bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated analysis of rabbit knee calcified cartilage morphology using micro‐computed tomography and deep learning
Authors: Rytky Santeri J. O. , Huang Lingwei , Tanska Petri , Tiulpin Aleksei , Panfilov Egor , Herzog Walter , Korhonen Rami K. , Saarakkala Simo , Finnilä Mikko A. J. 
Published: March 2021

AbstractStructural dynamics of calcified cartilage (CC) are poorly understood. Conventionally, CC structure is analyzed using histological sections. Micro‐computed tomography (µCT) allows for three‐dimensional (3D) imaging of mineralized tissues; however, the segmentation between bone and mineralized cartilage is challenging. Here, we present state‐of‐the‐art deep learning segmentation for µCT images to assess 3D CC morphology. The sample includes 16 knees from 12 New Zealand White rabbits dissected into osteochondral samples from six anatomical regions: lateral and medial femoral condyles, lateral and medial tibial plateaus, femoral groove, and patella (n = 96). The samples were imaged with µCT and processed for conventional histology. Manually segmented CC from the images was used to train segmentation models with different encoder–decoder architectures. The models with the greatest out‐of‐fold evaluation Dice score were selected. CC thickness was compared across 24 regions, co‐registered between the imaging modalities using Pearson correlation and Bland–Altman analyses. Finally, the anatomical CC thickness variation was assessed via a Linear Mixed Model analysis. The best segmentation models yielded average Dice of 0.891 and 0.807 for histology and µCT segmentation, respectively. The correlation between the co‐registered regions was strong (r = 0.897, bias = 21.9 µm, standard deviation = 21.5 µm). Finally, both methods could separate the CC thickness between the patella, femoral, and tibial regions (p < 0.001). As a conclusion, the proposed µCT analysis allows for ex vivo 3D assessment of CC morphology. We demonstrated the biomedical relevance of the method by quantifying CC thickness in different anatomical regions with a varying mean thickness. CC was thickest in the patella and thinnest in the tibial plateau. Our method is relatively straightforward to implement into standard µCT analysis pipelines, allowing the analysis of CC morphology. In future research, µCT imaging might be preferable to histology, especially when analyzing dynamic changes in cartilage mineralization. It could also provide further understanding of 3D morphological changes that may occur in mineralized cartilage, such as thickening of the subchondral plate in osteoarthritis and other joint diseases.
An Automated Algorithm for Optic Nerve Sheath Diameter Assessment from B‐mode Ultrasound Images
Authors: Stevens Raoul R. F. , Huberts Wouter , Gommer Erik D. , Ertl Michael , Aries Marcel , Mess Werner H. , Delhaas Tammo 
Published: March 2021

ABSTRACTBACKGROUND AND PURPOSEThe optic nerve sheath diameter (ONSD) is a promising surrogate marker for the detection of raised intracranial pressure (ICP). However, inconsistencies in manual ONSD assessment are thought to affect ONSD and the corresponding ONSD cutoff values for the diagnosis of elevated ICP, hereby hampering the full potential of ONSD. In this study, we developed an image intensity‐invariant algorithm to automatically estimate ONSD from B‐mode ultrasound images at multiple depths.METHODSThe outcomes of the algorithm were validated against manual ONSD measurements by two human experts. Each expert analyzed the images twice (M1 and M2) in unknown order.RESULTSThe algorithm proved capable of segmenting the ONSD in 39 of 42 images, hereby showing mean differences of −.08 ± .45 and −.05 ± .41 mm compared to averaged ONSD values (M1 + M2/2) of Operator 1 and Operator 2, respectively, whereas the mean difference between the two experts was .03 ± .26 mm. Moreover, differences between algorithm‐derived and expert‐derived ONSD values were found to be much smaller than the 1 mm difference that is expected between patients with normal and elevated ICP, making it likely that our algorithm can distinguish between these patient groups.CONCLUSIONSOur algorithm has the potential to improve the accuracy of ONSD as a surrogate marker for elevated ICP because it has no intrinsic variability. However, future research should be performed to validate if the algorithm does indeed result in more accurate noninvasive ICP predictions.
What Materials and Reproducible Techniques May Be Used in Recording Centric Relation? Best Evidence Consensus Statement
Authors: Kattadiyil Mathew T. , Alzaid Abdulaziz A. , Campbell Stephen D. 
Published: March 2021

AbstractPurposeThe purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: What are the techniques used and their reproducibility in recording centric relation (CR) in a dentate and partially dentate population and what effect do different recording materials have on the reproducibility of CR?Materials and MethodsKeywords used in the initial search were: CR, interocclusal records, CR accuracy, CR reproducibility, and CR technique. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta‐analyses, and Clinical Trials.ResultsInitial search related to the selected search terms resulted in more than 3500 articles. When subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta‐Analysis and Clinical Trials, this resulted in 291 articles selected for further analysis.ConclusionsTechniques using chin point guidance, bimanual manipulation, power centric, Gothic arch tracing, leaf gauge, and anterior deprogramming devices to record CR can all be comparable in precision and clinical accuracy in regards to clinical relevance. Practitioner experience and familiarity with a particular technique is critical for accuracy when recording CR. Polyvinyl siloxane and polyether consistently performed better in the broad range of studies on recording materials. Virtual capture of CR could serve as a comparable recording medium but requires further clinical study.
The Impact of Pessimistic Expectations on the Effects of COVID‐19‐Induced Uncertainty in the Euro Area*
Authors: Pellegrino Giovanni , Ravenna Federico , Züllig Gabriel 
Published: March 2021

AbstractWe estimate a monthly interacted‐VAR model for euro area macroeconomic aggregates allowing for the impact of uncertainty shocks to depend on the state of the average outlook for the economy measured by survey data. We find that, in response to an uncertainty shock, the peak decrease in industrial production and inflation is around three and a half times larger during pessimistic times. We build an assessment of the role of uncertainty for a path of innovations consistent with the increase in the observed VSTOXX measure of uncertainty since the outset of the COVID‐19 epidemics in February and March 2020. Industrial production is predicted to experience a year‐over‐year peak loss of around 9.2% in the fourth quarter of 2020, and subsequently to recover with a rebound to pre‐crisis levels roughly in June 2021. The large impact is the result of an extreme shock to uncertainty occurring at a time of very negative expectations for the economic outlook. We conduct simulations that quantify the potential benefit of recovered confidence in reducing the uncertainty‐induced losses associated with a possible third wave of the pandemic.
A Numerical Framework for Geometrically Nonlinear Deformation of Flexoelectric Solids Immersed in an Electrostatic Medium
Authors: Kim Moonhong 
Published: March 2021

Abstract
A numerical formulation coupling finite and boundary element methods is developed to analyze the mechanical deformation and electric polarization of flexoelectric solids experiencing geometrically nonlinear deformation. The proposed method considers the electrical interactions among flexoelectric solids, electric charges, and their surrounding medium. First, a higher-order gradient theory is proposed based on the skew-symmetric couple-stress model to analyze the geometrically nonlinear deformation of flexoelectric solids. This theory includes a total Lagrangian weak form that satisfies linear momentum conservation, angular momentum conservation, and Gauss’s law. Based on the proposed theory, a finite element is developed using basis functions that satisfy C1 continuity. Second, a coupled formulation is developed to consider the electrical interactions among solids, electric charges, and their surrounding medium. In this formulation, conventional boundary elements are adopted to account for the electrostatic surroundings. Besides, electric boundary conditions are naturally imposed on solid boundaries according to the electrical interactions between solids and their electrostatic surroundings. Finally, the proposed method is validated via the comparisons of the numerical results with closed-form solutions.
Analytical Models for Predicting the Nonlinear Stress–Strain Relationships and Behaviors of Two-Dimensional Carbon Materials
Authors: Xiong Zixin , Zhang Teng , Li Xiaoyan 
Published: March 2021

Abstract
Due to having a single atom layer, two-dimensional (2D) materials represented by graphene monolayers exhibit unique and excellent mechanical properties, such as ultrahigh moduli and strengths. A large number of experiments and atomistic simulations have demonstrated nonlinear stress–strain responses. However, there is no theoretical model that analytically describes the relationships between nonlinear mechanical properties and interatomic interaction parameters of 2D materials. Here, we developed a nonlinear stick-spiral model for four typical 2D materials (including graphene, γ-graphyne, β-graphyne, and hexagonal boron nitride) based on a molecular mechanics model. By using the perturbation method, we derived a series of analytical expressions for nonlinear stress–strain relationships and elastic constants of these 2D materials under uniaxial tension along the zigzag and armchair directions. Our analytic models indicated that both Young’s moduli and Poisson’s ratios of these 2D materials are isotropic and dominate the linear elastic deformation, while their third-order moduli are orientation-dependent and essentially characterize the nonlinear stress–strain responses. The nonlinear stress–strain relationships, elastic constants, and atomic behaviors (such as bond elongation and bond angle variation during deformation) predicted from our analytical models are in good agreement with those from atomistic simulations and previous experiments. Our analytical models further demonstrated that the mechanical properties and behaviors of 2D materials are linked with their bonding and atomic structures (from a quantitative perspective) and are mainly determined by stiffnesses for bond stretching, angle variation, and bond lengths. Our current study provides an effective and accurate analytical approach for investigating the nonlinear behaviors of 2D materials.
Failure Strain and Fracture Prediction During Shock Tube Impact Forming of AA 5052-H32 Sheet
Authors: Barik Saibal Kanchan , Ganesh Narayanan R. , Sahoo Niranjan 
Published: March 2021

Abstract
The present study deals with both numerical and experimental evaluation of failure strain and fracture pattern during shock tube impact forming of 1.5 mm thick AA 5052-H32 sheet. A hemispherical end nylon striker is propelled to deform the sheet at different velocities. Here, the main objective is to understand the effect of flow stress models and fracture models on the forming outputs. The experimental situation is modeled in two stages, i.e., incorporating the pressure in the first stage and displacement of the striker in the second stage in finite element simulation using the finite element (FE) code (DEFORM-3D). A new strategy followed to evaluate the rate-dependent flow stress data from the tensile test of samples sectioned from shock tube-based deformed sheet is acceptable, and finite element simulations incorporating these properties predicted accurate failure strain and fracture pattern. Out of all the flow stress models, the modified Johnson–Cook model has a better flow stress predictability due to the inclusion of the non-linear strain rate sensitivity term in the model. During the prediction of the failure strain and necking location, the Cockcroft–Latham failure model, Brozzo failure model, and Freudenthal failure model have a fair agreement with experimental data in combination with the two flow stress models, i.e., Johnson–Cook model and modified Johnson–Cook model.
Influence of Roller-End Axial Profiling Type on Lubrication Performance in Thermal Elastohydrodynamic Finite Line Contacts
Authors: Habchi W. 
Published: March 2021

Abstract
This study presents a finite-element-based numerical investigation of the influence of roller-end axial profiling type on the lubrication performance of thermal elastohydrodynamic finite line contacts. Performance is evaluated with respect to the reference case of straight rollers. The two most commonly used profiling types (i.e., dub-off and logarithmic) are compared under similar profiling length and height. It is found that a logarithmic profile outperforms a dub-off one by all accounts (i.e., frictional dissipation, lubricant film thickness, pressure buildup, and temperature rise), unless an extremely steep logarithmic shape is adopted. In the latter case, lubricant film thickness and pressure buildup may end up being negatively affected.
Serious game versus standard care for rehabilitation after distal radius fractures: a protocol for a multicentre randomised controlled trial
Authors: Meijer Henriëtte A W , Graafland Maurits , Obdeijn Miryam C , van Dieren Susan , Goslings J Carel , Schijven Marlies P 
Published: March 2021

IntroductionDistal radius fractures are among the most prevalent traumatic injuries worldwide. These injuries are associated with high healthcare-related and socioeconomic costs, mainly resulting from loss of productivity. To optimise recovery and return to work, wrist exercises are recommended. However, adherence to standard exercise regimens is low. Serious games provide a treatment platform for standardised postoperative care, uniting meaningful recovery with entertainment. Also, mobile serious games, for example, smartphone or tablet applications, are able to send practice reminders believed to improve self-efficacy.Methods and analysisTo test the effectiveness of a mobile serious game for distal radius fracture rehabilitation compared with standard care, a multicentre, randomised controlled clinical trial was designed. Primary outcome will be the Patient-Rated Wrist Evaluation (PRWE) score after 6 weeks of treatment. Secondary outcomes are range of motion, grip strength, pain scores, and self-reported treatment adherence after 2, 6 and 12 weeks of treatment.Adult patients with any type of closed distal radius fracture are included directly after non-operative or operative fracture treatment. Patients are recruited in the outpatient clinics of four teaching hospitals. The intended sample size is 92 patients, based on the minimal clinically important difference of the PRWE score at 6 weeks, using a superiority model.Patients are randomised between using the wearable-controlled mobile serious gameReValidate!(intervention group) and standard care consisting of unsupervised exercises and a referral for physiotherapy or exercise therapy upon request or recommendation by the treating clinician (control group).Ethics and disseminationThe protocol has been approved by the Medical Ethical Review Board of the Amsterdam University Medical Centres, location Academic Medical Centre in Amsterdam, the Netherlands. Results will be made available to involved healthcare providers, funders, and to the general public including patients via peer-reviewed academic journals and international conferences.Trial registration numberDutch Trial Registry (NTR), NL6140, protocol V.2.
First-line palliative systemic therapy alternated with electrostatic pressurised intraperitoneal aerosol chemotherapy (oxaliplatin) for isolated unresectable colorectal peritoneal metastases: protocol of a multicentre, single-arm, phase II study (CRC-PIPAC-II)
Authors: Lurvink Robin J. , Rauwerdink Paulien , Rovers Koen P. , Wassenaar Emma C.E. , Deenen Maarten J. , Nederend Joost , Huysentruyt Clément J.R. , van "t Erve Iris , Fijneman Remond J.A. , van der Hoeven Erik J.R.J. , Seldenrijk Cornelis A. , Constantinides Alexander , Kranenburg Onno , Los Maartje , Herbschleb Karin H. , Thijs Anna M.J. , Creemers Geert-Jan M. , Burger Jacobus W.A. , Wiezer Marinus J. , Nienhuijs Simon W. , Boerma Djamila , de Hingh Ignace H.J.T. 
Published: March 2021

IntroductionDespite its increasing use, first-line palliative systemic therapy alternated with electrostatic pressurised intraperitoneal aerosol chemotherapy with oxaliplatin (ePIPAC-OX), hereinafter referred to as first-line bidirectional therapy, has never been prospectively investigated in patients with colorectal peritoneal metastases (CPM). As a first step to address this evidence gap, the present study aims to assess the safety, feasibility, antitumour activity, patient-reported outcomes, costs and systemic pharmacokinetics of first-line bidirectional therapy in patients with isolated unresectable CPM.Methods and analysisIn this single-arm, phase II study in two Dutch tertiary referral centres, 20 patients are enrolled. Key eligibility criteria are a good performance status, pathologically proven isolated unresectable CPM, no previous palliative systemic therapy for colorectal cancer, no (neo)adjuvant systemic therapy ≤6 months prior to enrolment and no previous pressurised intraperitoneal aerosol chemotherapy (PIPAC). Patients receive three cycles of bidirectional therapy. Each cycle consists of 6 weeks first-line palliative systemic therapy at the medical oncologists’ decision (CAPOX-bevacizumab, FOLFOX-bevacizumab, FOLFIRI-bevacizumab or FOLFOXIRI-bevacizumab) followed by ePIPAC-OX (92 mg/m2) with an intraoperative bolus of intravenous leucovorin (20 mg/m2) and 5-fluorouracil (400 mg/m2). Study treatment ends after the third ePIPAC-OX. The primary outcome is the number of patients with—and procedures leading to—grade ≥3 adverse events (Common Terminology Criteria for Adverse Events V.5.0) up to 4 weeks after the last procedure. Key secondary outcomes include the number of bidirectional cycles in each patient, treatment-related characteristics, grade ≤2 adverse events, tumour response (histopathological, cytological, radiological, biochemical, macroscopic and ascites), patient-reported outcomes, systemic pharmacokinetics of oxaliplatin, costs, progression-free survival and overall survival.Ethics and disseminationThis study is approved by the Dutch competent authority, a medical ethics committee and the institutional review boards of both study centres. Results will be submitted for publication in peer-reviewed medical journals and presented to patients and healthcare professionals.Trial registration numberNL8303.
Impact of the COVID-19 pandemic on remote mental healthcare and prescribing in psychiatry: an electronic health record study
Authors: Patel Rashmi , Irving Jessica , Brinn Aimee , Broadbent Matthew , Shetty Hitesh , Pritchard Megan , Downs Johnny , Stewart Robert , Harland Robert , McGuire Philip 
Published: March 2021

ObjectivesThe recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in-person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications.Design and settingThe Clinical Record Interactive Search tool was used to examine deidentified electronic health records of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing.ParticipantsAll patients receiving care from SLaM between 7 January 2019 and 20 September 2020 (around 37 500 patients per week).Outcome measures(i) The number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week.(ii) Prescribing of antipsychotic and mood stabiliser medications per week.ResultsFollowing the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared with that in the previous year (β coefficient: −5829.6 contacts, 95% CI −6919.5 to −4739.6, p<0.001), while the frequency of remote contacts significantly increased (β coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels.ConclusionsThe COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.
Disease burden and quality of life of patients with chronic cough in Japan: a population-based cross-sectional survey
Authors: Kubo Takekazu , Tobe Keisuke , Okuyama Kotoba , Kikuchi Masashi , Chen Yirong , Schelfhout Jonathan , Abe Machiko , Tokita Shigeru 
Published: March 2021

BackgroundCough lasting 3–8 and >8 weeks are defined as subacute/prolonged cough and chronic cough (CC), respectively. Studies have revealed that CC negatively impact patients’ quality of life (QoL). In Japan, there is limited data on the impact of CC on health-related quality of life (HRQoL), work productivity and activity impairment (WPAI) and healthcare resource utilisation (HRU) using validated instruments. This study aimed to estimate the burden of CC and to compare the burden among patients with CC between subgroups.MethodsData from two cross-sectional online surveys conducted between September and November 2019 were combined for the analysis. Eligible patients with cough were propensity score matched to non-cough respondents. Comparisons of general HRQoL, WPAI, HRU and other symptoms experienced were conducted between matched non-cough respondents and patients with cough. Among patients with CC, subgroup comparisons were performed to understand general HRQoL, WPAI, HRU, cough-related QoL (Leicester Cough Questionnaire and Hull Airway Reflux Questionnaire) between patients with CC of different severities, patients with refractory CC and patients with non-refractory CC and patients with CC whose underlying diseases were unknown and others.ResultsPatients with CC (n=568) in Japan reported significantly poorer HRQoL, increased WPAI, more HRU and higher proportion of psychological and sleep problems, compared with matched non-cough respondents selected from 21 415 non-cough respondents. More patients with severe CC reported significantly poorer HRQoL, increased WPAI and worse cough-related QoL. Patients with refractory CC experienced significantly greater burden measured by cough-related QoL. No significant differences were observed between patients with CC whose underlying diseases were unknown and other patients with CC in terms of general HRQoL and cough-related QoL.ConclusionsThis study showed that patients with CC in Japan experienced significant burden compared with non-cough respondents. Patients with more severe cough and refractory CC experienced worse cough-related QoL. These results highlighted the unmet need for better interventions and treatments to reduce the burden among patients with CC.