bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventricular Myocardial Deformation in Fetuses With Tetralogy of Fallot: A Necessary Field of Investigation
Authors: Song Xiaoyan , Cao Haiyan , Hong Liu , Zhang Li , Li Meng , Shi Jiawei , Liu Juanjuan , Ma Jing , Cui Li , Zhang Yi , Li Yuman , Lv Qing , Xie Mingxing 
Published: December 2021

Background: Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart defects (CHDs). The patterns of fetal myocardial deformations in TOF have not been well-studied. This study aimed to assess biventricular myocardial deformations in fetuses with TOF compared with normal fetuses.Methods: A retrospective cohort study of fetuses with TOF and gestational age (GA)-matched controls was conducted at a single tertiary referral center from 2014 to 2020. All enrolled fetuses underwent detailed echocardiography, and four-chamber video-clips were recorded and analyzed offline for deformation assessment by using two-dimensional speckle tracking echocardiography (2D-STE). Comparisons for baseline characteristics, cardiac morphological measurements (ventricular, atrial, and great arterial diameters or ratios, global sphericity index), systolic function parameters [ejection fraction (EF), fractional area change (FAC)], and strain parameters [global longitudinal strain (GLS), global longitudinal strain rate in systole and diastole (GLSRs, GLSRd)] were performed between fetuses with TOF and GA-matched controls.Results: Fifty-two fetuses with TOF and 52 GA-matched controls were enrolled in this study. Fetuses with TOF exhibited similar left ventricular (LV) EF (58.51 ± 5.11% vs. 57.59 ± 5.38%, P = 0.16) and right ventricular (RV) FAC (43.64 ± 2.89% vs. 44.27 ± 3.04%, P = 0.25), compared to normal fetuses. While, in deformational analysis, TOF fetuses demonstrated significantly lower LV and RV GLS values (−22.57 ± 2.91% vs. −27.39 ± 4.38%, P &lt; 0.001 for LV GLS; −24.27 ± 3.18% vs. −28.71 ± 4.48%, P &lt; 0.001 for RV GLS). Both LV GLS (r = −0.518, P &lt; 0.001) and RV GLS (r = −0.534, P &lt; 0.001) were found negatively correlated with the aortic valve-to-pulmonary valve diameter ratio (AV:PV ratio). Z-scores of PV annulus and main pulmonary artery (MPA) also had positive correlation with LV and RV GLS, respectively.Conclusions: Decreased biventricular myocardial deformations can appear even in fetuses with TOF with normal systolic ventricular function. Both LV and RV GLS values are correlated with the severity of right ventricular outflow tract obstruction. It indicates 2D-STE may be a more sensitive tool to assess fetal cardiac function than the conventional echocardiographic methods.
It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
Authors: Song Jian , Wu Jinlin , Sun Xiaogang , Qian Xiangyang , Wei Bo , Wang Wei , Wang De , Qiu Jiawei , Cao Fangfang , Gao Wei , Zhao Rui , Dai Lu , Fan Shuya , Xie Enzehua , Qiu Juntao , Luo Xinjin , Yu Cuntao 
Published: December 2021

Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patients who underwent arch surgery in our center.Methods: All consecutive patients who underwent surgical treatment for TAAD in Fuwai Hospital from January 2013 to December 2018 were included in this study and divided into four quartile groups based on HCA time. Baseline characteristics, perioperative indicators, and early mortality were statistically analyzed by propensity score matching (PSM) and restricted cubic spline (RCS) method. Perioperative adverse events were confirmed according to the American STS database and Penn classification.Results: About 1,018 consecutive patients (mean age 49.11 ± 1.4 years, male 74.7%) with TAAD treated surgically were eventually included in this study. After PSM, with the prolongation of HCA time, the surgical mortality rates of group [2,15], (15,18], (18,22], and (22,73] were 4.1, 6.6, 7.8, and 10.9% with p = 0.041, respectively. As shown in RCS, the mortality rate increased sharply after the HCA time exceeded 22 min. And from the subgroup analysis, the HCA time of 22 min or less was associated with better clinical outcomes (OR 2.09, 95%CI 1.25–3.45, p = 0.004).Conclusions: The early mortality increases significantly with the duration of HCA time when arch surgery was performed. And multiple systems throughout the body can be adversely affected.
A Multi-Frequency Focused Impedance Measurement System Based on Analogue Synchronous Peak Detection
Authors: Kadir Muhammad Abdul , Wilson Adrian J. , Siddique-e Rabbani K. 
Published: December 2021

Monitoring of anatomical structures and physiological processes by electrical impedance has attracted scientists as it is noninvasive, nonionizing and the instrumentation is relatively simple. Focused Impedance Method (FIM) is attractive in this context, as it has enhanced sensitivity at the central region directly beneath the electrode configuration minimizing contribution from neighboring regions. FIM essentially adds or averages two concentric and orthogonal combinations of conventional Tetrapolar Impedance Measurements (TPIM) and has three versions with 4, 6, and 8 electrodes. This paper describes the design and testing of a multi-frequency FIM (MFFIM) system capable of measuring all three versions of FIM at 8 frequencies in the range 10 kHz—1 MHz. A microcontroller based multi-frequency signal generator and a balanced Howland current source with high output impedance (476 kΩ at 10 kHz and 58.3 kΩ at 1 MHz) were implemented for driving currents into biological tissues with an error &lt;1%. The measurements were carried out at each frequency sequentially. The peak values of the amplified voltage signals were measured using a novel analogue synchronous peak detection technique from which the transfer impedances were obtained. The developed system was tested using TPIM measurements on a passive RC Cole network placed between two RC networks, the latter representing skin-electrode contact impedances. Overall accuracy of the measurement was very good (error &lt;4% at all frequencies except 1 MHz, with error 6%) and the resolution was 0.1 Ω. The designed MFFIM system had a sampling rate of &gt;45 frames per second which was deemed adequate for noninvasive real-time impedance measurements on biological tissues.
A Circular Approach for Making Fischer–Tropsch E-fuels and E-chemicals From Biogas Plants in Europe
Authors: Marchese Marco , Gandiglio Marta , Lanzini Andrea 
Published: December 2021

In a mature circular economy model of carbon material, no fossil compound is extracted from the underground. Hence, the C1 molecule from non-fossil sources such as biogas, biomass, or carbon dioxide captured from the air represents the raw material to produce various value-added products through carbon capture and utilization routes. Accordingly, the present work investigates the utilization of the full potential of biogas and digestate waste streams derived from anaerobic digestion processes available at the European level to generate synthetic Fischer–Tropsch products focusing on the wax fraction. This study estimates a total amount of available carbon dioxide of 33.9 MtCO2/y from the two above-mentioned sources. Of this potential, 10.95 MtCO2/y is ready-to-use as separated CO2 from operating biogas-upgrading plants. Similarly, the total amount of ready-to-use wet digestate corresponds to 29.1 Mtdig/y. Moreover, the potential out-take of Fischer–Tropsch feedstock was evaluated based on process model results. Utilizing the full biogas plants’ carbon potential available in Europe, a total of 10.1 Mt/h of Fischer–Tropsch fuels and 3.86 Mt/h of Fischer–Tropsch waxes can be produced, covering up to 79% of the global wax demand. Utilizing only the streams derived from biomethane plants (installed in Europe), 136 ton/h of FT liquids and 48 ton/h of FT wax can be generated, corresponding to about 8% of the global wax demand. Finally, optimal locations for cost-effective Fischer–Tropsch wax production were also identified.
A Systematic Study on the Effects of Process Parameters on Spinning of Thin-Walled Curved Surface Parts With 2195 Al-Li Alloy Tailor Welded Blanks Produced by FSW
Authors: Zhang Hongrui , Zhan Mei , Zheng Zebang , Li Rui , Lyu Wei , Lei Yudong 
Published: December 2021

The manufacturing process is inevitably accompanied with the production of scraps, which leads to resource waste and environmental pollution. Recycling and remanufacturing are the most commonly used approaches for metal scraps due to their well-established advantages from economic and environmental perspectives. In this study, spinning experiments with 2195 Al-Li alloy tailor welded blanks produced by friction stir welding from metal scraps were conducted under different process parameter designs. And then the effects of various process parameters on spinning of thin-walled curved surface parts were systematically studied. The results of the corresponding experimental groups show that the roller attack angle, the spinning clearance, and the installation method of tailor welded blanks have the most significant effect on the weld torsion angle. In addition, it was found that along the longitude direction of spun parts, the surface roughnesses of the weld of spun parts were greatly improved under the roller nose radius of 10 mm, the spinning clearance of 1.0 mm, the constant linear velocity, and the installation method of tailor welded blanks (the lower surface of tailor welded blanks is spun by rollers), while the process parameters have little significant effect on the surface roughness along the latitude direction of spun parts. Furthermore, it can be concluded that the forming profiles of spun parts fitted the mandrel well under the roller nose radius of 6 mm, double rollers, the roller attack angle of 30° and 45°, spinning clearance of 1.5 mm, and the installation method of tailor welded blanks (the upper surface of tailor welded blanks is spun by rollers). The research results will provide guidance for the precise spinning of thin-walled curved surface parts with tailor welded blanks. Thereby, it is also beneficial for green manufacturing involving recycling and remanufacturing of metal scraps.
Development and Validation of a Simplified Prehospital Triage Model Using Neural Network to Predict Mortality in Trauma Patients: The Ability to Follow Commands, Age, Pulse Rate, Systolic Blood Pressure and Peripheral Oxygen Saturation (CAPSO) Model
Authors: Li Yun , Wang Lu , Liu Yuyan , Zhao Yan , Fan Yong , Yang Mengmeng , Yuan Rui , Zhou Feihu , Zhang Zhengbo , Kang Hongjun 
Published: December 2021

Objective: Most trauma scoring systems with high accuracy are difficult to use quickly in field triage, especially in the case of mass casualty events. We aimed to develop a machine learning model for trauma mortality prediction using variables easy to obtain in the prehospital setting.Methods: This was a retrospective prognostic study using the National Trauma Data Bank (NTDB). Data from 2013 to 2016 were used for model training and internal testing, and data from 2017 were used for validation. A neural network model (NN-CAPSO) was developed using the ability to follow commands (whether GCS-motor was &lt;6), age, pulse rate, systolic blood pressure (SBP) and peripheral oxygen saturation, and a new score (the CAPSO score) was developed based on logistic regression. To achieve further simplification, a neural network model with the SBP variable removed (NN-CAPO) was also developed. The discrimination ability of different models and scores was compared based on the area under the receiver operating characteristic curve (AUROC). Furthermore, a reclassification table with three defined risk groups was used to compare NN-CAPSO and other models or scores.Results: The NN-CAPSO had an AUROC of 0.911(95% confidence interval 0.909 to 0.913) in the validation set, which was higher than the other trauma scores available for prehospital settings (all p &lt; 0.001). The NN-CAPO and CAPSO score both reached the AUROC of 0.904 (95% confidence interval 0.902 to 0.906), and were no worse than other prehospital trauma scores. Compared with the NN-CAPO, CAPSO score, and the other trauma scores in reclassification tables, NN-CAPSO was found to more accurately classify patients to the right risk groups.Conclusions: The newly developed CAPSO system simplifies the method of consciousness assessment and has the potential to accurately predict trauma patient mortality in the prehospital setting.
Nutritional Risk, Health Outcomes, and Hospital Costs Among Chinese Immobile Older Inpatients: A National Study
Authors: Liu Hongpeng , Song Baoyun , Jin Jingfen , Liu Yilan , Wen Xianxiu , Cheng Shouzhen , Nicholas Stephen , Maitland Elizabeth , Wu Xinjuan , Zhu Dawei , Chen Wei 
Published: December 2021

Purpose:Evidence of the impact of nutritional risk on health outcomes and hospital costs among Chinese older inpatients is limited. Relatively few studies have investigated the association between clinical and cost outcomes and nutritional risk in immobile older inpatients, particularly those with neoplasms, injury, digestive, cardiac, and respiratory conditions.Methods:This China-wide prospective observational cohort study comprised 5,386 immobile older inpatients hospitalized at 25 hospitals. All patients were screened for nutritional risk using the Nutrition Risk Screening (NRS 2002). A descriptive analysis of baseline variables was followed by multivariate analysis (Cox proportional hazards models and generalized linear model) to compare the health and economic outcomes, namely, mortality, length of hospital stay (LoS), and hospital costs associated with a positive NRS 2002 result.Results:The prevalence of a positive NRS 2002 result was 65.3% (n= 3,517). The prevalence of “at-risk” patients (NRS 2002 scores of 3+) was highest in patients with cardiac conditions (31.5%) and lowest in patients with diseases of the respiratory system (6.9%). Controlling for sex, age, education, type of insurance, smoking status, the main diagnosed disease, and Charlson comorbidity index (CCI), the multivariate analysis showed that the NRS 2002 score = 3 [hazard ratio (HR): 1.376, 95% CI: 1.031–1.836] were associated with approximately a 1.5-fold higher likelihood of death. NRS 2002 scores = 4 (HR: 1.982, 95% CI: 1.491–2.633) and NRS scores ≥ 5 (HR: 1.982, 95% CI: 1.498–2.622) were associated with a 2-fold higher likelihood of death, compared with NRS 2002 scores &lt;3. An NRS 2002 score of 3 (percentage change: 16.4, 95% CI: 9.6–23.6), score of 4 (32.4, 95% CI: 24–41.4), and scores of ≥ 5 (36.8, 95% CI 28.3–45.8) were associated with a significantly (16.4, 32.4, and 36.8%, respectively) higher likelihood of increased LoS compared with an NRS 2002 scores &lt;3. The NRS 2002 score = 3 group (17.8, 95% CI: 8.6–27.7) was associated with a 17.8%, the NRS 2002 score = 4 group (31.1, 95% CI: 19.8–43.5) a 31.1%, and the NRS 2002 score ≥ 5 group (44.3, 95% CI: 32.3–57.4) a 44.3%, higher likelihood of increased hospital costs compared with a NRS 2002 scores &lt;3 group. Specifically, the most notable mortality-specific comorbidity and LoS-specific comorbidity was injury, while the most notable cost-specific comorbidity was diseases of the digestive system.Conclusions:This study demonstrated the high burden of undernutrition at the time of hospital admission on the health and hospital cost outcomes for older immobile inpatients. These findings underscore the need for nutritional risk screening in all Chinese hospitalized patients, and improved diagnosis, treatment, and nutritional support to improve immobile patient outcomes and to reduce healthcare costs.
Longitudinal Association of Salaries for Medical Staff With Medical Service Utilization and Expenditure in China, 2007–2016
Authors: Zhu Dawei , Guo Na , Wang Jian , Nicholas Stephen , Chen Li 
Published: December 2021

Objectives: To test the hypothesis that higher salary levels of the medical staff are associated with lower medical service utilization and expenditure.Methods: Using longitudinal data from 31 Chinese provinces for the period 2007-2016, we constructed fixed effects models to analyze the association between the salary of medical staff and medical service utilization, medical expenditure, medication expenditure, and medication proportion.Results: A 10,000 CNY increase in medical staff's salaries was associated with a 0.89% decrease in the average number of annual inpatient admissions per person; 1.88 and 1.59% decreases in average expenditures per outpatient visit and inpatient admission, respectively; 3.05 and 2.66% decreases in drug expenditures per outpatient visit and inpatient admission, respectively; 0.58 percent point and 0.39 percent point decreases in the share of drug expenditure in outpatient and inpatient, respectively. When medical staff's salaries increased by 450,000 CNY, the turning point was reached when the maximum medical expenditure savings offset the medical staff salary increases, yielding a 634 billion CNY surplus from medical expenditure.Conclusions: Our results supported the hypothesis that higher salary levels of the medical staff are associated with lower medical service utilization and expenditure. Further studies are requested to test whether higher medical staff's salaries will attenuate over-treatment and that savings from reduced prescriptions and service charges will offset the increased salaries of medical staff.
A Comparison between a Classical and a Modified Root Fillet
Authors: Hodgyai Norbert , Tolvaly-Roșca Ferenc , Máté Márton 
Published: December 2021

Abstract
The main purpose of this paper consists in improving the rigidity of the gear tooth by applying various root fillet forms that differ from the classical 0.38m radius circle arc. During the research the necessity of the re-formulation of the undercut appeared. It appears much later in case of applying rounded addendum edge planing comb as in case of using a classic generating profile tool. Therefore, the limits of the profile shifting can be significantly extended without weakening the tooth dedendum.
The paper presents the stress repartitions under equal load, which occur on classic teeth, and on teeth having a modified root fillet. In this last case, the modified root fillet is the envelope of the curve family constituted by the rounded edge curves, in the relative motion of the comb related to the cut gear.
Control of a Permanent Magnet Synchronous Motor in Simulink
Authors: Katona Mihály , Kiss Péter 
Published: December 2021

Abstract
Nowadays, before the era of modern Steer-by-wire steering systems, the most widely used steering technology is Electric Power Steering (EPS). This paper contains the developing of a Permanent Magnet Synchronous Motor (PMSM) control circuit for EPS systems, in Matlab Simulink environment. The mathematical model of the Permanent Magnet Synchronous Motor was created via the four equations that represent the relation between the fluxes, voltages and currents in d-q reference frame and the motor torque equation. Mathematical transformations are required to generate the equivalent input values of the model from analog input waves. In this way, the embedded software is able to communicate with the motor through the analog input and output signals. The control model was also tested in a physically implemented system. The control software is executed on a dSpace AutoBox hardware. The output interface block creates the output phase voltages specified by the control module, and the input interface block allows the phase currents generated by the output voltage to be measured back.
Analysis of the Treatment of Synthetic Bathing Waters and Their Effects on Seedlings
Authors: Pál Krisztina , Szabolcsik Andrea Izbékiné , Bodnár Ildikó , Bellér Gábor 
Published: December 2021

Abstract
Synthetically produced bathing waters and their effect on seedlings were analysed in our research. The artificially produced bath waters were treated in different ways. Primarily, simple filtration was performed through a layer of silica sand. During the tests, the obtained greywater was investigated before and after the treatment with the help of various water quality parameters. Irrigation was set as the goal of recycling, and germination experiments were performed on mustard seeds. In these experiments, the synthetically generated treated and untreated bath water was used as irrigation water. Considering the results obtained during the germination, it can be said that the treatment is necessary in any case. Based on the results, it was shown that the filtration was not sufficient, so coagulation was used as an additional treatment method, for which we determined the optimal amount of treatment agent as a starting step.
Method for Efficient Regeneration of Solvent Mixture: Extractive Heterogeneous-Azeotropic Distillation
Authors: Tóth András József , Schmidt Szilvia 
Published: December 2021

Abstract
The fine chemical and pharmaceutical industries use large amounts of various organic solvents in their manufacturing processes. By reusing them, production costs can be significantly reduced. If we can regenerate waste solvent mixtures, we have the opportunity to reuse them in the production process or in other production processes. Our study illustrates an efficient regeneration process using the example of a four-component solvent mixture. Calculations were performed in a professional process simulator to demonstrate that the highly non-ideal Water-Ethyl Alcohol-Methyl Ethyl Ketone-Ethyl Acetate solvent mixture can be efficiently decomposed into azeotropic pairs and thus regenerated by the extractive heterogeneous-azeotropic distillation technique.