bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Progress and Prospect on Tooth Modification of Involute Cylindrical
Gear
Authors: Han Lin , Qi Yang 
Published: April 2021

Background:
Recent reviews on tooth modification of involute cylindrical gear are presented.
Gear pairs are widely employed in motion and power transmission systems. Manufacturing
and assembling errors of gear parts, time-varying mesh stiffness, and transmission error of gear pair
usually induce vibration, noise, non-uniformly load distribution, and stress concentration, resulting
in earlier failure of gear. Tooth modification is regarded as one of the most popular ways to suppress
vibration, reduce the noise level, and improve the load distribution of gear pairs.

Objective:
The objective of this study was to provide an overview of recent research and patents on
tooth modification methods and technology.

Methods:
This article reviews related research and patents on tooth modification. The modification
method, evaluation, optimization, and machining technology are introduced.

Results:
Three types of modifications are compared and analyzed, and influences of each on both
static and dynamic performances of gear pair are concluded. By summarizing a number of patents
and research about tooth modification of cylindrical gears, the current and future development of
research and patent are also discussed.

Conclusion:
Tooth modification is classified into the tip or root relief along with tooth profile, lead
crown modification along tooth width, and compound modification. Each could be applied in different
ways. In view of design, optimization under the given working condition to obtain optimal
modification parameters is more practical. Machining technology and device for modified gear is a
key to get high-quality performance of the geared transmission. More patents on tooth modification
should be invented in the future.
Federated Learning for Thyroid Ultrasound Image Analysis to Protect Personal Information: Validation Study in a Real Health Care Environment
Authors: Lee Haeyun , Chai Young Jun , Joo Hyunjin , Lee Kyungsu , Hwang Jae Youn , Kim Seok-Mo , Kim Kwangsoon , Nam Inn-Chul , Choi June Young , Yu Hyeong Won , Lee Myung-Chul , Masuoka Hiroo , Miyauchi Akira , Lee Kyu Eun , Kim Sungwan , Kong Hyoun-Joong 
Published: April 2021

Background
Federated learning is a decentralized approach to machine learning; it is a training strategy that overcomes medical data privacy regulations and generalizes deep learning algorithms. Federated learning mitigates many systemic privacy risks by sharing only the model and parameters for training, without the need to export existing medical data sets. In this study, we performed ultrasound image analysis using federated learning to predict whether thyroid nodules were benign or malignant.

Objective
The goal of this study was to evaluate whether the performance of federated learning was comparable with that of conventional deep learning.

Methods
A total of 8457 (5375 malignant, 3082 benign) ultrasound images were collected from 6 institutions and used for federated learning and conventional deep learning. Five deep learning networks (VGG19, ResNet50, ResNext50, SE-ResNet50, and SE-ResNext50) were used. Using stratified random sampling, we selected 20% (1075 malignant, 616 benign) of the total images for internal validation. For external validation, we used 100 ultrasound images (50 malignant, 50 benign) from another institution.

Results
For internal validation, the area under the receiver operating characteristic (AUROC) curve for federated learning was between 78.88% and 87.56%, and the AUROC for conventional deep learning was between 82.61% and 91.57%. For external validation, the AUROC for federated learning was between 75.20% and 86.72%, and the AUROC curve for conventional deep learning was between 73.04% and 91.04%.

Conclusions
We demonstrated that the performance of federated learning using decentralized data was comparable to that of conventional deep learning using pooled data. Federated learning might be potentially useful for analyzing medical images while protecting patients’ personal information.
An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study
Authors: Vilendrer Stacie , Amano Alexis , Brown Johnson Cati G , Favet Marissa , Safaeinili Nadia , Villasenor Jacqueline , Shaw Jonathan G , Hertelendy Attila J , Asch Steven M , Mahoney Megan 
Published: April 2021

Background
The COVID-19 pandemic has created unprecedented challenges for first responders (eg, police, fire, and emergency medical services) and nonmedical essential workers (eg, workers in food, transportation, and other industries). Health systems may be uniquely suited to support these workers given their medical expertise, and mobile apps can reach local communities despite social distancing requirements. Formal evaluation of real-world mobile app–based interventions is lacking.

Objective
We aimed to evaluate the adoption, acceptability, and appropriateness of an academic medical center–sponsored app-based intervention (COVID-19 Guide App) designed to support access of first responders and essential workers to COVID-19 information and testing services. We also sought to better understand the COVID-19–related needs of these workers early in the pandemic.

Methods
To understand overall community adoption, views and download data of the COVID-19 Guide App were described. To understand the adoption, appropriateness, and acceptability of the app and the unmet needs of workers, semistructured qualitative interviews were conducted by telephone, by video, and in person with first responders and essential workers in the San Francisco Bay Area who were recruited through purposive, convenience, and snowball sampling. Interview transcripts and field notes were qualitatively analyzed and presented using an implementation outcomes framework.

Results
From its launch in April 2020 to September 2020, the app received 8262 views from unique devices and 6640 downloads (80.4% conversion rate, 0.61% adoption rate across the Bay Area). App acceptability was mixed among the 17 first responders interviewed and high among the 10 essential workers interviewed. Select themes included the need for personalized and accurate information, access to testing, and securing personal safety. First responders faced additional challenges related to interprofessional coordination and a “culture of heroism” that could both protect against and exacerbate health vulnerability.

Conclusions
First responders and essential workers both reported challenges related to obtaining accurate information, testing services, and other resources. A mobile app intervention has the potential to combat these challenges through the provision of disease-specific information and access to testing services but may be most effective if delivered as part of a larger ecosystem of support. Differentiated interventions that acknowledge and address the divergent needs between first responders and non–first responder essential workers may optimize acceptance and adoption.
Using a Scenario-Based Approach to Teaching Professionalism to Medical Students: Course Description and Evaluation
Authors: Ashcroft James , Warren Patrick , Weatherby Thomas , Barclay Stephen , Kemp Laurence , Davies Richard Justin , Hook Catherine Elizabeth , Fistein Elizabeth , Soilleux Elizabeth 
Published: April 2021

Background
Doctors play a key role in individuals’ lives undergoing a holistic integration into local communities. To maintain public trust, it is essential that professional values are upheld by both doctors and medical students. We aimed to ensure that students appreciated these professional obligations during the 3-year science-based, preclinical course with limited patient contact.

Objective
We developed a short scenario-based approach to teaching professionalism to first-year students undertaking a medical course with a 3-year science-based, preclinical component. We aimed to evaluate, both quantitatively and qualitatively, student perceptions of the experience and impact of the course.

Methods
An interactive professionalism course entitled Entry to the Profession was designed for preclinical first-year medical students. Two scenario-based sessions were created and evaluated using established professionalism guidance and expert consensus. Quantitative and qualitative feedback on course implementation and development of professionalism were gathered using Likert-type 5-point scales and debrief following course completion.

Results
A total of 70 students completed the Entry to the Profession course over a 2-year period. Feedback regarding session materials and logistics ranged from 4.16 (SD 0.93; appropriateness of scenarios) to 4.66 (SD 0.61; environment of sessions). Feedback pertaining to professionalism knowledge and behaviors ranged from 3.11 (SD 0.99; need for professionalism) to 4.78 (SD 0.42; relevance of professionalism). Qualitative feedback revealed that a small group format in a relaxed, open environment facilitated discussion of the major concepts of professionalism.

Conclusions
Entry to the Profession employed an innovative approach to introducing first-year medical students to complex professionalism concepts. Future longitudinal investigations should aim to explore its impact at various stages of preclinical, clinical, and postgraduate training.
Proof-of-Concept Support for the Development and Implementation of a Digital Assessment for Perinatal Mental Health: Mixed Methods Study
Authors: Martin-Key Nayra Anna , Spadaro Benedetta , Schei Thea Sofie , Bahn Sabine 
Published: April 2021

Background
Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the United Kingdom, with outbreaks of disease, like the COVID-19 pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies.

Objective
The aim of this study was to conduct a mixed methods evaluation of the current state of perinatal mental health care provision in the United Kingdom, as well as users’ (women and partners) and midwives’ interest in using a digital mental health assessment throughout the perinatal period.

Methods
Women, partners, and midwives were recruited to participate in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Behavior model and summarized using descriptive statistics.

Results
A total of 829 women, 103 partners, and 90 midwives participated in the study. The provision of adequate perinatal mental health care support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The majority of respondents (n=781, 76.42%) expressed that they would feel comfortable or very comfortable using or recommending a digital mental health assessment. The majority of women and partners showed a preference for in-person consultations (n=417, 44.74%), followed by a blended care approach (ie, both in-person and online consultations) (n=362, 38.84%), with fewer participants preferring online-only consultations (n=120, 12.88%). Identified benefits and barriers mainly related to physical opportunity (eg, accessibility), psychological capability (eg, cognitive skills), and automatic motivation (eg, emotions).

Conclusions
This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision making in the assessment of perinatal mental health concerns in the United Kingdom.
Pathway-Driven Coordinated Telehealth System for Management of Patients With Single or Multiple Chronic Diseases in China: System Development and Retrospective Study
Authors: Wang Zheyu , An Jiye , Lin Hui , Zhou Jiaqiang , Liu Fang , Chen Juan , Duan Huilong , Deng Ning 
Published: April 2021

BackgroundIntegrated care enhanced with information technology has emerged as a means to transform health services to meet the long-term care needs of patients with chronic diseases. However, the feasibility of applying integrated care to the emerging “three-manager” mode in China remains to be explored. Moreover, few studies have attempted to integrate multiple types of chronic diseases into a single system.ObjectiveThe aim of this study was to develop a coordinated telehealth system that addresses the existing challenges of the “three-manager” mode in China while supporting the management of single or multiple chronic diseases.MethodsThe system was designed based on a tailored integrated care model. The model was constructed at the individual scale, mainly focusing on specifying the involved roles and responsibilities through a universal care pathway. A custom ontology was developed to represent the knowledge contained in the model. The system consists of a service engine for data storage and decision support, as well as different forms of clients for care providers and patients. Currently, the system supports management of three single chronic diseases (hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease) and one type of multiple chronic conditions (hypertension with type 2 diabetes mellitus). A retrospective study was performed based on the long-term observational data extracted from the database to evaluate system usability, treatment effect, and quality of care.ResultsThe retrospective analysis involved 6964 patients with chronic diseases and 249 care providers who have registered in our system since its deployment in 2015. A total of 519,598 self-monitoring records have been submitted by the patients. The engine could generate different types of records regularly based on the specific care pathway. Results of the comparison tests and causal inference showed that a part of patient outcomes improved after receiving management through the system, especially the systolic blood pressure of patients with hypertension (P<.001 in all comparison tests and an approximately 5 mmHg decrease after intervention via causal inference). A regional case study showed that the work efficiency of care providers differed among individuals.ConclusionsOur system has potential to provide effective management support for single or multiple chronic conditions simultaneously. The tailored closed-loop care pathway was feasible and effective under the “three-manager” mode in China. One direction for future work is to introduce advanced artificial intelligence techniques to construct a more personalized care pathway.
Partisan Differences in Twitter Language Among US Legislators During the COVID-19 Pandemic: Cross-sectional Study
Authors: Guntuku Sharath Chandra , Purtle Jonathan , Meisel Zachary F , Merchant Raina M , Agarwal Anish 
Published: April 2021

Background
As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems.

Objective
We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared.

Methods
We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation.

Results
We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P<.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; P<.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; P<.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; P<.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; P<.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23).

Conclusions
Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.
Using an Information Package to Reduce Patients’ Risk of Renal Damage: Protocol for a Randomized Feasibility Trial
Authors: Leitch Sharon , Smith Alesha , Zeng Jiaxu , Stokes Tim 
Published: April 2021

Background
Non-steroidal anti-inflammatory drugs (NSAIDs) are a common cause of renal damage, especially when taken together with angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin II receptor blockers (ARBs) plus a diuretic — a combination known as the “triple whammy.” New Zealand patients are at high risk of the “triple whammy” because they can easily purchase NSAIDs without a prescription and in nonpharmacy retail settings (eg, the supermarket), there is no legal requirement to include patient information sheets with medication, and direct-to-consumer drug advertising is permitted. A patient information package has been developed for those at greatest risk of the “triple whammy,” consisting of a printable PDF and an interactive online learning activity. This information package aims to inform patients about their elevated risk of harm from NSAIDS and discourage use of NSAIDs. A randomized control trial was planned to assess the effect of the information package.

Objective
This study aims to pilot the trial procedures for recruiting patients and providing patient information online and to assess the acceptability of the patient information package.

Methods
A two-armed randomized feasibility trial will be undertaken in Northland, New Zealand. We will recruit 50 patients who are at least 18 years old from those who have signed up to receive email alerts through their general practice. Patients eligible for this study have been prescribed an ACE-i or ARB plus a diuretic in the past 3 months. They will be randomly allocated to 2 study arms. The intervention arm will receive access to an information package plus usual care; the control arm will receive usual care alone. Online surveys will be used to assess NSAID knowledge and NSAID use at baseline and after 2 weeks for both arms. The intervention arm will also evaluate the information package in an additional survey based on Normalization Process Theory (NPT) concepts. We will report the number and proportion of participants who are eligible and consent to participate in the trial. Response and drop-out rates will be reported for each trial arm. The numbers of patients who interact with the education package will be reported together with the patient evaluation of it.

Results
Funding has been obtained from the Health Research Council of New Zealand (HRC 18-031). The University of Otago Human Research Ethics Committee (H21/016) has approved this trial. Consultation has been undertaken with The Ngai Tahu research consultation committee. The trial commenced on April 12, 2021.

Conclusions
This feasibility trial will test the study processes prior to commencing a randomized controlled trial and will determine the acceptability of the patient information package. We anticipate this work will provide useful information for other researchers attempting similar work.

International Registered Report Identifier (IRRID)
PRR1-10.2196/29161
On the Issue of the Legal Status of the Marine Autonomous Vehicles
Authors: Belyakov V. G. 
Published: April 2021

The modern stage of world civilization development is characterized by a breakthrough in the scientific and technological sphere. Currently, national governments are betting on the use of unmanned navigation in the modern maritime industry. However, the Central problem here is the absence of appropriate legal operation of unmanned marine vehicles in terms of the established global ocean legal regime leading to the inevitable conflicts between subjects of international law.Based on the legal norm analysis of international and national maritime legislation, the author concludes that it is necessary to unify the terminology and conceptual apparatus governing the legal status and operation of ships without crews in various categories of maritime spaces, in order to resolve the dialectical contradiction that arises in the context of the evolutional transition from traditional navigation to unmanned navigation technologies.
Recurrent Hemorrhage from Intermittent Pneumatic Compression Device Use After the Removal of a Femoral Venous Catheter—A Case Review
Authors: Fukuda Masafumi , Nabeta Masakazu , Morita Toshio , Takasu Osamu 
Published: April 2021

Highlights

Abstract
Intermittent pneumatic compression (IPC) is an effective method for preventing deep vein thrombosis (DVT) and is comparatively low risk for hemorrhaging compared with anticoagulant therapy. IPC is easily administered, and severe complications are rare. The patient was a 69-year-old male with no underlying diseases related to hemorrhaging of hemostasis. He was hospitalized for treatment of a third-degree burn injury to the upper body. Because the treatment included surgical debridement and skin grafting, there was substantial concern regarding the potential of hemorrhagic complications; hence, IPC was initiated to prevent DVT rather than standard anticoagulant therapy. On the ninth day of hospitalization, a femoral venous catheter initially placed to manage hydration was removed. Manual compression was performed for 15 minutes, and after confirming hemostasis at the insertion site, a hemostasis band was applied for an additional hour. At 90 minutes after confirming hemostasis, there was a secondary hemorrhage at the site of catheter removal. The secondary hemorrhage was stopped with manual compression, and IPC was discontinued. It was concluded that IPC might result in increased blood flow in the femoral vein. This may have contributed to the secondary hemorrhage after the removal of the catheter. Clinicians need to be aware of the fact that IPC may promote secondary hemorrhage after removal of a femoral venous catheter.