bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Shroud Cavity Leakage in a Radial Turbine for Optimal Operation in Compressed Air Energy Storage System
Authors: Shao Ziyi , Li Wen , Wang Xing , Zhang Xuehui , Chen Haisheng 
Published: June 2020

Abstract
As an important energy generation device of the compressed air energy storage (CAES) system, the radial-inflow turbine with shrouded impeller is employed to avoid the leakage flow in the rotor, especially in the high-pressure stages. However, a lack of clarity in the leakage characteristics and their drivers still prevents a systematic approach to the efficient performance and proper design of the shrouded radial turbine. In the present work, the shroud cavity leakage of the shrouded radial turbine has been studied numerically. The physical quantity synergy is innovatively employed to research the internal flow field of the shroud cavity. It is found that the influence of high rotating speed on the seal leakage cannot be neglected, and the average reduced rate of seal leakage is found to be about 9.9% for the designed clearance. The leakage mass flow rate could be reduced by increasing the rotating speed or decreasing the seal clearance. The synergy angle is able to predict the flow resistance in shroud cavity very well. According to the volume-averaged synergy angle in the seal, the dimensionless seal clearance smaller than 1.5% in the shrouded radial turbine is recommended. Compared with the seal clearance in other high-pressure shrouded turbomachines, the current recommended clearance should be within a reasonable field.
The Influence of Anterior Cruciate Ligament Matrix Mechanical Properties on Simulated Whole-Knee Biomechanics
Authors: Rosario Ryan , Marchi Benjamin C. , Arruda Ellen M. , Coleman Rhima M. 
Published: June 2020

Abstract
Knee finite element (FE) models are used to study tissue deformation in response to complex loads. Typically, ligaments are modeled using transversely isotropic, hyperelastic material models fitted to tension data along the predominant fiber direction (longitudinal) and, less commonly, to tension data orthogonal to the fiber direction (transverse). Currently, the shear and bulk responses of the anterior cruciate ligament (ACL) are not fitted to experimental data. In this study, a newly proposed material model was fitted to longitudinal tension, transverse tension, and shear experimental data. The matrix transverse tensile, shear, and bulk stiffnesses were then varied independently to determine the impact of each property on knee kinematics and tissue deformation in a whole-knee FE model. The range of values for each parameter was chosen based on published FE studies of the knee. For a knee at full extension under 134 N anterior tibial force (ATF), increasing matrix transverse tensile stiffness, shear stiffness, or bulk stiffness decreased anterior tibial translation (ATT), ACL longitudinal strain, and ACL shear strain. For a knee under 134 N ATF and 1600 N compression, changing the ACL matrix mechanical properties caused variations in ATT and thus changed cartilage deformation contours by changing the point of contact between the femoral and the tibial cartilage. These findings indicate that material models for the ACL must describe matrix material properties to best predict the in vivo response to applied loads.
The Effect of the Loading Rate on the Full-Field Strain Distribution on the Surface on the Intervertebral Discs
Authors: Maria Luisa Ruspi , Luca Cristofolini 
Published: June 2020

Abstract
Contrasting results are reported when the spine is tested at different strain rates. Tissue specimens from the ligaments or the intervertebral discs (IVD, including annulus fibrosus and nucleus pulposus) exhibit higher stiffness and lower dissipation at high strain rates. Counterintuitively, when spine segments are tested at high rates, the hysteresis area and loop width increase. It is unclear how the load is shared between the different structures at different loading rates. The hypotheses of this study were: (i) As the IVD stiffens at higher loading rates, the strain distribution around the disc would be different depending on the loading rate; (ii) Preconditioning attenuates the strain-rate dependency of the IVD, thus making differences in strain distribution smaller at the different rates. Six segments of three vertebrae (L4–L6) were extracted from porcine spines and tested in presso-flexion at different loading rates (reaching full load in 0.67, 6.7, and 67 s). The full-field strain maps were measured using digital image correlation on the surface of the IVDs from lateral. The posterior-to-anterior trends of the strain were computed in detail for each IVD, and compared between loading rates. The values and the direction of principal strain on the surface of the IVDs, vertebrae, and endplates remained unchanged at different rates. In the transition zone between IVD and vertebra, only slight differences due to the loading rate appeared but with no statistical significance. These findings will allow better understanding of the rate-dependent behavior and failure of the IVD.
Investigating the Effects of Demographics on Shoulder Morphology and Density Using Statistical Shape and Density Modeling
Authors: Soltanmohammadi Pendar , Elwell Josie , Veeraraghavan Vishnu , Athwal George S. , Willing Ryan 
Published: June 2020

Abstract
A better understanding of how the shape and density of the shoulder vary among members of a population can help design more effective population-based orthopedic implants. The main objective of this study was to develop statistical shape models (SSMs) and statistical density models (SDMs) of the shoulder to describe the main modes of variability in the shape and density distributions of shoulder bones within a population in terms of principal components (PCs). These PC scores were analyzed, and significant correlations were observed between the shape and density distributions of the shoulder and demographics of the population, such as sex and age. Our results demonstrated that when the overall body sizes of male and female donors were matched, males still had, on average, larger scapulae and thicker humeral cortical bones. Moreover, we concluded that age has a weak but significant inverse effect on the density within the entire shoulder. Weak and moderate, but significant, correlations were also found between many modes of shape and density variations in the shoulder. Our results suggested that donors with bigger humeri have bigger scapulae and higher bone density of humeri corresponds with higher bone density in the scapulae. Finally, asymmetry, to some extent, was noted in the shape and density distributions of the contralateral bones of the shoulder. These results can be used to help guide the designs of population-based prosthesis components and pre-operative surgical planning.
Improving Utilization of Maximal Oxygen Uptake and Work Economy in Recreational Cross-Country Skiers With High-Intensity Double-Poling Intervals
Authors: Johansen Jan-Michael , Eriksen Sondre , Sunde Arnstein , Slettemeås Øystein B. , Helgerud Jan , Støren Øyvind 
Published: June 2020

Purpose:To investigate the effect of a double-poling (DP) high-intensity aerobic interval-training (HIT) intervention performed without increasing total HIT volume. This means that regular HIT training (eg, running) was replaced by HIT DP. The aim was to explore whether this intervention could improve peak oxygen uptake in DP, the fractional utilization of maximal oxygen uptake (VO2max) in DP, oxygen cost of DP, maximal aerobic speed, and a 3-km DP time trial.Methods:Nine non-specially-DP-trained cross-country skiers (intervention group) and 9 national-level cross-country skiers (control group) were recruited. All participants were tested for VO2max in running, peak oxygen uptake in DP, oxygen cost of DP, and time-trial performance before and after a 6-wk, 3-times-per-week HIT DP intervention. The intervention group omitted all regular HIT with HIT in DP, leaving the total weekly amount of HIT unchanged.Results:Seven participants in each group completed the study. VO2max in running remained unchanged in both groups, whereas peak oxygen uptake in DP improved by 7.1% (P = .005) in the intervention group. The fractional utilization of VO2max in DP thus increased by 7.3% (P = .019), oxygen cost of DP by 9.2% (P = .047), maximal aerobic speed by 16.5% (P = .009), and time trial by 19.5% (P = .004) in the intervention group but remained unchanged in the control group.Conclusions:The results indicate that a 6-wk HIT DP intervention could be an effective model to improve DP-specific capacities, with maintenance of VO2max in running.
Colon capsule endoscopy in colorectal cancer screening: a randomised controlled trial
Authors: Kaalby Lasse , Deding Ulrik , Kobaek-Larsen Morten , Havshoi Anne-Line Volden , Zimmermann-Nielsen Erik , Thygesen Marianne Kirstine , Kroijer Rasmus , Bjørsum-Meyer Thomas , Baatrup Gunnar 
Published: June 2020

IntroductionThe use of capsule endoscopy has become an approved method in small bowel diagnostics, but the same level of integration is not seen in large bowel diagnostics. We will use colon capsule endoscopy (CCE) as a filter test in colorectal cancer (CRC) screening between the faecal immunochemical test (FIT) and colonoscopy. We aim to investigate the clinical performance, population acceptability, and economic implications of the procedure in a large-scale clinical trial.Methods and analysisWe will randomly allocate 124 214 Danish citizens eligible for participation in the national CRC screening programme within the Region of Southern Denmark to either an intervention group or a control group. Prior to submitting a FIT, citizens randomised to the intervention group will be informed about their opportunity to undergo CCE, instead of colonoscopy, if the FIT is positive. Suspected cancers; >3 adenomas <10 mm in size, 1 adenoma >10 mm in size or >4 adenomas regardless of size, detected during CCE will generate an invitation to colonoscopy as per regular screening guidelines, whereas citizens with suspected low risk polyps will re-enter the biennial screening programme. Citizens with no CCE findings will be excluded from screening for 8 years. In the control group, citizens will follow standard screening procedures.Ethics and disseminationAll participants must consent prior to capsule ingestion. All collected data will be handled and stored in accordance with current data protection legislation. Approvals from the regional ethics committee (ref. S-20190100) and the Danish data protection agency have been obtained (ref. 19/29858).Trial registration detailsThe study has been registered with ClinicalTrials.gov under:NCT04049357.
Spatial and epidemiological drivers ofPlasmodium falciparummalaria among adults in the Democratic Republic of the Congo
Authors: Deutsch-Feldman Molly , Brazeau Nicholas F , Parr Jonathan B , Thwai Kyaw L , Muwonga Jeremie , Kashamuka Melchior , Tshefu Kitoto Antoinette , Aydemir Ozkan , Bailey Jeffrey A , Edwards Jessie K , Verity Robert , Emch Michael , Gower Emily W , Juliano Jonathan J , Meshnick Steven R 
Published: June 2020

BackgroundAdults are frequently infected with malaria and may serve as a reservoir for further transmission, yet we know relatively little about risk factors for adult infections. In this study, we assessed malaria risk factors among adults using samples from the nationally representative, cross-sectional 2013–2014 Demographic and Health Survey (DHS) conducted in the Democratic Republic of the Congo (DRC). We further explored differences in risk factors by urbanicity.MethodsPlasmodium falciparuminfection was determined by PCR. Covariates were drawn from the DHS to model individual, community and environmental-level risk factors for infection. Additionally, we used deep sequencing data to estimate the community-level proportions of drug-resistant infections and included these estimates as potential risk factors. All identified factors were assessed for differences in associations by urbanicity.ResultsA total of 16 126 adults were included. Overall prevalence of malaria was 30.3% (SE=1.1) by PCR; province-level prevalence ranged from 6.7% to 58.3%. Only 17% of individuals lived in households with at least one bed-net for every two people, as recommended by the WHO. Protective factors included increasing within-household bed-net coverage (Prevalence Ratio=0.85, 95% CI=0.76–0.95) and modern housing (PR=0.58, 95% CI=0.49–0.69). Community-level protective factors included increased median wealth (PR=0.87, 95% CI=0.83–0.92). Education, wealth, and modern housing showed protective associations in cities but not in rural areas.ConclusionsThe DRC continues to suffer from a high burden of malaria; interventions that target high-risk groups and sustained investment in malaria control are sorely needed. Areas of high prevalence should be prioritised for interventions to target the largest reservoirs for further transmission.
MEDLINK: a low-cost, portable, verbally interactive and programmable remote patient monitoring (RPM) device
Authors: Ejofodomi O'tega , Zara Jason , Ofualagba Godswill 
Published: June 2020

Remote patient monitoring (RPM) devices are a novel method for physicians to monitor their patients after discharge and long after they have gone home. Usually RPM devices are bulky, relatively expensive, restricted in the physiological parameters they measure and are hard to operate.MEDLINK is a low cost (~$C1500), verbally interactive, programmable and portable RPM device that possesses the ability to verbally interact with a physician to obtain his or her information as well as the patient’s key statistics, and then to obtain the physician’s selection of physiological parameters he or she wishes to remotely monitor from that particular patient. When the patient switches on the unit, MEDLINK also verbally interacts with the patient to measure and acquire the physician’s selected physiological parameter and sends this information to the physician’s phone, via text messages and emails. Security and privacy of patient’s medical data can be preserved by using the patient’s ID instead of patient name.Physiological parameters that can be acquired by MEDLINK include: ECG, blood pressure, heart rate, blood glucose, pulse rate, blood oxygen saturation, electromyography, body temperature, spirometer, respiratory rate and much more. Future work involves the integration of more biomedical sensors to the existing MEDLINK product to expand its range of measurable physiological parameters to its maximum, and to conduct a short clinical trial on the product prior to commercialisation.
Lessons learned: using adverse incident reports to investigate the characteristics and causes of prescribing errors
Authors: Lane Natalie , Hunter Ian 
Published: June 2020

IntroductionPrescribing errors are a principal cause of preventable harm in healthcare. This study aims to establish a systematic approach to analysing prescribing-related adverse incident reports, in order to elucidate the characteristics and contributing factors of common prescribing errors and target multifaceted quality improvement initiatives.MethodsAll prescribing-related adverse incident reports submitted across one NHS board over 12 months were selected. Incidents involving commonly implicated drugs (involved in ≥10 incidents) underwent analysis to establish likely underlying causes using Reason’s Model of Accident Causation.Results330 prescribing-related adverse incident reports were identified. Commonly implicated drugs were insulin (10% of incidents), gentamicin (7%), co-amoxiclav (5%) and amoxicillin (5%). The most prevalent error types were prescribing amoxicillin when contraindicated due to allergy (5%); prescribing co-amoxiclav when contraindicated due to allergy (5%); prescribing the incorrect type of insulin (3%); and omitting to prescribe insulin (3%). Error-producing factors were identified in 86% of incidents involving commonly implicated drugs. 53% of incidents involved error-producing factors related to the working environment; 38% involved factors related to the healthcare team; and 37% involved factors related to the prescriber.DiscussionThis study establishes that systematic analysis of adverse incident reports can efficiently identify the characteristics and contributing factors of common prescribing errors, in a manner useful for targeting quality improvement. Furthermore, this study produced a number of salient findings. First, a narrow range of drugs were implicated in the majority of incidents. Second, a small number of error types were highly recurrent. Lastly, a range of contributing factors were evident, with those related to the working environment contributing to the majority of prescribing errors analysed.
Acute kidney injury associated with immune checkpoint inhibitor therapy: incidence, risk factors and outcomes
Authors: Meraz-Muñoz Alejandro , Amir Eitan , Ng Pamela , Avila-Casado Carmen , Ragobar Claire , Chan Christopher , Kim Joseph , Wald Ron , Kitchlu Abhijat 
Published: June 2020

BackgroundImmune checkpoint inhibitors (ICPi) are a novel and promising anti-cancer therapy. There are limited data on the incidence, risk factors and outcomes of acute kidney injury (AKI) in patients receiving ICPi.MethodsWe conducted a cohort study of patients receiving ICPi at our center between 2010 and 2017 via electronic health record. The primary outcome was AKI (increase of >50% from baseline serum creatinine (sCr)). Risk factors for AKI were assessed using logistic regression. Survival among those with and without AKI was compared using the Kaplan-Meier method.ResultsAmong 309 patients on ICPi, 51 (16.5%) developed AKI (Kidney Disease Improving Global Outcomes (KDIGO) stages 1: 53%, 2: 22%, 3: 25%). AKI was associated with other immune-related adverse events (IRAE) (OR 3.2, 95% CI 1.6 to 6; p<0.001), hypertension (OR 4.3, 95% CI 1.8 to 6.1; p<0.001) and cerebrovascular disease (OR 9.2; 95% CI 2.1 to 40; p<0.001). Baseline sCr, cancer, and ICPi type was not associated with AKI. Use of angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (OR 2.9; 95% CI 1.5 to 5.7; p=0.002), diuretics (OR 4.3; 95% CI 1.9 to 9.8; p<0.001), and corticosteroid treatment (OR 1.9; 95% CI 1.1 to 3.6; p=0.03) were associated with AKI. In the multivariable analysis, AKI was associated only with other IRAE (OR 2.82; 95% CI 1.45 to 5.48; p=0.002) and hypertension (OR 2.96; 95% CI 1.33 to 6.59; p=0.008). AKI was not associated with increased risk of mortality (HR 1.1; 95% CI: 0.8 to 1.6; p=0.67). ICPi nephrotoxicity was attributed via biopsy or nephrologist assessment in 12 patients (six interstitial nephritis, two membranous nephropathy, two minimal change disease, and two thrombotic microangiopathy). Subsequent doses of ICPi were administered to 12 patients with prior AKI, with one (8.3%) having recurrent AKI.ConclusionAKI is a common complication in patients receiving ICPi treatment. The development of other IRAE and previous diagnosis of hypertension were associated with increased AKI risk. AKI was not associated with worse survival. Distinguishing kidney IRAE from other causes of AKI will present a frequent challenge to oncology and nephrology practitioners. Kidney biopsy should be considered to characterize kidney lesions and guide potential therapy.
Research priorities in advanced heart failure: James Lind alliance priority setting partnership
Authors: Taylor Clare J , Huntley Alyson L , Burden John , Gadoud Amy , Gronlund Toto , Jones Nicholas Robert , Wicks Eleanor , McKelvie Sara , Byatt Kit , Lehman Richard , King Anna , Mumford Bev , Feder Gene , Mant Jonathan , Hobbs Richard , Johnson Rachel 
Published: June 2020

ObjectiveTo determine research priorities in advanced heart failure (HF) for patients, carers and healthcare professionals.MethodsPriority setting partnership using the systematic James Lind Alliance method for ranking and setting research priorities. An initial open survey of patients, carers and healthcare professionals identified respondents’ questions, which were categorised to produce a list of summary research questions; questions already answered in existing literature were removed. In a second survey of patients, carers and healthcare professionals, respondents ranked the summary research questions in order of priority. The top 25 unanswered research priorities were then considered at a face-to-face workshop using nominal group technique to agree on a ‘top 10’.Results192 respondents submitted 489 responses each containing one or more research uncertainty. Out-of-scope questions (35) were removed, and collating the responses produced 80 summary questions. Questions already answered in the literature (15) were removed. In the second survey, 65 questions were ranked by 128 respondents. The top 10 priorities were developed at a consensus meeting of stakeholders and included a focus on quality of life, psychological support, the impact on carers, role of the charity sector and managing prognostic uncertainty. Ranked priorities by physicians and patients were remarkably divergent.ConclusionsEngaging stakeholders in setting research priorities led to a novel set of research questions that might not have otherwise been considered. These priorities can be used by researchers and funders to direct future research towards the areas which matter most to people living with advanced HF.
In-silico analysis to identify the role of MEN1 missense mutations in breast cancer
Authors: Ganakammal Satishkumar Ranganathan , Koirala Mahesh , Wu Bohua , Alexov Emil 
Published: June 2020

Background: The multiple endocrine neoplasia type 1 (MEN1) gene located on chromosome 11q13 encodes menin protein. Previously reported mutations were thought to result in loss of function of menin protein and that they are associated with multiple endocrine neoplasia 1 disorder. However, recently menin has also been characterized as an oncosuppressor protein and it was suggested that mutations in it are associated with various other tumors. Studies indicate that the menin protein stimulates the estrogen receptor (ER) that in turn increases the predisposition for inherited breast cancer. Methods: Here, we used our supervised in-house combinatory in-silico predictor method to investigate the impact of unclassified missense mutations in MEN1 gene found in breast cancer tissue. We also examined the biophysical and biochemical properties to predict the effects of these missense variants on the menin protein stability and interactions. The results are compared with the effects of known pathogenic mutations in menin causing neoplasia. Results: Our analysis indicates that some of the variants found in breast cancer tissue show similar pattern of destabilizing the menin protein and its interactions as the pathogenic variants associated with neoplasia. Taking together with the results of our in-silico consensus predictor, we classify missense mutations in menin protein found in breast cancer tissue into pathogenic and benign, and thus, suggesting as an indicator for early detection of elevated breast cancer risk.