bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Topology Optimized Bending-Twisting Soft Finger
Authors: Chen Zhili , Rahimi Nohooji Hamed , Chew Chee-Meng 
Published: December 2021

Abstract
This paper proposed a systematic framework to automatically design and fabricate optimized soft robotic fingers. The soft finger is composed of a soft silicone structure with inner air chambers and a harder outer layer, which are fabricated by molding process and 3D printing, respectively. The softer layer is utilized for actuation while the supportive hard structure is used to impose constraints. The framework applies a topology optimization approach based on rational approximation of material properties (RAMP) method to obtain an optimal design of the outer layer of the soft fingers. Two basic motion primitives (bending and twisting) of the soft finger were explored. A multi-segmented soft bending finger and a soft twisting finger were designed and fabricated through the proposed framework. This work also explored the combination of bending and twisting primitives by developing a combined bending-twisting soft finger. The soft fingers were characterized by free and blocked movement tests. The experiments showed that the triple-segmented soft finger can achieve a maximum of 50.5 deg no-load bending under the actuation pressure of 53 kPa. The blocked movement test on the multi-segmented soft actuating finger showed that this finger could generate up to a maximum of 0.63 N force under 57 kPa actuation pressure in 7 s of inflating time. The developed twisting soft finger was shown to achieve tip rotation of up to 219 deg under 29 kPa actuation pressure. Finally, the potential capability of the bending-twisting soft fingers was verified through applications like screwing and object grasping.
Case Studies of Olympic Medalist Coach–Athlete Relationships: A Retrospective Analysis Prior to and During the Olympics
Authors: Zuleger Brian , McGuire Rick 
Published: December 2021

The Olympics is a unique and challenging performance setting that tests the strength of the coach–athlete relationship. The purpose of this study was to investigate the coach–athlete relationship prior to and during the Olympics with Olympic-medal-winning athletes and their coaches. Qualitative research methods were implemented where three Olympic medalist coach–athlete dyads participated in semistructured interviews. Data collection included three separate interviews (athlete, coach, and coach–athlete) for each dyad. Cross-case analysis identified three lower order themes related to creating an athlete-centered environment: (a) empowering effective decision making, (b) open and honest communication, and (c) mental cue-based instruction and feedback. In addition, three lower order themes related to developing a caring supportive relationship emerged: (a) developed trust, (b) commitment, and (c) gratitude. Results indicated that coaches and athletes perceived that their success at the Olympics Games was influenced by the strength of the coach–athlete relationship that was developed over multiple years prior to the Olympics.
Acute kidney injury in paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is not associated with progression to chronic kidney disease
Authors: Stewart Douglas John , Mudalige Nadeesha Lakmal , Johnson Mae , Shroff Rukshana , du Pré Pascale , Stojanovic Jelena 
Published: December 2021

BackgroundPaediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a rare complication of SARS-CoV-2 associated with single or multiorgan dysfunction.ObjectiveWe aimed to evaluate the incidence of acute kidney injury (AKI) and risk factors for kidney dysfunction in PIMS-TS, with reporting of 6-month renal follow-up data. We also evaluated renal involvement between first and second waves of the SARS-CoV-2 pandemic in the UK, the latter attributed to the Alpha variant.DesignA single-centre observational study was conducted through patient chart analysis.SettingData were collected from patients admitted to Great Ormond Street Hospital, London, UK, between April 2020 and March 2021.Patients110 patients <18 years of age.Main outcome measureAKI during hospitalisation. AKI classification was based on upper limit of reference interval (ULRI) serum creatinine (sCr) values.ResultsAKI occurred in 33 (30%) patients. Hypotension/hypoperfusion was associated with almost all cases. In univariate analysis, the AKI cohort had higher peak levels of triglycerides (OR, 1.27 (95% CI, 1.05 to 1.6) per 1 mmol/L increase) and C reactive protein (OR, 1.06 (95% CI, 1.02 to 1.12) per 10 mg/L increase), with higher requirement for mechanical ventilation (OR, 3.8 (95% CI, 1.46 to 10.4)) and inotropic support (OR, 15.4 (95% CI, 3.02 to 2.81)). In multivariate analysis, triglycerides were independently associated with AKI stages 2–3 (adjusted OR, 1.26 (95% CI, 1.04 to 1.6)). At follow-up, none had macroalbuminuria and all had sCr values <ULRI. No discrepancy in renal involvement between pandemic waves was found.ConclusionDespite a high incidence of AKI in PIMS-TS, renal recovery occurs rapidly with current therapies, and no patients developed chronic kidney disease.
Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care
Authors: Falcaro Milena , Osborn David , Hayes Joseph , Couperthwaite Lisa , Weich Scott , Walters Kate R 
Published: December 2021

ObjectivesTo investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without.DesignLongitudinal cohort study using primary healthcare records.SettingEnglish primary care.Participants882 849 patients registered with participating practices recorded as current smokers during 2007–2014, including three groups: (1) 13 078 with SMI, (2) 55 630 with no SMI but recent depression and (3) 814 141 with no SMI nor recent depression.OutcomesRecorded advice to quit smoking, referrals to smoking cessation services, prescriptions for smoking cessation medication, recorded quit attempts and changes of smoking status.ResultsThe majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups. Bupropion and varenicline prescribing was very low and lower for those with SMI. Few smokers (<5%) had referrals to stop smoking services, though this increased over time, but no significant differences were observed between those with and without mental health problems.ConclusionsThere was no evidence of consistent inequalities in access to GP-delivered smoking cessation interventions for people with mental health conditions. Smoking cessation advice was widely reported as taking place in all groups. In order to address the widening gap in smoking prevalence in those with poor mental health compared with those without, the emphasis should be on addressing the quality of advice and support given.
Factors associated with HIV testing and counselling services among women and men in Nepal: a cross-sectional study using data from a nationally representative survey
Authors: Bhattarai Navaraj , Bam Kiran , Acharya Kiran , Thapa Rajshree , Shrestha Bhagawan 
Published: December 2021

ObjectivesThis study is set up to explore the factors associated with Human Immunodeficiency Virus (HIV) testing among women and men in Nepal.Study designNepal Demographic and Health Survey, 2016 adopts a cross-sectional design.SettingNepal.ParticipantsWomen and men of age 15–49 years.Primary outcome measuresOur primary outcome was ever tested for HIV. We used multivariable analysis at a 95% level of significance to measure the effect in outcome variables.ResultsAbout one in 10 women (10.8%) and one in five men (20.5%) ever tested for HIV. Women who had media exposure at least once a week ((adjusted odds ratio (aOR)=2.8; 95% CI: 1.4 to 5.3) were more likely to get tested for HIV compared with those who had no media exposure at all. Similarly, those who had their recent delivery in the health facility (aOR=3.9; 95% CI: 2.4 to 6.3) were more likely to get tests for HIV compared with those delivered elsewhere. Likewise, among men, compared with adolescents (15–19 years), those from older age groups were more likely to get tested for HIV. Compared with no education, secondary (aOR=2.3; 95% CI: 1.4 to 3.6) and higher education (aOR=1.7; 95% CI: 1.0 to 2.8) had higher odds of getting tested for HIV. Similarly, wealth quintiles in richer and richest groups were more likely to get tested for HIV compared with the poorest quintile. Other characteristics like media exposure, paid sex and 2+ sexual partners were positively associated with being tested for HIV.ConclusionsHIV testing is not widespread and more men than women are accessing HIV services. More than two-thirds of women who delivered at health facilities never tested for HIV. It is imperative to reach out to people engaging in risky sexual behaviour, people with lower educational attainment, and those in the lower wealth quintile for achieving 95–95–95 targets by 2030.
Magnitude of preterm hospital neonatal mortality and associated factors in northern Ethiopia: a cross-sectional study
Authors: Girma Bekahegn , Nigussie Jemberu 
Published: December 2021

ObjectiveThis study aimed to assess the magnitude of preterm neonatal mortality in hospitals and associated factors in northern Ethiopia.DesignInstitutional-based cross-sectional study.SettingComprehensive specialised hospitals in the Tigray region, northern Ethiopia.ParticipantsPreterm neonates admitted in Ayder and Aksum comprehensive specialised hospitalsPrimary outcomeMagnitude of preterm neonatal mortality.Secondary outcomeFactors associated with preterm neonatal mortalityResultThis study was conducted from 1 April 2019 to 15 May 2019 among 336 participants with a response rate of 96.8%. The magnitude of preterm neonatal mortality was 28.6% (95% CI: 24.0 to 33.7). In multivariable logistic regression, respiratory distress syndrome (adjusted odd ratio (AOR)=2.85; 95% CI: 1.35 to 6.00), apnoea of prematurity (AOR=5.45; 95% CI: 1.32 to 22.5), nulli parity (AOR=3.63; 95% CI: 1.59 to 8.24) and grand parity (AOR=3.21; 95% CI: 1.04 to 9.94) were significant factors associated with preterm neonatal mortality. However, receiving Kangaroo mother care (AOR=0.08; 95% CI: 0.03 to 0.20) and feeding initiated during hospitalisation (AOR=0.07; 95% CI: 0.03 to 0.15) were protective against preterm neonatal mortality.ConclusionsThe magnitude of preterm neonatal mortality in hospitals was still high. Interventions geared towards curbing preterm in-hospital neonatal mortality should strengthen early diagnosis and treatment of preterm newborns with respiratory distress syndrome and apnoea of prematurity; while concomitantly reinforcing the implementation of kangaroo care and early feeding initiation is important.
Determinants and pathways of healthcare-seeking behaviours in under-5 children for common childhood illnesses and antibiotic prescribing: a cohort study in rural India
Authors: Khare Shweta , Pathak Ashish , Purohit Manju Raj , Sharma Megha , Marrone Gaetano , Tamhankar Ashok J , Stålsby Lundborg Cecilia , Diwan Vishal 
Published: December 2021

ObjectivesTo explore the healthcare-seeking pathways, antibiotic prescribing and determine the sociodemographic factors associated with healthcare-seeking behaviour (HSB) of caregivers for common illnesses in under-5 (U-5) children in rural Ujjain, India.Study designProspective cohort study.Study setting and study sampleThe cohort included 270 U-5 children from selected six villages in rural demographic surveillance site, of the R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India. A community-based cohort was visited two times weekly for over 113 weeks (August 2014 to October 2016) to record the HSB of caregivers using HSB diaries. Sociodemographic information was also solicited.Primary and secondary outcome measuresPrimary outcomes: first point of care, healthcare-seeking pathway and quantify antibiotic prescribing for the common acute illnesses.Secondary outcomeHSB risk factors were determined using mixed-effects multinomial logistic regression.ResultsA total of 60 228 HSB follow-up time points for 270 children were recorded with a total of 2161 acute illness episodes. The most common illnesses found were respiratory tract infections (RTI) (69%) and gastrointestinal tract infections (8%). No healthcare was sought in 33% of illness episodes, mostly for RTIs. The most common healthcare-seeking pathway was to informal healthcare providers (IHCPs, 49% of illness episodes). The adjusted relative risk for obtaining no treatment, home treatment and treatment by IHCPs was higher for RTIs (aRR=11.54, 1.82 and 1.29, respectively), illiterate mothers (aRR=2.86, 2.38 and 1.93, respectively), and mothers who were homemakers (aRR=2.90, 4.17 and 2.10, respectively). Socioeconomic status was associated with HSB, with the highest aRR for no treatment in the lowest two socioeconomic quintiles (aRR=6.59 and 6.39, respectively). Antibiotics were prescribed in 46% (n=670/1450) illness episodes and the majority (85%, n=572/670) were broad spectrum.ConclusionIn our rural cohort for many acute episodes of illnesses, no treatment or home treatment was done, which resulted in overall reduced antibiotic prescribing. The most common healthcare-seeking pathway was to visit IHCPs, which indicates that they are major healthcare providers in rural areas. Most of the antibiotics were prescribed by IHCPs and were commonly prescribed for illnesses where they were not indicated.
Young Survivors at KSA: registry for standardised assessment of long-term and late-onset health events in survivors of childhood and adolescent cancer—a study protocol
Authors: Otth Maria , Drozdov Daniel , Hügli Claudia , Scheinemann Katrin 
Published: December 2021

IntroductionA high proportion of survivors of childhood and adolescent cancer experience chronic medical conditions — late effects. Most studies on late effects have a retrospective or questionnaire-based design, which leads to unavoidable limitations such as missing data or different severity coding and grading of late effects. We, therefore, need prospective data, including standardised severity coding and grading. ‘Young Survivors at KSA’ aims to close this gap by assessing frequency, severity, risk factors and longitudinal changes of late effects in childhood cancer survivors prospectively and in a standardised way.Methods and analysisWithin the ‘Young Survivors at KSA’ registry, we collect data from regular follow-up visits in a comprehensive database prospectively and repeatedly from start of the study and retrospectively at most until January 2016. We classify and grade the severity of late effects according to the Common Terminology Criteria for Adverse Events version 4.0 modified by Hudsonet al. The outcome variables correspond to results from risk-stratified organ examinations, performed according to the Children’s Oncology Group guidelines version 5.0 and the recommendations by the International Guideline Harmonization Group. We collect the exposure variables from the patients’ medical history, including detailed information on cancer diagnosis and treatment. We analyse the data in an exposure-driven and organ system-driven approach. We start recruitment with patients treated at the Kantonsspital Aarau, Switzerland. However, our design allows the inclusion of additional national centres later.Ethics and dissemination‘Young Survivors at KSA’ is approved by the Ethikkommission Nordwest- und Zentralschweiz, reference number AO_2020–00012. The results of this study will be presented at scientific meetings, including meetings with childhood cancer survivors and published in peer-reviewed and if possible open access journals. New insights gained from the study will be used directly in clinical practice.Trial registration numberClinicalTrials.govNCT04811794;https://clinicaltrials.gov/ct2/show/study/NCT04811794
The heart & mind trial: intervention with cognitive–behavioural therapy in patients with cardiac disease and anxiety: randomised controlled trial protocol
Authors: Berg Selina Kikkenborg , Herning Margrethe , Schjødt Inge , Thorup Charlotte Brun , Juul Carsten , Svendsen Jesper Hastrup , Jorgensen Martin Balslev , Risom Signe Stelling , Christensen Signe Westh , Thygesen Lau , Rasmussen Trine Bernholdt 
Published: December 2021

IntroductionPatients with cardiac disease often experience anxiety (prevalence about 20%–25%) and have a doubled mortality risk when suffering from anxiety compared with patients without anxiety. This calls for interventions aiming to reduce anxiety.Methods and analysisThe Heart & Mind Trial consists of three parts: (1) screening of all hospitalised and outpatient cardiac patients with arrhythmia, heart failure or ischaemic heart disease at four university hospitals in Denmark using the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A); Patients scoring ≥8 is invited to participate; (2) Assessment of the type of anxiety by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders and (3) Randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive–behavioural therapy (CBT) performed by a CBT-trained cardiac nurse plus usual care or, usual care alone. The primary outcome is anxiety measured with HADS-A at 5 months. Secondary outcomes include anxiety symptoms measured with Becks Anxiety Inventory and heart rate variability. Exploratory outcomes measured at 12 months include blood cortisol (stress response), blood C reactive protein (stress response), health-related quality of life, readmission, mortality and attributable direct costs. A total of 336 patients will be included. The primary analyses are based on the intention-to-treat principle. For the primary outcome, we will use a linear regression model. For the long-term outcomes, mixed regression models will be used including repeated measurements.Ethics and disseminationThe trial is performed in accordance with the Declaration of Helsinki. All patients must give informed consent prior to participation and the trial is initiated after approval by the Danish Data Protection Agency (P-2020-894) and the National Committee on Health Research Ethics (H-20066739). Positive, neutral and negative results of the trial will be published.Trial registration numberNCT04582734.
Mediating role of multimorbidity in inequality in mortality: a register study on the Danish population
Authors: Diderichsen Finn , Bender Anne Mette , Lyth Alice Clark , Andersen Ingelise , Pedersen Jacob , Bjørner Jakob Bue 
Published: December 2021

BackgroundThe social inequality in mortality is due to differential incidence of several disorders and injury types, as well as differential survival. The resulting clustering and possible interaction in disadvantaged groups of several disorders make multimorbidity a potentially important component in the health divide. This study decomposes the effect of education on mortality into a direct effect, a pure indirect effect mediated by multimorbidity and a mediated interaction between education and multimorbidity.MethodsThe study uses the Danish population registers on the total Danish population aged 45–69 years. A multimorbidity index based on all somatic and psychiatric hospital contacts as well as prescribed medicines includes 22 diagnostic groups weighted together by their 5 years mortality risk as weight. The Aalen additive hazard model is used to estimate and decompose the 5 years risk difference in absolute numbers of deaths according to educational status.ResultsMost (69%–79%) of the effect is direct not involving multimorbidity, and the mediated effect is for low educated women 155 per 100 000 of which 87 is an effect of mediated interaction. For low educated men, the mediated effect is 250 per 100 000 of which 93 is mediated interaction.ConclusionMultimorbidity plays an important role in the social inequality in mortality among middle aged in Denmark and mediated interaction represents 5%–17%. As multimorbidity is a growing challenge in specialised health systems, the mediated interaction might be a relevant indicator of inequities in care of multimorbid patients.
The fate of $$\mathbf{V}_\mathbf{1}$$ vector leptoquarks: the impact of future flavour data
Authors: Hati C. , Kriewald J. , Orloff J. , Teixeira A. M. 
Published: December 2021

AbstractMotivated by the recent experimental progress on the B-meson decay anomalies (in particular the angular observables in $$B\rightarrow K^*\mu \mu $$

B
→

K
∗

μ
μ

), we rely on a simplified-model approach to study the prospects of vector leptoquarks in what concerns numerous flavour observables, identifying several promising decay modes which would allow to (indirectly) probe such an extension. Our findings suggest that the confirmation of the B-meson decay anomalies, in parallel with positive signals (at Belle II or LHCb) for $$\tau \rightarrow \phi \mu $$

τ
→
ϕ
μ

, $$B_{(s)}$$

B

(
s
)

-meson decays to $$\tau ^+ \tau ^-$$

τ
+

τ
-

and $$\tau ^+ \mu ^-$$

τ
+

μ
-

($$\tau ^+ e^-$$

τ
+

e
-

) final states, as well as an observation of certain charged lepton flavour violation decays (at COMET or Mu2e), would contribute to strengthen the case for this scenario. We also illustrate how the evolution of the experimental determination of $$R_{D^{(*)}}$$

R

D

(

∗
)

could be instrumental in falsifying an explanation of the anomalous B-meson decay data via a vector $$V_1$$

V
1

leptoquark.