bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of the combined hydropneumatic isolations on improving vibration of vibratory roller cab: Experiment and simulation
Authors: Zhou Huaxiang , Nguyen Vanliem , Wu Xiaoyan 
Published: March 2021

This study, based on preeminent characteristics of both the pneumatic and hydraulic isolations, combined hydropneumatic isolations (CHPIs), is proposed for improving the cab ride quality of the vibratory rollers in low-frequency domain. A 3D dynamic model and mathematical model of the cab isolations and the vibratory rollers are established to simulate CHPI’s characteristics under the excitations of the off-road terrain and vibratory drum at 28 Hz and 35 Hz. To enhance the reliability of research results, vehicle’s mathematical models are also verified via the experimental investigation. The effectiveness of CHPIs on ameliorating the cab’s ride quality is then analyzed via two indicators of the power spectral density (PSD) acceleration on the frequency region and root-mean-square (RMS) acceleration on the time domain of the cab and operator seat. It is found that with the combination of the high-elastic stiffness parameter and high nonlinear damping coefficient of CHPIs using for the vehicle’s cab isolations, the results of the cab’s ride quality are greatly improved compared with other cab isolations in the well-known existing works.
Biosynthesized TiO2 nanoparticles an efficient biogenic material for photocatalytic and antibacterial applications
Authors: Meenatchisundaram Nagalakshmi , Chellamuthu Jeganathan , Jeyaraman Anandha Raj , Arjunan Nithya , Muthuramalingam Jothi Basu , Karuppuchamy Subbian 
Published: March 2021

A simple one-step biosynthesis route has been adopted for the synthesis of high crystalline phase pure anatase TiO2 nanoparticles. The structural conformation and functional group analysis of the synthesized nanoparticles were made through X-Ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR), respectively. The optical property and the band gap were estimated by using UV-Visible diffuse reflectance spectroscopy (UV-DRS). The surface morphological properties of the anatase TiO2 nanoparticles were confirmed using Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) and the size of the synthesized nanoparticles are 8 nm. The element analysis was evaluated by using EDS and X-ray photoelectron spectroscopy (XPS). The photocatalytic activity of the prepared sample was investigated by the decolourization of Methylene blue dye under UV and solar light irradiation. The maximum dye removal efficiency of 99.2% was observed for solar light irradiation. Besides, the prepared samples also exhibit excellent antibacterial activity against Klebsilla Pneumoniae and Streptococcus Pneumoniae. The antibacterial activity for the synthesized TiO2 nanoparticles show maximum zone of inhibition (23.5 mm). Thus, the biogenic property of the bioprocessed TiO2 nanoparticles is a potential material for environmental and biomedical applications. [Formula: see text]
Which patients with systemic lupus erythematosus in remission can withdraw low dose steroids? Results from a single inception cohort study
Authors: Fasano Serena , Coscia Melania Alessia , Pierro Luciana , Ciccia Francesco 
Published: March 2021

Background A progressive tapering until withdrawal of glucocorticoids (GC) is considered one of the main goals of Systemic Lupus Erythematosus (SLE) management. However, which patient may be a candidate for safe GC withdrawal has not been determined yet. This study aimed to evaluate the rate of low-dose GC withdrawal in SLE patients in remission and to identify predictors of flares. Methods Eligible patients were SLE patients in prolonged clinical remission defined by a cSLEDAI = 0 for at least 2 years and on a stable SLE treatment (including daily 5 mg prednisone). Flares were defined by SELENA-SLEDAI Flare Index. Predictors of flares after GC withdrawal were analyzed by Cox regression. Results We selected 56 patients in whom a GC withdrawal was attempted. 98 patients were in the prednisone maintenance group. The proportion of patients experiencing a flare was not significantly lower in the maintenance group than in the withdrawal group (p = 0.81). However, among the withdrawal group, the rate of flares was significantly higher in serologically active clinically quiescent (SACQ) patients (p < 0,0001). At Cox regression analysis, duration of hydroxychloroquine (HCQ) therapy and ≥5 year remission at withdrawal were protective factors, while a SACQ disease and history of lupus nephritis increased the risk of disease flare. Conclusion GC withdrawal is an achievable target in SLE and may be attempted in patients in complete remission.However, it might underline a caution in patients with SACQ disease who may be at greater risk forflare when GCare discontinued. HCQ therapy and durable remission can significantly reduce the risk.
Impact of National Health Mission of India on Infant and Maternal Mortality: A Logical Framework Analysis
Authors: Kumar Rajesh 
Published: March 2021

Background: Since independence, life expectancy has increased substantially in India, but the goal of health-for-all has not been achieved yet. Hence, National Rural Health Mission was launched in 2005, and several strategies were implemented to strengthen the health system. Impact evaluation of the mission was done to learn lessons for future health planning. Materials and Methods: Logical evaluation framework was used to examine input, output and impact indicators systematically using time series data from Health Management Information System, National Family Health Surveys, National Sample Surveys and Sample Registration Scheme. Findings: After launch of the mission, fund allocation has increased nearly five times. The number of auxiliary nurse midwives has doubled, and the number of nurses has trebled. The number of accredited social health activists has increased to about one million. Institutional deliveries have increased from 38.7% in 2005–2006 to 78.9% in 2015–2016. Full immunisation coverage has increased from 43.5% to 62%. Oral rehydration solution (ORS) use in childhood diarrhoea has increased from 26% to 51%. Infant mortality rate has declined from 58 in 2005 to 33 per 1,000 live births in 2017 and maternal mortality ratio has also registered a decline from 254 in 2004–2006 to 122/100000 live births in 2015–2017. However, out-of-pocket health expenditure continues to be fairly high (69.3% of the total expenditure on health). Conclusions: Though National Health Mission has made a significant impact, the goal of universal care coverage is not yet fully achieved. Hence, capacity of health system needs to be trebled by a substantial increase in fund allocation.
A Review of Publicly Available Automatic Brain Segmentation Methodologies, Machine Learning Models, Recent Advancements, and Their Comparison
Authors: Singh Mahender Kumar , Singh Krishna Kumar 
Published: March 2021

Background: The noninvasive study of the structure and functions of the brain using neuroimaging techniques is increasingly being used for its clinical and research perspective. The morphological and volumetric changes in several regions and structures of brains are associated with the prognosis of neurological disorders such as Alzheimer’s disease, epilepsy, schizophrenia, etc. and the early identification of such changes can have huge clinical significance. The accurate segmentation of three-dimensional brain magnetic resonance images into tissue types (i.e., grey matter, white matter, cerebrospinal fluid) and brain structures, thus, has huge importance as they can act as early biomarkers. The manual segmentation though considered the “gold standard” is time-consuming, subjective, and not suitable for bigger neuroimaging studies. Several automatic segmentation tools and algorithms have been developed over the years; the machine learning models particularly those using deep convolutional neural network (CNN) architecture are increasingly being applied to improve the accuracy of automatic methods. Purpose: The purpose of the study is to understand the current and emerging state of automatic segmentation tools, their comparison, machine learning models, their reliability, and shortcomings with an intent to focus on the development of improved methods and algorithms. Methods: The study focuses on the review of publicly available neuroimaging tools, their comparison, and emerging machine learning models particularly those based on CNN architecture developed and published during the last five years. Conclusion: Several software tools developed by various research groups and made publicly available for automatic segmentation of the brain show variability in their results in several comparison studies and have not attained the level of reliability required for clinical studies. The machine learning models particularly three dimensional fully convolutional network models can provide a robust and efficient alternative with relation to publicly available tools but perform poorly on unseen datasets. The challenges related to training, computation cost, reproducibility, and validation across distinct scanning modalities for machine learning models need to be addressed.
Effect of defocus combined with rotation on the optical performance of trifocal toric IOLs
Authors: Ruiz-Alcocer Javier , Martínez-Alberquilla Irene , Lorente-Velázquez Amalia , Alfonso José F , Madrid-Costa David 
Published: March 2021

Purpose: To objectively analyze the optical quality of the FineVision Toric intraocular lens (IOL) with two cylinder powers when different combinations of rotations and residual refractive errors are induced. Methods: This study assessed the FineVision Toric IOL with two different cylinder powers: 1.5 and 3.0 diopters (D). Three different rotation positions were considered: centered, 5° and 10° rotated. An optical bench (PMTF) was used for optical analysis. The optical quality of the IOLs was calculated by the modulation transfer function (MTF) at five different focal points (0.0, 0.25, 0.50, 0.75, and 1.00 D). Results: The MTF averaged value of the reference situation was 38.58 and 37.74 for 1.5 and 3.0 D of cylinder, respectively. For the 1.5 D cylinder, the combination of 5° of rotation with a defocus of 0.25, 0.50, 0.75, and 1.0 D induced a decrease on the MTF of 12.39, 19.94, 23.43, 24.23 units, respectively. When induced rotation was 10°, the MTF decrease was 17.26, 23.40, 24.33, 24.48 units, respectively. For the 3.0 D cylinder, the combination of 5° with 0.25, 0.50, 0.75, and 1.0 D of defocus, induced a decrease on the MTF of 12.51, 18.97, 22.36, 22.48 units, respectively. When induced rotation was 10°, the MTF decrease was: 18.42, 21.57, 23.08, and 23.61 units, respectively. Conclusion: For both FineVision Toric IOLs there is a certain optical tolerance to rotations up to 5° or residual refractive errors up to 0.25 D. Situations over these limits and their combination would affect the visual quality of patients implanted with these trifocal toric IOLs.
The safety of clinically indicated replacement or routine replacement of peripheral intravenous catheters: A randomized controlled study
Authors: Lu Huapeng , Yang Qinling , Nor Hilal Mohamed , Lv Yi , Zheng Xuemei , Xin Xia , Feng Aifang , Sun Yali , Zhou Xiaoling , Zhang Li , Qu Yan , Li Juanli , Guo Xiaoye , Yang Yali , Jiao Jianfang , Xie Na 
Published: March 2021

Objective: The primary purpose of this study was to explore the safety of peripheral intravenous catheter (PIVC) replacement every 96 h compared to that of clinically indicated catheter removal. Methods: A prospective, single-blind, randomized controlled trial was conducted. A random number table method was used. Six hundred patients treated with PIVC intravenous infusion in 10 nursing units of a hospital from September to October 2019 were selected. Sixty were collected from each nursing unit, including 30 in the clinically indicated replacement group and 30 in the routine replacement group. The incidence of phlebitis, catheter-related infection (CRI), occlusion, infiltration, and any form of infusion therapy failure were compared between the two groups. SPSS 23.0 software was used. Results: The dwelling times of PIVC in the clinically indicated replacement group and routine replacement group were significantly different (hours) (83.62 ± 50.08, 69.75 ± 25.54, t = 3.021, p = 0.003). The incidence of any form of infusion therapy failure (RR = 4.448, 95% CI: 3.158–6.265, p < 0.001), phlebitis (RR = 2.416, 95% CI: 1.595–3.660, p < 0.001), occlusion (RR = 6.610, 95% CI: 3.062–14.268, p < 0.001), infiltration (RR = 2.607, 95% CI: 1.130–6.016, p = 0.020), accidental dislodgement (RR = 2.027, 95% CI: 1.868–2.200, p = 0.013), and pain at the insertion site (RR = 2.521, 95% CI: 1.742–3.649, p < 0.001) was higher in the clinically indicated replacement group than that in the routine replacement group. The overall survival curve of PIVC was drawn with Kaplan–Meier survival analysis. The median survival time of intravenous infusion was 59.58 h; the cumulative survival rates of 48 h, 72 h, and 96 h were 77.00%, 51.33%, and 20.33%, respectively. Conclusion: Replacement of PIVC every 96 h is safer than clinically indicated.
Making sense of child and adolescent mental health services (CAMHS): An audit of the referral journey and the use of routine outcome measures (ROMS)
Authors: Gibbons Naomi , Harrison Emma , Stallard Paul 
Published: March 2021

Background: There is increased emphasis on the national reporting of Routine Outcome Measures (ROMS) as a way of improving Child and Adolescent Mental Health Services (CAMHS). This data needs to be viewed in context so that reasons for outcome completion rates are understood and monitored over time. Method: We undertook an in-depth prospective audit of consecutive referrals accepted into the Bath and North East Somerset, Swindon and Wiltshire (BSW) CAMHS service from November 2017 to January 2018 ( n = 1074) and April to September 2019 ( n = 1172). Results: Across both audits 90% of those offered an appointment were seen with three quarters completing baseline ROMS. One in three were not seen again with around 30% still being open to the service at the end of each audit. Of those closed to the service, paired ROMS were obtained for 46% to 60% of cases. There were few changes in referral problems or complexity factors over time. Conclusion: Understanding the referral journey and the reasons for attrition will help to put nationally collected data in context and can inform and monitor service transformation over time.
Associations between social camouflaging and internalizing symptoms in autistic and non-autistic adolescents
Authors: Bernardin Courtney J , Lewis Timothy , Bell Debora , Kanne Stephen 
Published: March 2021

Autistic individuals experience higher rates of psychiatric comorbidities than their peers. Camouflaging, the process through which individuals hide autistic traits, can be detrimental to mental health. This may be particularly true for autistic females, although research on sex differences in the relationship between camouflaging and mental health has focused on adults. The purpose of this study was to extend previous research on camouflaging and mental health through examining age, sex, autism diagnosis, and camouflaging as predictors of depression, anxiety, and stress levels in autistic and non-autistic adolescents. One hundred forty adolescents ages 13–18 years (62 non-autistic, 58 female) completed an online survey including measures of camouflaging, autistic traits, and internalizing symptoms. Hierarchical linear regression was used to examine age, sex, diagnosis, and camouflaging as predictors of internalizing symptoms. Findings suggest that level of camouflaging is an important predictor of depression, anxiety, and stress in autistic and non-autistic adolescents and that camouflaging may be particularly distressing for females, regardless of diagnosis. These findings inform our understanding of camouflaging and its consequences and point to future directions for support for autistic and non-autistic adolescents. Clinicians may consider interventions targeting social skills, self-acceptance, and self-esteem to reduce possible negative effects of camouflaging. Lay abstract Autistic individuals have more mental health difficulties than non-autistic individuals. It is important to understand why this might be. Research has shown that camouflaging, or strategies used to hide autistic traits, might contribute to mental health difficulties in autistic adults. We examined whether this was also the case for autistic adolescents. This study included 140 adolescents ages 13–18 years (62 non-autistic, 58 female). All participants answered questions about camouflaging, autistic traits, and mental health difficulties. We found that autistic and non-autistic adolescents who reported higher levels of camouflaging also reported higher levels of depression, anxiety, and stress. We also found that camouflaging might be particularly stressful for females. These findings improve our understanding of camouflaging during adolescence and point to potential ways to support autistic adolescents, such as help with social skills, self-acceptance, and self-esteem. The findings also support the importance of increasing autism acceptance in the general population.
Social Ecology of Hypertension Management Among Latinos Living in the U.S.–Mexico Border Region
Authors: Cacari Stone Lisa , Sanchez Victoria , Bruna Sean Patrick , Muhammad Michael , Zamora, MPH Carmen 
Published: March 2021

Introduction While a growing body of research examines individual factors affecting the prevalence and management of hypertension among Latinos, less is known about how socioecological factors operate to determine health and affect implementation of interventions in rural communities. Method We conducted eight focus groups to assess perceived risks and protective factors associated with managing hypertension among Latino adults and their family members living in two rural/frontier counties in the U.S.–Mexico border region. This analysis is part of a larger study, Corazon por la Vida (Heart for Life), which involved multiple data collection strategies to evaluate the effectiveness of a primary care and a promotora de salud intervention to manage hypertension. Results Of the 49 focus group participants, 70% were female and 30% were male, 39% were Spanish-only speakers, and 84% had hypertension. Participants’ ages ranged between 18 and 75 years, and 63% reported annual incomes below $30,000. Drawing from a social–ecological framework to analyze focus group data, four major themes and subthemes emerged as factors facilitating or inhibiting disease management: (1) individual (emotional burdens, coping mechanisms), (2) social relationships (family as a source of support, family as a source of stress), (3) health system (trust/mistrust, patient–provider communication), and (4) environment (lack of access to safe exercise environment, lack of affordable food). Conclusion Our findings are relevant to public health practitioners, researchers, and policymakers seeking to shift from individual level or single interventions aimed at improving treatment-modality adherence to multilevel or multiple interventions for rural Latino communities.
BladderScan Feedback Method in Predicting Bladder Filling for Prostate Radiotherapy: A Prospective Study
Authors: Kuo Deng-Yu , Hsu Chen-Yang , Wang Wei-Chun , Chen Hsiu-Hsi , Shueng Pei-Wei 
Published: March 2021

Purpose: Approximately 5%–10% of men who receive prostate cancer radiotherapy will suffer from radiation cystitis. Bladder filling before the administration of radiotherapy results in lower radiation exposure to the bladder. BladderScan, an ultrasound-based bladder volume scanner, has the potential to evaluate bladder volume during radiotherapy; thus, a prospective pilot study was initiated. Methods: Eleven men receiving tomotherapy for localized prostate cancer were enrolled. The validity of BladderScan was evaluated by comparing the measurements from BladderScan with the calculated volume from megavoltage computed tomography (MVCT). With a crossover design to compare different methods in bladder filling, the radiotherapy was divided into 2 sequences. Conventional method: the patient was asked to drink water after voiding urine. The amount of water and the duration of waiting were the same as in the setting of the simulation. BladderScan feedback method: the bladder filling procedure depended on the BladderScan measurements. Results: There were 314 sets of data from 11 patients. The correlation coefficient between VBS and VCT was 0.87, where VBS is the mean volume of 3 measurements by BladderScan and VCT is the bladder volume derived from MVCT. The BladderScan feedback method resulted in a significant larger bladder volume than the conventional method, with a mean difference of 36.9 mL. When the failure was defined as VCT <80% of planned volume, the BladderScan feedback method brought about a relative reduction in the failure rate with an odds ratio of 0.44 and an absolute reduction of 9.1%. Conclusion: The accuracy of BladderScan was validated by MVCT in our study. The BladderScan feedback method can help patients fill the bladder adequately, with a larger bladder volume and a lower failure rate.
Rituximab in the treatment of immune-mediated necrotizing myopathy: a review of case reports and case series
Authors: Xiong Anji , Yang Guancui , Song Zhuoyao , Xiong Chen , Liu Deng , Shuai Yu , He Linqian , Zhang Liangwen , Guo Zepeng , Shuai Shiquan 
Published: March 2021

Immune-mediated necrotizing myopathy (IMNM) is a group of immune-related myopathies characterized by progressive proximal muscle weakness, extremely high serum creatine kinase (CK) levels, and necrotic muscle fibers with a relative lack of inflammation. Treatment of IMNM is challenging, with most cases refractory to high-dose steroids in combination with multiple immunotherapies. The role of rituximab (RTX) for IMNM has been explored in isolated case reports and small series. The aim of this article was to perform a literature review of patients with IMNM treated with RTX and to evaluate RTX efficacy and safety. A total of 34 patients with IMNM were reviewed: 52.9% (18/34) with anti-signal recognition particle (SRP) antibodies and 47.1% (16/34) with anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies. Patient age at onset varied from 11 years to 81 years (mean 41 years). The majority of patients presented as a severe proximal muscle weakness and the peak level of CK varied from 3900 IU/L to 56,000 IU/L (mean 18,440 IU/L). Prior to RTX administration, all patients were treated with high-dose steroids and most were treated with multiple immunotherapies. The reason for initiating RTX was that 64.7% (22/34) of patients showed no improvement after previous treatments, and 35.3% (12/34) of patients relapsed when attempting to wean steroids or other immunosuppressive agents. With regard to RTX efficacy, 61.8% (21/34) of patients presented a response to RTX. Our data may support the use of RTX as an effective treatment strategy against IMNM resistant to steroids and multiple immunotherapies. Meanwhile, RTX as a first-line therapy could be a choice in IMNM, particularly in African Americans with anti-SRP antibody-positive subsets. ANA, antinuclear antibody; CK, creatine kinase; HMGCR, 3-hydroxy-3-methylglutaryl-CoA reductase; IMNM, immune-mediated necrotizing myopathy; MAC, membrane attack complex; MHC-I, major histocompatibility complex-I; RTX, rituximab; SRP, signal recognition particle.