bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing organizational learning for scaling‐up community‐based primary health care in Ghana
Authors: Awoonor‐Williams John Koku , Phillips James F. 
Published: June 2021

AbstractIntroductionAchieving effective community‐based primary health care requires evidence for guiding strategic decisions that must be made. However, research processes often limit data collection to particular organizational levels or disseminate results to specific audiences. Decision‐making that emerges can fail to account for the contrasting perspectives and needs of managers at each organizational level. The Ghana Health Service (GHS) addressed this problem with a multilevel and sequential research and action approach that has provided two decades of implementation learning for guiding community‐based primary health care development.MethodThe GHS implementation research initiatives progressed from (i) a participatory pilot investigation to (ii) an experimental trial of strategies that emerged to (iii) replication research for testing scale‐up, culminating in (iv) evidence‐based scale‐up of a national community‐based primary health care program. A reform process subsequently repeated this sequence in a manner that involved stakeholders at the community, sub‐district, district, and regional levels of the system. The conduct, interpretation, and dissemination of results that emerged comprised a strategy for achieving systems learning by conducting investigations in phases in conjunction with bottom‐up knowledge capture, lateral exchanges for fostering peer learning at each system level, and top‐down processes for communicating results as policy. Continuous accumulation of qualitative data on stakeholder reactions to operations at each organizational level was conducted in conjunction with quantitative monitoring of field operations.ResultsImplementation policies were enhanced by results associated with each phase. A quasi‐experiment for testing the reform process showed that scale‐up of community‐based primary health care was accelerated, leading to improvements in childhood survival and reduced fertility.ConclusionChallenges to system learning were overcome despite severe resource constraints. The integration of knowledge generation with ongoing management processes institutionalized learning for achieving evidence‐driven program action.
Free medialis tarsus flap transfer for reconstruction of toe necrosis: A case report
Authors: Tsukuura Reiko , Yamamoto Takumi 
Published: June 2021

AbstractThe medial tarsal area is a commonly used donor site for skin grafts to the digits and toes, with good color and texture match as well as a concealable donor site scar. Yet, there has been no report as a perforator free flap donor site. The purpose of this report is to present a new perforator flap harvested from medial tarsal region. We present a case of a soft tissue defect of the fifth toe due to essential thrombocythemia (ET), successfully treated with a free medialis tarsus flap (MTF) transfer. A 62‐year‐old male with ET suffered from the right fifth toe necrosis caused by digital artery thrombosis. After the manifestation of the necrosis, necrotic tissue was completely debrided, which resulted in a 3 × 1.5 cm skin defect with exposure of the tendon and the phalangeal bone. Sixth days after debridement, a 4.5 × 1.7 cm MTF was harvested transversely and inferiorly to the right medial ankle, locating the preoperatively detected posterior tibial artery perforator (PTAP) in the flap. Perforator‐to‐perforator anastomosis was done using the dorsal metatarsal artery perforator and the subcutaneous vein as recipient vessels. The donor site was closed primarily. Postoperative course was uneventful, and the reconstruction preserved the toe length and functions of extension and flexion at 9 months postoperatively. The patient could walk with conventional shoes by himself. MTF may be an option for small skin defect in the digits and toes where skin graft is not indicated.
Crack growth angle prediction of an internal crack under mixed mode load for unfilled elastomer using the strain energy density factor
Authors: El Yaagoubi Mohammed , Meier Jens 
Published: June 2021

ABSTRACTThis article investigates the prediction of the crack growth angle of an existing internal crack under mixed mode loading at the crack tip for an unfilled ethylene propylene diene terpolymer rubber (EPDM). For the realization of mixed mode loading, the cracks of the uniaxial loaded specimens were oriented with different angles to the loading direction. The energy density factor was used as a potential criterion for determining the crack growth angle. The determination of the strain energy density factor was carried out simulatively in Abaqus. The second‐order Ogden model was used to describe the rubber‐like material behavior. The relative local minimum of the strain energy density factor provides the possible growth angle. The experimental investigations show that the initial cracks grow orthogonally to the loading direction for the different crack orientation angles. For the crack orientation angle parallel to the load direction, the crack growth was observed because the strong stretching of the specimen caused strong necking in the crack region. The crack growth for the remaining crack orientation angles were induced due to shear loading at the crack tip. The predictive angle of different crack orientation angles shows very good accordance to the measured crack growth angles.
Impact responses of an open‐cell natural rubber foam impregnated with shear thickening fluid
Authors: Kaewpradit Pornsiri , Kongchoo Arunya , Chonlathan Pannarai , Lehman Nussana , Kalkornsurapranee Ekwipoo 
Published: June 2021

AbstractThis research aims to investigate the impact responses of an impact absorbing material prepared from natural rubber (NR). Shear thickening fluid (STF) was developed in order to improve compatibility, and impact response capability of a NR foam. The material was prepared by impregnating NR foam with STF (30 wt% nanosilica with 10 nm). The obtained material is soft under normal circumstances, but immediately stiff when undergoing sudden impact before softening again. The effects of foam densities (0.098, 0.15, 0.24 g/cm3), STF contents (10, 20, 30 vol%), and fluid filling techniques were investigated. Experimental results show that the absorbed force tends to increase by increasing the foam density and the fluid content. Impact absorption capability of the proposed STF (STFA)/NR foam is higher than that of the conventional STF (STF0)/NR foam. In other words, STFA can improve the impact responses of the material providing comparable results with the commercial kneepad, which has the dilatant behavior.
Ultrasonographic prevalence of ulnar nerve displacement at the elbow in young baseball players
Authors: Kawabata Masashi , Miyata Toru , Tatsuki Hiroaki , Naoi Daichi , Ashihara Mitsuaki , Miyatake Kazuma , Kusaba Yohei , Watanabe Daiki , Matsuzaki Masashi , Suzuki Yuta , Kamiya Kentaro 
Published: June 2021

AbstractBackgroundOverhead‐throwing athletes are at risk of elbow injury because of valgus stress, leading to unstable ulnar nerves and neuropathy. Studies regarding ulnar nerve damage/displacement have been performed primarily in adults.ObjectiveTo determine the prevalence and related factors associated with ulnar nerve displacement at the elbow in young baseball players.DesignCross‐sectional study.ParticipantsYouth baseball players ages 10–12 years were eligible to participate. Exclusion criteria were history of neuropathic pain, trauma, or prior surgery of the upper limb. Fifty‐seven participants were eligible for inclusion in the study.Main Outcome MeasurementsDemographic data and ultrasonography findings of ulnar nerve dynamics at the cubital tunnel were analyzed in a total of 114 elbows. Elbows were grouped into nondislocation and displacement (subluxation or dislocation) groups according to ultrasound findings. Logistic generalized estimating equations were used to identify factors associated with ulnar nerve displacement.ResultsThirty‐six (31.6%) elbows demonstrated sonographic findings of ulnar nerve displacement, with 13 (11.4%) subluxations and 23 (20.2%) dislocations. Fourteen (24.6%) participants experienced nerve displacement in the dominant elbow only, whereas nerve displacement in both elbows occurred in 11 (19.3%) participants. Nerve displacement in the nondominant elbow only was not observed. Hand dominance and tenderness of the arcade of Struthersʼ were factors associated with ulnar nerve displacement (odds ratio, 2.81, and 9.73; 95% confidence interval, 1.34–5.91 and 2.45–38.68; p = .006 and .001, respectively).ConclusionOne‐third of the young baseball players evaluated had ultrasonographic findings compatible with ulnar nerve displacement at the elbow. Hand dominance and tenderness of Struthers arcade were the only factors associated with ulnar nerve displacement. Ultrasound may help identify patients with ulnar nerve displacement and contribute to the understanding of its pathophysiology in young baseball players.
Blood eosinophils, specific immunoglobulin E, and bronchiolitis severity
Authors: Mitri Elie J. , Zheng David X. , Garg Vebhav , Crifase Cassandra C. , Herrera Nicole M. , Espinola Janice A. , Hasegawa Kohei , Camargo Carlos A. 
Published: June 2021

AbstractBackgroundBronchiolitis is the leading cause of hospitalization for United States infants. Blood eosinophil and serum specific IgE (sIgE) levels are separately linked to clinical severity but few studies have examined these biomarkers together.ObjectiveAmong infants hospitalized for bronchiolitis, we investigated the association between (1) blood eosinophilia and severity, (2) sIgE sensitization and severity, and (3) interaction between the two biomarkers on severity.MethodsWe enrolled 1016 infants hospitalized for bronchiolitis between 2011 and 2014 across 17 U.S. hospitals into a prospective cohort study. Of those, 873 (86%) had eosinophils measured and all had sIgE levels from blood collected at hospitalization. We investigated higher bronchiolitis severity using intensive care therapy as the outcome (i.e., intensive care unit admission, intubation, and/or receipt of continuous positive pressure ventilation).ResultsAmong 873 infants in the analytic cohort, 18% had blood eosinophilia of ≥3%, and 20% were positive for sIgE. With regard to bronchiolitis severity, 15% received intensive care therapy. In unadjusted analyses, eosinophils ≥3% was not associated with intensive care therapy, while sIgE was associated with a significantly higher risk (odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.08–1.92; p = .01). In a multivariable model for intensive care therapy, eosinophilia remained unassociated with severity, and sIgE remained associated (OR: 1.60, 95% CI: 1.05–2.45; p = .03). Also, sIgE did not modify the association between eosinophil level and intensive care therapy (pinteraction = .14).ConclusionBlood eosinophilia of ≥3% was not associated with bronchiolitis severity. By contrast, sIgE was independently associated with bronchiolitis severity and did not modify the association between eosinophil level and severity.
Intensity‐modulated radiotherapy combined with intensity‐modulated radiotherapy CT–guided iodine 125 seed brachytherapy for non‐small cell lung cancer: A case report
Authors: Gu Xinyi , Wang Zhe , Sun Yingming , Yang Liang , Wu Jinyu , Ju Zaishuang , Wang Ruoyu 
Published: June 2021

AbstractIntensity‐modulated radiotherapy (IMRT) has been used to treat locally advanced non‐small cell lung cancer (LA‐NSCLC) disseminated to primary gross tumor volume (pGTV) and mediastinal lymph nodes (LNs). However, it is challenging to deliver definitive doses to the pGTV and regional LNs without exceeding the tolerance of the organs at risk (OAR). Iodine‐125 (I‐125) brachytherapy has recently been applied in clinical practice for the treatment of malignant tumors. Its merits include a higher dose to the primary tumor lesion and lower dose surrounding the tumor mass. Using brachytherapy in these settings may maximize the dose delivered to the pGTV while minimizing the dose delivered to the OAR. I‐125 brachytherapy combined with IMRT for the treatment of LA‐NSCLC has rarely been reported. Here we report a patient with peripheral squamous cell carcinoma of the lung who received I‐125 brachytherapy for pulmonary lung lesions and IMRT for metastatic mediastinal LNs. The patient received 16 months of follow‐up care with no evidence of complications or disease recurrence. Moreover, we compared brachytherapy plus IMRT to theoretically planned IMRT dosimetry to evaluate the merits of each approach. This treatment modality resulted in a higher target dose escalation and lower doses delivered to the OAR.
Layer of protection analysis as auxiliary technique in process safety incident investigations
Authors: Pawolocki Fernando Javier 
Published: June 2021

AbstractThis work demonstrates the usefulness in using layer of protection analysis (LOPA) concept as an auxiliary technique in process safety incident investigations. It allows the investigation team to go further in causal analysis, by identifying and exploring the role played by each layer of protection in the incident, looking for “holes” as findings (causes) to use in the investigation process. This approach achieves better quality investigations, with more accurate lessons learned, and recommendations, as well as developing a clearer way to communicate what happened. This approach helps anyone who reads the incident report understand and learn about the process safety incident. Moreover, it provides a clearer way to communicate what happened, helping everyone who sees the incident report to understand and learn about how the process safety incident evolved from process deviation going thru the layers of protection up to the emergency response. At the same time, it shows what a process safety incident is in a much more suitable and understandable way, which emphasizes the process safety point of view, impacting in the organization process safety culture.
Epoxydicoumarin Derivative is a Novel Non‐Nucleoside TLR8 Agonist: Screening, Synthesis and Biological Evaluation
Authors: Damuka Naresh , Kammari Kurumurthy , Potshangbam Angamba Meetei , Kondapi Anand Kumar , Vindal Vaibhav 
Published: June 2021

AbstractToll‐like receptors (TLRs) activate host innate immunity by recognizing microbial ligands and viral nucleic acids. Of late, TLR8 has emerged as an attractive target for antiviral activity, antitumor activity and vaccine development owing to its ability to recognize small synthetic molecules that induce pro‐inflammatory cytokines, type 1 interferons and chemokines. Of the many synthetic and natural ligands researched so far, ligands derived from coumarin have been known to have enhanced antiviral and immunomodulatory properties. Thus, the coumarin scaffold plays an important role through the modulation of cytokines by noncovalent interactions with various enzymes and receptors. The present study aims to identify a coumarin derivative that binds to the TLR8 receptor and induce NF‐κB activity. In silico screening and chemical synthesis were performed to realize novel coumarin leads with potential TLR8 agonistic activity. HEK‐Blue™ hTLR8 cell line was used to validate the TLR8 agonist evaluation In vitro. The key finding of this study brings out strong evidence supporting the binding of the 3,31‐(411‐N,N‐dimethylaminophenylmethylene)‐4,41‐epoxydicoumarin to TLR8 receptor in comparison to the co‐crystallized R848 ligand.
A Waterborne Polyurethane‐Based Dye with Green Fluorescence Excited by Visible Light
Authors: Li Mingjun , Hu Xianhai , Xian Yuxi , Liu Xiang , Liu Manli , Li Gen , Hu Pengwei , Cheng Congliang , Liu Jin , Wang Ping 
Published: June 2021

AbstractA waterborne aminofluorescein polyurethane‐based dye (AF‐WPU) with green fluorescence excited by visible light was synthesized by anchoring aminofluorescein (AF) to waterborne polyurethane chains. The structural characteristics of AF‐WPU was confirmed by means of 1H‐NMR, FT‐IR and UV‐vis absorption. Compared with AF, there is a hypsochromic shift, and a new absorption peak generating in the UV‐vis spectra of AF‐WPU. Meanwhile, AF‐WPU emited excellent fluorescence. The fluorescence intensity of AF‐WPU increased five times at the same concentration. It is found that the fluorescence intensities of AF‐WPU decreaseed with increased temperature, and increased first and then decreased with increasing concentration. The fluorescence of AF‐WPU is very stable and insensitive to quenching agents. Moreover, AF‐WPU which excited by visible light is less phototoxic to health, and has a broad prospect in practical applications.
Defect‐Rich Core‐Shell Carbon Derived from Ionic Liquid for Direct Synthesis of Imines
Authors: He Peipei , Lv Ying , Shang Sensen , Chen Bo , Liang Hongliang , Niu Jingyang , Dai Wen 
Published: June 2021

AbstractDevelopment of metal‐free catalysis in chemical transformation is highly desirable due to its significant inherent advantages compared with conventional metal or metal oxide catalysts but challenging. Herein, ionic liquid 1‐ethyl‐3‐methylimidazolium dicyanamide and sodium tetraphenylborate were employed as joint precursors to facilely prepare micro‐mesoporous core‐shell carbon with specific surface area up to 2870 m2 g−1, consisting of smooth unpenetrated shell and secondary hollow spherical carbon core. The as‐obtained core‐shell carbon as metal‐free catalyst exhibited good performance for self‐coupling and cross‐coupling of amines to achieve the corresponding symmetry and asymmetry imines under mild and neat conditions. Excitingly, for the challenging aliphatic amines, the desired imines were achieved in our case in 55.9 % yield. The nearly linearly correlation between imine yield and ID/IG indicated that the resulting defects from departure of heteroatoms during pyrolysis may be active site.
Task‐Specific Deep Eutectic Solvent for Selective Oxidation of Aromatic Methyl to Aldehyde
Authors: Bhise Rupali S. , Patel Khushbu P. , Ghorpade Prashant V. , Shankarling Ganapati S. 
Published: June 2021

AbstractBiodegradable and economically viable choline chloride‐FeCl2.H2O deep eutectic solvent (DES), was synthesized and successfully utilized as a catalyst and reaction medium for the selective oxidation of aromatic methyl groups to aldehydes. To demonstrate the synthetic potential of this protocol, the reaction was scaled up to the gram scale. The DES could be reused up to four times without considerable effect on the yield of the reaction. The key features of the protocol that qualify the process as green include the ambient reaction temperatures, easy isolation of the products, higher yields, recyclability of the catalyst, and reactions without the use of conventional organic solvents.
Late Cretaceous hydrothermal vent communities from the Troodos ophiolite, Cyprus: systematics and evolutionary significance
Authors: Kaim Andrzej , Little Crispin T.S. , Kennedy William J. , Mears Ellen M. , Anderson Louise M. 
Published: June 2021

AbstractModern hydrothermal vent communities are based on chemosynthesis by microbial primary producers. Molecular phylogenetic divergence estimates indicate that many of the dominant vent taxa arose during the Cenozoic and Cretaceous; however, the fossil record of vent communities from these time periods is poor. One occurrence of such Cretaceous vent communities pertains to six volcanogenic massive sulphide deposits in the Troodos ophiolite of Cyprus. These deposits represent hydrothermal activity on deep (2500–5000 m) arc‐related spreading ridge(s) in the Neotethyan Ocean over several million years during the late Cenomanian and earliest Turonian. The Cyprus vent communities consist of worm tubes, representing possible vestimentiferans and serpulids, together with a moderate diversity of abyssochrysoid gastropods, belonging to eight new species (Desbruyeresia kinousaensis sp. nov., Desbruyeresia memiensis sp. nov., Desbruyeresia kambiaensis sp. nov., Hokkaidoconcha morisseaui sp. nov., Ascheria canni sp. nov., Cyprioconcha robertsoni gen. et sp. nov., Paskentana xenophontosi sp. nov. and Paskentana dixoni sp. nov.) in five genera and three families; none of the species is shared between vent sites. A single gaudryceratid ammonite from one of the vent sites most likely represents a water‐logged shell that sank from surface waters. The gastropod fauna contains the first representatives of the genera Desbruyeresia, Hokkaidoconcha, Ascheria and Paskentana from hydrothermal vents, and also the youngest representative of the last‐named genus in any environment. The Cypriot vent communities share tube worms with slightly older (Cenomanian) and younger (Turonian–Santonian) vent communities elsewhere in the western part of the Neotethyan Ocean.
Investigation of impact behavior of reinforced concrete beam to column connection strengthened with carbon fiber‐reinforced polymer strips
Authors: Kaya Turgut , Aras Murat , Yilmaz Tolga , Çalişkan Özlem , Anil Özgür , Erdem R. Tuğrul 
Published: June 2021

AbstractReinforced concrete (RC) members may expose to impulsive dynamic loads due to the reasons such as the explosions occurring in the interior or exterior part of them, rockfall, the vehicle crash to the bridges, the collision of masses with the effects of floods and landslide. Many studies have investigated the effects of impulsive dynamic loads on the beam, column, and slab RC structural elements have been investigated in the literature. However, the authors have not encountered any study focused on the impact behavior of beam to column connections of the frames constructing the bearing system of reinforced concrete structures. Therefore, an experimental study has been planned to investigate RC beam impact behavior to column connections strengthened with carbon fiber‐reinforced polymer (CFRP) strips. The concrete compressive strength, shear reinforcement spacing, CFRP strip spacing, and input impact energy applied to test specimens were taken as experimental variables. The time histories of impact load acting on test specimens, accelerations, displacements, and the strains measured from CFRP strips have been recorded in experiments. The experimental variables' effect on dynamic responses of RC beam to column connections strengthened with CFRP strips subjected to impact load has been interpreted in detail. The study's scope and improved numerical analysis procedure have also been introduced to verify experimental results. Good agreement between numerical and experimental results demonstrated that the presented numerical procedures could be safely used for evaluation of impact behavior of RC beam to column connections strengthened with CFRP strips.
Antibiofilm activity of silver nanoparticles against biofilm forming Staphylococcus pseudintermedius isolated from dogs with otitis externa
Authors: Seo Mimi , Oh Taeho , Bae Seulgi 
Published: June 2021

BackgroundSilver nanoparticles (AgNPs) are known to possess antimicrobial properties. Although the antibiofilm activity of AgNPs has been demonstrated in humans, this activity has not yet been elucidated in veterinary medicine.ObjectivesThe purpose of this study was to evaluate the antibiofilm activity of silver nanoparticles against Staphylococcus pseudintermedius.MethodsTen isolates of S. pseudintermedius obtained from dogs with otitis externa were treated with AgNPs, and the antibiofilm activity was measured using a modified microtiter plate and Congo red agar (CRA) method and scanning electron microscopy.ResultsAgNPs displayed a significant dose‐dependent antibiofilm activity and reduced biofilm formation at concentrations of 20 and 10 µg/ml (p < 0.05). S. pseudintermedius exposed to 20 µg/ml of AgNPs formed less bacterial slime compared to the controls on CRA plates. Scanning electron micrographs showed that the biofilm had few individually scattered cells along its surface when treated with AgNP concentrations of 20 and 10 µg/ml. Untreated surfaces showed an aggregated biofilm.ConclusionsOur results suggested that AgNP may be a valuable alternative antibiofilm agent for canine otitis externa.