bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loosening of Posteromedial Meniscal Root Repairs Affects Knee Mechanics: A Finite Element Study
Authors: Steineman Brett D. , LaPrade Robert F. , Haut Donahue Tammy L. 
Published: November 2021

Abstract
Meniscal root repairs are susceptible to unrecoverable loosening that may displace the meniscus from the initial position reduced during surgery. Despite this, the effects of a loosened meniscal root repair on knee mechanics are unknown. We hypothesized that anatomic root repairs without loosening would restore knee mechanics to the intact condition better than loosened anatomic root repairs, but that loosened repairs would restore mechanics better than untreated meniscal root tears. Finite element knee models were used to evaluate changes in cartilage and meniscus mechanics due to repair loosening. The mechanical response from loosened anatomic root repairs was compared to anatomic repairs without loosening and untreated root tears. All conditions were evaluated at three flexion angles, 0 deg, 30 deg, and 60 deg, and a compressive force of 1000 N to simulate return-to-activity loading. The two-simple suture method was represented within the models to simulate posteromedial meniscal root repairs and the loosening of repairs was derived from previous biomechanical experimental data. Loosening decreased hoop stresses throughout the meniscus, increased posterior extrusion, and shifted loading through the meniscus-cartilage region to the cartilage-cartilage region compared to the anatomic root repair without loosening. Despite differences between repairs and loosened repairs, the changes from loosened repairs more closely resembled the anatomic repair without loosening than the untreated root repair condition. Therefore, meniscal root repairs are susceptible to loosening that will prevent a successful initial repair from remaining in the intended position and will alter cartilage and meniscus mechanics, although repairs that loosen appear better than leaving tears untreated.
A Method of Stall and Surge Prediction in Axial Compressors Based on Three-Dimensional Body-Force Model
Authors: Zeng Hanxuan , Zheng Xinqian , Vahdati Mehdi 
Published: November 2021

AbstractThe occurrence of stall and surge in axial compressors has a great impact on the performance and reliability of aero-engines. Accurate and efficient prediction of the key features during these events has long been the focus of engine design processes. In this paper, a new body-force model that can capture the three-dimensional and unsteady features of stall and surge in compressors at a fraction of time required for URANS computations is proposed. To predict the rotating stall characteristics, the deviation of local airflow angle from the blade surface is calculated locally during the simulation. According to this local deviation, the computational domain is divided into stalled and forward flow regions, and the body-force field is updated accordingly; to predict the surge characteristics, the local airflow direction is used to divide the computational domain into reverse flow regions and forward flow regions. A single-stage axial compressor and a three-stage axial compressor are used to verify the proposed model. The results show that the method is capable of capturing stall and surge characteristics correctly. Compared to the traditional fully three-dimensional URANS method (fRANS), the simulation time for multistage axial compressors is reduced by 1–2 orders of magnitude.
High-Temperature Thermal Diffusivity Measurements Using a Modified Ångström's Method With Transient Infrared Thermography
Authors: Hu Yuan , Abuseada Mostafa , Alghfeli Abdalla , Holdheim Saurin , Fisher Timothy S. 
Published: November 2021

Abstract
This work reports a method to measure thermal diffusivity of thin disk samples at high temperatures (approximately 900–1150 K) using a modified Ångström's method. Conventionally, samples are heated indirectly from the surroundings to reach high temperatures for such measurements, and this process is time-consuming, typically requiring hours to reach stable temperatures. In this work, samples are heated directly in a custom instrument by a concentrated light source and are able to reach high steady-periodic temperatures in approximately 10 min, thus enabling rapid thermal diffusivity characterization. Further, existing Ångström's methods for high temperature characterization use thermocouples for temperature detection that are commonly attached to samples via drilling and welding, which are destructive to samples and introduce thermal anomalies. We use an infrared camera calibrated to 2000 °C for noncontact, nondestructive, and data-rich temperature measurements and present an image analysis approach to process the infrared (IR) data that significantly reduces random noise in temperature measurements. We extract amplitude and phase from processed temperature profiles and demonstrate that these metrics are insensitive to uncertainty in emissivity. Previous studies commonly use regression approaches for parameter estimation that are ill-posed (i.e., nonunique solutions) and lack rigorous characterization of parameter uncertainties. Here, we employ a surrogate-accelerated Bayesian framework and a “no-U-turn” sampler for uncertainty quantification. The reported results are validated using graphite and copper disks and exhibit excellent agreement within 5% as compared to reference values obtained by other methods.
Numerical Analysis of Heat-Pipe-Based Battery Thermal Management System for Prismatic Lithium-Ion Batteries
Authors: Cheng Jianping , Shuai Shenlong , Zhao Renchen , Tang Zhiguo 
Published: November 2021

Abstract
An effective battery thermal management system (BTMS) is essential for controlling both the maximum temperature and the temperature uniformity of a battery module. In this study, a novel and lightweight BTMS for prismatic batteries based on a heat pipe is proposed. A numerical model is created to study the influence of heat-transfer designs and other factors on the thermal performance of the BTMS, and the simulation results are checked experimentally. The results show that when the condensation section of the heat pipe is cooled by liquid, the maximum temperature of the battery (Tmax) is reduced by 18.1% compared with air cooling. Decreasing the coolant temperature can reduce Tmax, but can also lead to an undesirable temperature nonuniformity. The Tmax and the maximum temperature difference (ΔTmax) in a battery module both increase rapidly as the discharge rate rises. The Tmax and ΔTmax are lower than 40 °C and 5 °C, respectively, when the discharge rate of the battery is lower than 2 °C. Under preheating conditions in cold weather, increasing the temperature of the heating medium can improve the temperature of the batteries, but at the same time it can make the battery module's temperature more nonuniform, and also add to cost. The temperature of the heating medium should therefore be selected with care. It could be concluded that the above results can provide perspectives in designing and optimizing battery thermal management systems.
Focused Plunging Breaking Waves Impact on Pile Group in Finite Water Depth
Authors: Cui Ting , Kamath Arun , Wang Weizhi , Yuan Lihao , Han Duanfeng , Bihs Hans 
Published: November 2021

Abstract
Accuracy estimation of wave loading on cylinders in a pile group under different impact scenarios is essential for both the structural safety and cost of coastal and offshore structures. Differing from the interaction of waves with a single cylinder, less attention has been paid to pile groups under different arrangements. Numerical simulations of interactions between plunging breaking waves and pile group in finite water depth are performed using the two-phase flow model in REEF3D, an open-source computational fluid dynamics program to investigate the wave loads and flow kinematics characteristics. The Reynolds-averaged Navier–Stokes equation with the two equation k − ω turbulence model is adopted to resolve the numerical wave tank. The model is validated by comparing the numerical wave forces and free surface elevation with measurements from experiments. The computational results show fairly good agreement with experimental data. Four cases are simulated with different relative distances, numbers of cylinders, and arrangements. Results show that the wave forces on cylinders in the pile group are effected by the relative distance between cylinders. The staggered arrangement has a significant influence on the wave forces on the first and second cylinder. The interaction inside a pile group mostly happens between the neighboring cylinders. These interactions are also effected by the relative distance and the numbers of the neighboring cylinders.
Effect of mobile application user interface improvements on minimum expected home visit coverage by community health workers in Mali: a randomised controlled trial
Authors: Yang Jane E , Lassala Diego , Liu Jenny X , Whidden Caroline , Holeman Isaac , Keita Youssouf , Djiguiba Yasamba , N’Diaye Sory Ibrahima , Fall Fatou , Kayentao Kassoum , Johnson Ari D 
Published: November 2021

BackgroundProactive community case management (ProCCM) has shown promise to advance goals of universal health coverage (UHC). ProCCM community health workers (CHWs) face operational challenges when pursuing their goal of visiting every household in their service area at least twice monthly to proactively find sick patients. We developed a software extension (UHC Mode) to an existing CHW mobile application featuring user interface design improvements to support CHWs in planning daily home visits. We evaluated the effect of UHC Mode on minimum expected home visit coverage.MethodsWe conducted a parallel-group, two-arm randomised controlled trial of ProCCM CHWs in two separate regions in Mali. CHWs were randomly assigned to UHC Mode or the standard mobile application (control) with a 1:1 allocation. Randomisation was stratified by health catchment area. CHWs and other programme personnel were not masked to arm allocation. CHWs used their assigned intervention for 4 months. Using a difference-in-differences analysis, we estimated the mean change in minimum expected home visit coverage from preintervention to postintervention between arms.ResultsEnrolment occurred in January 2019. Of 199 eligible CHWs randomised to the intervention or control arm, 196 were enrolled and 195 were included in the analysis. Households whose CHW used UHC Mode had 2.41 times higher odds of minimum expected home visit coverage compared with households whose CHW used the control (95% CI 1.68 to 3.47; p<0.0005). Minimum expected home visit coverage in the UHC Mode arm increased 13.6 percentage points (95% CI 8.1 to 19.0) compared with the control arm.ConclusionOur findings suggest UHC Mode is an effective tool that can improve home visit coverage and promote progress towards UHC when implemented in the ProCCM context. User interface design of health information systems that supports health workers’ daily practices and meets their requirements can have a positive impact on health worker performance and home visit coverage.Trial registration numberNCT04106921.
Diabetes Prevention Education Program in a population with pre-diabetes in Nepal: a study protocol of a cluster randomised controlled trial (DiPEP)
Authors: Shakya Pushpanjali , Shrestha Archana , Karmacharya Biraj Man , Shrestha Abha , Kulseng Bård Eirik , Skovlund Eva , Sen Abhijit 
Published: November 2021

IntroductionEvidence suggests that diabetes burden can be reduced by implementing early lifestyle intervention programmes in population with pre-diabetes in high-income countries. However, little is known in developing nations like Nepal. This study aims to assess effectiveness of community-based Diabetes Prevention Education Program (DiPEP) on haemoglobin A1c (HbA1c) level, proportion of pre-diabetes reverting to normoglycaemia, diet, physical activity, weight reduction, diabetes knowledge and health literacy after 6 months of follow-up. Furthermore, we will also conduct qualitative studies to explore experiences of participants of intervention sessions and perception of healthcare workers/volunteers about DiPEP.Methods and analysesThis is a community-based two-arm, open-label, cluster randomised controlled trial. We will randomise 14 clusters into intervention arm and control arm. Estimated total sample size is 448. We will screen individuals without diabetes, aged 18–64 years, and permanent residents of study sites. HbA1c test will be only performed if both Indian Diabetes Risk Score and random blood sugar value are ≥60 and 140–250 mg/dL, respectively. At baseline, participants in intervention arm will receive DiPEP package (including intensive intervention classes, diabetes prevention brochure, exercise calendar and food record booklet), and participants in control arm will be provided only with diabetes prevention brochure. The change in outcome measures will be compared between intervention to control arm after 6 months of follow-up by linear mixed models. Also, we will conduct individual interviews among participants and healthcare workers as part of a qualitative study. We will use thematic analysis to analyse qualitative data.Ethics and disseminationRegional Committee for Medical and Health Research Ethics, Norway; Nepal Health Research Council, Nepal and Institutional Review Committee, Kathmandu University School of Medical Sciences have approved the study. The DiPEP package can be implemented in other communities of Nepal if it is effective in preventing diabetes.Trial registration numberNCT04074148, 2019/783.
Predicting opioid-induced oversedation in hospitalised patients: a multicentre observational study
Authors: Garrett John , Vanston Anneliese , Ogola Gerald , da Graca Briget , Cassity Cindy , Kouznetsova Maria A , Hall Lauren R , Qiu Taoran 
Published: November 2021

ObjectivesOpioid-induced respiratory depression (OIRD) and oversedation are rare but potentially devastating adverse events in hospitalised patients. We investigated which features predict an individual patient’s risk of OIRD or oversedation; and developed a risk stratification tool that can be used to aid point-of-care clinical decision-making.DesignRetrospective observational study.SettingTwelve acute care hospitals in a large not-for-profit integrated delivery system.ParticipantsAll inpatients ≥18 years admitted between 1 July 2016 and 30 June 2018 who received an opioid during their stay (163 190 unique hospitalisations).Main outcome measuresThe primary outcome was occurrence of sedation or respiratory depression severe enough that emergent reversal with naloxone was required, as determined from medical record review; if naloxone reversal was unsuccessful or if there was no evidence of hypoxic encephalopathy or death due to oversedation, it was not considered an oversedation event.ResultsAge, sex, body mass index, chronic obstructive pulmonary disease, concurrent sedating medication, renal insufficiency, liver insufficiency, opioid naïvety, sleep apnoea and surgery were significantly associated with risk of oversedation. The strongest predictor was concurrent administration of another sedating medication (adjusted HR, 95% CI=3.88, 2.48 to 6.06); the most common such medications were benzodiazepines (29%), antidepressants (22%) and gamma-aminobutyric acid analogue (14.7%). The c-statistic for the final model was 0.755. The 24-point Oversedation Risk Criteria (ORC) score developed from the model stratifies patients as high (>20%, ≥21 points), moderate (11%–20%, 10–20 points) and low risk (≤10%, <10 points).ConclusionsThe ORC risk score identifies patients at high risk for OIRD or oversedation from routinely collected data, enabling targeted monitoring for early detection and intervention. It can also be applied to preventive strategies—for example, clinical decision support offered when concurrent prescriptions for opioids and other sedating medications are entered that shows how the chosen combination impacts the patient’s risk.
Modified tissue-selecting therapy stapler combined with complete anal canal epithelial preservation operation for the treatment of circumferential mixed haemorrhoids: a protocol for single-blind randomised controlled study
Authors: Huang Hua , Gu Yunfei , Li Youran , Ji Lijiang 
Published: November 2021

IntroductionThis protocol designed a randomised controlled trial (RCT) to evaluate the effectiveness, safety and prognostic outcomes of modified tissue selecting technique (M-TST) combined with complete anal canal epithelial preservation (CACP) among patients with circumferential mixed haemorrhoids.Methods and analysisThis study will be single-blinded, and recruit 348 patients who are admitted to the Changshu Hospital Affiliated to Nanjing University of Chinese Medicine and fulfil the inclusion criteria from January 2022 to December 2022. Patients will be randomly assigned to the treatment group and the control group in a 1:1 ratio. The statistician will be blinded for the allocation. The treatment group will receive M-TST combined with CACP (M-TST–CACP), while the control group will receive the procedure for prolapse and haemorrhoids. The two groups will receive the same preoperative and postoperative care. The primary outcome will be recurrence rate. The secondary outcomes will be operation time, intraoperative bleeding, incontinence, pain, postoperative complications (severe bleeding, perianal oedema, urinary retention, faecal urgency, skin tags and anal stenosis), prolapse, recovery time, quality of life, Haemorrhoid Severity Score, and Symptom Severity Score.Ethics and disseminationThis protocol has been approved by the Clinical Ethics Committee of the Changshu Hospital Affiliated to Nanjing University of Chinese Medicine (approval no. 202102001).Trial registration numberChiCTR2100042750.
Seroprevalence of anti-SARS-CoV-2 antibodies in women attending antenatal care in eastern Ethiopia: a facility-based surveillance
Authors: Assefa Nega , Regassa Lemma Demissie , Teklemariam Zelalem , Oundo Joseph , Madrid Lola , Dessie Yadeta , Scott JAG 
Published: November 2021

ObjectiveWe conducted serosurveillance of anti-SARS-CoV-2 antibodies among pregnant women attending their first antenatal care.SettingThe surveillance was set in one referral hospital in Harar, one district hospital and one health centre located in Haramaya district in rural eastern Ethiopia.ParticipantsWe collected questionnaire data and a blood sample from 3312 pregnant women between 1 April 2020 and 31 March 2021. We selected 1447 blood samples at random and assayed these for anti-SARS-CoV-2 antibodies at Hararghe Health Research laboratory using WANTAI SARS-CoV-2 Rapid Test for total immunoglobulin.OutcomeWe assayed for anti-SARS-CoV-2 antibodies and temporal trends in seroprevalence were analysed with a χ2test for trend and multivariable binomial regression.ResultsAmong 1447 sera tested, 83 were positive for anti-SARS-CoV-2 antibodies giving a crude seroprevalence of 5.7% (95% CI 4.6% to 7.0%). Of 160 samples tested in April–May 2020, none was seropositive; the first seropositive sample was identified in June and seroprevalence rose steadily thereafter (χ2test for trend, p=0.003) reaching a peak of 11.8% in February 2021. In the multivariable model, seroprevalence was approximately 3% higher in first-trimester mothers compared with later presentations, and rose by 0.75% (95% CI 0.31% to 1.20%) per month of calendar time.ConclusionsThis clinical convenience sample illustrates the dynamic of the SARS-CoV-2 epidemic in pregnant women in eastern Ethiopia; infection was rare before June 2020 but it spread in a linear fashion thereafter, rather than following intermittent waves, and reached 10% by the beginning of 2021. After 1 year of surveillance, most pregnant mothers remained susceptible.
Emergency department and hospital utilisation and expenditures in the last year of life: retrospective chronic diseases cohort study
Authors: Antunes Ana , Gomes Barbara , Campos Luís , Coelho Miguel , Lopes Sílvia 
Published: November 2021

ObjectivesWe aimed to examine the influence of chronic diseases in emergency department (ED) and inpatient utilisation and expenditures in the 12 months before death.MethodsRetrospective cohort study of ED and inpatient database. Adults deceased at a hospital in Portugal in 2013 were included. We tested the influence of chronic diseases on the number of ED visits, hospital admissions and expenditures using generalised linear models.ResultsThe study included 484 patients (81.8% ≥65 years, median two chronic diseases). Nearly all (91.3%) attended the ED in the 12 months before death. The median number of admissions was 1, median expenditure was €6159. Adjusting for confounders, chronic pulmonary disease increased ED and inpatient utilisation (1.49; 95% CI: 1.22 to 1.83; 95% CI 1.29, 1.09 to 1.51). Increased ED utilisation was observed for patients with renal disease, dementia and metastatic solid tumour (1.40, 95% CI 1.15 to 1.71; 1.39, 95% CI 1.11 to 1.75; 1.31, 95% CI 1.07 to 1.60). Other malignancies showed increased inpatient utilisation (1.24, 95% CI 1.09 to 1.42). The number of chronic conditions had a considerable effect on expenditures (3: 2.08, 95% CI 1.44 to 2.99; ≥4: 4.02, 95% CI 2.51 to 6.45).ConclusionWe found a high use of hospitals at the end of life, particularly EDs. Our findings suggest that people with cancer, renal disease, chronic pulmonary disease and dementia are relevant when developing cost-effective alternatives to hospital care.
COVID-19 hospital activity and in-hospital mortality during the first and second waves of the pandemic in England: an observational study
Authors: Gray William K , Navaratnam Annakan V , Day Jamie , Wendon Julia , Briggs Tim W R 
Published: November 2021

IntroductionWe aimed to examine the profile of, and outcomes for, all people hospitalised with COVID-19 across the first and second waves of the pandemic in England.MethodsThis was an exploratory retrospective analysis of observational data from the Hospital Episode Statistics data set for England. All patients aged ≥18 years in England with a diagnosis of COVID-19 who had a hospital stay that was completed between 1 March 2020 and 31 March 2021 were included. In-hospital mortality was the primary outcome of interest. The second wave was identified as starting on 1 September 2020. Multilevel logistic regression modelling was used to investigate the relationship between mortality and demographic, comorbidity and temporal covariates.ResultsOver the 13 months, 374 244 unique patients had a diagnosis of COVID-19 during a hospital stay, of whom 93 701 (25%) died in hospital. Adjusted mortality rates fell from 40%–50% in March 2020 to 11% in August 2020 before rising to 21% in January 2021 and declining steadily to March 2021. Improvements in mortality rates were less apparent in older and comorbid patients. Although mortality rates fell for all ethnic groups from the first to the second wave, declines were less pronounced for Bangladeshi, Indian, Pakistani, other Asian and black African ethnic groups.ConclusionsThere was a substantial decline in adjusted mortality rates during the early part of the first wave which was largely maintained during the second wave. The underlying reasons for consistently higher mortality risk in some ethnic groups merits further study.