bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numerical Investigation on Vortex Induced Motions of a Tension Leg Platform With Circular Columns
Authors: Zhi Pengfei , Zhang Xinshu 
Published: October 2021

Abstract
Vortex Induced Motion (VIM) of multi-column floating platforms, such as Tension Leg Platform (TLP) and semi-submersible (SEMI), in current is well-acknowledged. Substantial VIM response of the multi-column floating platform may cause fatigue failure of mooring and riser systems, which can affect the normal operation of the platform.
The present paper focuses on the numerical investigation on VIM of a TLP with circular columns using Computational Fluid Dynamics (CFD). Sensitivity analyses (e.g., mesh size, the number of prism layers and time-step size) for the VIM responses of the TLP are conducted. The effects of the current heading and mooring stiffness on the VIM are investigated. The three degrees of freedom VIM responses (in-line, transverse and yaw responses) and corresponding amplitude spectra are computed and analyzed. Motion trajectories are plotted to understand the VIM behaviors. Regarding the effect of the current heading, the largest transverse response is examined at 15° current heading and the corresponding maximum nominal amplitude is around 0.43. The difference of the maximum nominal amplitudes between the cases at 0° and 15° current headings is less than 5%. For 15°, 30° and 45° current headings, the nominal transverse amplitudes decrease as the current heading increases in the lock-in range. For the four studied current headings, the maximum width of the lock-in range is found at 0° current heading and narrows as the current incidence increases. The largest yaw response is observed at 0° current heading and the maximum nominal amplitude is around 9.1°. Regarding the effect of the mooring stiffness, the lock-in ranges and the maximum nominal amplitudes of the transverse motions have little difference for the four mooring stiffnesses. The maximum nominal transverse and yaw responses are around 0.25 and 5.1°, respectively, which occur when the mooring stiffness reaches the maximum. The flow pattern analyses indicate that the flow interference between the upstream and downstream columns may have significant effects on the VIM responses and a stronger interference at the present spacing ratio may lead to a larger VIM response. The contours of the vertical vorticity in the horizontal plane show that the mean positions of the flow separation points are always on highest or lowest (in the transverse direction perpendicular to the current heading) points of the columns, which is the reason that the VIM trajectories for the TLP with circular columns are always along the direction perpendicular to the current heading.
Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis
Authors: Noviyani Rini , Youngkong Sitaporn , Nathisuwan Surakit , Bagepally Bhavani Shankara , Chaikledkaew Usa , Chaiyakunapruk Nathorn , McKay Gareth , Sritara Piyamitr , Attia John , Thakkinstian Ammarin 
Published: October 2021

ObjectivesTo assess cost-effectiveness of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF) by pooling incremental net benefits (INBs).DesignSystematic review and meta-analysis.SettingWe searched PubMed, Scopus and Centre for Evaluation of Value and Risks in Health Registry from inception to December 2019.ParticipantsPatients with AF.Main outcome measuresThe INB was defined as a difference of incremental effectiveness multiplied by willing to pay threshold minus the incremental cost; a positive INB indicated favour treatment. These INBs were pooled (stratified by level of country income, perspective, time-horizon, model types) with a random-effects model if heterogeneity existed, otherwise a fixed effects model was applied. Heterogeneity was assessed using Q test and I2statistic. Risk of bias was assessed using the economic evaluations bias (ECOBIAS) checklist.ResultsA total of 100 eligible economic evaluation studies (224 comparisons) were included. For high-income countries (HICs) from a third-party payer (TPP) perspective, the pooled INBs for DOAC versus VKA pairs were significantly cost-effective with INBs (95% CI) of $6632 ($2961.67 to $10 303.72; I2=59.9%), $6353.24 ($4076.03 to $8630.45; I2=0%), $7664.58 ($2979.79 to $12 349.37; I2=0%) and $8573.07 ($1877.05 to $15 269.09; I2=0%) for dabigatran, apixaban, rivaroxaban and edoxaban relative to VKA, respectively but only dabigatran was significantly cost-effective from societal perspective (SP) with an INB of $11 746.96 ($2429.34 to $21 064.59; I2=52.4%). The pooled INBs of all comparisons for upper-middle income countries (UMICs) were not significantly cost-effective. The ECOBIAS checklist indicated that risk of bias was mostly low for most items with the exception of five items which should be less influenced on pooling INBs.ConclusionsOur meta-analysis provides comprehensive economic evidence that allows policy makers to generalise cost-effectiveness data to their local context. All DOACs may be cost-effective compared with VKA in HICs with TPP perspective. The pooling results produced moderate to high heterogeneity particularly in UMICs. Further studies are required to inform UMICs with SP.PROSPERO registeration numberCRD 42019146610.
The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone
Authors: Sevalie Stephen , Youkee Daniel , van Duinen A J , Bailey Emma , Bangura Thaimu , Mangipudi Sowmya , Mansaray Esther , Odland Maria Lisa , Parmar Divya , Samura Sorie , van Delft Diede , Wurie Haja , Davies Justine I , Bolkan H A , Leather Andrew J M 
Published: October 2021

IntroductionThe COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on hospital utilisation in a sub-Saharan country, Sierra Leone.MethodsMixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals) and qualitative interviews with healthcare workers and patients. Hospital data were compared across quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity and paediatric) and hospital type (government or private non-profit). Referrals in 2020 were compared with 2019 to assess whether any changes were the result of seasonality. Comparisons were performed using Student’s t-test. Qualitative data were analysed using thematic analysis.ResultsFrom Q1 to Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8% than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8% decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), while caesarean sections and facility-based deliveries showed significant increases: 12.7% (p=0.014) and 7.5% (p=0.03), respectively. In Q3, total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared with 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship.ConclusionThe study demonstrated a decrease in hospital utilisation during COVID-19, the decrease is less than reported in other countries during COVID-19 and less than reported during the Ebola epidemic.
Mental health symptoms in electronic football players
Authors: Pereira Ana Monteiro , Teques Pedro , Verhagen Evert , Gouttebarge Vincent , Figueiredo Pedro , Brito João 
Published: October 2021

BackgroundThe escalated competitive pressure and professionalisation of esports players could predispose them to mental health symptoms. We aimed to develop a model to explore the association between distress and anxiety/depression symptoms and potential associations between adaptive or maladaptive coping strategies, sleeping disturbance, alcohol consumption and eating habits in electronic football players.MethodsThe present exploratory cross-sectional study includes the Distress Screener, General Health Questionnaire, Brief Cope, Sleep Disturbance Domain of the Patient-Reported Outcomes Measurement Information System, Alcohol Use Disorders Identification Test Consumption and a set of questions regarding eating habits. A two-step robust maximum likelihood method of the Structural Equation Modelling approach was used.ResultsBoth measurement model (χ2/df=1065.04 (637), p<0.001; Tucker-Lewis Index (TLI)=0.91, Comparative Fit Index (CFI)=0.92, standardised root mean residual (SRMR)=0.07 and root mean square error of approximation (RMSEA)=0.05; 95% CI 0.043 to 0.053) and hypothesised structural model (χ2/df=1131.98 (648); p<0.001; TLI=0.90, CFI=0.91, SRMR=0.07 and RMSEA=0.05; 95% CI 0.054 to 0.06) showed an adequate fit to the data. Stress was positively related with depression and anxiety symptoms. Only anxiety symptoms were linked with coping strategies. Maladaptive coping strategies were related to sleep disturbance, alcohol consumption and poor eating habits, whereas adaptive coping strategies were associated with less sleep disturbance, reduced alcohol consumption and better eating habits.ConclusionAn integrative approach to help electronic football players when early signs of distress are present might help avoid other mental health symptoms that interfere with players’ well-being and overall health. Additionally, adequate coping strategies to manage anxiety symptoms due to distress may help counteract potential negative consequences for lifestyle habits in electronic football players.
Aberrant expression ofBDNFmight serve as a candidate target for cocaine-induced psychosis: insights from bioinformatics analysis and microarray validation
Authors: Zhu Youwei , Zhao Yan , Xu Xiaomin , Su Hang , Li Xiaotong , Zhong Na , Jiang Haifeng , Du Jiang , Zhao Min 
Published: October 2021

BackgroundCocaine use disorder (CUD) and associated psychosis are major public health issues worldwide, along with high relapse outcome and limited treatment options. Exploring the molecular mechanisms underlying cocaine-induced psychosis (CIP) could supply integrated insights for understanding the pathogenic mechanism and potential novel therapeutic targets.AimsThe aim of the study was to explore common alterations of CUD-schizophrenia-target genes and identify core risk genes contributing to CIP through data mining and network pharmacology approach.MethodsTarget genes of CUD were obtained from GeneCards, Comparative Toxicogenomics Database, Swiss Target Prediction platform and PubChem. Schizophrenia-related target genes were derived from DisGeNET, GeneCards, MalaCards and Online Mendelian Inheritance in Man databases. Then, the overlap genes of these two sets were regarded as risk genes contributing to CIP. Based on these CUD-schizophrenia-target genes, functional annotation and pathway analysis were performed using the clusterProfiler package in R. Protein–protein interaction network construction and module detection were performed based on the Search Tool for the Retrieval of Interacting Genes (STRING) database and Cytoscape software. Gene expression datasets GSE54839 and GSE93577 were applied for data validation and diagnostic capacity evaluation of interested hub genes.ResultsA total of 165 CUD-schizophrenia-target genes were obtained. These genes were mainly contributing to chemical synaptic transmission, neuropeptide hormone activity, postsynaptic membrane and neuroactive ligand–receptor interaction pathway. Network analysis and validation analysis indicated thatBDNFmight serve as an important risk gene in mediating CIP.ConclusionsThis study generates a holistic view of CIP and provides a basis for the identification of potential CUD-schizophrenia-target genes involved in the development of CIP. The abnormal expression ofBDNFwould be a candidate therapeutic target underlying the pathogenesis of CUD and associated CIP.
Interleukin 6 trans-signalling and the risk of future cardiovascular events in men and women
Authors: Miri Yasmin , Leander Karin , Eriksson Per , Gigante Bruna , Ziegler Louise 
Published: October 2021

ObjectivePro-inflammatory interleukin 6 (IL6) trans-signalling is associated with increased risk of cardiovascular events (CVEs). Whether this association exists for both sexes is, however, uncertain. Hence, we analysed the risk of CVE associated with IL6 trans-signalling in men and women and investigated if potential interaction between IL6 trans-signalling and sex affects the risk.MethodsIn a prospective cohort of 60-year-old men and women without cardiovascular disease (men=2039, women=2193), subjects were followed for 20 years. To assess the IL6 trans-signalling activity, the proportion between the active binary and inactive ternary IL6 complexes, the binary/ternary ratio (B/T ratio), was estimated. CVE (myocardial infarction, angina pectoris and ischaemic stroke, n=629) risk was analysed with Cox regression, presented as HRs with 95% CIs. B/T ratio was dichotomised, with levels >median representing IL6 trans-signalling. Interaction was analysed on the additive scale and expressed as the synergy index (S). Analyses were adjusted for cardiovascular risk factors.ResultsB/T ratio >median was associated with increased CVE risk in men (HR 1.63; 95% CI 1.32 to 2.01), but not in women (HR 1.21; 95% CI 0.93 to 1.57). There was a significant synergistic interaction (S=1.98; 95% CI 1.15 to 3.42) between the B/T ratio and male sex, the combination increasing the risk by 88%.ConclusionsOur results suggest differential susceptibility to inflammation mediated by IL6 trans-signalling and subsequent CVE in men and women. The B/T ratio could be considered as a novel biomarker for cardiovascular risk in men, but not in women.
Barriers and facilitators to answering clinical questions in the Americas: a cross-sectional study of surgical trauma care providers
Authors: Noble Helen Elizabeth , Vega Rivera Felipe , LaGrone Lacey 
Published: October 2021

BackgroundWe aimed to understand how surgical trauma providers in the Americas acquire answers to clinical questions and what barriers and facilitators they face in efforts to practice according to recommendations for common surgical cases. We hypothesized that increased English proficiency and country income improved providers’ acquisition and application of clinical knowledge.MethodsA 23-question survey evaluated reported confidence in interpretation of evidence, perceived language fluency, and access to and application of recommendations on sepsis and appendicitis. Electronic surveys were distributed across the Americas to Pan American Trauma Society members.Results108 participants from 21 countries completed this survey. 59% had ≥21 years of provider experience. 38% reported their English reading comprehension as less than or equal to “limited working proficiency.” 44% endorsed using Google Translate; 35% reported they did not need translation tools to evaluate medical literature. 59% felt uncertainty regarding clinical care at least weekly. 65% reported inability to answer their clinical questions at least once per month. 86% felt confident in their ability to interpret and apply evidence for their practice. To answer clinical questions, participants listed guidelines (76%), full-text peer-reviewed journal articles (61%), and meta-analyses (49%) as their most used resources. 25% answered all five clinical questions correctly, whereas 43% answered three or fewer correctly. 79% felt they had adequate access to resources to answer the five clinical questions. When controlling for individual demographic characteristics, decreased age (p<0.01) and increased country income level (p=0.03) positively impacted correct answers to questions.DiscussionUncertainties in clinical care are unavoidable. Language, age, and country income level impacted provider acquisition and application of knowledge relevant to select clinical scenarios. These findings highlight disparities in access and training and add urgency to the movement for improved dissemination and implementation approaches for evidence-based practice in surgery.Level of evidenceIV.
Conditional PD-1/PD-L1 Probody Therapeutics Induce Comparable Antitumor Immunity but Reduced Systemic Toxicity Compared with Traditional Anti–PD-1/PD-L1 Agents
Authors: Assi Hikmat H. , Wong Chihunt , Tipton Kimberly A. , Mei Li , Wong Ken , Razo Jennifer , Chan Chanty , Howng Bruce , Sagert Jason , Krimm Michael , Diep Linnea , Jang Andrew , Nguyen Margaret T. , Lapuyade Nicole , Singson Victoria , Villanueva Ruth , Paidhungat Madan , Liu Shouchun , Rangan Vangipuram , Vasiljeva Olga , West James W. , Richardson Jennifer H. , Irving Bryan , Daniel Dylan , Belvin Marcia , Kavanaugh W. Michael 
Published: October 2021

Abstract

Immune-checkpoint blockade has revolutionized cancer treatment. However, most patients do not respond to single-agent therapy. Combining checkpoint inhibitors with other immune-stimulating agents increases both efficacy and toxicity due to systemic T-cell activation. Protease-activatable antibody prodrugs, known as Probody therapeutics (Pb-Tx), localize antibody activity by attenuating capacity to bind antigen until protease activation in the tumor microenvironment. Herein, we show that systemic administration of anti–programmed cell death ligand 1 (anti–PD-L1) and anti–programmed cell death protein 1 (anti–PD-1) Pb-Tx to tumor-bearing mice elicited antitumor activity similar to that of traditional PD-1/PD-L1–targeted antibodies. Pb-Tx exhibited reduced systemic activity and an improved nonclinical safety profile, with markedly reduced target occupancy on peripheral T cells and reduced incidence of early-onset autoimmune diabetes in nonobese diabetic mice. Our results confirm that localized PD-1/PD-L1 inhibition by Pb-Tx can elicit robust antitumor immunity and minimize systemic immune-mediated toxicity. These data provide further preclinical rationale to support the ongoing development of the anti–PD-L1 Pb-Tx CX-072, which is currently in clinical trials.
Monitoring PD-1 Phosphorylation to Evaluate PD-1 Signaling during Antitumor Immune Responses
Authors: Bu Xia , Juneja Vikram R. , Reynolds Carol G. , Mahoney Kathleen M. , Bu Melissa T. , McGuire Kathleen A. , Maleri Seth , Hua Ping , Zhu Baogong , Klein Sarah R. , Greenfield Edward A. , Armand Philippe , Ritz Jerome , Sharpe Arlene H. , Freeman Gordon J. 
Published: October 2021

Abstract

PD-1 expression marks activated T cells susceptible to PD-1–mediated inhibition but not whether a PD-1–mediated signal is being delivered. Molecular predictors of response to PD-1 immune checkpoint blockade (ICB) are needed. We describe a monoclonal antibody (mAb) that detects PD-1 signaling through the detection of phosphorylation of the immunotyrosine switch motif (ITSM) in the intracellular tail of mouse and human PD-1 (phospho–PD-1). We showed PD-1+ tumor-infiltrating lymphocytes (TILs) in MC38 murine tumors had high phosphorylated PD-1, particularly in PD-1+TIM-3+ TILs. Upon PD-1 blockade, PD-1 phosphorylation was decreased in CD8+ TILs. Phospho–PD-1 increased in T cells from healthy human donors after PD-1 engagement and decreased in patients with Hodgkin lymphoma following ICB. These data demonstrate that phosphorylation of the ITSM motif of PD-1 marks dysfunctional T cells that may be rescued with PD-1 blockade. Detection of phospho–PD-1 in TILs is a potential biomarker for PD-1 immunotherapy responses.
Artificial intelligence techniques over the fifth generation mobile networks: a review
Authors: Hassan Ashwaq N. , Al-Chlaihawi Sarab , Khekan Ahlam R. 
Published: October 2021

<span>A well Fifth generation (5G) mobile networks have been a common phrase in recent years. We have all heard this phrase and know its importance. By 2025, the number of devices based on the fifth generation of mobile networks will reach about 100 billion devices. By then, about 2.5 billion users are expected to consume more than a gigabyte of streamed data per month. 5G will play important roles in a variety of new areas, from smart homes and cars to smart cities, virtual reality and mobile augmented reality, and 4K video streaming. Bandwidth much higher than the fourth generation, more reliability and less latency are some of the features that distinguish this generation of mobile networks from previous generations. Clearly, at first glance, these features may seem very impressive and useful to a mobile network, but these features will pose serious challenges for operators and communications companies. All of these features will lead to considerable complexity. Managing this network, preventing errors, and minimizing latency are some of the challenges that the 5th generation of mobile networks will bring. Therefore, the use of artificial intelligence and machine learning is a good way to solve these challenges. in other say, in such a situation, proper management of the 5G network must be done using powerful tools such as artificial intelligence. Various researches in this field are currently being carried out. Research that enables automated management and servicing and reduces human error as much as possible. In this paper, we will review the artificial intelligence techniques used in communications networks. Creating a robust and efficient communications network using artificial intelligence techniques is a great incentive for future research.</span><span> The importance of this issue is such that the sixth generation (6G) of cellular communications; There is a lot of emphasis on the use of artificial intelligence.</span>