bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fibrin Glue and Conduit Form a Composite Structure in Digital Nerve Repair
Authors: Schimoler Patrick J. , Pope David , Kharlamov Alexander , Tang Peter , Miller Mark Carl 
Published: August 2021

Abstract
Repair of severed nerves without autograft or allograft has included suture, suture with glue alone, suture with conduit and suture with glue augmentation to conduit, where use of conduit is considered for separation of the nerve ends from 5 mm to 3 cm. Repairs must not only serve acutely to provide apposition of nerve ends but must enable the healing of the nerve. Using biological conduit can place suture at the ends of the conduit while fibrin glue alone eliminates suture but with limited strength. The combination of conduit and glue offers the growth guidance of conduit with sufficient strength from the glue to maintain the nerve within the conduit. The role of fibrin glue in the integrity of the repair remains an open question, however. We sought to determine the factors in the strength of a glue-conduit-nerve construct and include consideration of standard suture repair. Fresh-frozen cadaveric digital nerves were repaired with suture alone, with glue alone or with suture and glue together and then loaded to failure. Previously tested specimens with conduit, suture and glue were considered for comparison. The suture alone (2.02 N) and suture with glue (2.24 N) were not statistically different from each other but were statistically stronger than glue alone (0.15 N). When compared to the earlier results of the strength of conduit with glue (0.65 N), these simple results show that the glue and conduit act together. The increased area over which the glue adheres to the nerve and conduit creates a composite structure stronger than either alone.
Electromyography-Based Validation of a Musculoskeletal Hand Model
Authors: Melzner Maximilian , Engelhardt Lucas , Simon Ulrich , Dendorfer Sebastian 
Published: August 2021

Abstract
Regarding the prevention of injuries and rehabilitation of the human hand, musculoskeletal simulations using an inverse dynamics approach allow for insights of the muscle recruitment and thus acting forces on the hand. Currently, several hand models from various research groups are in use, which are mainly validated by the comparison of numerical and anatomical moment arms. In contrast to this validation and model-building technique by cadaver studies, the aim of this study is to further validate a recently published hand model [1] by analyzing numerically calculated muscle activities in comparison to experimentally measured electromyographical signals of the muscles. Therefore, the electromyographical signals of 10 hand muscles of five test subjects performing seven different hand movements were measured. The kinematics of these tasks were used as input for the hand model, and the numerical muscle activities were computed. To analyze the relationship between simulated and measured activities, the time difference of the muscle on- and off-set points was calculated, which resulted in a mean on- and off-set time difference of 0.58 s between the experimental data and the model. The largest differences were detected for movements that mainly addressed the wrist. One major issue comparing simulated and measured muscle activities of the hand is cross-talk. Nevertheless, the results show that the hand model fits the experiment quite accurately despite some limitations and is a further step toward patient-specific modeling of the upper extremity.
Designing Resilience: Seismic Analysis and Civil Design of Hinkley Point C Offshore Heat Sink
Authors: Parkinson Dyllan , Kukla Konrad , Clear Stuart 
Published: August 2021

Abstract
After nearly 20 years, a new British nuclear power station is being built at Hinkley Point, UK. A significant level of resilience is expected of the nuclear power plant, which is reflected in the UK regulatory requirements. As this takes place post-Fukushima and several other significant seismic events around the world, the expectations for resilience in design are heightened. Therefore, a substantial level of resilience is considered for the water-cooling supply system, which is the subject of this paper. As part of the cooling system, the heat sink consists of several marine structures, including the intake and outfall offshore heads. These offshore structures provide the required level of cooling water at any stage of the power plant operation, including extreme events. Therefore, to ensure an adequate level of resilience, all plausible eventualities must be considered in the design. In this paper, the design of six large offshore civil structures, forming an integral part of the Hinkley Point C (HPC) heat sink is summarized. It discusses the comprehensive soil and structural analyses and innovative civil design undertaken by the designer (Jacobs), the industry leading construction techniques employed by the contractor (Balfour Beatty), and the advanced 3D reinforcement model created by detailer while being supported throughout by the client (EDF's Nuclear New Build NNB).
Effects of Plate Edge Thickness on Droplet Generation Caused by Water Film Breakup at the Plate Edge
Authors: Ito Daisuke , Nakano Susumu , Matsuzaki Yu , Takeda Yoichi 
Published: August 2021

Abstract
Droplets generated at trailing edges of low-pressure steam turbines strike the leading edge of moving blades, resulting in severe damage by erosion. Although the trailing edges of stationary blades employed in the steam turbine industry are often sharpened to produce fine droplets, this process requires further investigation. In this study, water film flows on a plate and breakup patterns are observed and measured to investigate the breakup behavior and the effect of the plate edge thickness. First, to determine the general characteristics of droplet formation of water film flows, the droplet diameter frequency distributions, which significantly affect erosion damage, are measured for several flow conditions. Profiles of frequency distribution of the droplet diameters exhibit on approximately linear in a semilog graph. Water lumps formed on the plate edge are expressed as a spanwise wavelength and initiate the primary breakup of the water film, while fine droplets whose diameters are similar to the critical diameter are generated and are assumed to contribute significantly to erosion damage. The effect of edge thickness on droplet diameter frequency distribution and the spanwise wavelength are observed. The plate edge thickness does not affect the frequency distributions of the droplet diameter. However, it does affect the spanwise wavelength, which is related to the intermittent discharge of water from the edge. The spanwise wavelength and discharged water period become longer when the plate edge thickness increases. Based on an experiment involving the highest airflow velocity, the discharged water frequency is similar to that generated by a general turbine rotation speed.
Analysis of Mechanochemical Reaction in Dual Shot Peening
Authors: Qi Ye , Nguyen Vinh , Melkote Shreyes , Varenberg Michael 
Published: August 2021

Abstract
Using a combination of solid mechanics and reaction kinetics models, this work simulates a mechanochemical reaction in dual shot peening with a mixture of Al2O3 and Cu2S particles used to form a tribologically beneficial iron sulfide layer on treated surfaces. The model predicts that the dissociation of the Fe–Fe and Cu–S bonds needed for the formation of Fe–S bonds accelerates monotonically with an increase in the shot peening particle speed, whereas its rate reaches a local maximum at the impact angle of about 75 deg. The latter finding is validated by treating the rake faces of high-speed steel cutting tools and performing orthogonal cutting experiments in which the tools peened at the impact angle of 75 deg exhibit lower cutting and thrust forces than those peened at 40 deg. Additional peening parameters, namely, the particle volume ratio and the stage speed, are found to be much less statistically significant under the conditions tested. The developed approach may be instrumental in guiding process optimization to improve the tribological performance of mechanochemically treated surfaces.
Aerodynamic Influence of a Bleed on the Last Stage of a Low-Pressure Compressor and S-Duct
Authors: Spanelis Apostolos , Walker A. Duncan 
Published: August 2021

Abstract
This paper uses computational fluid dynamics to investigate the effect of an engine handling bleed situated on the outer casing downstream of the last rotor stage of a low-pressure compressor and upstream of the outlet guide vane and S-shaped duct. The model, validated against existing experimental data, utilized an unsteady Reynolds-averaging Navier–Stokes (RANS) solver incorporating a Reynolds stress closure to examine the unsteady component interactions. The results showed that at bleed rates less than 25% of the mainstream flow, the bleed effects were negligible. However, at higher bleed rates, performance was significantly degraded. A uniform flow extraction hypothesis was employed to separate the positional bias effects of the bleed from the bulk flow diffusion. This revealed that the bleed-induced radial flow distortion can significantly affect the outlet guide vane (OGV) loading distribution, which thereby dictates the position and type of stall within the OGV passage. Extraction of the rotor tip leakage via the shroud bleed, combined with the radial flow distortion, contributed to a 28% reduction in duct loss at 10% bleed and up to 50% reduced loss at 25% bleed. The actual amount of flow required to be extracted for an OGV stall to develop was 30%. That was independent of the bleed location and the type of stall. For bleeds up to 20%, the S-duct displayed a remarkable resilience and consistency of flow variables at duct exit. However, a stalled OGV deteriorated the radial flow uniformity that was presented to the high-pressure compressor.
Interfacial Competitive Debonding of a Bilayer Elastic Film on a Rigid Substrate
Authors: Yin Hanbin , Yao Yin , Yang Yazheng , Peng Zhilong , Chen Shaohua 
Published: August 2021

Abstract
Different from the system of a single-layer elastic film on a rigid substrate, the debonding interface is difficult to determine in a bilayer or multilayer film-substrate system. A peeling model of a bilayer elastic film on a rigid substrate is established in the present paper, in order to predict which interface debonding occurs first. The interfacial competitive debonding mechanism is theoretically analyzed with the help of the beam bending theory. A criterion of which interface debonding occurs first is proposed. It is found that the interfacial debonding path is mainly controlled by five dimensionless parameters, i.e., the strength ratio and the critical separation distance ratio of the upper and lower interfaces, the Young's modulus ratio and the thickness ratio of the upper and lower films, and the possible initial cantilever length for ease of loading. The corresponding competitive debonding map is well obtained. From the map, which interface debonding occurs first can be easily predicted. It is interesting to find that the interfacial debonding path can be well tuned by any one of the five parameters. The results of the finite element calculation further confirm the theoretical predictions. The present work can not only provide a theoretical method to determine the interfacial debonding path but also be helpful for the optimal design of multilayer film-substrate systems in practical applications.
Zircon (U-Th)/He thermochronology reveals pre-Great Unconformity paleotopography in the Grand Canyon region, USA
Authors: Peak B.A. , Flowers R.M. , Macdonald F.A. , Cottle J.M. 
Published: August 2021

Abstract
The Great Unconformity is an iconic geologic feature that coincides with an enigmatic period of Earth's history that spans the assembly and breakup of the supercontinent Rodinia and the Snowball Earth glaciations. We use zircon (U-Th)/He thermochronology (ZHe) to explore the erosion history below the Great Unconformity at its classic Grand Canyon locality in Arizona, United States. ZHe dates are as old as 809 ± 25 Ma with data patterns that differ across both long (∼100 km) and short (tens of kilometers) spatial wavelengths. The spatially variable thermal histories implied by these data are best explained by Proterozoic syn-depositional normal faulting that induced differences in exhumation and burial across the region. The data, geologic relationships, and thermal history models suggest Neoproterozoic rock exhumation and the presence of a basement paleo high at the present-day Lower Granite Gorge synchronous with Grand Canyon Supergroup deposition at the present-day Upper Granite Gorge. The paleo high created a topographic barrier that may have limited deposition to restricted marine or nonmarine conditions. This paleotopographic evolution reflects protracted, multiphase tectonic activity during Rodinia assembly and breakup that induced multiple events that formed unconformities over hundreds of millions of years, all with claim to the title of a “Great Unconformity.”
The Ambiguity Issue in Solving Inverse Problems of Small-Angle Scattering: A Consistent Approach Using an Insulin Receptor-Related Receptor as an Example. Methods for Interpreting SAXS Data
Authors: Petoukhov M. V. , Konarev P. V. , Volkov V. V. , Mozhaev A. A. , Shtykova E. V. 
Published: August 2021

Abstract
The construction of three-dimensional models of protein macromolecules is a serious challenge due to the possible ambiguity of solving the inverse problem of reconstructing a three-dimensional structure from a one-dimensional small-angle scattering profile. The target function of this task can have several local minima, which leads to the dependence of the solution on the initial values of the model parameters and on the method of finding the global minimum. The problem of creating structural models is also complicated by averaging the scattering pattern over all orientations of particles in space and by the size and shape distribution of scattering objects in the case of polydispersity and/or polymorphism. In this study, the issue of ambiguity in solving inverse problems and restoring the three-dimensional structure of a protein is considered using the structure of the ectodomain of an insulin receptor-related receptor (ectoIRR) in solution as an example. The paper presents a consistent approach to solving this problem, starting from the determination of general structural parameters and ab initio reconstruction of shape to modeling by rigid bodies (using molecular tectonics), hybrid methods, and analysis of scattering profiles by singular vector decomposition.
Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia
Authors: Moon Jade Y. , Garg Itika , Cui Ying , Katz Raviv , Zhu Ying , Le Rongrong , Lu Yifan , Lu Edward S. , Ludwig Cassie A. , Elze Tobias , Wu David M. , Eliott Dean , Miller Joan W. , Kim Leo A. , Husain Deeba , Vavvas Demetrios G. , Miller John B. 
Published: August 2021

Background/aimsPathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA).MethodsThis prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated.ResultsThis study evaluated 75 eyes of 48 patients with high myopia (HM), 43 eyes of 31 patients with mild to moderate myopia and 68 eyes of 53 age-matched controls. Controlling for age and the presence of systemic hypertension, we found that HM was associated with decrease in VD and VSD in all layers on 12×12 mm² scans. Furthermore, HM was associated with a VD and VSD decrease in every Early Treatment Diabetic Retinopathy Study grid, with a larger decrease temporally (βVD=−0.39, βVSD=−10.25, p<0.01). HM was associated with decreased RT and CT. Reduction in RT was outside the macular region, while reduction in CT was in the macular region.ConclusionUsing WF SS-OCTA, we identified reduction in microvasculature and structural changes associated with myopia. Decrease in VD and VSD was greater in the temporal quadrant, and reductions in RT and CT were uneven across the retina. Further work may help identify risk factors for the progression of PM and associated vision-threatening complications.
Trends and outcomes in primary health care expenditures in low-income and middle-income countries, 2000–2017
Authors: Schneider Matthew T , Chang Angela Y , Crosby Sawyer W , Gloyd Stephen , Harle Anton C , Lim Stephen , Lozano Rafael , Micah Angela E , Tsakalos Golsum , Su Yanfang , Murray Christopher J L , Dieleman Joseph L 
Published: August 2021

IntroductionAs the world responds to COVID-19 and aims for the Sustainable Development Goals, the potential for primary healthcare (PHC) is substantial, although the trends and effectiveness of PHC expenditure are unknown. We estimate PHC expenditure for each low-income and middle-income country between 2000 and 2017 and test which health outputs and outcomes were associated with PHC expenditure.MethodsWe used three data sources to estimate PHC expenditures: recently published health expenditure estimates for each low-income and middle-income country, which were constructed using 1662 country-reported National Health Accounts; proprietary data from IQVIA to estimate expenditure of prescribed pharmaceuticals for PHC; and household surveys and costing estimates to estimate inpatient vaginal delivery expenditures. We employed regression analyses to measure the association between PHC expenditures and 15 health outcomes and intermediate health outputs.ResultsPHC expenditures in low-income and middle-income countries increased between 2000 and 2017, from $41 per capita (95% uncertainty interval $33–$49) to $90 ($73–$105). Expenditures for low-income countries plateaued since 2014 at $17 per capita ($15–$19). As national income increased, the proportion of health expenditures on PHC generally decrease; however, the fraction of PHC expenditures spent via ambulatory care providers grew. Increases in the fraction of health expenditures on PHC was associated with lower maternal mortality rate (p value≤0.001), improved coverage of antenatal care visits (p value≤0.001), measles vaccination (p value≤0.001) and an increase in the Health Access and Quality index (p value≤0.05). PHC expenditure was not systematically associated with all-age mortality, communicable and non-communicable disease (NCD) burden.ConclusionPHC expenditures were associated with maternal and child health but were not associated with reduction in health burden for other key causes of disability, such as NCDs. To combat changing disease burdens, policy-makers and health professionals need to adapt primary healthcare to ensure continued impact on emerging health challenges.
Experiences and needs of patients with MDR/XDR-TB: a qualitative study among Saharia tribe in Madhya Pradesh, Central India
Authors: Nigam Samridhi , Sharma Ravendra K , Yadav Rajiv , Rao Vikas Gangadhar , Mishra Prashant , Lingala Mercy Aparna , Bhat Jyothi 
Published: August 2021

BackgroundDrug-resistant tuberculosis (DR-TB) continues to be a major public health threat posing a critical challenge to TB treatment and control worldwide. The present study was conducted among patients with DR-TB of the Saharia tribe residing in Madhya Pradesh state of Central India to document their experiences and needs, and to identify gaps for treatment adherence as this population is known to be poor because of migration and other factors.MethodsWe conducted 16 in-depth interviews on purposively selected patients with DR-TB among the Saharia tribe using a predesigned open-ended in-depth interview guide, which included questions on domains like general physical health, diagnosis, treatment adherence, side-effects of drugs and experience related to the health facility. Out of these interviews, various subthemes were extracted. The obtained qualitative data were subjected to thematic analysis.ResultsThe study helped to understand the experiences and needs of the patients with DR-TB in various stages from diagnosis to treatment. Also, there was the impact of factors like lack of education and awareness, poor living conditions and lack of healthcare facilities on predominance of the disease in the community. Poor access to a healthcare facility, high pill burden and related side-effects, longer duration of treatment, financial burden, misbeliefs and misconceptions were prominent issues posing a challenge to treatment adherence. The narratives pointed out their struggle at every stage be it with diagnosis, treatment initiation or treatment adherence.ConclusionIt is paramount to address the needs and experiences of patients with DR-TB to develop a patient-centric and context-specific approach conducive to the sociocultural set-up of tribal people. This will scale down the attrition rate of tribal patients while adhering to the complete treatment process and reducing the high burden of TB among the Saharia community. In addition, tribal patients should be counselled at regular intervals to increase their confidence in the treatment.
Community health worker-led, technology-enabled private sector intervention for diabetes and hypertension management among urban poor: a retrospective cohort study from large Indian metropolitan city
Authors: Deo Sarang , Singh Preeti 
Published: August 2021

ObjectivesWe assessed the effectiveness of community health workers (CHWs)-led, technology-enabled programme as a large-scale, real-world solution for screening and long-term management of diabetes and hypertension in low-income and middle-income countries.DesignRetrospective cohort design.SettingForty-seven low-income neighbourhoods of Hyderabad, a large Indian metropolis.ParticipantsParticipants (aged ≥20 years) who subscribed to an ongoing community-based chronic disease management programme employing CHWs and technology to manage diabetes and hypertension.Primary and secondary outcome measuresWe used deidentified programme data between 1 March 2015 and 8 October 2018 to measure participants’ pre-enrolment and post-enrolment retention rate and within time-interval mean difference in participants’ fasting blood glucose and blood pressure using Kaplan-Meier and mixed-effect regression models, respectively.Results51 126 participants were screened (median age 41 years; 65.2% women). Participant acquisition rate (screening to enrolment) was 4%. Median (IQR) retention period was 163.3 days (87.9–288.8), with 12 months postenrolment retention rate as 16.5% (95% CI 14.7 to 18.3). Reduction in blood glucose and blood pressure levels varied by participants’ retention in the programme. Adjusted mean difference from baseline ranged from −14.0 mg/dL (95% CI −18.1 to −10.0) to −27.9 mg/dL (95% CI −47.6 to −8.1) for fasting blood glucose; −2.7 mm Hg (95% CI −7.2 to 2.7) to −7.1 mm Hg (95% CI −9.1 to −4.9) for systolic blood pressure and −1.7 mm Hg (95% CI −4.6 to 1.1) to −4.2 mm Hg (95% CI −4.9 to −3.6) for diastolic blood pressure.ConclusionsCHW-led, technology-enabled private sector interventions can feasibly screen individuals for non-communicable diseases and effectively manage those who continue on the programme in the long run. However, changes in the model (eg, integration with the public health system to reduce out-of-pocket expenditure) may be needed to increase its adoption by individuals and thereby improve its cost-effectiveness.