bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analytical and Experimental Studies on Wear in Spur Gear Running in Dry Condition
Authors: Sudhagar S. , Bhaskara Rao Lokavarapu 
Published: April 2021

Abstract
This study was performed to measure the extent of wear of unlubricated spur gears on the involute tooth. Contacts that roll and slide normally undergo wear. When material removal occurs due to surface wear from the gear profile, the surface pressure in the gear profile is redistributed. A mathematical model for predicting wear and wear pattern in spur gear has been developed. The prediction is based on wear-rate equation, load shared by the tooth in single-pair contact zone and double-pair contact zone. The distribution of the contact pressure was determined using the Hertzian cylindrical contact theory. For determining the sliding distance of the gears, the two-point observation method (TPOM) was used. Sliding distance at pitch point of gear and pinion was zero, because theoretically at pitch point, both zero sliding and pure rolling occur. The pin on the wear test method was used to obtain the wear-rate on the material and simplified to the time of measurement on the gear wear. Taguchi's method for the design of the experiment was used, which significantly reduced experimental time with less experiment.
Modulators of Change-of-Direction Economy After Repeated Sprints in Elite Soccer Players
Authors: Dolci Filippo , Kilding Andrew E. , Spiteri Tania , Chivers Paola , Piggott Ben , Maiorana Andrew , Hart Nicolas H. 
Published: April 2021

Purpose: To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect. Methods: Eleven young elite male soccer players (18.5 [1.4] y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with heart rate, minute ventilation, and blood lactate measured. Results: Pooled group analysis indicated no significant changes for SRE following RSA due to variability in individual responses, with a potentiation or impairment effect of up to 4.5% evident across soccer players. The SRE responses to RSA were significantly and largely correlated to players’ lower-body stiffness (r = .670; P = .024), and moderately (but not significantly) correlated to players’ force production (r = −.455; P = .237) and blood lactate after RSA (r = .327; P = .326). Conclusions: In summary, SRE response to RSA in elite male soccer players appears to be highly individual. Higher lower-body stiffness appears as a relevant physical contributor to preserve or improve SRE following RSA.
Autonomic and Perceptual Responses to Induction of a Ketogenic Diet in Free-Living Endurance Athletes: A Randomized, Crossover Trial
Authors: Maunder Ed , Dulson Deborah K. , Shaw David M. 
Published: April 2021

Purpose: Considerable interindividual heterogeneity has been observed in endurance performance responses following induction of a ketogenic diet (KD). It is plausible that a physiological stress response in the period following the dramatic dietary shift associated with transition to a KD may explain this heterogeneity. Methods: In a randomized, crossover study design, 8 trained male runners completed an incremental exercise test and ran to exhaustion at 70%VO2max before and after a 31-day rigorously controlled habitual diet or KD intervention, and recorded heart rate variability (root mean square of the sum of successive differences in R–R intervals [rMSSD]) upon waking each morning along with the recovery–stress questionnaire for athletes each week. Data were analyzed using linear mixed models. Results: A significant reduction in rMSSD was observed in the KD (−9.77 [4.03] ms, P = .02), along with an increase in day-to-day variability in rMSSD (2.1% [1.0%], P = .03). The reduction in rMSSD in the KD for the subgroup of individuals exhibiting impaired exercise capacity following induction of the KD approached significance (Δ −22 [15] ms, P = .06, N = 4); whereas no effect was observed in those who exhibited unchanged exercise capacity (Δ 5 [18] ms, P = .61, N = 4). No main effects were observed for recovery–stress questionnaire for athletes. Conclusions: Our data suggest those working with endurance athletes transitioning onto a KD may consider using noninvasive, inexpensive resting heart rate variability measures to gain individual-level insights into the likely short-term effects on exercise capacity.
Simultaneous kissing stents in acute left main total occlusion complicated with cardiogenic shock
Authors: Alsagaff Mochamad Yusuf , Hidayat Dwi Fachrul Octafian , Daida Hiroyuki 
Published: April 2021

We present a case of acute left main bifurcation lesion presenting as very high-risk non-ST elevation acute coronary syndrome. Consequently, an immediate invasive strategy for this complex anatomical lesion in an unstable patient requires an emergent bailout strategy to restore the haemodynamic condition.Our case shows the simultaneous kissing stents technique in a patient with a true left main bifurcation lesion (Medina 1-1-1) as a strategy to overcome the compromised haemodynamics. This protocol would be an alternative life-saving strategy in an acute setting.
Severe metabolic ketoacidosis as a primary manifestation of SARS-CoV-2 infection in non-diabetic pregnancy
Authors: van Amesfoort Jojanneke Epke , Werter Dominique E , Painter Rebecca C , Hermans Frederik J R 
Published: April 2021

We present a case of a metabolic acidosis in a term-pregnant woman with SARS-CoV-2 infection.Our patient presented with dyspnoea, tachypnoea, thoracic pain and a 2-day history of vomiting, initially attributed to COVID-19 pneumonia. Differential diagnosis was expanded when arterial blood gas showed a high anion gap metabolic non-lactate acidosis without hypoxaemia. Most likely, the hypermetabolic state of pregnancy, in combination with maternal starvation and increased metabolic demand due to infection, had resulted in metabolic ketoacidosis. Despite supportive treatment and rapid induction of labour, maternal deterioration and fetal distress during labour necessitated an emergency caesarean section. The patient delivered a healthy neonate. Postpartum, after initial improvement in metabolic acidosis, viral and bacterial pneumonia with subsequent significant respiratory compromise were successfully managed with oxygen supplementation and corticosteroids. This case illustrates how the metabolic demands of pregnancy can result in an uncommon presentation of COVID-19.
Therapeutic drug monitoring guides the management of patients with chronic non-infectious uveitis treated with adalimumab: a retrospective study
Authors: Sejournet Lucas , Kerever Sebastien , Mathis Thibaud , Kodjikian Laurent , Jamilloux Yvan , Seve Pascal 
Published: April 2021

AimTo assess the relevance of therapeutic drug monitoring (TDM) of adalimumab (ADA) treatment for the control of intraocular inflammation and treatment adjustment in chronic non-infectious uveitis (CNIU).MethodsRetrospective study of CNIU patients treated with ADA and for whom at least one dosage of serum ADA level and an antibodies against ADA (AAA) serology were performed, between June 2003 and July 2019.ResultsA total of 44 ADA-treated patients benefited from a TDM. A total of 48/79 (61%) TDM were performed in responders, 11/79 (14%) in primary non-responders, and 20/79 (25%) in secondary non-responders. Responders had significantly higher ADA levels than non-responders (p=0.0004). AAA were detectable in six patients, they were primary non-responders (n=2), secondary non-responders (n=3) or responders (n=1). In the five non-responders and immunised patients, ADA was switched (to golimumab or methotrexate). Among non-responders, TDM led to an increased frequency of injections 12/31 (38%), increased dose 1/31 (3%) and switch of treatment 10/31 (32%) (one missing data). No modification of biotherapy was performed 7/31 (22%) and only local or oral corticotherapy was adjusted. In 24/31 cases of therapeutic adjustment in non-responders, an improvement was observed in 87% of cases. Among responders for whom the ADA level was above the efficacy threshold, the frequency of injections was decreased for 15/31 (48.4%) cases and no relapse was observed in 12/15 (80%) cases.ConclusionTDM of ADA treatment proved relevant to provide CNIU patients with a personalised and optimised treatment course (in terms of frequency and type of drug).
Data sharing to improve concordance in variant interpretation across laboratories: results from the Canadian Open Genetics Repository
Authors: Mighton Chloe , Smith Amanda C , Mayers Justin , Tomaszewski Robert , Taylor Sherryl , Hume Stacey , Agatep Ron , Spriggs Elizabeth , Feilotter Harriet E , Semenuk Laura , Wong Henry , Lazo de la Vega Lorena , Marshall Christian R , Axford Michelle M , Silver Talia , Charames George S , Di Gioacchino Vanessa , Watkins Nicholas , Foulkes William D , Clavier Marcos , Hamel Nancy , Chong George , Lamont Ryan E , Parboosingh Jillian , Karsan Aly , Bosdet Ian , Young Sean S , Tucker Tracy , Akbari Mohammad Reza , Speevak Marsha D , Vaags Andrea K , Lebo Matthew S , Lerner-Ellis Jordan 
Published: April 2021

BackgroundThis study aimed to identify and resolve discordant variant interpretations across clinical molecular genetic laboratories through the Canadian Open Genetics Repository (COGR), an online collaborative effort for variant sharing and interpretation.MethodsLaboratories uploaded variant data to the Franklin Genoox platform. Reports were issued to each laboratory, summarising variants where conflicting classifications with another laboratory were noted. Laboratories could then reassess variants to resolve discordances. Discordance was calculated using a five-tier model (pathogenic (P), likely pathogenic (LP), variant of uncertain significance (VUS), likely benign (LB), benign (B)), a three-tier model (LP/P are positive, VUS are inconclusive, LB/B are negative) and a two-tier model (LP/P are clinically actionable, VUS/LB/B are not). We compared the COGR classifications to automated classifications generated by Franklin.ResultsTwelve laboratories submitted classifications for 44 510 unique variants. 2419 variants (5.4%) were classified by two or more laboratories. From baseline to after reassessment, the number of discordant variants decreased from 833 (34.4% of variants reported by two or more laboratories) to 723 (29.9%) based on the five-tier model, 403 (16.7%) to 279 (11.5%) based on the three-tier model and 77 (3.2%) to 37 (1.5%) based on the two-tier model. Compared with the COGR classification, the automated Franklin classifications had 94.5% sensitivity and 96.6% specificity for identifying actionable (P or LP) variants.ConclusionsThe COGR provides a standardised mechanism for laboratories to identify discordant variant interpretations and reduce discordance in genetic test result delivery. Such quality assurance programmes are important as genetic testing is implemented more widely in clinical care.
DFT study of low-energy electron interaction with pyridine, pyrazine and their halo derivatives
Authors: Tańska Natalia 
Published: April 2021

Abstract
In this work, the density functional theory with B3LYP hybrid functional was employed to calculate quantities useful for estimating the behavior of pyridine, pyrazine and their derivatives monosubstituted with Cl or Br atom, when exposed to low-energy electron impact. Vertical electron affinities obtained in several Pople basis sets and in aug-cc-pVTZ basis set are reported. Although some of the investigated molecules do not form stable anions, the results are in a satisfactory agreement with the available, albeit sparse experimental data, if the diffuse functions are included in calculations. It was found that the 6-31+G* basis is sufficient and its further enlargement does not significantly change the results. At this level of theory, potential energy curves, supported by enthalpies of dissociation to the neutral and anion fragment, were also determined for the description of the dissociative electron attachment. According to B3LYP, the potential energy curves of the halogen bond are almost repulsive in halopyridines, whereas halopyrazine anions require small activation energy for dissociation. Vertical electron affinities, enthalpies and equilibrium C-X distances (X=H, Cl, Br) were also calculated using Møller-Plesset second-order perturbation theory.

Graphic Abstract
The Hartle–Hawking–Israel state on spacetimes with stationary bifurcate Killing horizons
Authors: Gérard Christian 
Published: April 2021

We consider a free massive quantized Klein–Gordon field in a spacetime [Formula: see text] containing a stationary bifurcate Killing horizon, i.e. a bifurcate Killing horizon whose Killing vector field is globally time-like in the right wedge [Formula: see text] associated to the horizon. We prove the existence of the Hartle–Hawking–Israel (HHI) vacuum state, which is a pure state on the whole spacetime whose restriction to [Formula: see text] is a thermal state [Formula: see text] for the time-like Killing field at Hawking temperature [Formula: see text], where [Formula: see text] is the surface gravity of the horizon. We show that the HHI state is a Hadamard state and is the unique Hadamard state which is equal to the double [Formula: see text]-KMS state in the double wedge [Formula: see text]. We construct the HHI state by Wick rotation in Killing time coordinates, using the notion of the Calderón projector for elliptic boundary value problems.
Pseudo-Sylvester domains and skew Laurent polynomials over firs
Authors: Henneke Fabian , López-Álvarez Diego 
Published: April 2021

Building on recent work of Jaikin-Zapirain, we provide a homological criterion for a ring to be a pseudo-Sylvester domain, that is, to admit a division ring of fractions over which all stably full matrices become invertible. We use the criterion to study skew Laurent polynomial rings over free ideal rings (firs). As an application of our methods, we prove that crossed products of division rings with free-by-{infinite cyclic} and surface groups are pseudo-Sylvester domains unconditionally and Sylvester domains if and only if they admit stably free cancellation. This relies on the recent proof of the Farrell–Jones conjecture for normally poly-free groups and extends previous results of Linnell–Lück and Jaikin-Zapirain on universal localizations and universal fields of fractions of such crossed products.
Two-Year Follow Up of the LATERAL Clinical Trial
Authors: Wieselthaler Georg M. , Klein Liviu , Cheung Anson W. , Danter Matthew R. , Strueber Martin , Mahr Claudius , Mokadam Nahush A. , Maltais Simon , McGee Edwin C. 
Published: April 2021

Background:
The LATERAL trial validated the safety and efficacy of the thoracotomy approach for implantation of the HeartWare HVAD System, leading to Food and Drug Administration approval. We sought to analyze 24-month adverse event (AE) rates, including a temporal analysis of the risk profile, associated with the thoracotomy approach for the HVAD system.

Methods:
AEs from the LATERAL trial were evaluated over 2 years postimplant. Data was obtained from the Interagency Registry for Mechanically Assisted Circulatory Support database for 144 enrolled United States and Canadian patients. Temporal AE profiles were expressed as events per patient year.

Results:
During 162.5 patient years of support, there were 25 driveline infections (0.15 events per patient year), 50 gastrointestinal bleeds (0.31 events per patient year), and 21 strokes (0.13 events per patient year). Longitudinal AE analysis at follow-up intervals of <30 and 30 to 180 days, and 6 to 12 and 12 to 24 months revealed the highest AE rate at <30 days, with a decrease in total AEs within the first 6 months. After 6 months, most AE rates either stabilized or decreased through 2 years, including a 95% overall freedom from disabling stroke.

Conclusions:
Two-year follow-up of the LATERAL trial revealed a favorable morbidity profile in patients supported with the HVAD system, as AE rates were more likely to occur in the first 30 days postimplant, and overall AE rates were significantly reduced after 6 months. Importantly, 2-year freedom from disabling stroke was 95%. These data further support the improving AE profile of patients on long-term HVAD support.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02268942.
Increased Risk of Congestive Heart Failure Following Carbon Monoxide Poisoning
Authors: Huang Chien-Cheng , Chen Tzu-Hao , Ho Chung-Han , Chen Yi-Chen , Hsu Chien-Chin , Lin Hung-Jung , Wang Jhi-Joung , Chang Ching-Ping , Guo How-Ran 
Published: April 2021

Background:
Carbon monoxide poisoning (COP) is an important public health issue around the world. It may increase the risk of myocardial injury, but the association between COP and congestive heart failure (CHF) remains unclear. We conducted a study incorporating data from epidemiological and animal studies to clarify this issue.

Methods:
Using the National Health Insurance Database of Taiwan, we identified patients with COP diagnosed between 1999 and 2012 and compared them with patients without COP (non-COP cohort) matched by age and the index date at a 1:3 ratio. The comparison for the risk of CHF between the COP and non-COP cohorts was made using Cox proportional hazards regression. We also established a rat model to evaluate cardiac function using echocardiography and studied the pathological changes following COP.

Results:
The 20 942 patients in the COP cohort had a higher risk for CHF than the 62 826 members in the non-COP cohort after adjusting for sex and underlying comorbidities (adjusted hazard ratio, 2.01 [95% CI, 1.74–2.32]). The increased risk of CHF persisted even after 2 years of follow-up (adjusted hazard ratio, 1.85 [95% CI, 1.55–2.21]). In the animal model, COP led to a decreased left ventricular ejection fraction on echocardiography and damage to cardiac cells with remarkable fibrotic changes.

Conclusions:
Our epidemiological data showed an increased risk of CHF was associated with COP, which was supported by the animal study. We suggest close follow-up of cardiac function for patients with COP to facilitate early intervention and further studies to identify other long-term effects that have not been reported in the literature.
Global Differences in Heart Failure With Preserved Ejection Fraction
Authors: Tromp Jasper , Claggett Brian L. , Liu Jiankang , Jackson Alice M. , Jhund Pardeep S. , Køber Lars , Widimský Jiří , Boytsov Sergey A. , Chopra Vijay K. , Anand Inder S. , Ge Junbo , Chen Chen-Huan , Maggioni Aldo P. , Martinez Felipe , Packer Milton , Pfeffer Marc A. , Pieske Burkert , Redfield Margaret M. , Rouleau Jean L. , Van Veldhuisen Dirk J. , Zannad Faiez , Zile Michael R. , Rizkala Adel R. , Inubushi-Molessa Akiko , Lefkowitz Martin P. , Shi Victor C. , McMurray John J.V. , Solomon Scott D. , Lam Carolyn S.P. ,   on behalf of the PARAGON-HF Investigators
Published: April 2021

Background:
Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most inclusive global HFpEF trial.

Methods:
We studied differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region.

Results:

Regional differences in patient characteristics and comorbidities were observed: patients from Western Europe were oldest (mean 75±7 years) with the highest prevalence of atrial fibrillation/flutter (36%); Central/Eastern European patients were youngest (mean 71±8 years) with the highest prevalence of coronary artery disease (50%); North American patients had the highest prevalence of obesity (65%) and diabetes (49%); Latin American patients were younger (73±9 years) and had a high prevalence of obesity (53%); and Asia-Pacific patients had a high prevalence of diabetes (44%), despite a low prevalence of obesity (26%). Rates of the primary composite end point of total hospitalizations for HF and death from cardiovascular causes were lower in patients from Central Europe (9 per 100 patient-years) and highest in patients from North America (28 per 100 patient-years), which was primarily driven by a greater number of total hospitalizations for HF. The effect of treatment with sacubitril-valsartan was not modified by region (interaction
P
>0.05).

Conclusions:
Among patients with HFpEF recruited worldwide in PARAGON-HF, there were important regional differences in clinical characteristics and outcomes, which may have implications for the design of future clinical trials.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01920711.
Medullary breast carcinoma: a pathogenic review and immunohistochemical study using tissue microarray
Authors: Lee Ming , Jara-Lazaro Ana Richelia , Cheok Poh Yian , Thike Aye Aye 
Published: April 2021

Abstract

Introduction:
Medullary breast carcinomas (MBCs) are distinguished by circumscribed, high-grade morphology with dense chronic inflammation; they are associated with the basal phenotype but have a relatively good prognosis.

Methods:
This study aimed to review the clinicopathological features of MBCs diagnosed at the Department of Pathology, Singapore General Hospital and correlate them with immunohistochemical expression of hormonal markers and c-erbB-2, the basal markers p53, cytokeratin (CK) 14, epidermal growth factor receptor (EGFR) and 34BE12, and the follow-up outcome.

Results:
Using Ridolfi’s criteria for histologic reviews, 62 patients previously diagnosed as having ‘typical MBC’ (n = 26), ‘atypical MBC’ (n = 32) and ‘invasive carcinoma with focal medullary-like features’ (n = 4) were re-classified as follows: ‘typical MBC’ (n = 6; 9.7%), ‘atypical MBC’ (n = 46; 74.2%), and ‘non-medullary infiltrating carcinoma’ (n = 10; 16.1%). Clinicopathological parameters, including ethnicity, age, tumour size and concurrent ductal carcinoma in situ (DCIS), showed no statistically significant correlation with review diagnoses and immunohistochemical findings. Presence of lymphovascular invasion and nodal stage were significantly correlated with recurrence and breast cancer-related deaths, respectively. ER negativity was significantly correlated with triple positivity for basal markers CK14, EGFR and 34BE12, which comprised patients who showed a significantly decreased disease-free survival rate within a 10–15-year follow-up period.

Conclusions:
Lymphovascular invasion and high nodal stage as well as triple negativity among typical and atypical MBCs that have basal-like phenotype represent a portion of invasive carcinomas with medullary features that may have poor outcomes in this otherwise relatively good prognostic group.