bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Methodology for Inflection Circle-Based Synthesis of Straight Line Crank Rocker Mechanism
Authors: Shiwalkar P. B. , Moghe S. D. , Modak J. P. 
Published: December 2021

Abstract
Emerging fields like Compact Compliant Mechanisms have created newer/novel situations for application of straight line mechanisms. Many of these situations in Automation and Robotics are multidisciplinary in nature. Application Engineers from these domains are many times uninitiated in involved procedures of synthesis of mechanisms and related concepts of Path Curvature Theory. This paper proposes a predominantly graphical approach using properties of Inflection Circle (IC) to synthesize a crank rocker mechanism for tracing a coupler curve which includes the targeted straight line path. The generated approximate straight line path has acceptable deviation in length, orientation, and extent of approximate nature well within the permissible ranges. Generation of multiple choices for the link geometry is unique to this method. To ease the selection, a trained artificial neural network (ANN) is developed to indicate relative length of various options generated. Using studied unique properties of Inflection Circles a methodology for anticipating the orientation of the straight path vis-à-vis the targeted path is also included. Two straight line paths are targeted for two different crank rockers. Compared with the existing practice of selecting the mechanism with some compromise due to inherent granularity of the data in Atlases, proposed methodology helps in indicating the possibility of completing the dimensional synthesis. The developed solution is well within the design specifications and is without a compromise.
Comparative Study of Tip Injection in a Transonic and Subsonic Compressor
Authors: Wang Wei , Liu Boxing , Lu Jinling , Feng Jianjun , Chu Wuli , Wu Yanhui 
Published: December 2021

Abstract
Discrete tip injection is an effective method to enhance stability of compressors. This study compares the effects of injection parameters on compressor performance and underlying mechanisms in two different compressors. The transonic compressor is studied using unsteady simulations, and the subsonic compressor is mainly investigated with experiments. Results show that tip injection improves stable operating range by 35.6% and 77.9% for the transonic compressor and subsonic compressor, respectively, without decreasing compressor efficiency. The effects of circumferential coverage percentage and injector throat height on compressor stability are similar in the two compressors when the injection velocity is double the velocity of the main flow. The optimal injector throat height which is normalized by the tip clearance size is the same for the two compressors, and the best circumferential coverage percentage for the subsonic compressor is lower than that in the transonic compressor. For the two compressors, the adaption of the main flow to the discrete tip injection is unsteady, and the hysteresis effect that the recovery of tip blockage lags behind the recovery of tip leakage vortex accounts for the improved stability using partial coverage of injection. The injection efficiency, which is defined to quantify the improved quality of the flow field in the injection domain, is proven to determine the stall limits by studying the effects of different injection parameters. The guidelines built in the subsonic compressor can be used in the transonic compressor to design tip injection, but the optimal values of some injection parameters should be reconfirmed.
Aeroelastic Aspects of Axial Compressor Stage With Self-Recirculating Casing Treatment
Authors: Kumar S. Satish , Alone Dilipkumar Bhanudasji , Thimmaiah Shobhavathy M. , Mudipalli Janaki Rami Reddy , Kumar Lakshya , Jana Soumendu , Kandagal S. B. , Ganguli Ranjan 
Published: December 2021

Abstract
For successful implementation of casing treatment designs in axial compressors, apart from the stall margin improvement benefits, aeroelasticity also plays a major role. This manuscript addresses the not often discussed aeroelastic aspects of a new discrete type of passive self-recirculating casing treatment (RCT) designed for a transonic axial compressor stage. Experiments are carefully designed for synchronized measurement of the unsteady fluidic disturbances and vibrations during rotating stall for compressor with baseline solid casing and self-RCT. The modal characteristics of the axial compressor rotor-disk assembly are studied experimentally and numerically. Experimentally it is observed that the rotating stall cells excite the blades in their fundamental mode in a compressor with baseline solid casing at the stall flow condition. In contrast, there is no excitation of the blades in the compressor with self-RCT at the same solid casing stall flow condition. Also, the self-RCT compared to the solid casing can significantly reduce the overall vibration levels of the blades that are excited at the stall flow condition. The casing treatment is able to alter the flow field near the tip region of the rotor blade, and hence influencing the forcing function of the rotating cantilever blades to have the aeroelastic benefit.
Proterozoic–Phanerozoic tectonic evolution of the Qilian Shan and Eastern Kunlun Range, northern Tibet
Authors: Wu Chen , Li Jie , Zuza Andrew V. , Haproff Peter J. , Chen Xuanhua , Ding Lin 
Published: December 2021

AbstractThe Proterozoic–Phanerozoic tectonic evolution of the Qilian Shan, Qaidam Basin, and Eastern Kunlun Range was key to the construction of the Asian continent, and understanding the paleogeography of these regions is critical to reconstructing the ancient oceanic domains of central Asia. This issue is particularly important regarding the paleogeography of the North China-Tarim continent and South China craton, which have experienced significant late Neoproterozoic rifting and Phanerozoic deformation. In this study, we integrated new and existing geologic field observations and geochronology across northern Tibet to examine the tectonic evolution of the Qilian-Qaidam-Kunlun continent and its relationships with the North China-Tarim continent to the north and South China craton to the south. Our results show that subduction and subsequent collision between the Tarim-North China, Qilian-Qaidam-Kunlun, and South China continents occurred in the early Neoproterozoic. Late Neoproterozoic rifting opened the North Qilian, South Qilian, and Paleo-Kunlun oceans. Opening of the South Qilian and Paleo-Kunlun oceans followed the trace of an early Neoproterozoic suture. The opening of the Paleo-Kunlun Ocean (ca. 600 Ma) occurred later than the opening of the North and South Qilian oceans (ca. 740–730 Ma). Closure of the North Qilian and South Qilian oceans occurred in the Early Silurian (ca. 440 Ma), whereas the final consumption of the Paleo-Kunlun Ocean occurred in the Devonian (ca. 360 Ma). Northward subduction of the Neo-Kunlun oceanic lithosphere initiated at ca. 270 Ma, followed by slab rollback beginning at ca. 225 Ma evidenced in the South Qilian Shan and at ca. 194 Ma evidenced in the Eastern Kunlun Range. This tectonic evolution is supported by spatial trends in the timing of magmatism and paleo-crustal thickness across the Qilian-Qaidam-Kunlun continent. Lastly, we suggest that two Greater North China and South China continents, located along the southern margin of Laurasia, were separated in the early Neoproterozoic along the future Kunlun-Qinling-Dabie suture.
Diet and development among children aged 36–59 months in low-income countries
Authors: Bliznashka Lilia , Perumal Nandita , Yousafzai Aisha , Sudfeld Christopher 
Published: December 2021

ObjectiveTo assess the associations between diet, stimulation and development among children 36–59 months of age in low-income and middle-income countries (LMICs).DesignWe pooled Demographic and Health Survey data on 12 126 children aged 36–59 months from 15 LMICs. Child diet indicators included dietary diversity score (DDS, range 0–7), minimum dietary diversity (MDD, defined as DDS ≥4) and animal source foods (ASFs) consumption. Child development was assessed using the Early Childhood Development Index and stimulation by the number of stimulation activities (range 0–6). Associations were assessed using generalised linear models.ResultsIn our sample, 18% of children met MDD and 50% received ≥4 stimulation activities. The prevalence of suboptimal cognitive, socioemotional, literacy-numeracy and physical development was 24%, 32%, 87% and 11%, respectively. Higher DDS, meeting MDD and consuming ASFs were associated with 8%–13% more stimulation activities. Children who met MDD were slightly less likely to have suboptimal literacy-numeracy development compared with children who did not meet MDD: relative risk 0.97 (95% CI 0.95 to 1.00). DDS, meeting MDD and ASFs consumption were not associated with cognitive, socioemotional or physical development. However, there was evidence of positive associations between MDD and cognitive and literacy-numeracy development among subgroups of children, including those who received ≥4 stimulation activities or attended an early childhood care and education programme.ConclusionsChild diet was associated with more stimulation activities. However, independent of stimulation, socioeconomic status and other factors, child diet appeared to be a prominent determinant only of literacy-numeracy development among children 36–59 months of age.
Application of machine learning techniques to understand ethnic differences and risk factors for incident chronic kidney disease in Asians
Authors: Lim Cynthia Ciwei , He Feng , Li Jialiang , Tham Yih Chung , Tan Chieh Suai , Cheng Ching-Yu , Wong Tien-Yin , Sabanayagam Charumathi 
Published: December 2021

IntroductionChronic kidney disease (CKD) is increasing in Asia, but there are sparse data on incident CKD among different ethnic groups. We aimed to describe the incidence and risk factors associated with CKD in the three major ethnic groups in Asia: Chinese, Malays and Indians.Research design and methodsProspective cohort study of 5580 general population participants age 40–80 years (2234 Chinese, 1474 Malays and 1872 Indians) who completed both baseline and 6-year follow-up visits. Incident CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2in those free of CKD at baseline.ResultsThe 6-year incidence of CKD was highest among Malays (10.0%), followed by Chinese (6.1%) and Indians (5.8%). Logistic regression showed that older age, diabetes, higher systolic blood pressure and lower eGFR were independently associated with incident CKD in all three ethnic groups, while hypertension and cardiovascular disease were independently associated with incident CKD only in Malays. The same factors were identified by machine learning approaches, gradient boosted machine and random forest to be the most important for incident CKD. Adjustment for clinical and socioeconomic factors reduced the excess incidence in Malays by 60% compared with Chinese but only 13% compared with Indians.ConclusionIncidence of CKD is high among the main Asian ethnic groups in Singapore, ranging between 6% and 10% over 6 years; differences were partially explained by clinical and socioeconomic factors.
Maximum body mass index before onset of type 2 diabetes is independently associated with advanced diabetic complications
Authors: Ozawa Harutoshi , Fukui Kenji , Komukai Sho , Y Baden Megu , Fujita Shingo , Fujita Yukari , Kimura Takekazu , Tokunaga Ayumi , Iwahashi Hiromi , Kozawa Junji , Shimomura Iichiro 
Published: December 2021

IntroductionThe maximum body mass index (BMI) before onset of type 2 diabetes (MBBO) might be used to estimate a patient’s insulin secretion capacity. There have been few factors that can predict future diabetic complications at the time of diagnosis of diabetes mellitus. This study aimed to clarify the clinical usefulness of MBBO for predicting the development of advanced diabetic microvascular complications.Research design and methodsThis was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 435 patients for whom we could confirm their MBBO. Univariate and multivariate logistic regression analyses were performed to examine whether MBBO or BMI on admission was associated with advanced diabetic retinopathy or nephropathy. To evaluate the predictive performance of these indexes, we performed cross-validation in various models with MBBO or BMI and evaluated the areas under the curve (AUCs) yielded by these analyses.ResultsUnivariate analyses suggested that MBBO was associated with advanced retinopathy and nephropathy, while BMI on admission was associated only with advanced nephropathy. In multivariate analyses, MBBO was significantly associated with advanced complications, while BMI on admission was not. For advanced diabetic retinopathy, the AUCs were 0.70–0.72, and for advanced nephropathy, the AUCs were 0.81–0.83. When comparing the AUCs among models, the models with MBBO sustained high predictive performance for diabetic complications.ConclusionsMBBO was independently associated with advanced diabetic complications, while BMI on admission was not. Diabetic microvascular complications in patients with high MBBO could progress more rapidly. At the time of the diagnosis of diabetes mellitus, MBBO would enable us to predict the progress of diabetic complications.
Durability of effects from short-term economic incentives for clinic attendance among HIV positive adults in Tanzania: long-term follow-up of a randomised controlled trial
Authors: Fahey Carolyn A , Njau Prosper F , Kelly Nicole K , Mfaume Rashid S , Bradshaw Patrick T , Dow William H , McCoy Sandra I 
Published: December 2021

IntroductionConditional economic incentives are shown to promote medication adherence across a range of health conditions and settings; however, any long-term harms or benefits from these time-limited interventions remain largely unevaluated. We assessed 2–3 years outcomes from a 6-month incentive programme in Tanzania that originally improved short-term retention in HIV care and medication possession.MethodsWe traced former participants in a 2013–2016 trial, which randomised 800 food-insecure adults starting HIV treatment at three clinics to receive either usual care (control) or up to 6 months of cash or food transfers (~US$11/month) contingent on timely attendance at monthly clinic appointments. The primary intention-to-treat analysis estimated 24-month and 36-month marginal risk differences (RD) between incentive and control groups for retention in care and all-cause mortality, using multiple imputation for a minority of missing outcomes. We also estimated mortality HRs from time-stratified Cox regression.ResultsFrom 3 March 2018 to 19 September 2019, we determined 36-month retention and mortality statuses for 737 (92%) and 700 (88%) participants, respectively. Overall, approximately 660 (83%) participants were in care at 36 months while 43 (5%) had died. There were no differences between groups in retention at 24 months (86.5% intervention vs 84.4% control, RD 2.1, 95% CI −5.2 to 9.3) or 36 months (83.3% vs 77.8%, RD 5.6, –2.7 to 13.8), nor in mortality at either time point. The intervention group had a lower rate of death during the first 18 months (HR 0.27, 95% CI 0.10 to 0.74); mortality was similar thereafter (HR 1.13, 95% CI 0.33 to 3.79).ConclusionThese findings confirm that incentives are a safe and effective tool to promote short-term adherence and potentially avert early deaths at the critical time of HIV treatment initiation. Complementary strategies are recommended to sustain lifelong retention in HIV care.Trial registration numberNCT01957917
How do people perceive different labels for rotator cuff disease? A content analysis of data collected in a randomised controlled experiment
Authors: Zadro Joshua R , Michaleff Zoe A , O'Keeffe Mary , Ferreira Giovanni E , Haas Romi , Harris Ian A , Buchbinder Rachelle , Maher Christopher G 
Published: December 2021

ObjectivesExplore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.SettingWe performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.Participants1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels:subacromial impingement syndrome, rotator cuff tear, bursitis, rotator-cuff-related shoulder pain, shoulder sprainandepisode of shoulder pain.Primary and secondary outcomesParticipants answered two questions (free-text response) about: (1) words or feelings evoked by the label; (2) what treatments they feel are needed. Two researchers iteratively developed coding frameworks to analyse responses.Results1308/1626 (80%) complete responses for each question were analysed. Psychological distress (21%), uncertainty (22%), serious condition (15%) and poor prognosis (9%) were most often expressed by those labelled withsubacromial impingement syndrome. For those labelled with arotator cuff tear,psychological distress (13%), serious condition (9%) and poor prognosis (8%) were relatively common, while minor issue was expressed least often compared with the other labels (5%). Treatment/investigation and surgery were common among those labelled with arotator cuff tear(11% and 19%, respectively) andsubacromial impingement syndrome(9% and 10%) compared withbursitis(7% and 5%).ConclusionsWords or feelings evoked by certain labels for rotator cuff disease and perceived treatment needs may explain why some labels drive management preferences towards surgery and imaging more than others.
Exploring medical students’ perceptions of the challenges and benefits of volunteering in the intensive care unit during the COVID-19 pandemic: a qualitative study
Authors: Ali Aliya , Staunton Marita , Quinn Adam , Treacy Gordon , Kennelly Patrick , Hill Arnold , Sreenan Seamus , Brennan Marian 
Published: December 2021

ObjectivesIn March 2020, the WHO declared SARS-CoV-2 a pandemic. Hospitals across the world faced staff, bed and supply shortages, with some European hospitals calling on medical students to fill the staffing gaps. This study aimed to document the impact of volunteering during the COVID-19 pandemic on students’ professional development, resilience and future perceived career choices.DesignThis is a retrospective, qualitative study of student reflections, using purposive sampling.The Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences recruited 26 medical student volunteers to assist in pronation and supination of ventilated patients affected by SARS-CoV-2. These students were invited to complete an anonymous survey based on their experiences as volunteers. Thematic analysis was performed on these written reflections.ResultsThe results showed that volunteering during the COVID-19 pandemic developed key skills from RCSI’s medical curriculum, significantly fostered medical students’ resilience and guided their career choices. Major areas of development included communication, teamwork, compassion and altruism, which are not easily developed through the formal curriculum. A further area that was highlighted was the importance of evidence-based health in a pandemic. Finally, our respondents were early stage medical students with limited clinical exposure. Some found the experience difficult to cope with and therefore supports should be established for students volunteering in such a crisis.ConclusionThese results suggest that clinical exposure is an important driver in developing students’ resilience and that volunteering during a pandemic has multiple benefits to students’ professional development and professional identity formation.
Taming the chaos: NHS professionals’ perspective of using video consulting during COVID-19 in Wales
Authors: Johns Gemma , Khalil Sara , Ogonovsky Mike , Hesseling Markus , Wardhaugh Allan , Phipps Kerrie , Williams Jessica , Whistance Bethan , Ahuja Alka 
Published: December 2021

The use of video consulting (VC) in the UK has expanded rapidly during the COVID-19 pandemic. Technology Enabled Care (TEC) Cymru, the Welsh Government and Local Health boards began implementing the National Health Service (NHS) Wales VC Service in March 2020. This has been robustly evaluated on a large-scale All-Wales basis, across a wide range of NHS Wales specialities.AimsTo understand the early use of VC in Wales from the perspective of NHS professionals using it. NHS professionals were approached by TEC Cymru to provide early data.MethodsUsing an observational study design with descriptive methods including a cross-sectional survey, TEC Cymru captured data on the use, benefits and challenges of VC from NHS professionals in Wales during August and September 2020. This evidence is based on the rapid adoption of VC in Wales, which mirrors that of other nations.ResultsA total of 1256 NHS professionals shared their VC experience. Overall, responses were positive, and professionals expressed optimistic views regarding the use and benefit of VC, even when faced with challenges on occasions.ConclusionsThis study provides evidence of general positivity, acceptance and the success of the VC service in Wales. Future research studies will now be able to explore and evaluate the implementation methods used within this study, and investigate their effectiveness in being able to achieve better outcomes through VC.
Mobile stroke care expedites intravenous thrombolysis and endovascular thrombectomy
Authors: Bender Matthew T , Mattingly Thomas K , Rahmani Redi , Proper Diana , Burnett Walter A , Burgett Jason L , LEsperance Joshua , Cushman Jeremy T , Pilcher Webster H , Benesch Curtis G , Kelly Adam G , Bhalla Tarun 
Published: December 2021

BackgroundThe number of mobile stroke programmes has increased with evidence, showing they expedite intravenous thrombolysis. Outstanding questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical outcomes.ObjectiveOur mobile stroke unit (MSU), based at an academic medical centre in upstate New York, launched in October 2018. We reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service (EMS) patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical outcomes.ResultsOver 568 days in service, the MSU was dispatched 1489 times (2.6/day) and transported 300 patients (20% of dispatches). Intravenous tissue plasminogen activator (tPA) was administered to 57 MSU patients and the average time from 911 call-to-tPA was 42.5 min (±9.2), while EMS transported 73 patients who received tPA at 99.4 min (±35.7) (p<0.001). Seven MSU patients (12%) received tPA from 3.5 hours to 4.5 hours since last known well and would likely have been outside the window with EMS care. Endovascular thrombectomy was performed on 21 MSU patients with an average 911 call-to-groin puncture time of 99.9 min (±18.1), while EMS transported 54 patients who underwent endovascular thrombectomy (ET) at 133.0 min (±37.0) (p=0.0002). There was no difference between MSU and traditional EMS in modified Rankin score at 90-day clinic follow-up for patients undergoing intravenous thrombolysis or endovascular thrombectomy, whether assessed as a dichotomous or ordinal variable.ConclusionsMobile stroke care expedited both intravenous thrombolysis and endovascular thrombectomy. There is an ongoing need to show improved functional outcomes with MSU care.