bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicaid Cost and Reimbursement for Low‐Risk Prenatal Care in the United States
Authors: Baker Mary V. , Butler‐Tobah Yvonne S. , Famuyide Abimbola O. , Theiler Regan N. 
Published: October 2021

IntroductionWe calculate the financial margins for delivery of routine antenatal care as reimbursed by Medicaid. Prenatal care cost varies with overhead, health care provider type, and number of office visits. Antenatal care is only one component of the global maternity bundle, which also includes intrapartum and postpartum care.MethodsTime for provision of low‐risk antenatal care was determined prospectively from a study of 133 low‐risk pregnant patients. Health care provider time cost was estimated using mean wages for obstetricians and midwives. Margins were estimated by subtracting cost of provider services and overhead for the antenatal component of maternity care from total Medicaid reimbursement for the pregnancy global package (CPT 59400) using 2015 dollars. The maternity bundle elements of routine prenatal laboratory tests, ultrasounds, intrapartum care, and postpartum care were not included in our analysis of cost components.ResultsPatients received an average of 215 minutes of direct provider time per pregnancy. At the 50th percentile for physician payment and assuming overhead is 53.4% of revenue, practice margins varied by state from −$1067 to +$675, with a median of −$357. Median margins for midwifery care were +$15, with a range of −$579 to +$885. Margins were negative if overhead costs exceeded 33% of revenue for physician care and 55% of revenue for midwifery care.DiscussionIn many states, Medicaid reimbursement for the global maternity package is less than the actual cost of antenatal care alone. Improving reimbursement or decreasing costs is necessary to make maternity care more cost‐effective.
Traditional prenatal and postpartum food restrictions among women in northern Lao PDR
Authors: Smith Taryn J. , Tan Xiuping , Arnold Charles D. , Sitthideth Dalaphone , Kounnavong Sengchanh , Hess Sonja Y. 
Published: October 2021

AbstractCulturally determined food restrictions are common among pregnant and postpartum women in Asia. This study aimed to describe perinatal dietary restrictions, factors associated with food avoidances and attainment of minimum dietary diversity (MDD‐W) among women in Lao PDR. Mother–child (aged 21 days to <18 months) dyads (n = 682) were enrolled into a cohort study in northern Lao PDR and interviewed at one time point postpartum. During pregnancy and postpartum, 1.6% and 97% of women reported following dietary restrictions, respectively. Cluster analysis identified four distinct postpartum dietary patterns: most restrictive (throughout first 2 months postpartum); least restrictive; 2 weeks highly restrictive and 1 month highly restrictive, followed by 19%, 15%, 5% and 62% of women, respectively. Greater maternal age, gravidity and higher household socioeconomic status were associated with allowing more diverse foods, while women from food insecure households followed more restrictive diets for longer. Women belonging to the Hmong ethnic group followed a highly restrictive diet of white rice and chicken for the first month postpartum. MDD‐W was achieved by 10% of women restricting their diet at the time of the interview compared with 17% of women who were consuming their normal diet (p = 0.04). Postpartum dietary restrictions are widespread among women in northern Lao PDR. These highly restrictive diets, low dietary diversity and food insecurity likely contribute to micronutrient deficiencies in women that may have important consequences for their breastfed infants through reduced breastmilk micronutrient content, which requires further exploration. Culturally appropriate strategies to increase micronutrient intakes among women should be considered.
The effects of slow deep breathing on microvascular and autonomic function and symptoms in adults with irritable bowel syndrome: A pilot study
Authors: Katherine Jurek Mary , Seavey Hannah , Guidry Meredith , Slomka Emily , Hunter Stacy D. 
Published: October 2021

AbstractBackgroundIrritable bowel syndrome (IBS) is linked to disruptions in sympathovagal balance, which could impair vascular homeostasis and cause IBS symptoms. Studies have shown reductions in sympathetic activity following a single slow, deep breathing (SDB) bout in healthy adults; however, no studies have investigated its chronic effects in IBS. The purpose of this study was to evaluate the feasibility and impact of a SDB intervention on microvascular and autonomic function and symptoms in adults with IBS.MethodsFourteen participants (ages 18–65 years) with IBS were randomly assigned to 4‐week SDB or control conditions. The SDB group completed a 20‐min video 5 times weekly while the control group maintained their normal activities. Microvascular endothelial function was measured using laser Doppler in response to thermal provocation and expressed as cutaneous vascular conductance at 39°C relative to a maximum response at 43.5°C (%CVCmax). Heart rate variability (HRV) and post‐exercise heart rate recovery (HRR) were employed as surrogate measures of autonomic function. IBS symptoms were assessed using the IBS‐Severity Scale (IBS‐SS).Key ResultsThirteen participants (6 controls and 7 SDB) completed the study. Age (p = 0.541) and body mass index (p = 0.157) were similar between groups. In the SDB group, %CVCmax increased from 45% to 59% (p < 0.00001) after the 4‐week intervention. HRV, HRR, and IBS‐SS scores were unaltered.Conclusionsand Inferences.These results demonstrate the feasibility of a SDB intervention in adults with IBS and suggest improvements in microvascular function in the absence of changes in symptoms or autonomic function in this population.
The Application of H‐Loop in Arthroscopic Knotless Double‐Row Rotator Cuff Repairs
Authors: Guo Jiang , Hou Jingyi , Yu Menglei , Alike Yamuhanmode , Long Yi , Tang Yiyong , Li Qingyue , Li Fangqi , Zhang Yuhao , Ali MaslahIdiris , Zheng Zhenze , Meng Ke , Wang Peng , Yang Rui 
Published: October 2021

ObjectiveTo determine the functional outcomes after a novel method of H‐loop knotless double‐row technique in patients with rotator cuff tears.MethodFrom June 2020 to September 2020, a total of six patients (five women, one man) with arthroscopic rotator cuff repair using the H‐loop knotless double‐row technique were enrolled in our study. The average age is 54 years (range: 50–61 years). The preoperative and final follow‐up clinical outcome were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS), University of California Los Angeles (UCLA) score, and Constant–Murley score. The active shoulder range of motion (ROM) was also collected preoperatively and postoperatively at the final follow‐up (forward flexion and abduction). Accordingly, intraoperative and postoperative complications were observed as well.ResultThere were six patients that underwent arthroscopic rotator cuff repair using the H‐loop knotless double‐row technique. The average follow‐up period was 7.52 ± 0.70 months. The VAS, UCLA, ASES, and Constant–Murley scores improved from 5 ± 2.45, 15.67 ± 3.44, 47.67 ± 17.41 and 49.17 ± 8.98 preoperatively, to 0.83 ± 0.75, 36.27 ± 3.83, 91.67 ± 10.76 and 85.83 ± 4.31 at the final follow‐up, with statistical significances of P = 0.009, P < 0.001, P = 0.006, and P = 0.001, respectively. Meanwhile, the active shoulder ROM (forward flexion and abduction) improved from 135.00 ± 46.80 and 125 ± 56.48 preoperatively, to 173.67 ± 4.13 and 172 ± 3.27 at final follow‐up, respectively (P = 0.082, P = 0.088). During the follow‐up, there were no postoperative complications such as wound‐site infection, nerve or vessel damage, subcutaneous hematoma, and suture anchor problems.ConclusionWith the benefit of reducing the possibility of strangulation and blood supply affection for the rotator cuff, The H‐loop knotless double row technique may be an alternative method to significantly improve subjective functional outcomes and increase the healing rate of medium‐sized rotator cuff tears with degeneration issues and poor tissue quality.
ProteinCand comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts
Authors: Sunlight Crystal , Weisse Chick , Berent Allyson , Tozier Eric 
Published: October 2021

AbstractObjectiveTo evaluate protein C (PC) activity after intrahepatic portosystemic shunt (IHPSS) percutaneous transvenous coil embolization (PTCE) in dogs; to identify if PC is associated with clinical status after intervention, and to compare PC with standard biochemical values.Study designRetrospective case series.AnimalsForty‐seven client‐owned dogs with IHPSS undergoing PTCE.MethodsRecords were reviewed for preoperative and postoperative PC, hematocrit (HCT), mean corpuscular volume (MCV), albumin (ALB), and blood urea nitrogen (BUN). Ultimate clinical status was classified as excellent, fair, or poor, based on ongoing medical management and the presence of clinical signs. Intrahepatic portosystemic shunt was considered to be completely or incompletely occluded intraoperatively based on angiography.ResultsPostoperative PC activity increased in 37/47 (78.7%) dogs with a mean increase of 38.7% ± 2.1%. Ultimate postoperative clinical status was excellent in 16/43 (37.2%), fair in 19/43 (44.2%), and poor in 8/43 dogs (18.6%). No association was detected between preoperative PC (46.8% ± 1.8%) and ultimate clinical status but mean postoperative PC (75.7% ± 1.4%), HCT, MCV, ALB, and BUN were higher in dogs with excellent clinical status. Postoperative PC activity was higher when shunts were completely occluded (96.3% ± 10.9%), which was a finding associated with excellent status.ConclusionPostoperative, but not preoperative, PC activity was higher in dogs with better ultimate clinical status. Similar trends were noted in standard hematological and biochemical values. Complete occlusion of shunts was associated with a higher postoperative PC and superior ultimate clinical status.Clinical significancePostoperative PC may provide valuable information about the success of PTCE for IHPSS as it relates to the ultimate status and the need for additional procedures.
Hybrid Multi-Objective Optimization Approach in Water Flooding
Authors: Al-Aghbari Mohammed , Gujarathi Ashish M. , Al-Wadhahi Majid , Chakraborti Nirupam 
Published: October 2021

AbstractNon-dominated sorting genetic algorithm, second version (NSGA-II) is used as a stochastic optimization technique successfully in different engineering applications. In this study, a data-driven optimization strategy based upon evolutionary neural network (EvoNN) algorithm is developed for providing input into NSGA-II optimization. Evolutionary neural network data-driven model is built and trained using initial solutions generated by NSGA-II optimization coupled with the reservoir simulation model. Evolutionary optimization incorporated in the EvoNN strategy is applied in the trained data-driven model to generate the Pareto optimal solution, which is then used as a guiding input into NSGA-II optimization. The described method is applied in two case studies (i.e., Brugge field model and water injection pattern model). The Pareto optimal solutions obtained with data-driven model guided NSGA-II in both models show improvement in convergence and diversity of the solution. The convergence to the Pareto optimal solution has improved by 9% for case-1 (i.e., Brugge field) and by 43% for case-2 (i.e., water injection pattern model). In addition, the Pareto optimal solution obtained by the proposed hybridization has shown improvement in the water–oil ratio (WOR) up to 6% in the Brugge field and up to 97% in the water injection pattern model. This improvement can lead to wide applications in using evolutionary optimizations in real-field simulation models at acceptable computation time.
Corrugated Diaphragm Actuator for Soft Robotic Applications
Authors: Erel Veysel , Lindsay Alexandra R. , Singh Inderjeet , Wijesundara Muthu B. J. 
Published: October 2021

AbstractSoft robotics is projected to have a significant impact on healthcare, industry, and the military to deliver assistance in rehabilitation, daily living activities, repetitive motion tasks, and human performance augmentation. Many attempts have been made for application-specific robotic joints, robots, and exoskeletons using various actuator types, materials, and designs. The progress of creating soft robotic systems can be accelerated if a set of actuators with defined characteristics were developed, similar to conventional robotic actuators, which can be assembled to create desired systems including exoskeletons and end effectors. This work presents the design methodology of such a modular actuator, created with a novel corrugated diaphragm that can apply linear displacement, angular displacement, and force. This modular actuator approach allows for creating various robotic joints by arranging them into different configurations. The modular corrugated diaphragm actuator concept was validated through numerical simulation, fabrication, and testing. Linear displacement, angular displacement, and force characteristics were shown for a single module and in multi-module assemblies. Actuator assemblies that are configured in a serial and parallel manner were investigated to demonstrate the applicability and versatility of the concept of the modular corrugated diaphragm actuator for creating single and multi-degree-of-freedom joints.
Influence of Surface Structure on Performance of Inkjet Printed Cathode Catalyst Layers for Polymer Electrolyte Fuel Cells
Authors: Park Kayoung , Wei Yuting , So Magnus , Noh Tae Hyoung , Kimura Naoki , Tsuge Yoshifumi , Inoue Gen 
Published: October 2021

Abstract
The structure of the cathode catalyst layer (CCL) is critically important for improving the performance, durability, and stability of polymer electrolyte fuel cells (PEFCs). In this study, we designed CCLs with a three-dimensional (3D) structure that could increase the surface area of the CCLs to decrease their oxygen transfer resistance. The CCLs were fabricated using an inkjet printing method, and the electrochemical performance of the CCLs in a membrane electrode assembly was evaluated using an actual cell. The results showed that at high Pt loadings, the performance of the CCL with the 3D structure was superior to that of the flat structure. In particular, at a high current density, which is related to mass transport resistance, the two structures exhibited a significant difference in performance. At a Pt loading of 0.3 mg/cm2, the CCL with the 3D structure showed the highest maximum power density among all the CCLs investigated in this study. This indicates that the 3D structure decreases the oxygen transfer resistance of the CCL. Overall, the 3D structure provided improved morphological and microstructural characteristics to the CCL for fuel cell applications.
Hydrodynamic Coefficients of a Floater Near a Partially Reflecting Seawall in the Presence of an Array of Caisson Blocks
Authors: Vijay K. G. , Koley S. , Trivedi K. , Nishad C. S. 
Published: October 2021

Abstract
In the present study, surface gravity wave scattering and radiation by a freely floating rectangular buoy placed near a partially reflecting seawall and in the presence of an array of caisson blocks are analyzed. Various hydrodynamic parameters related to the wave scattering and radiation, such as the added mass and radiation damping coefficients, correspond to sway, heave, and roll motions of the floating buoy, horizontal force, vertical force, and moment acting on the floating structure, and horizontal wave force acting on the partially reflecting seawall, are studied for a variety of wave and structural parameters. The study reveals that the resonating pattern in various hydrodynamic coefficients occurs for moderate values of the wavenumber. Furthermore, when the distance between the floater and the sidewall is an integral time of half wavelength, the resonating behavior in the sway, heave, and roll added masses, and associated damping coefficients appears, and the aforementioned hydrodynamic coefficients change rapidly around this zone. These resonance phenomena can be diminished significantly with appropriate positioning of the floater with respect to the sidewall and in the presence of partially reflecting seawall.
Passive Drag Reduction Technology Using Microfiber Coatings
Authors: Hasegawa Mitsugu , Sakaue Hirotaka 
Published: October 2021

Abstract
Engineered surfaces and coatings can passively manipulate flow over a bluff-body without significant retrofitting and are of great technological interest for a broad range of applications in the engineering field. A microfiber coating with a hair-like structure is developed and studied as a passive drag reduction method for flow over a cylinder that features both attached and separated flow. The impact of the microfiber coating on drag is experimentally investigated at a Reynolds number of 6.1 × 104 based on the cylinder diameter. Microfiber coatings of various lengths between 1.1% and 8.0% of the cylinder diameter are fabricated using flocking technology and applied to various positions on the cylinder surface between the leading and trailing edges. It is shown that the microfiber length and location are both influential parameters in drag reduction. Two types of drag reduction can be seen depending on the location of the microfiber coating: (1) Drag is reduced significantly if the microfiber coating is applied before flow separates over the cylinder (2) Drag is reduced moderately if the microfiber coating is applied after the point of flow separation on the cylinder. The former case’s best performance is achieved with a microfiber length of less than 1.8% of the cylinder diameter. The latter case shows better performance with relatively long fibers, where the microfiber’s length is greater than 3.3% of the cylinder diameter.
A High-Order Flux Reconstruction Method for 2-D Vorticity Transport
Authors: Gharakhani Adrin 
Published: October 2021

Abstract
A compact high-order finite difference method on unstructured meshes is developed for discretization of the unsteady vorticity transport equations (VTE) for 2-D incompressible flow. The algorithm is based on the Flux Reconstruction Method of Huynh [1, 2], extended to evaluate a Poisson equation for the streamfunction to enforce the kinematic relationship between the velocity and vorticity fields while satisfying the continuity equation. Unlike other finite difference methods for the VTE, where the wall vorticity is approximated by finite differencing the second wall-normal derivative of the streamfunction, the new method applies a Neumann boundary condition for the diffusion of vorticity such that it cancels the slip velocity resulting from the solution of the Poisson equation for the streamfunction. This yields a wall vorticity with order of accuracy consistent with that of the overall solution. In this paper, the high-order VTE solver is formulated and results presented to demonstrate the accuracy and convergence rate of the Poisson solution, as well as the VTE solver using benchmark problems of 2-D flow in lid-driven cavity and backward facing step channel at various Reynolds numbers.
Aeroacoustic Analysis of a UAV Propeller Operable at Various Altitudes
Authors: Song Ji-Hun , Jang Seungsoo , Kim Youn-Jea 
Published: October 2021

Abstract
With technological development and the wide application range of unmanned aerial vehicles (UAVs), the regulation of UAV altitude limits in many countries is further alleviated, and the problem of UAV noise pollution has emerged with the recent advent of urban air mobility (UAM) and personal air vehicle (PAV) markets. In this study, one typical propeller, the T-motor 15 × 5 propeller, was analyzed by use of the commercial CFD software, ANSYS FLUENT V19.3. The effects of gravity and convection were analyzed to determine the noise characteristics at altitude using the FW-H equation. A high-altitude drone, which operates at heights from 0 to 10 km with 1,000 to 5,000 revolutions per minute, was analyzed using the steady-state k-ω SST turbulence model. And using the steady-state data to initialize values, an unsteady analysis was performed with the LES turbulence model. The time step was divided based on the 1-degree rotational time, and the velocity residual on each axis was calculated until a value of 10−7 or less was achieved and there was no fluctuation of thrust, at which point it was considered converged. The CFD results were validated with the experimental results for thrust and their results show that the maximum error was 8.64%. The overall sound pressure level was calculated, and noise characteristics in the audible frequency range according to receiver points were also compared. Through this study, thrust and noise data according to altitude were provided. The aerodynamic and aeroacoustic characteristics at high-altitudes, which are generally difficult to measure by experiment, are also presented. Therefore, the appropriate operating altitudes and rotational speeds will be presented through the aeroacoustics analysis corresponding to operational altitude, and the basic research data can then be applied to upcoming unmanned aircraft system (UAS) market.
Impact of Flow Characteristics on the Pressure Distribution on Sluice Gates
Authors: Steppert Michael , Epple Philipp , Malcherek Andreas 
Published: October 2021

Abstract
The pressure distribution on sluice gate walls was investigated in this paper, based on CFD simulations. The flow characteristics impacting the pressure distribution were analyzed. Based on this analyzation, a new parametrization approach for the gate pressure distribution is derived for both, standard sluice gates and inclined sluice gates. Based on these investigations the impact of 3D flow characteristics on the pressure profile at the sluice gate wall is presented and discussed in detail.
Shock-Induced Multiphase Instability in a High Volume Fraction Finite-Thickness Particle Layer
Authors: Rollin Bertrand , Ouellet Frederick , Durant Bradford , Koneru Rahul Babu , Balachandar S. 
Published: October 2021

Abstract
We study the interaction of a planar air shock with a perturbed, monodispersed, particle curtain using point-particle simulations. In this Eulerian-Lagrangian approach, equations of motion are solved to track the position, momentum, and energy of the computational particles while the carrier fluid flow is computed in the Eulerian frame of reference. In contrast with many Shock-Driven Multiphase Instability (SDMI) studies, we investigate a configuration with an initially high particle volume fraction, which produces a strongly two-way coupled flow in the early moments following the shock-solid phase interaction. In the present study, the curtain is about 4 mm in thickness and has a peak volume fraction of about 26%. It is composed of spherical particles of d = 115μm in diameter and a density of 2500 kg.m−3, thus replicating glass particles commonly used in multiphase shock tube experiments or multiphase explosive experiments. We characterize both the evolution of the perturbed particle curtain and the gas initially trapped inside the particle curtain in our planar three-dimensional numerical shock tube. Control parameters such as the shock strength, the particle curtain perturbation wavelength and particle volume fraction peak-to-trough amplitude are varied to quantify their influence on the evolution of the particle cloud and the initially trapped gas. We also analyze the vortical motion in the flow field. Our results indicate that the shock strength is the primary contributor to the cloud particle width. Also, a classic Richtmyer-Meshkov instability mixes the gas initially trapped in the particle curtain and the surrounding gas. Finally, we observe that the particle cloud contribute to the formation of longitudinal vortices in the downstream flow.