bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Branching Redesign Technique Used for Upgrading Steel-Pipes-Based Hydraulic Systems: Re-Examined
Authors: Chaker Mohamed Amir , Triki Ali 
Published: July 2020

Abstract
The branching technique demonstrated an effective ability to attenuate severe hydraulic-head magnitudes into existing steel-pipes-based hydraulic systems. However, there was no detailed exploration of circumferential-stress, radial-strain, and wave-oscillation period behaviors, which are equally embedded in the design stage of hydraulic systems. Accordingly, this paper examined these last parameters to provide relevant information on the entire design key parameters. The numerical solver used the Method of Characteristics for discretizing the extended one-dimensional water-hammer model incorporating the Vitkovsky and the Kelvin–Voigt formulations along with the discrete gas cavity model to represent column separation. The plastic short-penstock material types utilized in this study included high- or low-density polyethylene (HDPE or LDPE). Results demonstrated that the branching technique is promising in terms of hydraulic-head attenuation waves; however, this research emphasized the limitation of this technique, not previously delineated, including the amplification of the radial-strain peaks or crests and the spreading of the wave-oscillation period. Ultimately, a methodology was suggested for optimizing the plastic short-penstock diameter and length parameters.
A Bionic Hierarchy Generative Design for Conductive Heat Transfer
Authors: Lin Qiyin , Liu Lian , Wang Jihong , Yan Ke , Guo Junkang , Su Wenjun 
Published: July 2020

Abstract
A bionic hierarchy generative design algorithm inspired by the leaf vein growth process is presented for the layout design of heat conduction channels. The design domain is discretized based on the element-free Galerkin (EFG) method. The generations of main channels and lateral channels are separated. The effectiveness of the developed bionic hierarchy generative design approach is investigated based on the general “volume-to-point” heat conduction problem.
Rotational Effect on Flow Field and Thermal Characteristics of a Turboexpander for Helium Liquefaction System: A Numerical Perspective
Authors: Kumar Manoj , Behera Suraj K. , Kumar Amitesh , Sahoo Ranjit K. 
Published: July 2020

Abstract
Cryogenic turboexpander is an essential component to produce the refrigeration effect in various helium liquefaction systems. The convergent nozzle and small-scale radial inflow turbine (turboexpander) are the important components that are responsible for increasing the performance of the cycle. In this paper, an optimum preliminary design approach of the turbine and nozzle is explained using real gas properties. Initially, the Sobol method is used to determine the sensitivity indices and optimized range of ten important nondimensional and geometrical variables for better performance of the radial turbine. Three turboexpanders of a modified Collins cycle-based helium liquefaction system have been designed considering the optimized ranges. The proposed method improves the isentropic efficiency and power output of the turbine up to 3.86% and 5.14%, respectively, as compared to the initial design. Hereafter, a comparative three-dimensional numerical analysis is conducted to characterize the flow physics and thermal properties of three turboexpander systems (16 bar and 40 K, 6 bar and 20 K, and 16 bar and 10 K). The thermal and fluid flow properties such as temperature, Prandtl number, static enthalpy, entropy, velocity vectors, Reynolds number, and turbulence kinetic energy are determined at different spans and streamwise locations. Moreover, the present numerical results are also verified with the experimental and numerical results obtained from the existing literature. The study highlights the optimal range of design variables for helium turbine, the methodology for helium liquefaction system, and the numerical analysis to understand the flow physics and thermal properties of helium near its boiling point.
Children with type 1 diabetes have elevated high-sensitivity C-reactive protein compared with a control group
Authors: Pérez-Segura Pilar , de Dios Olaya , Herrero Leticia , Vales-Villamarín Claudia , Aragón-Gómez Isabel , Gavela-Pérez Teresa , Garcés Carmen , Soriano-Guillén Leandro 
Published: July 2020

IntroductionOur objective was to compare high-sensitivity C-reactive protein (hsCRP) levels in children with type 1 diabetes, healthy controls, and children with obesity. Additionally, we aimed to analyze the association between hsCRP levels and glycemic control measured by glycohemoglobin A (HbA1c) and anthropometric and biochemical variables.Research design and methodsWe conducted a non-randomized descriptive study of children with type 1 diabetes matched for sex and age with a control group and group with obesity. We recorded anthropometric parameters and studied variables related to diabetes, blood pressure, lipid profile, and HbA1c. hsCRP was measured by ELISA.ResultsWe included 49 children with type 1 diabetes, 46 controls, and 40 children with obesity. hsCRP levels were significantly higher in the group with type 1 diabetes compared with controls and nearly significantly lower than in the group comprising children with obesity. We found no correlation between hsCRP and HbA1c and characteristics of type 1 diabetes with the exception of albumin to creatinine ratio. Statistically significant association was found between hsCRP and body mass index (BMI) and waist circumference Z-score.ConclusionsThe higher hsCRP levels observed in children with type 1 diabetes compared with a control group with a similar BMI suggest a basal inflammatory state that could increase cardiovascular risk. The main factors related to hsCRP are BMI and waist circumference, so obesity prevention should be a priority when performing follow-up in children with type 1 diabetes.
Moving beyond the Cox proportional hazards model in survival data analysis: a cervical cancer study
Authors: Li Lixian , Yang Zijing , Hou Yawen , Chen Zheng 
Published: July 2020

ObjectivesThis study explored the prognostic factors and developed a prediction model for Chinese-American (CA) cervical cancer (CC) patients. We compared two alternative models (the restricted mean survival time (RMST) model and the proportional baselines landmark supermodel (PBLS model, producing dynamic prediction)) versus the Cox proportional hazards model in the context of time-varying effects.Setting and data sourcesA total of 713 CA women with CC and available covariates (age at diagnosis, International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis and radiation) from the Surveillance, Epidemiology and End Results database were included.DesignWe applied the Cox proportional hazards model to analyse the all-cause mortality with the proportional hazards assumption. Additionally, we applied two alternative models to analyse covariates with time-varying effects. The performances of the models were compared using the C-index for discrimination and the shrinkage slope for calibration.ResultsOlder patients had a worse survival rate than younger patients. Advanced FIGO stage patients showed a relatively poor survival rate and low life expectancy. Lymph node metastasis was an unfavourable prognostic factor in our models. Age at diagnosis, FIGO stage and lymph node metastasis represented time-varying effects from the PBLS model. Additionally, radiation showed no impact on survival in any model. Dynamic prediction presented a better performance for 5-year dynamic death rates than did the Cox proportional hazards model.ConclusionsWith the time-varying effects, the RMST model was suggested to explore diagnosis factors, and the PBLS model was recommended to predict a patient’s w-year dynamic death rate.
Multimorbidity patterns in low-middle and high income regions: a multiregion latent class analysis using ATHLOS harmonised cohorts
Authors: Bayes-Marin Ivet , Sanchez-Niubo Albert , Egea-Cortés Laia , Nguyen Hai , Prina Matthew , Fernández Daniel , Haro Josep Maria , Olaya Beatriz 
Published: July 2020

ObjectivesOur aim was to determine clusters of non-communicable diseases (NCDs) in a very large, population-based sample of middle-aged and older adults from low- and middle-income (LMICs) and high-income (HICs) regions. Additionally, we explored the associations with several covariates.DesignThe total sample was 72 140 people aged 50+ years from three population-based studies (English Longitudinal Study of Ageing, Survey of Health, Ageing and Retirement in Europe Study and Study on Global Ageing and Adult Health) included in the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and representing eight regions with LMICs and HICs. Variables were previously harmonised using an ex-post strategy. Eight NCDs were used in latent class analysis. Multinomial models were made to calculate associations with covariates. All the analyses were stratified by age (50–64 and 65+ years old).ResultsThree clusters were identified: ‘cardio-metabolic’ (8.93% in participants aged 50–64 years and 27.22% in those aged 65+ years), ‘respiratory-mental-articular’ (3.91% and 5.27%) and ‘healthy’ (87.16% and 67.51%). In the younger group, Russia presented the highest prevalence of the ‘cardio-metabolic’ group (18.8%) and England the ‘respiratory-mental-articular’ (5.1%). In the older group, Russia had the highest proportion of both classes (48.3% and 9%). Both the younger and older African participants presented the highest proportion of the ‘healthy’ class. Older age, being woman, widowed and with low levels of education and income were related to an increased risk of multimorbidity. Physical activity was a protective factor in both age groups and smoking a risk factor for the ‘respiratory-mental-articular’.ConclusionMultimorbidity is common worldwide, especially in HICs and Russia. Health policies in each country addressing coordination and support are needed to face the complexity of a pattern of growing multimorbidity.
Abductor muscle strength deficit in patients after total hip arthroplasty for hip osteoarthritis: a protocol for a systematic review and meta-analysis
Authors: Ismailidis Petros , Kvarda Peter , Vach Werner , Appenzeller-Herzog Christian , Mündermann Annegret 
Published: July 2020

IntroductionConservation of abductor muscle strength is directly associated with physical function after total hip replacement (THA). Although many studies have tried to explore and quantify a potential abductor muscle strength deficit after THA as well as identify possible causes and treatment options, this topic has not been addressed systematically.Methods and analysisHuman-based studies reporting measurements of hip abductor strength will be included in this review. Studies reporting on hip abductor strength measured manually or isometric measurements at an abduction angle other than 0° will not be considered. No restriction will be placed on study design, publication date operative approach, prosthesis design, age and sex of the patients or severity of OA. Data sources will be Embase via embase.com, Medline ALL via Ovid and the Cochrane Central Register of Controlled Trials. The preliminary search was conducted on 5 May 2019. Data regarding absolute values or torque ratio of hip abductor torque between sides as well as patient demographic data, surgical approaches and rehabilitation protocols will be extracted. The assessment of quality and risk of bias will be performed with the modified Newcastle-Ottawa Scale. The screening, data extraction and quality assessment will be performed by two reviewers independently. Where necessary, a third review author will make a final judgement. Narrative synthesis as well as tabular presentation of the extracted data will be included. Whenever possible, metaregression and subgroup specific meta-analyses will be used to investigate the influence of time since THA and type of measurement (isokinetic or isometric) on the different outcomes. In case of sufficient information, these analyses will be extended to include characteristics such as age, sex, surgical approach or rehabilitation programme.Ethics and disseminationNo ethics approval is required. The results will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42020153185.
Effectiveness of intraoperative peritoneal lavage (IOPL) with saline in patient with intra-abdominal infections: a systematic review and meta-analysis protocol
Authors: Zhou Qi , Shi Qianling , Yu Xuan , Wang Zijun , Zhang Jingyi , Yang Nan , Wang Jianjian , Ma Yanfang , Luo Xufei , Xun Yangqin , Zhao Siya , Zheng Bobo , Meng Wenbo , Yang Kehu , Chen Yaolong , Sawyer Robert 
Published: July 2020

IntroductionIntra-abdominal infections (IAIs) are common surgical emergencies and cause a significant worldwide burden per year. Since the concept of intraoperative peritoneal lavage (IOPL) was proposed in 1905, it has been widely used in the surgery practice. However, the effectiveness of IOPL in patients with IAIs has always been controversial. Our objective is to identify whether it is beneficial to flush the abdominal cavity with saline in IAIs surgery through a comprehensive systematic review and meta-analysis.Methods and analysisThis protocol is reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Electronic databases (including the Cochrane library, MEDLINE, EMBASE, Web of Science, etc) and clinical trial registry platforms will be searched from inception to 8 September 2019. Randomised controlled trials, quasi-randomised clinical trials and cohort studies comparing IOPL and suction alone in IAIs will be included. The primary outcomes are mortality and abscess rate. Two independent reviewers will screen literature, collect data and assess risk of bias of included studies. Discussion or a third reviewer will be referred for any disagreements. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to assess the quality of the evidence. We will perform meta-analysis using random-effects model. Subgroup analysis, sensitivity analysis and publication bias will be conducted if data are enough.Ethics and disseminationEthical approval is not required for this systematic review and meta-analysis protocol. Results of this study will be published in a peer-reviewed journal, presented at relevant conferences and disseminated to local and international policy makers.PROSPERO registration numberCRD42019145109.
Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study
Authors: Villarreal-Zegarra David , Cabrera-Alva Milagros , Carrillo-Larco Rodrigo M , Bernabe-Ortiz Antonio 
Published: July 2020

ObjectivesThis study aimed to estimate the trends in the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru from 2014 to 2018.DesignA secondary analysis was conducted using five nationally representative surveys carried out consecutively in the years between 2014 and 2018.SettingThe study was conducted in Peru.ParticipantsIndividuals, men and women, aged ≥15 years who participated in the selected surveys. Sampling was probabilistic using a two-stage approach.Main outcome measuresTwo versions of the Patient Health Questionnaire (PHQ-9) that focused on the presence of depressive symptoms were administered (one in the last 2 weeks and other in the last year). Scores ≥15 were used as the cut-off point in both versions of the PHQ-9 to define the presence of depressive symptoms. Also, the treatment rate was based on the proportion of individuals who had experienced depressive symptoms in the last year and who had self-reported having received specific treatment for these symptoms. The age-standardised prevalence was estimated.ResultsA total of 161 061 participants were included. There was no evidence of a change in age-standardised prevalence rates of depressive symptoms at the 2 weeks prior to the point of data collection (2.6% in 2014 to 2.3% in 2018), or in the last year (6.3% in 2014 to 6.2% in 2018). Furthermore, no change was found in the proportion of depressive cases treated in the last year (14.6% in 2014 to 14.4% in 2018). Rural areas and individuals with low-level of wealth had lower proportion of depressive cases treated.ConclusionsNo changes in trends of rates of depressive symptoms or in the proportion of depressive cases treated were observed. This suggests the need to reduce the treatment gap considering social determinants associated with inequality in access to adequate therapy.
Survey of physician attitudes to using multisource feedback for competence assessment in Alberta
Authors: Ashworth Nigel , Kain Nicole Allison , Jess Ed , Mazurek Karen 
Published: July 2020

BackgroundThe use of multisource feedback (MSF) for assessing physician performance is widespread and rapidly growing. Findings from early very small research studies using highly selected participants suggest high levels of satisfaction and support. However, after nearly two decades of experience using MSF to evaluate all physicians in Alberta, we are sceptical of this.ObjectivesTo determine physicians’ actual opinions of MSF using the entire physician population of Alberta, CanadaDesignOnline survey.SettingAlberta, Canada.ParticipantsAll physicians with a full licence to practice in Alberta in 2015.InterventionsAll participants were asked to grade how well they thought MSF was at assessing various aspects of physician performance using a 10-point Likert-type scale. There was also a text response field for written comments.OutcomesMean responses to quantitative questions. Qualitative content and thematic analysis of open-ended text responses.We analysed the data using SPSS V.23 and NVivo V.11 and built a multivariate model highlighting the predictors of high and low opinions of MSF.ResultsSurvey response rate was high for physicians with 2215 responses (25%). The mean rating for how successful MSF was at assessing a variety of dimensions, varied from a low of 5.03/10 for medical knowledge to a high of 6.38/10 for professionalism and communication. Canadian-trained MDs rated MSF significantly lower on every dimension by approximately 20% compared with non-Canadian-trained MDs.ConclusionsAlberta physicians have much lower opinions about the ability of MSF to measure any dimension of their performance than what has been suggested in the literature. Canadian-trained MDs have a particularly low opinion of MSF for reasons that remain unclear. The results of this survey offer a serious challenge to the effectiveness of a programme that is designed to promote self-reflection and performance improvement.
Prospective long-term follow-up analysis of the cardiovascular system in marathon runners: study design of the Pro-MagIC study
Authors: Schoenfeld Julia , Schindler Michael Johannes , Haller Bernhard , Holdenrieder Stefan , Nieman David Christopher , Halle Martin , La Gerche André , Scherr Johannes 
Published: July 2020

IntroductionProlonged strenuous exercise training may result in structural, functional and electrical cardiac remodelling, as well as vascular and myocardial injuries. However, the extent to which high-volume, intense exercise is associated with arrhythmias, myocardial fibrosis, coronary heart disease and pathological alterations of the vasculature remains unknown. In addition, there is no clear consensus on the clinical significance of these exercise-induced changes. Previous studies typically used cross-sectional designs and examined exercise-induced cardiovascular changes in small cohorts of athletes for up to 3–7 days of recovery. Long-term longitudinal studies investigating cardiovascular changes induced by prolonged strenuous exercise in large cohorts of athletes are needed to improve scientific understanding in this area.Methods and analysisIn this prospective observational monocenter study, 277 participants of the Beer, Marathon, Genetics, Inflammation and the Cardiovascular System (Be-MaGIC) study (ClinicalTrials.gov:NCT00933218) will be invited to participate in this 10-year follow-up study. A minimum target sample size of 130 participants will be included in the study. Participating athletes will be examined via the following: anthropometry, resting electrocardiography and echocardiography, blood sampling, retinal vessel diameters, carotid sonography and cardiopulmonary exercise testing, including exercise electrocardiography.DiscussionThis longitudinal study will provide comprehensive data on physiological changes in the cardiovascular system and the development of pathologies after a 10-year period of prolonged and strenuous endurance exercise. Since the participants will have engaged in a wide range of training loads and competitive race events, this study will provide useful risk factor determinants and training load cut-off values. The primary endpoint is the association between the exercise-induced increase in cardiac troponin during the Munich marathon 2009 and the decline in right ventricular ejection fraction over the next 10 years.Trial registration numberNCT04166903.
Monocyte-derived APCs are central to the response of PD1 checkpoint blockade and provide a therapeutic target for combination therapy
Authors: Schetters Sjoerd T T , Rodriguez Ernesto , Kruijssen Laura J W , Crommentuijn Matheus H W , Boon Louis , Van den Bossche Jan , Den Haan Joke M M , Van Kooyk Yvette 
Published: July 2020

BackgroundPD1 immune checkpoint blockade (αPD1 ICB) has shown unparalleled success in treating many types of cancer. However, response to treatment does not always lead to tumor rejection. While αPD1 ICB relies on cytotoxic CD8+T cells, antigen-presenting cells (APCs) at the tumor site are also needed for costimulation of tumor-infiltrating lymphocytes (TILs). It is still unclear how these APCs develop and function before and during αPD1 ICB or how they are associated with tumor rejection.MethodsHere, we used B16 mouse melanoma and MC38 colorectal carcinoma tumor models, which show differential responses to αPD1 ICB. The immune composition of ICB insensitive B16 and sensitive MC38 were extensively investigated using multi-parameter flow cytometry and unsupervised clustering and trajectory analyses. We additionally analyzed existing single cell RNA sequencing data of the myeloid compartment of patients with melanoma undergoing αPD1 ICB. Lastly, we investigated the effect of CD40 agonistic antibody on the tumor-infiltrating monocyte-derived cells during αPD1 ICB.ResultsWe show that monocyte-derived dendritic cells (moDCs) express high levels of costimulatory molecules and are correlated with effector TILs in the tumor microenvironment (TME) after αPD1 ICB only in responding mouse tumor models. Tumor-resident moDCs showed distinct differentiation from monocytes in both mouse and human tumors. We further confirmed significant enrichment of tumor-resident differentiated moDCs in patients with melanoma responding to αPD1 ICB therapy compared with non-responding patients. Moreover, moDCs could be targeted by agonistic anti-CD40 antibody, supporting moDC differentiation, effector T-cell expansion and anti-tumor immunity.ConclusionThe combined analysis of myeloid and lymphoid populations in the TME during successful and non-successful PD1 ICB led to the discovery of monocyte-to-DC differentiation linked to expanding T-cell populations. This differentiation was found in patients during ICB, which was significantly higher during successful ICB. The finding of tumor-infiltrating monocytes and differentiating moDCs as druggable target for rational combination therapy opens new avenues of anti-tumor therapy design.