bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wire arc additive manufacturing of thin-wall low-carbon steel parts: Microstructure and mechanical properties
Authors: Le Van Thao , Banh Tien Long , Nguyen Duc Toan , Le Van Tao 
Published: August 2020

Wire arc additive manufacturing (WAAM) has received much attention for manufacturing metal parts with medium and large dimensions because of its high deposition rate and low production costs. In this study, the effects of the heat input on the microstructure formation of thin-wall low-carbon steel parts built by a WAAM process were addressed. The mechanical properties of built materials were also studied. The results indicate that the heat input significantly influences on the shape of built thin walls, but has slight effects on the microstructure evolution of built materials. The WAAM thin-wall low-carbon steel presents suitable microstructures and good tensile strengths (YS: 320 – 362 MPa, UTS: 429 – 479 MPa) that are adequate with industrial applications.
Epsilon local rigidity and numerical algebraic geometry
Authors: Frohmader Andrew , Heaton Alexander 
Published: August 2020

A well-known combinatorial algorithm can decide generic rigidity in the plane by determining if the graph is of Pollaczek–Geiringer–Laman type. Methods from matroid theory have been used to prove other interesting results, again under the assumption of generic configurations. However, configurations arising in applications may not be generic. We present Theorem 4.2 and its corresponding Algorithm 1 which decide if a configuration is [Formula: see text]-locally rigid, a notion we define. A configuration which is [Formula: see text]-locally rigid may be locally rigid or flexible, but any continuous deformations remain within a sphere of radius [Formula: see text] in configuration space. Deciding [Formula: see text]-local rigidity is possible for configurations which are smooth or singular, generic or non-generic. We also present Algorithms 2 and 3 which use numerical algebraic geometry to compute a discrete-time sample of a continuous flex, providing useful visual information for the scientist.
Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease in Patients With a History of Heart Failure or Left Ventricular Dysfunction
Authors: Lopes Renato D. , Alexander Karen P. , Stevens Susanna R. , Reynolds Harmony R. , Stone Gregg W. , Piña Ileana L. , Rockhold Frank W. , Elghamaz Ahmed , Lopez-Sendon Jose Luis , Farsky Pedro S. , Chernyavskiy Alexander M. , Diaz Ariel , Phaneuf Denis , De Belder Mark A. , Ma Yi-tong , Guzman Luis A. , Khouri Michel , Sionis Alessandro , Hausenloy Derek J. , Doerr Rolf , Selvanayagam Joseph B. , Maggioni Aldo Pietro , Hochman Judith S. , Maron David J. 
Published: August 2020

Background:
Whether an initial invasive strategy in patients with stable ischemic heart disease and at least moderate ischemia improves outcomes in the setting of a history of heart failure (HF) or left ventricular dysfunction (LVD) when ejection fraction is ≥35% but <45% is unknown.

Methods:
Among 5179 participants randomized into ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), all of whom had left ventricular ejection fraction (LVEF) ≥35%, we compared cardiovascular outcomes by treatment strategy in participants with a history of HF/LVD at baseline versus those without HF/LVD. Median follow-up was 3.2 years.

Results:

There were 398 (7.7%) participants with HF/LVD at baseline, of whom 177 had HF/LVEF >45%, 28 HF/LVEF 35% to 45%, and 193 LVEF 35% to 45% but no history of HF. HF/LVD was associated with more comorbidities at baseline, particularly previous myocardial infarction, stroke, and hypertension. Compared with patients without HF/LVD, participants with HF/LVD were more likely to experience a primary outcome composite of cardiovascular death, nonfatal myocardial infarction, or hospitalization for unstable angina, HF, or resuscitated cardiac arrest (4-year cumulative incidence rate, 22.7% versus 13.8%; cardiovascular death or myocardial infarction, 19.7% versus 12.3%; and all-cause death or HF, 15.0% versus 6.9%). Participants with HF/LVD randomized to the invasive versus conservative strategy had a lower rate of the primary outcome (17.2% versus 29.3%; difference in 4-year event rate, −12.1% [95% CI, −22.6 to −1.6%]), whereas those without HF/LVD did not (13.0% versus 14.6%; difference in 4-year event rate, −1.6% [95% CI, −3.8% to 0.7%];
P
interaction = 0.055). A similar differential effect was seen for the primary outcome, all-cause mortality, and cardiovascular mortality when invasive versus conservative strategy–associated outcomes were analyzed with LVEF as a continuous variable for patients with and without previous HF.

Conclusions:
ISCHEMIA participants with stable ischemic heart disease and at least moderate ischemia with a history of HF or LVD were at increased risk for the primary outcome. In the small, high-risk subgroup with HF and LVEF 35% to 45%, an initial invasive approach was associated with better event-free survival. This result should be considered hypothesis-generating.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01471522.
Colchicine in Patients With Acute Coronary Syndrome
Authors: Tong David C. , Quinn Stephen , Nasis Arthur , Hiew Chin , Roberts-Thomson Philip , Adams Heath , Sriamareswaran Rumes , Htun Nay M. , Wilson William , Stub Dion , van Gaal William , Howes Laurie , Collins Nicholas , Yong Andy , Bhindi Ravinay , Whitbourn Robert , Lee Astin , Hengel Chris , Asrress Kaleab , Freeman Melanie , Amerena John , Wilson Andrew , Layland Jamie 
Published: August 2020

Background:
Inflammation plays a crucial role in clinical manifestations and complications of acute coronary syndromes (ACS). Colchicine, a commonly used treatment for gout, has recently emerged as a novel therapeutic option in cardiovascular medicine owing to its anti-inflammatory properties. We sought to determine the potential usefulness of colchicine treatment in patients with ACS.

Methods:
This was a multicenter, randomized, double-blind, placebo-controlled trial involving 17 hospitals in Australia that provide acute cardiac care service. Eligible participants were adults (18–85 years) who presented with ACS and had evidence of coronary artery disease on coronary angiography managed with either percutaneous coronary intervention or medical therapy. Patients were assigned to receive either colchicine (0.5 mg twice daily for the first month, then 0.5 mg daily for 11 months) or placebo, in addition to standard secondary prevention pharmacotherapy, and were followed up for a minimum of 12 months. The primary outcome was a composite of all-cause mortality, ACS, ischemia-driven (unplanned) urgent revascularization, and noncardioembolic ischemic stroke in a time to event analysis.

Results:

A total of 795 patients were recruited between December 2015 and September 2018 (mean age, 59.8±10.3 years; 21% female), with 396 assigned to the colchicine group and 399 to the placebo group. Over the 12-month follow-up, there were 24 events in the colchicine group compared with 38 events in the placebo group (
P
=0.09, log-rank). There was a higher rate of total death (8 versus 1;
P
=0.017, log-rank) and, in particular, noncardiovascular death in the colchicine group (5 versus 0;
P
=0.024, log-rank). The rates of reported adverse effects were not different (colchicine 23.0% versus placebo 24.3%), and they were predominantly gastrointestinal symptoms (colchicine, 23.0% versus placebo, 20.8%).

Conclusions:
The addition of colchicine to standard medical therapy did not significantly affect cardiovascular outcomes at 12 months in patients with ACS and was associated with a higher rate of mortality.

Registration:

URL:
https://www.anzctr.org.au
; Unique identifier: ACTRN12615000861550.
Sex and Power in Cassius Dio’s Roman History
Authors: Chrysanthou Chrysanthos S. 
Published: August 2020

Abstract
This article contributes to our understanding of Dio’s technique of using sexual discourse as a useful tool of characterisation and ethical and historical interpretation. It also aims to advance our understanding of the role of sexual-moral critique in ancient historiography more generally. In the first part, it argues that comments on sexual matters in Dio’s history contribute to the construction of imperial portraits and the evaluation of an emperor. Sexual transgressions regularly coalesce with other bad characteristics of a ruler and his overall tyrannical behaviour. In the second part it is suggested that Dio’s representation of Elagabalus is considerably peculiar in terms of both its narrative technique and content, including themes and stories that unfold in signiﬁcantly different and unexpected ways. Sexual misconduct is not simply associated with other vices, but is also used as a significant stand-alone category in the historian’s assessment of Elagabalus’ character and reign. This understanding of Dio’s technique, it is proposed, makes not only a historiographical point, but also a significant historical one about Elagabalus, his rule, and the state of the Roman Empire at the time.
Does Self-isolation Violate the Right to Liberty? An Analysis of the European Court of Human Rights’ Practice in Light of the Ukrainian Experience
Authors: Litins’ka Yana , Karpenko Oleksandra 
Published: August 2020

Abstract
COVID-19 became a stress-test for many legal systems because it required that a balance be found between rapid action to prevent the spread of the disease, and continued respect for human rights. Many states in Europe, including Ukraine, chose to enforce an obligation to self-isolate. In this article we review what the obligation to self-isolate entails in the case of Ukraine. We also analyse whether such an obligation should be viewed as a deprivation or a mere restriction of liberty, and if it is permissible under the European Convention for the Protection of Human Rights and Fundamental Freedoms.
Auditory and Visual Durations Load a Unitary Working-Memory Resource
Authors: Yarrow Kielan , Samba Carine , Kohl Carmen , Arnold Derek H. 
Published: August 2020

Abstract
Items in working memory are typically defined by various attributes, such as colour (for visual objects) and pitch (for auditory objects). The attribute of duration can be signalled by multiple modalities, but has received relatively little attention from a working-memory perspective. While the existence of specialist stores (e.g., the phonological loop and visuospatial sketchpad) is often asserted in the wider working-memory literature, the interval-timing literature has more often implied a unitary (amodal) store. Here we combine two modelling frameworks to probe the basis of working memory for duration; a Bayesian-observer framework, previously used to explain behaviour in duration-reproduction tasks, and mixture models, describing distributions of continuous reports about items in working memory. We modelled different storage mechanisms, such as a limited number of fixed-resolution slots or a resource spread between items at a cost to resolution, in order to ask whether items from different sensory modalities are maintained in separate, independent stores. We initially analysed data from 32 participants, who memorised between one and eight items before reproducing the duration of a randomly selected target. In separate blocks, items could be all visual, all auditory, or an alternating mixture of both. A small control experiment included a further condition with precuing of target modality. Certain kinds of slot models, resource models, and combination models incorporating both mechanisms could account for the data. However, looking across all plausible models, the decline in performance with increasing memory load was most consistent with a single store for event durations, regardless of stimulus modality.
Omentoplasty Combined With Endoscopic Stenting in the Treatment of Lateral Duct Injury at Hepatic Duct Bifurcation
Authors: Wei Wei , Fanous Medhat 
Published: August 2020

Background Common bile duct injury (CBDI) is a devastating complication from laparoscopic cholecystectomy. The endoscopic retrograde cholangiopancreatography (ERCP)-based sphincterotomy and stenting were reportedly effective in treating low or distal lateral CBDI. However, in the circumstance of proximal lateral CBDI, the routine biliary stent may not provide coverage of the leak site, which posed a unique clinical challenge when such proximal CBDI occurred. Methods This patient is an 85-year-old man who underwent laparoscopic cholecystectomy for acute cholecystitis. The gallbladder was contracted and atrophic with extensive dense adhesions in the infundibular area. A dome-down approach was attempted, and a small side hole was identified from a tubular structure with minimal bilious leakage. The intraoperative cholangiogram showed a bile leak at the hepatic duct confluence. A vascularized omental patch was fashioned and secured to the vicinity of the CBDI in a tension-free manner. Two drains were placed. ERCP and endoscopic stenting were undertaken the following day. Results There was minimal bilious fluid output from the Jackson-Pratt drains in the first 24 hours. This was reduced further following ERCP and resolved in 2 days while tolerating a regular diet. All laboratory studies were normal. The drains were removed week postoperatively. The patient was seen in the clinic at 12 months, and there was no evidence of bile leak or stricture. Conclusion The combination of omentopexy and endoscopic stenting is safe in managing high lateral bile duct injury. Prospective studies are needed to further validate this technique.
Comparison of Traditional Upper Airway Surgery and Upper Airway Stimulation for Obstructive Sleep Apnea
Authors: Huntley Colin , Boon Maurits , Tschopp Samuel , Tschopp Kurt , Jenks Carolyn M , Thaler Erica , Baptista Jardin Peter , Shah Janki , Kominsky Alan , Kezirian Eric J , Heiser Clemens , Waxman Jonathan , Lin Ho-Sheng 
Published: August 2020

Objective: To compare patients with moderate-severe obstructive sleep apnea (OSA) undergoing traditional single and multilevel sleep surgery to those undergoing upper airway stimulation (UAS). Study Design: Case control study comparing retrospective cohort of patients undergoing traditional sleep surgery to patients undergoing UAS enrolled in the ADHERE registry. Setting: 8 multinational academic medical centers. Subjects and Methods: 233 patients undergoing prior single or multilevel traditional sleep surgery and meeting study inclusion criteria were compared to 465 patients from the ADHERE registry who underwent UAS. We compared preoperative and postoperative demographic, quality of life, and polysomnographic data. We also evaluated treatment response rates. Results: The pre and postoperative apnea hypopnea index (AHI) was 33.5 and 15 in the traditional sleep surgery group and 32 and 10 in the UAS group. The postoperative AHI in the UAS group was significantly lower. The pre and postoperative Epworth sleepiness scores (ESS) were 12 and 6 in both the traditional sleep surgery and UAS groups. Subgroup analysis evaluated those patients undergoing single level palate and multilevel palate and tongue base traditional sleep surgeries. The UAS group had a significantly lower postoperive AHI than both traditional sleep surgery subgroups. The UAS group had a higher percentage of patients reaching surgical success, defined as a postoperative AHI <20 with a 50% reduction from preoperative severity. Conclusion: UAS offers significantly better control of AHI severity than traditional sleep surgery. Quality life improvements were similar between groups.
Anti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis
Authors: Willems Ariane , Roeleveld Peter P , Labarinas Sonia , Cyrus John W , Muszynski Jennifer A , Nellis Marianne E , Karam Oliver 
Published: August 2020

The purpose was to compare time-based vs anti-Xa-based anticoagulation strategies in patients on ECMO. We conducted a systematic review and meta-analysis using multiple electronic databases and included studies from inception to July 19, 2019. The proportion of bleeding, thrombosis, and mortality were evaluated. Twenty-six studies (2,086 patients) were included. Bleeding occurred in 34.2% (95%CI 25.1;43.9) of the patients with anti-Xa-based versus 41.6% (95%CI 24.9;59.4) of the patients with time-based anticoagulation strategies. Thrombosis occurred in 32.6% (95%CI 19.1;47.7) of the patients with anti-Xa-based versus 38.4% (95%CI 22.2;56.1) of the patients with time-based anticoagulation strategies. And mortality rate was 35.4% (95%CI 28.9;42.1) of the patients with anti-Xa-based versus 42.9% (95%CI 36.9;48.9) of the patients with time-based anticoagulation strategies. Among the seven studies providing results from both anticoagulation strategies, significantly fewer bleeding events occurred in the anti-Xa-based anticoagulation strategy (adjusted OR 0.49 (95%CI 0.32;0.74), p < 0.001) and a significantly lower mortality rate (adjusted OR 0.61 (95%CI 0.40;0.95), p = 0.03). There was no significant difference in thrombotic events (adjusted OR 0.91 (95%CI 0.56;1.49), p = 0.71). In these seven observational studies, only a small fraction of the patients were adults, and data were insufficient to analyze the effect of the type of ECMO. In this meta-analysis of observational studies of patients on ECMO, an anti-Xa-based anticoagulation strategy, when compared to a time-based strategy, was associated with fewer bleeding events and mortality rate, without an increase in thrombotic events.
Protective ileostomy does not prevent anastomotic leakage after anterior resection of rectal cancer
Authors: Niu Lei , Wang Jin , Zhang Peng , Zhao Xiaomu 
Published: August 2020

Objective To explore whether protective ileostomy is beneficial in preventing anastomotic leakage after anterior resection of rectal cancer. Methods A total of 347 patients underwent anterior resection of rectal cancer in our hospital. Ninety-five patients were treated with protective ileostomy (treatment group), and 252 patients were not (control group). The incidences of anastomotic leakage and permanent stoma were compared between the two groups. Results The overall incidences of anastomotic leakage were 6.32% (6/95) and 8.73% (22/252) in the treatment group and control group, respectively. In the cohort of patients who underwent neoadjuvant radiotherapy, the incidence of anastomotic leakage was 5.88% (2/34) and 12.0% (3/25) in the treatment group and control group, respectively. Logistic regression showed that the incidence of anastomotic leakage was not statistically significant. However, diabetes and the anastomotic height significantly affected the occurrence of anastomotic leakage. The permanent stoma rate was 6.42% (6/95) and 5.95% (15/252) in the treatment group and control group, respectively. Conclusion Protective ileostomy did not show a significant advantage in reducing the incidence of postoperative anastomotic leakage in patients with rectal cancer, and it may lead to a permanent stoma.
Stakeholders’ perspectives on adapting the World Health Organization iSupport for Dementia in Australia
Authors: Xiao Lily D , McKechnie Sue , Jeffers Lesley , De Bellis Anita , Beattie Elizabeth , Low Lee-Fay , Draper Brian , Messent Petrea , Pot Anne Margriet 
Published: August 2020

Background In Australia, informal caregivers (family, friends and neighbours) play a crucial role in supporting people with dementia to remain at home. Within the community aged care policy, informal caregivers are acknowledged as assisting with managing care. However, they usually receive very limited dementia care education and training to support them in their role. The World Health Organization (WHO) developed iSupport for Dementia, a comprehensive online dementia education and skill training programme, to address the gap in supporting informal caregivers. Aim The aim of the study was to identify stakeholders’ perspectives regarding adapting the WHO iSupport for use by informal caregivers of people with dementia in Australia. Methods An interpretive description study design was used. Data were collected in focus groups with informal caregivers and care staff of dementia and aged care service providers conducted in May–July 2018. A thematic analysis was utilised to analyse data and identify findings. Results In total, 16 informal caregivers and 20 care staff participated in the study. Five themes were identified. First, informal caregivers perceived iSupport as an opportunity to provide an online one-stop shop to meet their education needs and their needs to manage care services. Second, both informal caregivers and care staff believed that an integrated caregiver network moderated by a health professional was much needed to enable informal caregivers to share learning experiences and enhance social support. Third, both informal caregivers and care staff strongly suggested that dementia and aged care service providers had a role to play in promoting the iSupport. Fourth, informal caregivers were concerned about the time commitment to participate in the iSupport programme. Finally, informal caregivers expected the iSupport to be user-friendly. Conclusion Stakeholders perceived the adaptation of the WHO iSupport in Australia would strengthen informal caregiver education and optimise support for informal caregivers.
Penetration of topical diclofenac into synovial tissue and fluid of osteoarthritic knees: a multicenter, randomized, placebo-controlled, pharmacokinetic study
Authors: Seefried Lothar , Blyth Mark , Maheshwari Rohit , McDonnell Stephen M. , Frappin Guillaume , Hagen Martina , Maybaum Nadine , Moreira Sebastian , Pandit Hemant 
Published: August 2020

Background: Topical diclofenac, a nonsteroidal anti-inflammatory drug, has proven efficacy and safety in the management of osteoarthritis pain. We investigated penetration of topical diclofenac into knee synovial tissue and fluid (primary objective) and evaluated relative exposure in the knee versus plasma (secondary objective). Methods: In this phase I, double-blind, multicenter study, patients scheduled for arthroplasty for end-stage knee osteoarthritis were randomly assigned 2:1 to 4 g diclofenac diethylamine 2.32% w/w gel (92.8 mg diclofenac diethylamine, equivalent to 74.4 mg diclofenac, per application) or placebo gel, applied to the affected knee by a trained nurse/designee every 12 h for 7 days before surgery. Diclofenac concentrations were measured in synovial tissue, synovial fluid and plasma from samples obtained during surgery ⩾12 h after last application. Treatment-emergent adverse events (TEAEs) were evaluated. Results: Evaluable synovial tissue or fluid samples were obtained from 45 (diclofenac n = 29; placebo n = 16) of 47 patients. All diclofenac-treated participants had measurable diclofenac concentrations in synovial tissue [geometric mean 1.57 (95% confidence interval (CI) 1.12, 2.20) ng/g] and fluid [geometric mean 2.27 (95% CI 1.87, 2.76) ng/ml] ⩾12 h after the last dose. Geometric mean (95% CI) ratio of diclofenac in synovial tissue:plasma was 0.32 (0.23, 0.45) and in synovial fluid:plasma was 0.46 (0.40, 0.54). TEAE rates were similar for diclofenac (55.2%) and placebo (58.8%); none were treatment related. Conclusions: Topical diclofenac diethylamine 2.32% w/w gel penetrated into the osteoarthritic knee after repeated application and remained detectable in synovial tissue and fluid at the end of the final 12 h dosing cycle.