bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strength-based design of a sunflower stalk cutter machine design using finite element analysis and experimental validation
Authors: İrsel Gürkan 
Published: December 2021

In this study, the total algorithm of the strength-based design of the system for mass production has been developed. The proposed algorithm, which includes numerical, analytical, and experimental studies, was implemented through a case study on the strength-based structural design and fatigue analysis of a tractor-mounted sunflower stalk cutting machine (SSCM). The proposed algorithm consists of a systematic engineering approach, material selection and testing, design of the mass criteria suitability, structural stress analysis, computer-aided engineering (CAE), prototype production, experimental validation studies, fatigue calculation based on an FE model and experimental studies (CAE-based fatigue analysis), and an optimization process aimed at minimum weight. Approximately 85% of the system was designed using standard commercially available cross-section beams and elements using the proposed algorithm. The prototype was produced, and an HBM data acquisition system was used to collect the strain gage output. The prototype produced was successful in terms of functionality. Two- and three-dimensional mixed models were used in the structural analysis solution. The structural stress analysis and experimental results with a strain gage were 94.48% compatible in this study. It was determined using nCode DesignLife software that fatigue damage did not occur in the system using the finite element analysis (FEA) and experimental data. The SSCM design adopted a multi-objective genetic algorithm (MOGA) methodology for optimization with ANSYS. With the optimization solved from 422 iterations, a maximum stress value of 57.65 MPa was determined, and a 97.72 kg material was saved compared to the prototype. This study provides a useful methodology for experimental and advanced CAE techniques, especially for further study on complex stress, strain, and fatigue analysis of new systematic designs desired to have an optimum weight to strength ratio.
Prediction Model of in-Hospital Venous Thromboembolism in Chinese Adult Patients after Hernia Surgery: The CHAT Score
Authors: Gu Zhi-Chun , Zhang Chi , Yang Ya , Wang Ming-Gang , Li Hang-Yu , Zhang Guang-Yong 
Published: December 2021

Background Venous thromboembolism (VTE) events after hernia surgery influence prognosis and life quality and may be preventable. This study aimed to develop a useful model for predicting in-hospital VTE in Chinese patients after hernia surgery. Methods Patients after hernia surgery were retrospectively recruited from 58 institutions (n = 14 322). Totally, 36 potential predictors were involved in the regression analysis. Weighted points were assigned to the predictors of in-hospital VTE identified in the multivariate logistic regression analysis and a prediction model was established. Decision curve analysis was performed to evaluate the net clinical benefit between the established and Caprini models. Results A total of 11 707 patients were included and five variables were explored as predictors related to in-hospital VTE: varicose veins of lower extremity, history of VTE, family history of thrombosis, interruption of antithrombotic agents, and reducible hernia. The prediction model (the CHAT score) revealed a good performance metrics (c-statistic, 0.81 [95% CI, 0.80 to 0.81]; Nagelkerke R2, 0.27 [95% CI, 0.26 to 0.30]; Brier score, 0.16 [95% CI, 0.13 to 0.23]). The rate of in-hospital VTE after hernia surgery at low-risk (−4 points), intermediate-risk (0-1 points), high-risk (4 points) and very high-risk (≥5 points) were 0.05%, 0.39%, 0.73% and 8.62%, respectively. The CHAT score identified a considerable variability (from 0.05% to 8.62%) for in-hospital VTE among the overall population after hernia surgery. Decision curve analysis found a superior net benefit of the established model than the Caprini score. Conclusions The CHAT score is likely to be a practical 5-item supporting tool to identify patients at high risk of in-hospital VTE after hernia surgery that might assist in decision making and VTE prevention. Further validated study will strengthen this finding.
Onco-pharmacist led evaluation of knowledge, attitude & practice (KAP) of safe handling cytotoxic drugs among health care professional's (HCP's) in tertiary care hospital: A hospital based interventional Study
Authors: Gudhoor Manjula , Ganachari Madiwalayya Shivakantayya , K Jyoti , Salimath Geetanjali S 
Published: December 2021

Background Cytotoxic drugs (CDs) are hazardous in nature. But it is necessary for the treatment in cancer patients. The healthcare professionals (HCPs) act as a facilitator through which the manufactured CDs reach the patient. However, safe handling of CDs becomes a primary concern not only for the recipients but also for the HCPs. Methods On Ethics committee approval, a prospective- interventional study was conducted among HCPs who are involved in handling of CDs in Oncology department of tertiary care hospital. The participants were screened for their eligibility criteria & 73 HCPs were recruited. The initial data was collected from the HCPs through interview & questionnaires. Later the participants were trained by oncology-pharmacist (7–8 months) for safe handling of CDs. After the training the participants were tested again through interview & questionnaires. Results 73 participants, (75%) nurses & (25%) physicians were included in the study. Among these participants, only 32.87% underwent training on reconstitution whereas 67.12% of the participants didn't undergo any training. The increase in mean score of KAP after the training was observed to be 3.44 ± 4.32, 1.23 ± 1.51 and 1.3 ± 1.01 respectively. Conclusion The study concludes that mandatory requirement of training for HCPs using SOP's by qualified oncology-pharmacist to minimize the hazardous effects of CDs. It also highlights the improvisation techniques for handling of CDs will enhance the safety profile of HCPs & the patients, which helps in refining the quality of pharmaceutical and health care services provided in the cancer care settings.
Bilateral laser peripheral iridotomy in a co-occurrence of unilateral iridocorneal endothelial syndrome and chronic angle closure glaucoma
Authors: Ahluwalia Navjot Singh , Shakya Rakesh , Parikh Dhairya 
Published: December 2021

Purpose To report a case of unilateral Iridocorneal endothelial (ICE) syndrome- Progressive iris atrophy (PIA) with an overlapping chronic angle closure glaucoma (CACG) and to highlight the effect of bilateral Laser peripheral iridotomy (LPI) in such a co-occurrence. Case description A patient presented to us with bilateral gradual painless progressive diminution of vision. Both eyes (BE) had a clear cornea, shallow peripheral anterior chamber depth, grade 2 nuclear sclerosis, raised intraocular pressure and glaucomatous optic neuropathy. In addition, the Left eye (LE) had an irregular anterior chamber, peripheral anterior synechiae (PAS) extending to cornea, patchy iris atrophy, subtle corectopia and a low endothelial cell count on specular microscopy. Indentation gonioscopy led to the diagnoses of CACG BE with ICE syndrome- PIA LE. LPI was performed bilaterally. On Anterior Segment Optical Coherence Tomography (ASOCT), there was evident widening of the angle away from PAS in the Right eye as well as in the LE with PIA post LPI. Conclusion This is a unique case of unilateral PIA with an associated CACG in BE. It is the first case demonstrating the effect of bilateral LPI in such a case scenario. Though not indicated in ICE syndrome, LPI did show short term evidence of significant widening of the angle away from areas of PAS even in the eye with PIA having a limited high PAS and a concurrent primary (chronic) angle closure disease.
Anterior Cruciate Ligament Reconstruction versus Nonoperative Treatment: Better Function and Less Secondary Meniscectomies But No Difference in Knee Osteoarthritis—A Meta-Analysis
Authors: Cuzzolin Marco , Previtali Davide , Zaffagnini Stefano , Deabate Luca , Candrian Christian , Filardo Giuseppe 
Published: December 2021

Objectives The impact of anterior cruciate ligament (ACL) reconstruction on knee osteoarthritis (OA) is still unclear. The aim of the current meta-analysis was to compare surgical treatment versus nonoperative management of ACL tears to assess the impact of these approaches on knee OA development at a 5 and 10 years of follow-up. Design A meta-analysis was performed after a systematic literature search (May 2021) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Both randomized and nonrandomized comparative studies with more than 5 years of follow-up were selected. Influence of the treatment was assessed in terms of knee OA development, subjective and objective clinical results, activity level, and risk of further surgeries. Risk of bias and quality of evidence were assessed following the Cochrane guidelines. Results Twelve studies matched the inclusion criteria, for a total of 1,004 patients. Level of evidence was rated low to very low. No difference was documented in terms of knee OA development, Tegner score, subjective International Knee Documentation Committee (IKDC), and Lysholm scores. A significant difference favoring the surgical treatment in comparison with a nonsurgical approach was observed in terms of objective IKDC score ( P = 0.03) and risk of secondary meniscectomy ( P < 0.0001). The level of evidence was considered very low for subjective IKDC, low for knee OA development, objective IKDC, number of secondary meniscectomies, and Lysholm score, and moderate for post-op Tegner score. Conclusions The meta-analysis did not support an advantage of ACL reconstruction in terms of OA prevention in comparison with a nonoperative treatment. Moreover, no differences were reported for subjective results and activity level at 5 and 10 years of follow-up. On the contrary, patients who underwent surgical treatment of their ACL tear presented important clinical findings in terms of better objective knee function and a lower rate of secondary meniscectomies when compared with conservatively managed patents. Protocol Registration: CRD420191156483 (PROSPERO)
Diosmetin attenuate experimental ulcerative colitis in rats via suppression of NF-κB, TNF-α and IL-6 signalling pathways correlated with down-regulation of apoptotic events
Authors: Yu Xiaoyan , Liu Yang 
Published: December 2021

Introduction Ulcerative colitis (UC) is a chronic inflammation of colon in which the innermost tissue of colon and rectum develops deep-rooted inflammation. Diosmetin is the aglycone of the flavonoid glycoside diosmin, commonly found in citrus fruits. Therapeutically diosmetin is indicated to demonstrate anticancer, antimicrobial, antioxidant, oestrogenic and anti-inflammatory activity. Methods In this research, we studied the action of diosmetin on TNBS (2,4,6-trinitrobenzene sulfonic acid)-induced UC in rats. Male Wister rats were anesthetised with pentobarbital and TNBS introduced by performing an enema. Diosmetin treatment was provided through oral gavage for the next 28 days. Animals were sacrificed on the 29th day and colon tissues were collected for further examinations. Results Diosmetin treatment decreased colonic ulceration dramatically and decreased the percentage of inflammation in the colonic mucosa. Depletion of the TNBS assisted of superoxide dismutase and catalase was substantially restricted, while lipid peroxidation was recorded in the colonic tissue as malondialdehyde content was also decreased. After treatment with diosmetin, the occurrence of TNF-α, IL-6and NF-κB was considerably lowered and the number of apoptotic cells observed was significantly reduced. Conclusion Taken together, these observations demonstrated the potential of diosmetin against ulcer formation and development.
Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial
Authors: Al-Ani Zeiad , Meknas Dana , Kartus Jüri-Toomas , Lyngedal Øyvind , Meknas Khaled 
Published: December 2021

Background: Achilles tendinopathy is a painful disorder, and various treatment options are available. Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis. Purpose/Hypothesis: The purpose was to compare the results between treatment with bipolar RFM and physical therapy (PT) for patients with midportion Achilles tendinopathy. It was hypothesized that RFM would be equivalent or superior to PT. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 38 patients with midportion Achilles tendinopathy were evaluated for 2 years. The patients were randomized to receive either RFM or PT. There were 20 patients in the RFM group and 18 patients in the PT group. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the Foot and Ankle Outcome Score (FAOS). The degree of tendinosis was evaluated with magnetic resonance imaging (MRI) of the affected ankle performed before intervention and 2 years after intervention. Results: In both groups, the VAS scores at the 2-year follow-up were significantly improved compared with preintervention: from 7.2 ± 1.5 to 1.0 ± 1.4 for the RFM group and from 5.9 ± 1.3 to 3.1 ± 1.8 for the PT group ( P < .01 for both). Compared with the PT group, the RFM group had significantly better VAS scores at both the 1- and 2-year follow-ups ( P < .01 for both) and better scores on 4 of the 5 FAOS subscales at the 2-year follow-up ( P < .01 for all). MRI revealed an improvement in the tendinosis score in both groups, without any significant difference between the groups. Conclusion: In this randomized study, the clinical assessments revealed significant improvements in the VAS, FAOS, and tendinosis score as seen on MRI 2 years after intervention with either RFM or PT in patients with midportion Achilles tendinopathy. The improvement was significantly better in the RFM group with regard to VAS and FAOS, but not in the MRI appearance. Registration: NCT03274557 ( ClinicalTrials.gov identifier).
Effect of Modified Arthroscopic Latarjet on Acromiohumeral Distance at 5-Year Follow-up
Authors: Liang Daqiang , Liu Haifeng , Liang Xinzhi , Qin Qihuang , Long Lujue , Huang Yong , Lu Wei , Deng Zhenhan 
Published: December 2021

Background: It is unclear whether coracoacromial ligament release during the Latarjet procedure will increase superior translation of the shoulder joint. Purpose: To evaluate whether a modified suture button Latarjet procedure can decrease the acromiohumeral distance (AHD). Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was conducted among 155 patients who underwent a modified suture button Latarjet procedure between 2013 and 2015. AHD was measured on bilateral computed tomography scans taken preoperatively and on scans of the affected shoulder taken on postoperative day 1 and postoperative month (POM) 6, POM 36, and POM 60. At each time point, we recorded pain on a visual analog scale (VAS) and objective shoulder function using the American Shoulder and Elbow Surgeons, Rowe, and Walch-Duplay scores. Preoperative and final follow-up VAS and functional scores were compared using the paired t test. Pairwise comparison of AHD values at each follow-up time point were compared with the preoperative intact side using the paired t test. Intra- and interobserver reproducibility of the AHD measurements was evaluated using the intraclass correlation coefficient. Results: A total of 104 patients who met the criteria completed the final follow-up, which occurred at 62.6 ± 2.4 months (mean ± SD). When compared with presurgery, the VAS and all functional scores improved significantly at the last follow-up ( P < .001 for all). Intra- and interobserver intraclass correlation coefficients indicated good reliability for the ADH measurements. Preoperatively, there were no differences in AHD values between the intact and affected shoulders (7.8 ± 0.8 mm for both; P = .851). The AHD values at postoperative day 1 and POM 6, POM 36, and POM 60 were 9.6 ± 0.7 mm, 8.6 ± 0.9 mm, 8.0 ± 0.8 mm, and 7.9 ± 0.8 mm, respectively, all of which were larger than those of the preoperative intact side ( P < .001 for all). Conclusion: The modified suture button Latarjet procedure not only offered satisfactory therapeutic effects but also did not decrease the AHD at 5-year follow-up.
Training of airway management for anesthesia teams – Measurement of transfer into daily work routine by questionnaire
Authors: Eismann Hendrik , Palmaers Thomas , Hagemann Vera , Flentje Markus 
Published: December 2021

Theory Problems in airway management are rare in anesthesia but when they occur, they have serious consequences for the patient. For this reason, training is recommended for professionals involved in anesthetic care. Here we investigated, if a newly developed technical/ non-technical hybrid airway training would be relevant for daily practice in a tertiary referral hospital. Hypotheses We hypothesized that: (a) both parts of the validated questionnaires meet the quality criteria for the application in anesthesia teams, (b) even though the team regularly deals with airway management, airway management training is relevant to all professions and (c) contents of the developed training can be integrated into the behaviour of the teams. Method In this observational study, 104 professionals took part in a one-day technical/non-technical hybrid airway training programme. Participants received a questionnaire six months after training, based on selected scales of the validated tools; “Training Evaluation Inventory” and “Transfer Climate Questionnaire”. RESULTS The scales of “perceived usefulness”, “task cues” and “positive reinforcement” showed good internal consistency and all were rated higher than 3.9 on a 5-point Likert scale (1=complete rejection; 5=fullest approval). The scale “negative reinforcement and punishment” showed satisfactory internal consistency for physicians (rated 2.75 ± 0.8). By removing an item in each case, the scales “attitude towards training” (rated 4.93 ± 0.2) and “extinction” (rated 3.02 ± 0.8) showed satisfactory internal consistency for nurses and anesthetic technicians. “Social Cues” did not meet qualitative criteria. There was no difference in the assessment by the professional groups. CONCLUSIONS The presented training course was perceived as useful by both professional groups equally, which supported the interprofessional concept. The content was positively reinforced in practice six months after training and is relevant for professionals who are regularly confronted with the topic “airway management”. Scales which meet qualitative criteria for only one profession and the scale “social cues” should be reconsidered in the context of an interprofessional team.
Statistical Analyses of the Strengths of Particulate Reinforced Metal Matrix Composites (PRMMCs) Subjected to Multiple Tensile and Shear Stresses
Authors: Chen Geng , Xin Shengzhen , Zhang Lele , Broeckmann Christoph 
Published: December 2021

AbstractFor design and application of particulate reinforced metal matrix composites (PRMMCs), it is essential to predict the material strengths and understand how do they relate to constituents and microstructural features. To this end, a computational approach consists of the direct methods, homogenization, and statistical analyses is introduced in our previous studies. Since failure of PRMMC materials are often caused by time-varied combinations of tensile and shear stresses, the established approach is extended in the present work to take into account of these situations. In this paper, ultimate strengths and endurance limits of an exemplary PRMMC material, WC-Co, are predicted under three independently varied tensile and shear stresses. In order to cover the entire load space with least amount of weight factors, a new method for generating optimally distributed weight factors in an n dimensional space is formulated. Employing weight factors determined by this algorithm, direct method calculations were performed on many statistically equivalent representative volume elements (SERVE) samples. Through analyzing statistical characteristics associated with results the study suggests a simplified approach to estimate the material strength under superposed stresses without solving the difficult high dimensional shakedown problem.
Influence of juvenile and mature wood on anatomical and chemical properties of early and late wood from Chinese fir plantation
Authors: Lu Changqing , Wu Jun , Jiang Qianqian , Liu Yamei , Zhou Liang , You Yunfei , Cheng Yitang , Liu Shengquan 
Published: December 2021

AbstractThe proportion of juvenile wood affects the utilization of wood seriously, and the transition year of juvenile wood (JW) and mature wood (MW) plays a decisive role in the rotation and the modification of wood. To find out the demarcation of JW and MW, the tracheid length (TL) and microfibril angle (MFA) of early wood (EW) and late wood (LW) from four Chinese fir clones were measured by optical microscopy and X-ray diffraction. Then the data were analyzed by the k-means clustering method. The correlation and the differences among wood properties between JW and MW were compared. Results indicated that the LW showed better properties than that of EW, but the anatomical differences between EW and LW did not influence the demarcation of JW and MW. The cluster analysis of TL and MFA showed that the transition year was in the 16th year and the transition zone of EW and LW was different among clones. The MW has longer and wider tracheid, thicker cell walls, and smaller MFA. In terms of chemistry, MW had a higher content of holocellulose, α-cellulose, less content of extract, but no significant difference in lignin content compared with JW. The stabilization of chemical components was earlier than that of the anatomic properties. Correlation analysis showed that there were strong correlations between the chemical composition and anatomical characteristics in JW and MW. In general, compared with chemical components, anatomical indicators were more suitable for JW and MW demarcation. The differences and correlations between JW and MW properties provide a theoretical basis for wood rotation and planting.
Robotic excision of interaortocaval paraganglioma: a case report with the literature review
Authors: Handa Anoop , Dash Sharat Chandra , Solanki Nimit , Singh Gagandeep 
Published: December 2021

Abstract
Background
Paragangliomas are rare neuroendocrine tumors of extra adrenal origin. The symptomatic paragangliomas require multimodal treatment approach.

Case Presentation
We report a case of 34-year-old female who presented with complains of headache and blurring of vision. Examination revealed Hypertensive crisis with grade 3 retinopathy. The patient was diagnosed as a case of extra-adrenal paraganglioma during evaluation for secondary hypertension. Magnetic Resonance Imaging of the abdomen revealed 23*28*28 mm mass lesion in the inter-aortocaval region at the level of L3–L4. The patient was started on medical management for hypertension and was managed safely with robot-assisted surgery, owing to enhanced visualization of feeding vessels and avoidance of excessive manipulation of tumor.

Conclusions
Our case report emphasizes on the robot assisted surgical technique for the removal of tumor in a vulnerable anatomical position and presents a review of the literature.