu Zhihui , Li Yuehuan , Meng Xu , Han Jie , Li Yan , Liu Kun , Shen Jinglun , Qin Ying , Zhang Haibo 
Published: December 2019

IntroductionWarfarin is an effective anticoagulant and the only oral anticoagulant available for patients with mechanical heart valves. The prothrombin time and the associated international normalised ratio (INR) are routinely tested to monitor the response to anticoagulation therapy in patients. Patients who undergo mechanical heart valve replacement need lifelong anticoagulation therapy, and their INR is regularly measured to adjust the anticoagulation strength and the dose of anticoagulation drugs. Appropriate warfarin anticoagulation management can reduce patient complications, such as bleeding and thrombosis, and improve the long-term survival rate. We propose modern internet technology as a platform to build a warfarin anticoagulation follow-up system after valve replacement surgery. This system will provide doctors and patients with more standardised and safer follow-up methods as well as a method to further reduce the risk of warfarin anticoagulation-related complications and improve its therapeutic effects.Methods and analysisA prospective, multicentre, randomised, controlled trial will be conducted. A total of 700 patients who require long-term warfarin anticoagulation monitoring after heart valve replacement will be enrolled and randomly divided at a 1:1 ratio into a traditional outpatient anticoagulation management group and a group undergoing a new method of management based on the internet technology with follow-up for 1 year. Differences in the percentage of time in the therapeutic range (TTR), drug dose adjustments, bleeding/thrombosis and other related complications will be observed. The primary endpoint is the difference in the TTR between the two groups. The purpose of this study is to explore a safer and more effective mode of doctor–patient interaction and communication in the internet era. As of 13 July 2019, 534 patients had been enrolled.Ethics and disseminationThis study protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. The results will be published in a peer-reviewed medical journal.Trial registration numberChiCTR1800016204.
Association between prescription of hypnotics/anxiolytics and mortality in multimorbid and non-multimorbid patients: a longitudinal cohort study in primary care
Authors: Linnet Kristjan , Sigurdsson Johann Agust , Tomasdottir Margret Olafia , Sigurdsson Emil Larus , Gudmundsson Larus Steinthor 
Published: December 2019

ObjectivesTo assess the risk of mortality in primary care patients, multimorbid (≥2 chronic conditions) or not, prescribed hypnotics/anxiolytics.DesignA longitudinal cohort studySettingPrimary healthcare in the Reykjavik area.Participants114 084 individuals (aged 10–79 years, average 38.5, SD 18.4) contacting general practitioners during 2009–2012 (mortality follow-up to 31 December 2016). Of those, the reference group comprised 58 560 persons who were neither multimorbid nor had redeemed prescriptions for hypnotics/anxiolytics. Participants (16 108) redeeming prescriptions for hypnotics/anxiolytics on a regular basis for 3 consecutive years were considered as consistent, long-term users. They were subdivided into low-dose (1–300 defined daily doses (DDD)/3 years), medium-dose (301–1095 DDDs/3 years) and high-dose users (>1095 DDDs/3 years). All six groups taking these drugs were compared with the reference group.Main outcome measuresAll-cause mortality.ResultsHRs were calculated with the no multimorbidity—no drug group as a reference, using Cox proportional hazards regression model adjusting for age, sex and the number of chronic conditions (n=111 767), patients with cancer excluded. During follow-up, 516 358 person-years in total, 1926 persons died. Mean follow-up was 1685 days (4.6 years), range 1–1826 days (5.0 years). For all multimorbid patients who took no drugs the HR was 1.14 (95% CI 1.00 to 1.30) compared with those without multimorbidity. HRs in the non-multimorbid participants varied from 1.49 to 3.35 (95% CI ranging from 1.03 to 4.11) with increasing doses of hypnotics/anxiolytics, and correspondingly from 1.55 to 3.52 (1.18 to 4.29) in multimorbid patients.ConclusionsMortality increased in a dose-dependent manner among both multimorbid and non-multimorbid patients taking hypnotics/anxiolytics. This increase was clearly associated with prescribing of these drugs. Their use should be limited to the recommended period of 2–4 up to 6 weeks; long-term use may incur increased risk and should be re-examined.