bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recovery and effective utilization of waste heat from the exhaust of internal combustion engines for cooling applications using ANSYS
Authors: Gohar Ghulam Abbas , Khan Muhammad Zia Ullah , Raza Hassan , Ahmad Arslan , Raza Yasir , Manzoor Tareq , Arshad Zeeshan , Aslam Faraz , Ullah Muhammad Safi , Arif Musa 
Published: November 2021

The exhaust gases from an internal combustion (IC) engine carry away about 75% of the heat energy which means only 25% of heat energy is operated for power production. A recovery unit at the exhaust outlet port can ensure heat exchange between different temperature fluids through conjugate heat transfer phenomena. This study represents heat recovery from exhaust gases that are emitted from IC engines which can be utilized in various applications such as vapor absorption refrigeration systems. In the present work, a new type of perforated fin heat exchanger for waste heat recovery of exhaust gases is designed using SolidWorks, and the flow field design of the heat recovery system is optimized using ANSYS software. Various parameters (velocity, pressure, temperature, and heat conduction) of hot and cold fluid have been analyzed. Inlet velocity of cold fluids including refrigerant (LiBr solution), water, and graphene oxide (GO) nanofluid have been adopted at 0.03 m/s, 0.165 m/s, and 0.3 m/s, respectively. Inlet velocity of hot fluid is taken as 2 m/s, 4 m/s, and 6 m/s, respectively, to develop a test matrix. The results showed that maximum temperature reduction by the exhaust is achieved at 104.8°C using graphene oxide nanofluids with an inlet velocity of 0.3 m/s and exit velocity of 2 m/s in the heat recovery unit. Similarly, temperature reduction by exhaust gases is acquired at 102 °C using water and 96.34 °C by using a refrigerant (LiBr solution) with the same exit velocity (2 m/ s). Furthermore, maximum effectiveness of 0.489 is also obtained for GO nanofluid when compared with water and the refrigerant. On the other hand, the refrigerant has the maximum log mean temperature difference from all fluids with a value of 224.4 followed by water and GO.
Experiences of Adult Men Who Are Homeless Accessing Care: A Qualitative Study
Authors: Henderson Marcus D. , McCurry Ian J. , Deatrick Janet A. , Lipman Terri H. 
Published: November 2021

Introduction: Homeless individuals experience increased rates of chronic physical and mental health conditions. They also experience difficulty accessing care and poor health outcomes compounded by social and economic factors, such as housing insecurity, unemployment, and limited social support. The purpose of this study was to describe the perceptions of homeless individuals related to their health and experiences accessing care. Method: Qualitative descriptive methods and content analysis were used to gather, analyze, and interpret the data and identify themes. Results: Three themes were identified: men who are homeless experience bias throughout their health care and interpersonal relationships, the best care is person-centered and considers patients’ priorities, and care coordination resources are inadequate. Discussion: The housing needs of homeless individuals are best contextualized by their health and social needs. In addition, their priorities must be taken into consideration to develop culturally congruent services that are appropriate and effective care for this population.
Does the Transversus Abdominis Plane Block Reduce Morbidity Following Iliac Crest Bone Harvest in Pediatric Patients With Alveolar Clefts?
Authors: Hashemi Sina , Ferraz dos Santos Beatriz , Chiasson Geneviève 
Published: November 2021

Objective The purpose of this study is to determine whether a Transversus Abdominis Plane (TAP) block can reduce donor site morbidity among pediatric patients undergoing iliac crest bone grafting for repair of their alveolar cleft. Design This retrospective cohort study was carried out at the Division of Dentistry at the Montreal Children's Hospital. Medical charts of patients who underwent alveolar cleft bone grafting between January 2011 and January 2021 were reviewed and they were divided into two groups, intraoperative TAP block and intraoperative local anesthesia infiltration (control group). The outcomes measured were patients’ post-operative pain at the donor site, in-hospital narcotics requirements and length of stay. Results A total of 66 patients were included. There were no significant differences in pain scale among the TAP group and control group [1.9 (SD 2.5) and 1.3 (SD 2.1), respectively ( p = 0.23)]. The mean length of stay for both groups was 1 day. Interestingly, there was a significant higher proportion of patients who required in-hospital opioids (morphine) in the TAP block group when compared to the control group ( p = 0.03). Conclusions The results of our study suggest there may be no role for a TAP block in reducing pain and improving opioid stewardship.
Greater trochanteric pain syndrome: focused shockwave therapy versus an ultrasound guided injection: a randomised control trial
Authors: Heaver Catriona , Pinches Megan , Kuiper Jan Herman , Thomas Geraint , Lewthwaite Simon , Burston Ben J , Banerjee Robin D 
Published: November 2021

Background: Greater trochanteric pain syndrome (GTPS) is a common problem with an incidence of 1.8–5.6 per 1000 population. Physiotherapy, anti-inflammatories, corticosteroid injections and surgery have all been described in the management of GTPS, with limited, temporal success. Extracorporeal shockwave therapy (ESWT) has been proposed as a potential non-invasive management option for this difficult presentation. Method: We ran a prospective, 2-arm, single-blinded, randomised control trial comparing focused shockwave therapy (f-ESWT) to an ultrasound guided corticosteroid injection. Primary outcome measure was the visual analogue pain score. Secondary outcome measures included the Harris Hip Score (HHS) and Trendelenburg test for function; SF-36 for quality of life (QoL); and a Likert scale question for subjective assessment of symptom improvement. Results: 104 patients (10 males and 94 females), of mean age 61.5 years were recruited. 53 were randomised to receive ESWT and 51 to receive an image-guided injection. 11 patients were lost to follow-up. There were no significant differences in baseline scores between groups. At 3 months, pain, function and QoL scores had improved in both groups but were not statistically significant. The Trendelenburg test was significantly improved in the f-ESWT group with 80% patients being negative compared to 20% at baseline ( p < 0.001). At 12 months, across all outcomes, the ESWT group had significantly improved scores compared to the injection group; VAS 37.1 versus 55.0 ( p = 0.007, 95% confidence interval [CI], 6.3–30.8), HHS 69.7 versus 57.5 ( p = 0.002, 95% CI, −20.0 to −4.6) and SF-36 52.4 versus 47.7 ( p = 0.048, 95% CI, −9.31 to −0.04). The improvement in Trendelenburg test was maintained in the ESWT group, but the injection group had reverted to baseline ( p < 0.001). Conclusions: We have shown f-ESWT is an effective treatment for patients with GTPS. We would advocate f-ESWT as an effective non-invasive treatment modality for this challenging patient population. Trial Registration No. ISRCTN8338223
Comparison of three galenic forms of lamivudine in young West African children living with Human Immunodeficiency Virus
Authors: Pressiat Claire , Dainguy Evelyne , Tréluyer Jean-Marc , Yonaba Caroline , Urien Saik , Eboua François , Foissac Frantz , Dahourou Désiré Lucien , Bouazza Naïm , Malateste Karen , Desmonde Sophie , Pruvost Alain , Leroy Valériane , Hirt Déborah , Study Group The MONOD ANRS 
Published: November 2021

Background Few pharmacokinetic data were reported on dispersible tablets despite their increasing use. One hundred fifty HIV-infected children receiving lamivudine were enrolled in the MONOD ANRS 12,206 trial. Three galenic forms were administered: liquid formulation, tablet form and dispersible scored tablet. Method HIV-infected children <4 years old were enrolled in the MONOD ANRS 12,206 trial designed to assess the simplification of a successful 12-months lopinavir-based antiretroviral treatment with efavirenz. Lamivudine plasma concentrations were analysed using nonlinear mixed effects modelling approach. Results One hundred and fifty children (age: 2.5 years (1.9–3.2), weight 11.1 (9.5–12.5) kg (median (IQR)) were included in this study. Over the study period, 79 received only the syrup form, 29 children switched from syrup form to tablet 3TC/AZT form, 36 from syrup to the orodispersible ABC/3TC form and two from the 3TC/AZT form to the orodispersible ABC/3TC form. The 630 lamivudine concentrations were best described by a two-compartment model allometrically scaled. Galenic form had no significant effect on 3TC pharmacokinetic. Conclusion This trial provided an opportunity to compare three galenic forms (liquid formulation, tablet form and dispersible scored tablet) of lamivudine in the target population of young HIV–1-infected children. Galenic form had no significant effect on lamivudine pharmacokinetics.
Influence of recent direct-to-EVT trials on practical decision-making for the treatment of acute ischemic stroke patients
Authors: McDonough Rosalie , Ospel Johanna , Kashani Nima , Kappelhof Manon , Liu Jianmin , Yang Pengfei , Majoie Charles , Roos Yvo , Goyal Mayank 
Published: November 2021

Background Current guidelines recommend that eligible acute ischemic stroke (AIS) patients receive intravenous alteplase (IVT) prior to endovascular treatment (EVT). Six randomized controlled trials recently sought to determine the risks of administering IVT prior to EVT, five of which have been published/presented. It is unclear whether and how the results of these trials will change guidelines. With the DEBATE survey, we assessed the influence of the recent trials on physicians’ IVT treatment strategies in the setting of EVT for large vessel occlusion (LVO) stroke. Methods Participants were provided with 15 direct-to-mothership case-scenarios of LVO stroke patients and asked whether they would treat with IVT  +  EVT or EVT alone, a) before publication/presentation of the direct-to-EVT trials, and b) now (knowing the trial results). Logistic regression clustered by respondent was performed to assess factors influencing the decision to adopt an EVT-alone paradigm after publication/presentation of the trial results. Results 289 participants from 37 countries provided 4335 responses, of which 13.5% (584/4335) changed from an IVT  +  EVT strategy to EVT alone after knowing the trial results. Very few switched from EVT alone to IVT  +  EVT (8/4335, 0.18%). Scenarios involving a long thrombus (RR 1.88, 95%CI:1.56–2.26), cerebral micro-hemorrhages (RR 1.78, 95%CI:1.43–2.23), and an expected short time to recanalization (RR 1.46 95%CI:1.19–1.78) had the highest chance of participants switching to an EVT-only strategy. Conclusion In light of the recent direct-to-EVT trials, a sizeable proportion of stroke physicians appears to be rethinking IVT treatment strategies of EVT-eligible mothership patients with AIS due to LVO in specific situations.
Experiences of living with postural tachycardia syndrome
Authors: Waterman Samantha , Opie Morwenna , Waterman Debbie , Langdon Dawn 
Published: November 2021

Objective Postural tachycardia syndrome (PoTS) is a disorder of the autonomic nervous system which involves a range of symptoms, worsened when adopting an orthostatic (upright) position. Symptoms can include tachycardia, dizziness, fainting, nausea as well as many others which, as is typical of a syndrome, vary from person to person. Although research is increasing into this condition, the unifying experiences of managing it on a daily basis have not been extensively investigated. This study aimed to capture participants’ experiences of living with PoTS. Method A longitudinal digital ethnographic approach was employed. Eight participants recorded daily video diaries discussing their experiences of PoTS and its impact for 17 days. Interpretative phenomenological analysis was utilised to analyse the data and identify connections across participants’ accounts. Results Four superordinate themes emerged: ‘loss of control and lack of agency over body’, ‘identity changes’, ‘lack of understanding from others’ and ‘adapting to cope with PoTS’. Discussion The findings demonstrated the complex and widespread impact these participants experience from their PoTS symptoms, including the consequent emotional difficulties that result from managing this condition. An overall lack of understanding about PoTS by others was emphasised, suggesting the requirement for better education and support services for this condition.
Addressing the Long COVID Crisis: Integrative Health and Long COVID
Authors: Roth Alan , Chan Pan San , Jonas Wayne 
Published: November 2021

While COVID-19 has killed millions of people globally, its lasting effects on the health and well-being of entire populations are just becoming clear. As many as 30% of those diagnosed with COVID-19 report continuing health-related problems, regardless of the severity of the initial infection. Given the infection rate in the world, that translates to between 5.4 and 17.9 million globally; about 700 000 in the US. The syndrome goes by many names; here we call it “long COVID.” Patients experience a wide range of symptoms, including serious organ system effects such as pulmonary fibrosis, myocarditis, new diabetes diagnoses, stroke, and other cerebrovascular events. They also experience ongoing pain, fatigue, and cognitive dysfunction. We suggest here that these patients require an integrative health approach, one that combines traditional medical management, non-pharmacological approaches, and behavior and lifestyle changes. Such an approach has been shown to be beneficial in other chronic illnesses such as fibromyalgia, chronic fatigue syndrome, and post-Lyme disease.
The protein-protein interaction ontology: for better representing and capturing the biological context of protein interaction
Authors: Li Mansheng , He Qiang , Yang Chunyuan , Ma Jie , He Fuchu , Chen Tao , Zhu Yunping 
Published: November 2021

Abstract
Background
With the rapid increase in the amount of Protein-Protein Interaction (PPI) data, the establishment of an event-centered PPI ontology that contains temporal and spatial vocabularies is urgently needed to clarify PPI biological annotations. In this paper, we propose a precisely designed schema - PPIO (PPI Ontology) for representing the biological context of PPIs.

Results
Inspired by the event model and the distinct characteristics of PPI events, PPIO consists of six core aspects of the information required for reporting a PPI event, including the interactor (who), the biological process (when), the subcellular location (where), the interaction type (how), the biological function (what) and the detection method (which). PPIO is implemented through the integration of appropriate terms from the corresponding vocabularies/ontologies, e.g., Gene Ontology, Protein Ontology, PSI-MI/MOD, etc. To assess PPIO, an approach based on PPIO in developed to extract PPI biological annotations from an open standard corpus “BioCreAtIvE-PPI”. The experiment results demonstrate PPIO’s high performance, a precision of 0.69, a recall of 0.72 and an F-score of 0.70.

Conclusions
PPIO is a well-constructed essential ontology in the interpretation of PPI biological context. The results of the experiments conducted on the BioCreAtIvE corpus demonstrate that PPIO is able to facilitate PPI annotation extraction from biomedical literature effectively and enrich essential annotation for PPIs.
Usefulness of ECG criteria to rule out left ventricular hypertrophy in older individuals with true left bundle branch block: an observational study
Authors: Tavares Caio Assis Moura , Samesima Nelson , Lazar Neto Felippe , Hajjar Ludhmila Abrahão , Godoy Lucas C. , Padrão Eduardo Messias Hirano , Facin Mirella , Jacob Filho Wilson , Farkouh Michael E. , Pastore Carlos Alberto 
Published: November 2021

Abstract
Background
Advanced age is associated with both left bundle branch block (LBBB) and hypertension and the usefulness of ECG criteria to detect left ventricular hypertrophy (LVH) in patients with LBBB is still unclear. The diagnostic performance and clinical applicability of ECG-based LVH criteria in patients with LBBB defined by stricter ECG criteria is unknown. The aim of this study was to compare diagnostic accuracy and clinical utility of ECG criteria in patients with advanced age and strict LBBB criteria.

Methods
Retrospective single-center study conducted from Jan/2017 to Mar/2018. Patients undergoing both ECG and echocardiogram examinations were included. Ten criteria for ECG-based LVH were compared using LVH defined by the echocardiogram as the gold standard. Sensitivity, specificity, predictive values, likelihood ratios, AUC, and the Brier score were used to compare diagnostic performance and a decision curve analysis was performed.

Results
From 4621 screened patients, 68 were included, median age was 78.4 years, (IQR 73.3–83.4), 73.5% with hypertension. All ECG criteria failed to provide accurate discrimination of LVH with AUC range between 0.54 and 0.67, and no ECG criteria had a balanced tradeoff between sensitivity and specificity. No ECG criteria consistently improved the net benefit compared to the strategy of performing routine echocardiogram in all patients in the decision curve analysis within the 10–60% probability threshold range.

Conclusion
ECG-based criteria for LVH in patients with advanced age and true LBBB lack diagnostic accuracy or clinical usefulness and should not be routinely assessed.
The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome
Authors: Todoroski Kristijan B. 
Published: November 2021

Abstract
Background
Both chewed aspirin and sublingual nitroglycerin are fast acting medications and reach therapeutic levels within a few minutes. Current guidelines for managing acute coronary syndrome (ACS) do not recognize the importance of the order or timing of administering aspirin and nitroglycerin. This retrospective study aimed to examine if there was any benefit to the timing of giving aspirin before or after nitroglycerin in cases of ACS.

Methods
From the large National Emergency Medical Services Information System (NEMSIS) 2017 Version database, 2594 patients with acute coronary syndrome were identified (based on chest pain and their ECG finding) that received aspirin plus nitroglycerin in prehospital settings. Based on which medication was given first, the patients were separated in 2 groups: an aspirin-first and a nitroglycerin-first group. The 2246 patients who received aspirin first were further stratified based on the time between administration of aspirin and the first dose of nitroglycerin. The other 348 patients who received nitroglycerin first were similarly stratified.

Results
In patients with STEMI ischemia, giving nitroglycerin 10 min after aspirin dosing (compared to giving them simultaneously) leads to a greater than 20% reduction in need for additional nitroglycerin, a greater than 7% decrease in subjective pain experienced by the patient and reduced need for additional opioids. The aspirin-first group in total, had a 39.6% decrease in subjective pain experience after giving additional nitroglycerin compared to nitroglycerin-first group.

Conclusion
In patients with ACS, this study found that giving nitroglycerin 10 min after aspirin was associated with a reduction in subjective pain scores, as well as a reduced need for additional nitroglycerin or opioids. Future prospective trials examining the timing of aspirin vs. nitroglycerin are needed to confirm these findings.
Undertaking general practice quality improvement to improve cancer screening - a thematic analysis of provider experiences
Authors: Trankle Steven A. , Metusela Christine , Reath Jennifer 
Published: November 2021

Abstract
Background
Cancer is a major cause of illness and death, and its incidence and mortality can be reduced through effective screening. In order to improve below target screening rates in one region of Australia, the local Primary Health Network supported local general practices to implement a range of quality improvement initiatives.

Methods
We used a qualitative approach and interviewed 18 general practice staff and five Primary Health Network staff and contractors to understand their experiences with these quality improvement initiatives.

Results
In a thematic analysis, we identified four key themes related to program set-up and implementation; patient and community education and promotion; engaging patients and communities in screening; and general practice enhancement. Program roles were clear and understood, and the program received strong oversight and support. Practice staff felt supported and motivated. Information Technology was a challenge for many practices often requiring tailored assistance. Education provided by practices facilitated patient empowerment but practice staff noted difficulties engaging patients in screening. Practices were enhanced though strong leadership and teamwork and practice learning activities.

Conclusions
The tailored evidence-based quality improvement initiatives were considered effective in supporting general practices to increase their cancer screening. Key facilitators reported by participants included use of Plan-Do-Study-Act cycles, enhanced data entry and audit capacity, effective recall and reminder systems and maintaining staff motivation.
Soluble urokinase plasminogen activator receptor is associated with short-term mortality and enhanced reactive oxygen species production in acute-on-chronic liver failure
Authors: Wang Yunyun , Wu Fengtian , Chen Chao , Xu Lichen , Lin Wei , Huang Chunhong , Yang Ying , Wu Shanshan , Qi Jinjin , Cao Hanqin , Li Guojun , Hong Meng , Zhu Haihong 
Published: November 2021

Abstract
Background
Acute-on-chronic liver failure (ACLF) is a comprehensive syndrome characterized by an acute deterioration of liver function and high short-term mortality rates in patients with chronic liver disease. Whether plasma soluble urokinase plasminogen activator receptor (suPAR) is a suitable biomarker for the prognosis of patients with ACLF remains unknown.

Method
A prospective cohort of 282 patients with ACLF from three hospitals in China was included. 88.4% of the group was hepatitis B virus-related ACLF (HBV-related ACLF). Cox regression was used to assess the impact of plasma suPAR and other factors on 30- and 90-day mortality. Reactive oxygen species (ROS) production were detected to explore the role of suPAR in regulating neutrophil function in HBV-related ACLF.

Result
There was no difference in plasma suPAR levels between HBV-related and non-HBV-related ACLF. Patients with clinical complications had higher suPAR levels than those without these complications. A significant correlation was also found between suPAR and prognostic scores, infection indicators and inflammatory cytokines. Cox’s regression multivariate analysis identified suPAR ≥ 14.7 ng/mL as a predictor for both day 30 and 90 mortality (Area under the ROC curve: 0.751 and 0.742 respectively), independent of the MELD and SOFA scores in patients with ACLF. Moreover, we firstly discovered suPAR enhanced neutrophil ROS production under E.coli stimulation in patients with HBV-related ACLF.

Conclusions
suPAR was a useful independent biomarker of short-term outcomes in patients with ACLF and might play a key role in the pathogenesis.
Trial registration CNT, NCT02965560.