bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitigating the Adverse Effects of Heavy Axle Loads
Authors: Kalay Semih F. , LoPresti Joseph A. , Plotkin Donald 
Published: November 2021

Abstract
Increasing the capacity and gross weight of North American freight cars above the current 263,000-pound car (33-ton axle loads) is one way to improve the productivity of rail freight operations. An increase in expenditures on track and bridge maintenance is normally essential if axle load increases are to provide promised benefits. If each train can carry more net tons of bulk commodity safely, then productivity savings will be achieved by reducing the number of train crews required to haul a given tonnage. If the ratio of net-to-gross tons can be increased, additional savings can be achieved in fuel, track costs, and equipment costs. With fewer trains to move any given tonnage, there will be an improvement in capacity and a reduction in meet-pass delays.
Over the past 15 years, Transportation Technology Center, Inc. (TTCI), a subsidiary of the Association of American Railroads (AAR), has devoted extensive research efforts to safety, technical, and economic issues related to increasing axle loads. Much of the research has been based upon the five phases of the Heavy Axle Load (HAL) test program. More than 1,200 million gross tons (MGT) of HAL traffic was accumulated at the Facility for Accelerated Service Testing (FAST) located at the Federal Railroad Administration’s (FRA) Transportation Technology Center near Pueblo, Colorado. AAR and the FRA jointly fund the HAL program with significant cooperation from railroads and suppliers.
Results show that, in general, heavier axle loads will increase track and facility costs, but decrease operating and equipment costs. Since track costs are much smaller than combined operating and equipment costs, HAL operations can be economically beneficial even if the percentage increase in track costs is far greater than the percentage decrease in operating plus equipment costs. However, it should be emphasized again that in situations where track and bridges need upgrading for heavier axle loads, investment in track and bridges needs to be made first in order to realize the operating benefits from HAL operations. Total track costs were predicted to rise 5 to 10 percent under 286,000-pound cars (36-ton axle loads) and 15 to 18 percent under 315,000-pound cars (39-ton axle loads). Bridge costs, which were included as their own separate category, were predicted to rise faster than track costs. While the predicted increases for bridges were extremely high, bridge costs were only 10 to 15 percent of track costs in the base case, so they did not dominate the analysis.
ECP Brake: Transitioning From Development to Deployment
Authors: Wright Eric C. 
Published: November 2021

Abstract
While the AAR and the rail supply industry have focused a great deal of energy on developing and validating Electronically Controlled Pneumatic (ECP) brake technology; to date, very little attention has been paid to developing strategies for post-development deployment of the technology. A simple model and implementation strategy for deploying ECP brakes in the AAR freight car fleet is presented.
Ultrasonography on the non-living. Current approaches.
Authors: Thomsen Thomas , Blaivas Michael , Sadiva Paulo , Kripfgans Oliver D. , Chan Hsun-Liang , Dong Yi , Chammas Maria Cristina , Hoffmann Beatrice , Dietrich Christoph F. 
Published: November 2021

The vast majority of clinicians associate diagnostic ultrasound with a tool that is designed for the living patient. However, it is of course possible to apply this imaging technology to evaluate the recently deceased patient for postmortem diagnosis, or even just examine postmortem tissue. We describe several cases in which ultrasound-enabled providers obtain answers in postmortem examinations and discuss potential future strategies and applications. In addition, we will also illustrate the use of sonography in minimally invasive post-mortem tissue sampling (MITS), an approach that can be used in post-mortem minimally invasive autopsies as well as for establishing ultrasound diagnostic parameters in new medical fields such as periodontal and dental implant specialties.
Photodiagnosis of genital herpes and warts within a specialist online sexual health service: an observational (mixed methods) study of user experience and clinical outcomes
Authors: Engen Jessica , Black Adam , Holdsworth Gillian , Howroyd Chris , Courtenay Mollie , Baraitser Paula 
Published: November 2021

ObjectivesTo evaluate the feasibility and acceptability of a pilot, free, online photodiagnosis service for genital herpes and warts with postal treatment delivered by a specialist digital sexual health service.SettingAn online sexual health service available free of charge in South East London, UK.ParticipantsRoutinely collected data from 237 users of the pilot service during the study period and qualitative interviews with a purposive sample of 15 users.InterventionA pilot, free, online photodiagnosis service for genital herpes and warts with postal treatment delivered by a specialist digital sexual health service.Primary and secondary outcome measuresProportion of users who successfully uploaded photographs and the proportion diagnosed, treated and referred to face-to-face clinical services. User experience of this service.ResultsThe service was accessed by 237 users during the study period with assessment possible for 86% of users based on the photographs provided. A diagnosis of genital herpes or warts was made for 40.5% and 89.6% were subsequently treated through the service. Eighteen per cent were diagnosed as normal/not needing treatment and 42% were signposted to clinic for further clinical assessment.Qualitative data showed that users felt able and willing to provide genital images for diagnosis. Those who were treated or reassured expressed high satisfaction with the service, valuing the convenience, discreetness and support provided. However, users, particularly those who required referral to other services requested more personal and detailed communication when a clinical diagnosis is given remotely.ConclusionsFindings suggest that online photodiagnosis was feasible and acceptable. However, effective and acceptable management of those who require referral needs careful remote communication.
Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis
Authors: Alamnia Tilahun Tewabe , Tesfaye Wubshet , Abrha Solomon , Kelly Matthew 
Published: November 2021

ObjectivesNon-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults.Research design and methodsThis systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings.ResultsFrom 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years.ConclusionsA signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.
Paediatric elbow fractures and public play spaces: adherence to standards for children’s playground equipment and surfacing
Authors: Smith Jennifer , Chhina Harpreet , Sidhu Pardeep , Brussoni Mariana , Pike Ian , Cooper Anthony 
Published: November 2021

BackgroundSupracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and surgical intervention. The aim of this study was to examine SCHF occurring at public play spaces—particularly to determine whether or not the playground equipment implicated in injurious falls aligned with Canadian playground safety standards.MethodsCases of children who attended the provincial paediatric orthopaedic clinic following SCHF at a public playground between April 2017 and October 2019 were included in the study. A research assistant visited each playground to measure the play structure type and dimensions, height of the equipment at the point from which the child fell and the type and depth of the surface material, and compare measurements to the 2016 safety standards. Child demographics and injury classification were also noted. Descriptive statistics were calculated and a scatterplot of fall height and surface depth was generated.ResultsForty-three sites, representing 47 SCHF cases (18 female, 29 male), were included in the final analysis. Fourteen children sustained type 1 fracture, 23 had type 2 fracture and the remaining 10 had type 3 fracture. Five children with type 2 fracture and all 10 children with type 3 fracture required surgery. The majority of sites had engineered wood fibre surfacing, with surfacing at 35 sites being less than 300 mm deep. Twenty-six play structures were upper body equipment (ie, monkey bars or similar), seven were track rides, five were rotating structures and the rest comprised a variety of classified and unclassified structures. Twenty-seven children fell from a height exceeding 2 m.ConclusionsThe majority of SCHF cases occurred at playgrounds with insufficient surface depth and/or non-compliant equipment. Upper body equipment, track rides and rotating play structures were of particular concern, as the children fell from heights exceeding the recommended standard, likely reflecting the degradation and compaction of the surfacing material over time.
Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals
Authors: Heightman Melissa , Prashar Jai , Hillman Toby E , Marks Michael , Livingston Rebecca , Ridsdale Heidi A , Roy Kay , Bell Robert , Zandi Michael , McNamara Patricia , Chauhan Alisha , Denneny Emma , Astin Ronan , Purcell Helen , Attree Emily , Hishmeh Lyth , Prescott Gordon , Evans Rebecca , Mehta Puja , Brennan Ewen , Brown Jeremy S , Porter Joanna , Logan Sarah , Wall Emma , Dehbi Hakim-Moulay , Cone Stephen , Banerjee Amitava 
Published: November 2021

IntroductionPost-COVID-19 complications require simultaneous characterisation and management to plan policy and health system responses. We describe the 12-month experience of the first UK dedicated post-COVID-19 clinical service to include hospitalised and non-hospitalised patients.MethodsIn a single-centre, observational analysis, we report the demographics, symptoms, comorbidities, investigations, treatments, functional recovery, specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post-COVID-19 service between April 2020 and April 2021, comparing by referral route: posthospitalised (PH), non-hospitalised (NH) and post emergency department (PED). Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression.Results1325 individuals were assessed (PH: 547, 41.3%; PED: 212, 16%; NH: 566, 42.7%). Compared with the PH and PED groups, the NH group were younger (median 44.6 (35.6–52.8) years vs 58.3 (47.0–67.7) years and 48.5 (39.4–55.7) years), more likely to be female (68.2%, 43.0% and 59.9%), less likely to be of ethnic minority (30.9%, 52.7% and 41.0%) or seen later after symptom onset (median (IQR): 194 (118–298) days, 69 (51–111) days and 76 (55–128) days; all p<0.0001). All groups had similar rates of onward specialist referral (NH 18.7%, PH 16.1% and PED 18.9%, p=0.452) and were more likely to require support for breathlessness (23.7%, 5.5% and 15.1%, p<0.001) and fatigue (17.8%, 4.8% and 8.0%, p<0.001). Hospitalised patients had higher rates of pulmonary emboli, persistent lung interstitial abnormalities and other organ impairment. 716 (54.0%) individuals reported <75% optimal health (median 70%, IQR 55%–85%). Less than half of employed individuals could return to work full time at first assessment.ConclusionPost-COVID-19 symptoms were significant in PH and NH patients, with significant ongoing healthcare needs and utilisation. Trials of interventions and patient-centred pathways for diagnostic and treatment approaches are urgently required.
Case–control study to estimate odds of death within 28 days of positive test for SARS-CoV-2 prior to vaccination for residents of long-term care facilities in England, 2020–2021
Authors: Paranthaman Karthik , Allen Hester , Chudasama Dimple , Verlander Neville Q , Sedgwick James 
Published: November 2021

BackgroundPersons living in long-term care facilities (LTCFs) are presumed to be at higher risk of adverse outcomes from SARS-CoV-2 infection due to increasing age and frailty, but the magnitude of increased risk is not well quantified.MethodsAfter linking demographic and mortality data for cases with confirmed SARS-CoV-2 infection between March 2020 and January 2021 in England, a random sample of 6000 persons who died and 36 000 who did not die within 28 days of a positive test was obtained from the dataset of 3 020 800 patients. Based on an address-matching process, the residence type of each case was categorised into one of private home and residential or nursing LTCF. Univariable and multivariable logistic regression analysis was conducted.ResultsMultivariable analysis showed that an interaction effect between age and residence type determined the outcome. Compared with a 60-year-old person not living in LTCF, the adjusted OR (aOR) for same-aged persons living in residential and nursing LTCFs was 1.77 (95% CI 1.21 to 2.6, p=0.0017) and 3.95 (95% CI 2.77 to 5.64, p<0.0001), respectively. At 90 years of age, aORs were 0.87 (95% CI 0.72 to 1.06, p=0.21) and 0.74 (95% CI 0.61 to 0.9, p=0.001), respectively. The model had an overall accuracy of 94.2% (94.2%) when applied to the full dataset of 2 978 800 patients.ConclusionThis study found that residents of LTCFs in England had higher odds of death up to 80 years of age. Beyond 80 years, there was no difference in the odds of death for LTCF residents compared with those in the wider community.
Prevalence and correlates of REM sleep behaviour disorder in patients with major depressive disorder: a two-phase study
Authors: Wang Jing , Chau Steven W H , Lam Siu Ping , Liu Yaping , Zhang Jihui , Chan Ngan Yin , Cheung Maxine M S , Yu Mandy Wai Man , Tsang Jessie C T , Chan Joey W Y , Huang Bei , Li Shirley X , Mok Vincent , Wing Yun Kwok 
Published: November 2021

ObjectiveTo investigate the prevalence and clinical correlates of video polysomnography (vPSG)-confirmed rapid eye movement sleep behaviour disorder (RBD) in patients with major depressive disorder (MDD).MethodsThis is a clinic-based two-phase epidemiological study. In phase 1, patients with MDD were screened by a validated questionnaire, RBD Questionnaire-Hong Kong (RBDQ-HK). In phase 2, a subsample of both the screen-positive (RBDQ-HK >20) and screen–negative patients with MDD underwent further clinical and sleep assessment (vPSG) to confirm the diagnosis of RBD (MDD+RBD). Poststratification weighting method was used to estimate the prevalence of MDD+RBD. The total likelihood ratio and the probability of prodromal Parkinson’s disease (PD) were calculated from prodromal markers and risk factors, as per the Movement Disorder Society research criteria.ResultsA total of 455 patients with MDD were screened (median age (IQR)=52.66 (15.35) years, 77.58% woman, 43.74% positive). Eighty-one patients underwent vPSG and 12 of them were confirmed MDD+RBD. The prevalence of MDD+RBD was estimated to be 8.77% (95% CI: 4.33% to 16.93%), with possibly male predominance. MDD+RBD were associated with colour vision and olfaction deficit and a higher probability for prodromal PD.ConclusionsAlmost 9% of patients with MDD in the psychiatric outpatient clinic has vPSG-confirmed RBD. Comorbid MDD+RBD may represent a subtype of MDD with underlying α-synucleinopathy neurodegeneration. Systematic screening of RBD symptoms and necessity of vPSG confirmation should be highlighted for capturing this MDD subtype with a view to enhance personalised treatment and future neuroprotection to prevent neurodegeneration.
Retinal inter-eye difference and atrophy progression in multiple sclerosis diagnostics
Authors: Nij Bijvank Jenny , Uitdehaag B M J , Petzold Axel 
Published: November 2021

BackgroundThe visual system could be included in the diagnostic criteria for multiple sclerosis (MS) to demonstrate dissemination in space (DIS) and dissemination in time (DIT).ObjectiveTo investigate the diagnostic value of retinal asymmetry in MS.MethodsA prospective, longitudinal study in individuals with MS (n=151) and healthy controls (n=27). Optical coherence tomography (OCT) was performed at 0, 2 and 4 years. Macular ganglion cell and inner plexiform layer (mGCIPL) thickness was determined as well as measures for retinal asymmetry: the inter-eye percentage difference (IEPD) and inter-eye absolute difference (IEAD). Receiver operator characteristics curves were plotted and the area under the curve (AUC) was calculated for group comparisons of the mGCIPL, IEPD, IEAD and atrophy rates.ResultsThe diagnostic accuracy of both the IEPD and IEAD for differentiating bilateral and unilateral MS optic neuritis was high and stable over time (AUCs 0.88–0.93). The IEPD slightly outperformed the IEAD. Atrophy rates showed low discriminatory abilities for differentiating MS from controls (AUC 0.49–0.58).ConclusionThe inter-eye differences of the mGCIPL have value for demonstration of DIS but in individuals with longstanding MS not for DIT. This may be considered as a test to detect DIS in future diagnostic criteria. Validation in a large prospective study in people presenting with symptoms suggestive of MS is required.
A novel fluorometric chemosensor based on imidazo[4,5-b]phenazine-2-thione for ultrasensitive detection and separation of Hg2+ in aqueous solution
Authors: Huang Qing , Li Qiao , Zhang Hai-Li , Zhu Wei , Qu Wen-Juan , Lin Qi , Yao Hong , Zhang You-Ming , Wei Tai-Bao 
Published: November 2021

We synthesized and developed 1,3-dihydro-2H-imidazo[4,5-b]phenazine-2-thione as a ratiometric chemosensor for Hg2+ recognition in a DMSO/H2O (v/v = 9:1) binary solution. We rationally introduced the phenazine imidazole group as the fluorophore and the thione moiety as the recognition site to bind Hg2+. Interestingly, the chemosensor showed an ultrasensitive response to Hg2+, and the lowest limit of detection was 0.167 nM. In addition, it can also separate Hg2+ from aqueous solutions with excellent ingestion capacity, with an adsorption ratio of up to 96%. Furthermore, ion test strips based on chemosensors were fabricated for convenient and efficient detection of Hg2+.
The Protein Kinase Activity of NME7 Activates Wnt/β-Catenin Signaling to Promote One-Carbon Metabolism in Hepatocellular Carcinoma
Authors: Ren Xinxin , Rong Zhuoxian , Liu Xiaoyu , Gao Jie , Xu Xu , Zi Yuyuan , Mu Yun , Guan Yidi , Cao Zhen , Zhang Yuefang , Zeng Zimei , Fan Qi , Wang Xitao , Pei Qian , Wang Xiang , Xin Haiguang , Li Zhi , Nie Yingjie , Qiu Zilong , Li Nan , Sun Lunquan , Deng Yuezhen 
Published: November 2021

Abstract

Metabolic reprogramming by oncogenic signaling is a hallmark of cancer. Hyperactivation of Wnt/β-catenin signaling has been reported in hepatocellular carcinoma (HCC). However, the mechanisms inducing hyperactivation of Wnt/β-catenin signaling and strategies for targeting this pathway are incompletely understood. In this study, we find nucleoside diphosphate kinase 7 (NME7) to be a positive regulator of Wnt/β-catenin signaling. Upregulation of NME7 positively correlated with the clinical features of HCC. Knockdown of NME7 inhibited HCC growth in vitro and in vivo, whereas overexpression of NME7 cooperated with c-Myc to drive tumorigenesis in a mouse model and to promote the growth of tumor-derived organoids. Mechanistically, NME7 bound and phosphorylated serine 9 of GSK3β to promote β-catenin activation. Furthermore, MTHFD2, the key enzyme in one-carbon metabolism, was a target gene of β-catenin and mediated the effects of NME7. Tumor-derived organoids with NME7 overexpression exhibited increased sensitivity to MTHFD2 inhibition. In addition, expression levels of NME7, β-catenin, and MTHFD2 correlated with each other and with poor prognosis in patients with HCC. Collectively, this study emphasizes the crucial roles of NME7 protein kinase activity in promoting Wnt/β-catenin signaling and one-carbon metabolism, suggesting NME7 and MTHFD2 as potential therapeutic targets for HCC.

Significance:
The identification of NME7 as an activator of Wnt/β-catenin signaling and MTHFD2 expression in HCC reveals a mechanism regulating one-carbon metabolism and potential therapeutic strategies for treating this disease.
Nonconvex Sparse Regularization for Deep Neural Networks and Its Optimality
Authors: Ohn Ilsang , Kim Yongdai 
Published: November 2021

Abstract
Recent theoretical studies proved that deep neural network (DNN) estimators obtained by minimizing empirical risk with a certain sparsity constraint can attain optimal convergence rates for regression and classification problems. However, the sparsity constraint requires knowing certain properties of the true model, which are not available in practice. Moreover, computation is difficult due to the discrete nature of the sparsity constraint. In this letter, we propose a novel penalized estimation method for sparse DNNs that resolves the problems existing in the sparsity constraint. We establish an oracle inequality for the excess risk of the proposed sparse-penalized DNN estimator and derive convergence rates for several learning tasks. In particular, we prove that the sparse-penalized estimator can adaptively attain minimax convergence rates for various nonparametric regression problems. For computation, we develop an efficient gradient-based optimization algorithm that guarantees the monotonic reduction of the objective function.