bluuebunny/crossref_metadata_2025_split huggingface dataset:
Express Wire Coil Cladding as an Advanced Technology to Accelerate Additive Manufacturing and Coating
Authors: Gipperich Marius , Riepe Jan , Day Robin , Bergs Thomas 
Published: August 2021

Abstract
Metal shafts are indispensable components in mobility, energy, and mechanical engineering. In such applications, the shafts need to withstand severe mechanical loads, friction, high temperature, or corrosive media. This is why shafts are often completely made of high-performance alloys. From a technical point of view, coating an inexpensive base shaft with a thin layer of high-performance material is mostly sufficient to ensure its functionality. Adding functional parts such as shoulders or bearing seats by additive manufacturing instead of creating them by subtractive manufacturing is an advantageous approach to increase flexibility and material efficiency. Reliable and economic Additive Manufacturing and coating processes need to be developed further, and laser-based processes such as wire-based laser metal deposition (LMD-w) offer high potential to accomplish this. They can generate a stable metallurgical bond between the base material and the cladding or the added feature without excessively heating the work piece. Due to their low build-up rate, however, LMD processes are not economically competitive with high-speed subtractive technologies such as drilling or turning, which are predominately used for shaft production. Motivated by this challenge, we present an alternative approach that increases the deposition rate for laser-based shaft cladding. Instead of adding the filler wire continuously, wire coils are wound and preplaced on the shaft. In a second step, laser processing while rotating the part generates a metallurgical bond between the wire and the substrate. In this study, several solid and flux-cored wires were analyzed regarding their suitability for this two-step coil winding and LMD process. The results from LMD experiments give an overview of the resulting surface state and of the welded joint quality after deposition. Metallographic cross-sections show low porosity of the deposited layers and small heat-affected zones in the base shaft. Thanks to its good scalability, this innovative two-step process can help strongly increase the build-up rate compared to classic LMD-w.
Dynamical Characterization of Thermoacoustic Oscillations in a Hydrogen-Enriched Partially Premixed Swirl-Stabilized Methane/Air Combustor
Authors: Kushwaha Abhishek , Kasthuri Praveen , Pawar Samadhan A. , Sujith R. I. , Chterev Ianko , Boxx Isaac 
Published: August 2021

Abstract
In this study, we systematically analyze the effects of hydrogen enrichment in the well-known PRECCINSTA burner, a partially premixed swirl-stabilized methane/air combustor. Keeping the equivalence ratio and thermal power constant, we vary the hydrogen percentage in the fuel. Successive increments in hydrogen fuel fraction increase the adiabatic flame temperature and also shift the dominant frequencies of acoustic pressure fluctuations to higher values. Under hydrogen enrichment, we observe the emergence of periodicity in the combustor resulting from the interaction between acoustic modes. As a result of the interaction between these modes, the combustor exhibits a variety of dynamical states, including period-1 limit cycle oscillations (LCO), period-2 LCO, chaotic oscillations, and intermittency. The flame and flow behavior is found to be significantly different for each dynamical state. Analyzing the coupled behavior of the acoustic pressure and the heat release rate oscillations during the states of thermoacoustic instability, we report the occurrence of 2:1 frequency-locking during period-2 LCO, where two cycles of acoustic pressure lock with one cycle of the heat release rate. During period-1 LCO, we notice 1:1 frequency-locking, where both acoustic pressure and heat release rate repeat their behavior in every cycle.
Transmuscular quadratus lumborum block versus oblique subcostal transversus abdominis plane block for analgesia in laparoscopic hysterectomy: a randomised single-blind trial
Authors: Huang Lvdan , Zheng Liangyu , Zhang Jingxiong , Zhu Xiaona , Pan Linmin , Zhang Yujian , Wang Quanguang , Shi Kejian 
Published: August 2021

ObjectiveThe transmuscular quadratus lumborum (TQL) block and the oblique subcostal transversus abdominis plane (OSTAP) block both contribute to multimodal analgesia after laparoscopic surgery. The objective of this study was to compare the analgesic effects of the TQL block versus OSTAP block after laparoscopic hysterectomy.DesignProspective single-centre randomised single-blind trial.SettingUniversity-affiliated hospital.ParticipantsPatients aged between 18 and 65 years scheduled for laparoscopic hysterectomy.InterventionsPatients were randomised into two groups (1:1 ratio) and received bilateral TQL block or bilateral OSTAP block with 0.375% ropivacaine 20 mL on each side before surgery.Primary and secondary outcome measuresThe primary outcome measure was the cumulative morphine dose in the first 24 hours. The secondary outcome measures were the morphine consumption at each time interval after surgery, the time from the end of surgery to the first need for morphine, the Numerical Rating Scale (NRS) scores for visceral and incisional pain intensity, and the incidence of adverse events.ResultsThe cumulative morphine dose was significantly lower in the TQL group than in the OSTAP group (17.2 (12.5) vs 26.1 (13.3) mg, p=0.010). Compared with the OSTAP group, the morphine doses from 6 to 12, 12 to 18, and 18 to 24 hours were significantly lower, the time of first need for morphine was significantly longer and the NRS scores for visceral pain intensity were significantly lower in the TQL group.ConclusionCompared with the OSTAP block, the TQL block reduced morphine consumption and provided better visceral pain relief with a longer duration of effect after laparoscopic hysterectomy.Trial registration numberChinese Clinical Trial Registry (ChiCTR1800017995); pre-results.
Tuberculosis care cascade in Zambia - identifying the gaps in order to improve outcomes: a population-based analysis
Authors: Lungu Patrick , Kerkhoff Andrew D , Kasapo Clara C , Mzyece Judith , Nyimbili Sulani , Chimzizi Rhehab , Silumesii Andrew , Kagujje Mary , Subbaraman Ramnath , Muyoyeta Monde , Malama Kennedy 
Published: August 2021

ObjectiveTuberculosis (TB) remains a leading cause of morbidity and mortality in Zambia, especially for people living with HIV (PLHIV). We undertook a care cascade analysis to quantify gaps in care and align programme improvement measures with areas of need.DesignRetrospective, population-based analysis.SettingWe derived national-level estimates for each step of the TB care cascade in Zambia. Estimates were informed by WHO incidence estimates, nationally aggregated laboratory and notification registers, and individual-level programme data from four provinces.ParticipantsParticipants included all individuals with active TB disease in Zambia in 2018. We characterised the overall TB cascade and disaggregated by drug susceptibility results and HIV status.ResultsIn 2018, the total burden of TB in Zambia was estimated to be 72 495 (range, 40 495–111 495) cases. Of these, 43 387 (59.8%) accessed TB testing, 40 176 (55.4%) were diagnosed with TB, 36 431 (50.3%) were started on treatment and 32 700 (45.1%) completed treatment. Among all persons with TB lost at any step along the care cascade (n=39 795), 29 108 (73.1%) were lost prior to accessing diagnostic services, 3211 (8.1%) prior to diagnosis, 3745 (9.4%) prior to initiating treatment and 3731 (9.4%) prior to treatment completion. PLHIV were less likely than HIV-negative individuals to successfully complete the care cascade (42.8% vs 50.2%, p<0.001). Among those with rifampicin-resistant TB, there was substantial attrition at each step of the cascade and only 22.8% were estimated to have successfully completed treatment.ConclusionsLosses throughout the care cascade resulted in a large proportion of individuals with TB not completing treatment. Ongoing health systems strengthening and patient-centred engagement strategies are needed at every step of the care cascade; however, scale-up of active case finding strategies is particularly critical to ensure individuals with TB in the population reach initial stages of care. Additionally, a renewed focus on PLHIV and individuals with drug-resistant TB is urgently needed to improve TB-related outcomes in Zambia.
Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis
Authors: Lin Jinhai , Wu Bingxin , Lin Luoqi , Ding Yining , Zhong Biying , Huang Zhiwei , Lin Miaoyang , Xu Dan-Ping 
Published: August 2021

IntroductionTakotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management.Methods and analysisAfter searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible.Ethics and disseminationEthics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020212729.
A cross-sectional study on adaptation and initial validation of a test to evaluate health claims among high school students: Croatian version
Authors: Aranza Diana , Milavić Boris , Marusic Ana , Buzov Magdalena , Poklepović Peričić Tina 
Published: August 2021

ObjectivesWe validated the Croatian version of the test using multiple-choice questions (MCQs) from the Claim Evaluation Tools item bank of the Informed Health Choices project, and measured the ability of high school students to appraise health claims.Setting16 high schools from the urban agglomeration of the city of Split, Croatia.ParticipantsFinal year high school students of at least 18 years of age.Interventions18 MCQs from the item bank considered relevant for high school students were translated. After face-validity testing, the questionnaire was piloted and sent to a convenient sample of 302 high school students.Primary and secondary outcome measuresDifficulty and discrimination indices were calculated for each MCQ to determine the validity of translation and the weight of MCQs. We assessed basic metric characteristics and performed initial validation of the test. Two tests were created, the full (18 MCQs) and the short version (12 MCQs). We analysed differences in test score according to gender and school.ResultsThe response rate was 96% (75% female respondents). Metric characteristics of both tests were satisfactory (Cronbach’s α=0.71 for the full and α=0.73 for the short version). The mean score (±SD) for the full version was 11.15±3.43 and 8.13±2.76 for the short version. There were 6 easy and 12 moderately difficult questions. Questions concerning effectiveness and dissimilar comparison groups were answered correctly by fewer than 40% of students. Female students and those from grammar and health schools scored higher on both tests.ConclusionsBoth tests showed good metric characteristics and may be used for quick and reliable assessments of adolescents’ ability to appraise health claims. They may be used to identify needs and inform development of educational activities to foster critical thinking about health among adolescents.
Loss of height predicts total and cardiovascular mortality: a cohort study of northern European women
Authors: Klingberg Sofia , Mehlig Kirsten , Dangol Rojina , Björkelund Cecilia , Heitmann Berit Lilienthal , Lissner Lauren 
Published: August 2021

ObjectiveTo examine height changes in middle-aged northern European women in relation to overall and cardiovascular mortality.DesignPopulation-based cohort studies with longitudinally measured heights and register-based mortality.SettingSweden and Denmark.ParticipantsPopulation-based samples of 2406 Swedish and Danish women born on selected years in 1908–1952, recruited to baseline examinations at ages 30–60, and re-examined 10–13 years later.Main outcome measureTotal and cardiovascular disease (CVD) specific mortality during 17–19 years of follow-up after last height measure.ResultsFor each 1 cm height loss during 10–13 years, the HR (95% CI) for total mortality was 1.14 (1.05 to 1.23) in Swedish women and 1.21 (1.09 to 1.35) in Danish women, independent of key covariates. Low height and high leisure time physical activity at baseline were protective of height loss, independent of age. Considering total mortality, the HR for major height loss, defined as height loss greater than 2 cm, were 1.74 (1.32 to 2.29) in Swedish women and 1.80 (1.27 to 2.54) in Danish women. Pooled analyses indicated that height loss was monotonically associated with an increased mortality, confirming a significant effect above 2 cm height loss. For cause-specific mortality, major height loss was associated with a HR of 2.31 (1.09 to 4.87) for stroke mortality, 2.14 (1.47 to 3.12) for total CVD mortality and 1.71 (1.28 to 2.29) for mortality due to causes other than CVD.ConclusionHeight loss is a marker for excess mortality in northern European women. Specifically the hazard of CVD mortality is increased in women with height loss during middle age, and the results suggest that the strongest cause-specific endpoint may be stroke mortality. The present findings suggest attention to height loss in early and mid-adulthood to identify women at high risk of CVD, and that regular physical activity may prevent early onset height loss.
Stability in eosinophil categorisation during subsequent severe exacerbations of COPD
Authors: Citgez Emanuel , van der Palen Job , van der Valk Paul , Kerstjens Huib A M , Brusse-Keizer Marjolein 
Published: August 2021

BackgroundThe blood eosinophil count has been shown to be a promising biomarker for establishing personalised treatment strategies to reduce corticosteroid use, either inhaled or systemic, in chronic obstructive pulmonary disease (COPD). Eosinophil levels seem relatively stable over time in stable state, but little is known whether this is also true in subsequent severe acute exacerbations of COPD (AECOPD).Aims and objectivesTo determine the stability in eosinophil categorisation between two subsequent severe AECOPDs employing frequently used cut-off levels.MethodsDuring two subsequent severe AECOPDs, blood eosinophil counts were determined at admission to the hospital in 237 patients in the Cohort of Mortality and Inflammation in COPD Study. The following four cut-off levels were analysed: absolute counts of eosinophils ≥0.2×10⁹/L (200 cells/µL) and ≥0.3×10⁹/L (300 cells/µL) and relative eosinophil percentage of ≥2% and ≥3% of total leucocyte count. Categorisations were considered stable if during the second AECOPD their blood eosinophil status led to the same classification: eosinophilic or not.ResultsDepending on the used cut-off, the overall stability in eosinophil categorisation varied between 70% and 85% during two subsequent AECOPDs. From patients who were eosinophilic at the first AECOPD, 34%–45% remained eosinophilic at the subsequent AECOPD, while 9%–21% of patients being non-eosinophilic at the first AECOPD became eosinophilic at the subsequent AECOPD.ConclusionsThe eosinophil variability leads to category changes in subsequent AECOPDs, which limits the eosinophil categorisation stability. Therefore, measurement of eosinophils at each new exacerbation seems warranted.
Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis
Authors: Naqvi Syeda Fatima , Lakhani Dhairya A , Sohail Amir Humza , Maurer James , Sofka Sarah , Sarwari Arif , Hadi Yousaf B 
Published: August 2021

IntroductionOutcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF.MethodsAnalysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF.ResultsA total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30±12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort.ConclusionPoor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.
Efficacy of convalescent plasma for treatment of COVID-19 in Uganda
Authors: Kirenga Bruce , Byakika-Kibwika Pauline , Muttamba Winters , Kayongo Alex , Loryndah Namakula Olive , Mugenyi Levicatus , Kiwanuka Noah , Lusiba John , Atukunda Angella , Mugume Raymond , Ssali Francis , Ddungu Henry , Katagira Winceslaus , Sekibira Rogers , Kityo Cissy , Kyeyune Dorothy , Acana Susan , Aanyu-Tukamuhebwa Hellen , Kabweru Wilberforce , Nakwagala Fred , Bagaya Bernard Sentalo , Kimuli Ivan , Nantanda Rebecca , Buregyeya Esther , Byarugaba Baterana , Olaro Charles , Mwebesa Henry , Joloba Moses Lutaakome , Siddharthan Trishul , Bazeyo William 
Published: August 2021

RationaleConvalescent plasma (CCP) has been studied as a potential therapy for COVID-19, but data on its efficacy in Africa are limited.ObjectiveIn this trial we set out to determine the efficacy of CCP for treatment of COVID-19 in Uganda.MeasurementsPatients with a positive SARS-CoV-2 reverse transcriptase (RT)-PCR test irrespective of disease severity were hospitalised and randomised to receive either COVID-19 CCP plus standard of care (SOC) or SOC alone. The primary outcome was time to viral clearance, defined as having two consecutive RT-PCR-negative tests by day 28. Secondary outcomes included time to symptom resolution, clinical status on the modified WHO Ordinal Clinical Scale (≥1-point increase), progression to severe/critical condition (defined as oxygen saturation <93% or needing oxygen), mortality and safety.Main resultsA total of 136 patients were randomised, 69 to CCP+SOC and 67 to SOC only. The median age was 50 years (IQR: 38.5–62.0), 71.3% were male and the median duration of symptom was 7 days (IQR=4–8). Time to viral clearance was not different between the CCP+SOC and SOC arms (median of 6 days (IQR=4–11) vs 4 (IQR=4–6), p=0.196). There were no statistically significant differences in secondary outcomes in CCP+SOC versus SOC: time to symptom resolution (median=7 (IQR=5–7) vs 7 (IQR=5–10) days, p=0.450), disease progression (9 (22.0%) vs 7 (24.0%) patients, p=0.830) and mortality (10 (14.5%) vs 8 (11.9%) deaths, p=0.476).ConclusionIn this African trial, CCP therapy did not result in beneficial virological or clinical improvements. Further trials are needed to determine subgroups of patients who may benefit from CCP in Africa.Trial registration numberNCT04542941.
Chest radiograph-based artificial intelligence predictive model for mortality in community-acquired pneumonia
Authors: Quah Jessica , Liew Charlene Jin Yee , Zou Lin , Koh Xuan Han , Alsuwaigh Rayan , Narayan Venkataraman , Lu Tian Yi , Ngoh Clarence , Wang Zhiyu , Koh Juan Zhen , Ang Christine , Fu Zhiyan , Goh Han Leong 
Published: August 2021

BackgroundChest radiograph (CXR) is a basic diagnostic test in community-acquired pneumonia (CAP) with prognostic value. We developed a CXR-based artificial intelligence (AI) model (CAP AI predictive Engine: CAPE) and prospectively evaluated its discrimination for 30-day mortality.MethodsDeep-learning model using convolutional neural network (CNN) was trained with a retrospective cohort of 2235 CXRs from 1966 unique adult patients admitted for CAP from 1 January 2019 to 31 December 2019. A single-centre prospective cohort between 11 May 2020 and 15 June 2020 was analysed for model performance. CAPE mortality risk score based on CNN analysis of the first CXR performed for CAP was used to determine the area under the receiver operating characteristic curve (AUC) for 30-day mortality.Results315 inpatient episodes for CAP occurred, with 30-day mortality of 19.4% (n=61/315). Non-survivors were older than survivors (mean (SD)age, 80.4 (10.3) vs 69.2 (18.7)); more likely to have dementia (n=27/61 vs n=58/254) and malignancies (n=16/61 vs n=18/254); demonstrate higher serum C reactive protein (mean (SD), 109 mg/L (98.6) vs 59.3 mg/L (69.7)) and serum procalcitonin (mean (SD), 11.3 (27.8) μg/L vs 1.4 (5.9) μg/L). The AUC for CAPE mortality risk score for 30-day mortality was 0.79 (95% CI 0.73 to 0.85, p<0.001); Pneumonia Severity Index (PSI) 0.80 (95% CI 0.74 to 0.86, p<0.001); Confusion of new onset, blood Urea nitrogen, Respiratory rate, Blood pressure, 65 (CURB-65) score 0.76 (95% CI 0.70 to 0.81, p<0.001), respectively. CAPE combined with CURB-65 model has an AUC of 0.83 (95% CI 0.77 to 0.88, p<0.001). The best performing model was CAPE incorporated with PSI, with an AUC of 0.84 (95% CI 0.79 to 0.89, p<0.001).ConclusionCXR-based CAPE mortality risk score was comparable to traditional pneumonia severity scores and improved its discrimination when combined.