bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autoantibodies against the immunodominant sCha epitope discriminate the risk of sudden death in chronic Chagas cardiomyopathy
Authors: Rodríguez‐Angulo Héctor O. , Lamsfus‐Calle Andrés , Isoler‐Alcaráz Javier , Galán‐Martínez Javier , Herreros‐Cabello Alfonso , Callejas‐Hernández Francisco , Chorro‐de‐Villaceballos María A. , Maza María C. , Santi‐Rocca Julien , Poveda Cristina , Moral‐Salmoral Javier Del , Marques Juan , Mendoza Iván , Ramírez Juan David , Guhl Felipe , Carrillo Irene , Pérez‐Tanoira Ramón , Górgolas Miguel , Pérez‐Ayala Ana , Monge‐Maillo Begoña , Norman Francesca , Pérez‐Molina José A. , López‐Vélez Rogelio , Fresno Manuel , Gironès Núria 
Published: March 2021

AbstractIn Chagas disease (ChD) caused by Trypanosoma cruzi, new biomarkers to predict chronic cardiac pathology are urgently needed. Previous studies in chagasic patients with mild symptomatology showed that antibodies against the immunodominant R3 epitope of sCha, a fragment of the human basic helix‐loop‐helix transcription factor like 5, correlated with cardiac pathology. To validate sCha as a biomarker and to understand the origin of anti‐sCha antibodies, we conducted a multicenter study with several cohorts of chagasic patients with severe cardiac symptomatology. We found that levels of antibodies against sCha discriminated the high risk of sudden death, indicating they could be useful for ChD prognosis. We investigated the origin of the antibodies and performed an alanine scan of the R3 epitope. We identified a minimal epitope MRQLD, and a BLAST search retrieved several T. cruzi antigens. Five of the hits had known or putative functions, of which phosphonopyruvate decarboxylase showed the highest cross‐reactivity with sCha, confirming the role of molecular mimicry in the development of anti‐sCha antibodies. Altogether, we demonstrate that the development of antibodies against sCha, which originated by molecular mimicry with T. cruzi antigens, could discriminate electrocardiographic alterations associated with a high risk of sudden death.
Anesthetic management for percutaneous reverse Potts shunt creation in children with refractory idiopathic pulmonary arterial hypertension: A case series
Authors: Valent Arnaud , Nefzi Imene , Lopez Vanessa , Mirabile Cristian , Orliaguet Gilles 
Published: March 2021

AbstractPercutaneous reverse Potts shunt improves right ventricular function in patients with suprasystemic idiopathic pulmonary arterial hypertension. There are no data regarding the anesthesia in this high‐risk procedure. We report our experience of the anesthetic management for the creation of percutaneous reverse Potts shunt in children with suprasystemic idiopathic pulmonary arterial hypertension. This study included 10 patients presenting with symptomatic idiopathic pulmonary arterial hypertension despite undergoing medical treatment. All patients underwent gradual induction of anesthesia to maintain hemodynamic stability (etomidate, n = 8; ketamine, n = 4). Four patients needed extracorporeal life support: 2 were rescued after cardiac arrest and 2 had elective extracorporeal life support due to preprocedural dysfunctional right ventricle and/or small left ventricle volumes with reduced cardiac output. All patients were admitted to the pediatric cardiac intensive care unit (4 [2–5] days). All patients with extracorporeal life support died. None of the six survivors needed pulmonary transplantation. Both ketamine and etomidate support hemodynamics. High‐dose opioid technique has the advantage of blunting noxious stimuli and subsequent increase in pulmonary vascular resistance. We recommend using multimodal monitoring with transesophageal echocardiography. The 100% mortality of extracorporeal life support patients, probably too sick to undergo such procedure, may question its usefulness. Further studies should identify suitable candidates for percutaneous reverse Potts shunt creation.
Does iron therapy have a place in the management of all breath‐holding spells?
Authors: Arslan Müjgan , Karaibrahimoğlu Adnan , Demirtaş Mehmet Semih 
Published: March 2021

AbstractBackgroundAim of this study was to analyze the effect of iron therapy in children with breath‐holding spells, irrespective of their hemoglobin level.MethodAll of the children were evaluated in terms of age, sex, age at onset of the attack, attack frequency, type of breath‐holding spell, family pedigree, laboratory values. All enrolled patients were given iron at the dose of 4 mg/kg/day as a single daily dose for 3 months. Patients were called for follow‐up appointments 1 and 3 months after the initiation of treatment to record the frequency and severity of spells.ResultsThe mean age of the patients was 12.50 ± 9.51 months. Patients were divided into two groups according to the hemoglobin level. The frequency of anemia in children with spells was recorded as 27%. Out of 100 patients treated with iron, 43% showed complete remission at the end of 1 month. At the end of the 3 months, percentage of complete responders increased to 80%. After three‐month of iron treatment, 96.2% of the anemic and 73.97% of the non‐anemic patients were spell‐free. Eight children had mild adverse effects after iron therapy that did not require dose modification.ConclusionsThis study confirmed that iron therapy reduces spell frequency regardless of anemia in all breath‐holding spells. A three‐month empiric iron therapy should be offered to all children with spells.
Clinical features and prognosis of severe scorpion envenomation in children
Authors: Rebahi Houssam , Ba‐M’hamed Saadia , Still Megan Elizabeth , Mouaffak Youssef , Younous Said , Bennis Mohamed 
Published: March 2021

AbstractBackgroundScorpionism is endemic and represents a real public health problem in Morocco. The most dangerous arthropod in the central area is Androctonus mauretanicus (Am) scorpion. Its venom can be lethal, especially for children. This study aimed to determine a clinico‐epidemiological profile of severe scorpion envenomation among children and identify risk factors for mortality.MethodsThis retrospective cohort study included 606 children admitted for severe scorpion envenomation (SSE) from January 2010 to July 2015 in the Pediatric Intensive Care Unit (PICU) of Mohammed VI Teaching Hospital.ResultsThe mean age of envenomed children was 6.3 ± 4.2 years. Seventy‐four percent of them came from rural settings. Envenomation occurred mostly during the summer months and 78.4% of stings were nocturnal. The time between the sting and evaluation was greater than 2 h in 83% of cases. Bivariate analysis indicated that from 1 to 24 months of age (P = 0.001), hyperthermia (P = 0.022), episodes of diarrhea (P < 0.001), tachycardia (P < 0.001), abdominal distention (P < 0.001), skin marbling (P < 0.001), signs of respiratory distress (P < 0.001), irritability (P < 0.001), generalized seizures (P = 0.053), and Glasgow Coma Score (GCS) of 3 to 9 (P < 0.001) were significantly correlated with mortality. On multivariate analysis, diarrhea (P = 0.007), skin marbling (P = 0.006), and respiratory distress (P = 0.002), and GCS 3‐9 (P = 0.007) were found to be independent risk factors for mortality in our patient population.ConclusionsChildren are at high risk of developing serious complications, even death, from severe scorpion envenomation. Here we identified multiple factors that appear to increase the mortality risk in children after scorpion envenomation, including previously described central nervous system alterations.
Inverse effects of time‐on‐task in task‐related and task‐unrelated theta activity
Authors: Arnau Stefan , Brümmer Tina , Liegel Nathalie , Wascher Edmund 
Published: March 2021

AbstractThe phenomenon of mental fatigue has recently been investigated extensively by means of the EEG. Studies deploying spectral analysis consistently reported an increase of spectral power in the lower frequencies with increasing time‐on‐task, whereas event‐related studies observed decreases in various measures related to task engagement and attentional resources. The results from these two lines of research cannot be aligned easily. (Frontal) theta power has been linked to cognitive control and was found to increase with time‐on‐task. In contrast, theoretical frameworks on mental fatigue suggest a decline in task‐engagement as causal for the performance decline observed in mental fatigue. The goal of the present study was to investigate mental fatigue in time–frequency space using linear regression on single‐trial data in order to obtain a better understanding about how time‐on‐task affects theta oscillatory activity. A data‐driven analysis approach indicated an increase of alpha and theta power during the intertrial interval. In contrast, task‐related theta activity declined. This reduction of stimulus‐locked theta power may be interpreted as a reduction of task engagement with increasing mental fatigue. The increase of theta spectral power in the intertrial interval, moreover, could possibly be explained by an increased idling of cognitive control networks. Alternatively, it might be the case that the increase of theta power with time‐on‐task is a by‐product an alpha power increase. As alpha peak frequency systematically decreases with time‐on‐task, the theta band might be affected as well.
Numerical and Network-Analyzer Solution of the Equivalent Circuits for the Elastic Field
Authors: Carter G. K. 
Published: March 2021

Abstract
This is a companion paper to one by Gabriel Kron. Particular cases of circuits in two independent variables are used. Test of these circuits by numerical substitution of known simple solutions indicates that the mesh size in the circuits need not be excessively small in order to give a useful accuracy of results. By trial of the a-c network analyzer, in similar cases, limitations on the use of the analyzer in its present form for the solution of elastic-field problems are studied. Finally, it is found by trial that solution of the circuits by hand, using a “relaxation” method, is practicable; and in this way the desirable objective of a solution of the elastic-field problem directly from given boundary conditions is achieved.
Analysis of the Valverde Thermostat
Authors: Wahl A. M. 
Published: March 2021

Abstract
In this paper, a method based on the theory of initially curved bars axially loaded is developed for calculating snapping temperatures and stresses in a new type of thermostat known as the Valverde thermostat. For facilitating practical use of the derived formulas, curves are given by means of which the effect of dimensional changes on the free snapping or buckling temperatures may easily be evaluated. The analysis has been found useful in the practical design of thermostats of this type.
Drawing Thin-Walled Tubing With a Moving Mandrel Through a Single Stationary Die
Authors: Sachs G. , Lubahn J. D. , Tracy D. P. 
Published: March 2021

Abstract
The fundamental equations for the drawing of tubing with a moving mandrel have been solved for the simplified cases of both cold-drawing and hot-drawing of thin-walled tubing through a stationary die. For the solution of the fundamental equation, a method of successive improvement can be used for any contour of the tools and any shape of the stress-strain curve. Algebraic solutions were developed for tapered tools and for a metal exhibiting a constant flow stress in cold-working, and for a metal with the flow stress depending exponentially upon the strain rate in hot-working. The effects of the die and punch contours and the friction coefficients between the metal and the die and punch, respectively, on the stresses in the metal, the draw forces, and the limits of drawing were determined. The calculations reveal that, with a small die angle and high friction on the mandrel, the process resembles extrusion rather than drawing, the limit being determined by the strength of the die rather than by the tensile strength of the metal.
The Effect of Blade Count on Body Force Model Performance for Axial Fans
Authors: Saini Palak , Defoe Jeffrey 
Published: March 2021

Abstract
Body force models enable inexpensive numerical simulations of turbomachinery. The approach replaces the blades with sources of momentum/energy. Such models capture a “smeared out” version of the blades’ effect on the flow, reducing computational cost. The body force model used in this paper has been widely used in aircraft engine applications. Its implementation for low speed, low solidity (few blades) turbomachines, such as automotive cooling fans, enables predictions of cooling flows and component temperatures without calibrated fan curves. Automotive cooling fans tend to have less than 10 blades, which is approximately 50% of blade counts for modern jet engine fans. The effect that has on the body force model predictions is unknown, and the objective of this paper is to quantify how varying blade count affects the accuracy of the predictions for both uniform and non-uniform inflow. The key findings are that reductions in blade metal blockage combined with spanwise flow redistribution drives the body force model to more accurately predict work coefficient as the blade count decreases and that reducing the number of blades is found to have negligible impacts on upstream influence and distortion transfer in non-uniform inflow until extremely low blade counts (such as 2) are applied.
On the Electro-Mechanical Stability of Elastomeric Coaxial Fibers
Authors: Clarke D. R. , Hutchinson J. W. 
Published: March 2021

Abstract
The stability of cylindrical coaxial fibers made from soft elastomeric materials is studied for electro-static loadings. The general configuration considered is a three-component axisymmetric fiber having a conducting core bonded to a dielectric annulus in turn bonded to an outer conducting annular sheath. A voltage difference between the conducting components is imposed. The stresses and actuated elongation in the perfectly concentric fiber are analyzed, and the critical voltage at which stability of the concentric configuration is lost is determined via solution of the non-axisymmetric bifurcation problem. The role of the geometry and moduli contrasts among the components is revealed, and the sub-class of two-component fibers is also analyzed. The idealized problem of a planar layer with conducting surfaces that is bonded to a stiff substrate on one surface and free on the other exposes the importance of short wavelength surface instability modes.
2021 consensus statement for preventing and managing low back pain in elite and subelite adult rowers
Authors: Wilson Fiona , Thornton Jane S , Wilkie Kellie , Hartvigsen Jan , Vinther Anders , Ackerman Kathryn E , Caneiro J P , Trease Larissa , Nugent Frank , Gissane Conor , McDonnell Sarah-Jane , McGregor Alison , Newlands Craig , Ardern Clare L 
Published: March 2021

PurposeTo synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice.MethodsThere were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice.ResultsThe scope of the consensus statement included epidemiology; biomechanics; management; the athlete’s voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged.ConclusionRecommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
Protocol for an interdisciplinary cross-sectional study investigating the social, biological and community-level drivers of antimicrobial resistance (AMR): Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA)
Authors: Asiimwe Benon B , Kiiru John , Mshana Stephen E , Neema Stella , Keenan Katherine , Kesby Mike , Mwanga Joseph R , Sloan Derek J , Mmbaga Blandina T , Smith V Anne , Gillespie Stephen H , Lynch Andy G , Sandeman Alison , Stelling John , Elliott Alison , Aanensen David M , Kibiki Gibson E , Sabiiti Wilber , Holden Matthew T G 
Published: March 2021

IntroductionAntimicrobial resistance (AMR) is a global health threat that requires urgent research using a multidisciplinary approach. The biological drivers of AMR are well understood, but factors related to treatment seeking and the social contexts of antibiotic (AB) use behaviours are less understood. Here we describe the Holistic Approach to Unravel Antibacterial Resistance in East Africa, a multicentre consortium that investigates the diverse drivers of drug resistance in urinary tract infections (UTIs) in East Africa.Methods and analysisThis study will take place in Uganda, Kenya and Tanzania. We will conduct geospatial mapping of AB sellers, and conduct mystery client studies and in-depth interviews (IDIs) with drug sellers to investigate AB provision practices. In parallel, we will conduct IDIs with doctors, alongside community focus groups. Clinically diagnosed patients with UTI will be recruited from healthcare centres, provide urine samples and complete a questionnaire capturing retrospective treatment pathways, sociodemographic characteristics, attitudes and knowledge. Bacterial isolates from urine and stool samples will be subject to culture and antibiotic sensitivity testing. Genomic DNA from bacterial isolates will be extracted with a subset being sequenced. A follow-up household interview will be conducted with 1800 UTI-positive patients, where further environmental samples will be collected. A subsample of patients will be interviewed using qualitative tools. Questionnaire data, microbiological analysis and qualitative data will be linked at the individual level. Quantitative data will be analysed using statistical modelling, including Bayesian network analysis, and all forms of qualitative data analysed through iterative thematic content analysis.Ethics and disseminationApprovals have been obtained from all national and local ethical review bodies in East Africa and the UK. Results will be disseminated in communities, with local and global policy stakeholders, and in academic circles. They will have great potential to inform policy, improve clinical practice and build regional pathogen surveillance capacity.
E-health ecosystem with integrated and stepped psychosocial services for breast cancer survivors: study protocol of a multicentre randomised controlled trial
Authors: Ochoa-Arnedo Cristian , Medina Joan Carles , Flix-Valle Aida , Anastasiadou Dimitra 
Published: March 2021

IntroductionPsychosocial interventions for patients with breast cancer (BC) have demonstrated their effectiveness at reducing emotional distress and improving quality of life. The current digitisation of screening, monitoring and psychosocial treatment presents the opportunity for a revolution that could improve the quality of care and reduce its economic burden. The objectives of this study are, first, to assess the effectiveness of an e-health platform with integrated and stepped psychosocial services compared with usual psychosocial care, and second, to examine its cost–utility.Methods and analysisThis study is a multicentre randomised controlled trial with two parallel groups: E-health intervention with integrated and stepped psychosocial services vs usual psychosocial care. An estimated sample of 338 patients with BC in the acute survival phase will be recruited from three university hospitals in Catalonia (Spain) and will be randomly assigned to one of two groups. All participants will be evaluated at the beginning of the study (T1: recruitment), 3 months from T1 (T2), 6 months from T1 (T3) and 12 months from T1 (T4). Primary outcome measures will include number of clinical cases detected, waiting time from detection to psychosocial intervention and proportion of cases successfully treated in the different steps of the intervention, as well as outcomes related to emotional distress, quality of life, post-traumatic stress and growth, treatment adherence and therapeutic alliance. Secondary outcomes will include the acceptability of the platform, patients’ satisfaction and usability. For the cost–utility analysis, we will assess quality-adjusted life years and costs related to healthcare utilisation, medication use and adherence, work absenteeism and infrastructure-related and transport-related costs.Ethics and disseminationThis study was approved by the Ethics committee of the Institut Català d’Oncologia network in Hospitalet, Spain. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences among the scientific community, workshops with patients and media press releases.Trial registration numberOnline Psychosocial Cancer Screening, Monitoring and Stepped Treatment in Cancer Survivors (ICOnnectat-B),NCT04372459.
Effectiveness of integrated treatment for eating disorders in Spain: protocol for a multicentre, naturalistic, observational study
Authors: Grau Touriño Antoni , Feixas Guillem , Medina Joan Carles , Paz Clara , Evans Chris 
Published: March 2021

IntroductionEating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and interventions make evaluation of treatments difficult. The present study aims to measure the effectiveness of a complex treatment programme for EDs which includes hospitalisation, day hospital and outpatient settings. Our purpose is to assess the complete therapeutic process of each patient through all these levels of care, capturing the multiplicity of trajectories that a programme of these characteristics involves.Methods and analysisThis protocol describes a multicentre, naturalistic, observational study. All patients starting between November 2017 and October 2020 in a healthcare network for EDs in Spain are being invited to participate. The first phase of intensive change monitoring to November 2020 is followed by lower intensity follow-up until October 2025. In the first phase progress of all participants is assessed every 3 weeks using specific measures for ED and the Clinical Outcomes Routine Evaluation system, a family of instruments specifically designed to measure change in psychotherapy. In the second phase data collection will happen quarterly. Both cross-sectional and longitudinal analyses will be conducted, with a special focus on patterns and predictors of change studied through multilevel linear models.Ethics and disseminationThe study has been approved by the Research Bioethics Committee of the University of Barcelona (no. IRB00003099) and the ethical committee of ITA Mental Health, the organisation to which all participating centres belong. Dissemination will be in papers for peer-reviewed research journals and to clinicians working with ED.Trial registration numberNCT04127214.