bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Assistive Strategies for Electric Bikes That Include Rider’s Physiological Characteristics
Authors: Zignoli Andrea , Beatrici Lorenzo , Biral Francesco 
Published: November 2018

Control strategies of electric-bikes (e-bikes) do not take the physiological characteristics (e.g. aerobic fitness status) of the rider into account. By means of mathematical modelling, our aim was to analyse different assistive strategies that include these characteristics.
Particularly, we applied an Optimal Control (OC) algorithm to test whether an attentive control strategy could guarantee a sustainable effort for the rider throughout an entire climbing course with varying slope. We found that the contribution of the electric motor was pivotal during accelerations, so the effort for the kinetic energy conversion was shared between the electric motor and the cyclist.
OC seems to fit very well in a scenario where e-bikes are adopted on a daily basis for commuting or to increase the level of physical activity in a sedentary population. We suggest that intelligent control algorithms, like OC, could be embedded in the electric motors to improve e-bike experience, especially in sedentary adults.
Customization of a 3D Printed Prosthetic Finger Using Parametric Modeling
Authors: Lim Daniel , Georgiou Thomás , Bhardwaj Aashish , O’Connell Grace D. , Agogino Alice M. 
Published: November 2018

Prosthetic limbs and assistive devices require customization to effectively meet the needs of users. Despite the expense and hassle involved in procuring a prosthetic, 56% of people with limb loss end up abandoning their devices [1]. Acceptance of these devices is contingent on the comfort of the user, which depends heavily on the size, weight, and overall aesthetic of the device. As seen in numerous applications, parametric modeling can be utilized to produce medical devices that are specific to the patient’s needs. However, current 3D printed upper limb prosthetics use uniform scaling to fit the prostheses to different users.
In this paper, we propose a parametric modeling method for designing prosthetic fingers. We show that a prosthetic finger designed using parametric modeling has a range of motion (ROM) (path of the finger tip) that closely aligns with the digit’s natural path. We also show that the ROM produced by a uniformly scaled prosthetic poorly matches the natural ROM of the finger. To test this, finger width and length measurements were collected from 50 adults between the ages of 18–30. It was determined that there is negligible correlation between the length and width of the index (D2) digit among the participants.
Using both the highest and the lowest length to width ratio found among the participants, a prosthetic finger was designed using a parametric model and fabricated using additive manufacturing. The mechanical design of the prosthetic finger utilized a crossed four bar linkage mechanism and its ROM was determined by Freudenstein’s equations. By simulating the different paths of the fingers, we demonstrate that parametrically modeled fingers outperform uniformly scaled fingers at matching a natural digit’s path.
Evaluating a Virtual Wind Power Park in a Churchyard: A Perception Study With Portable VR Devices
Authors: Ellman Asko , Tiainen Tarja , Tossavainen Aleksi 
Published: November 2018

Portable VR technology enables perception studies to be put into practice in the field. This is a notable advance for several reasons: First, VR studies can be performed in natural environments, second, it is easier to reach relevant informants, and third, informants are more focused on the test. In this study, we focus on the pre-design phase of a wind power park. It is an appropriate target for perception study because it is rather new technology, many people are affected by it and there is a lot of prejudice against it. Due to this, social resistance has become the most remarkable issue for building new wind power in countryside.
The research question of this paper is if the use of Virtual prototypes can influence inhabitant’s attitudes in the pre-design phase of a Wind Power Park. We present a perception study that is performed in a village next to which a wind power park is planned. This study was performed with portable VR technology in a churchyard of the village where they could experience the virtual landscape and soundscape caused by a future wind power park. Informant group consisted of 18 people from the village.
In this study, we found out that people with strong preconception did not change their opinions. However, people with mild preconception may change their opinion. Actually, 37 % of the informants changed their opinion on wind power after the virtual inspection. It is noteworthy that the change can take place in both directions. Furthermore, portable VR technology consisting of an Oculus Rift and a Laptop computer proved to be feasible in the field study.
A Needs Assessment for Physical Activity Programming Based on the Transtheoretical Model
Authors: Mettling Shannon , Lee Jung-Min , Blount Ashley , Dinkel Danae 
Published: November 2018

The purpose of this study was to (a) examine differences between type of physical activity (PA), college, gender, and body mass index (BMI); and (b) explore the needs of college students in regard to PA programming using the Transtheoretical Model (TTM). Students at a Midwestern university completed a PA programming questionnaire and the Stages of Change questionnaire. After exclusions, 535 questionnaires were analyzed. Of those surveyed, 45.6% met aerobic PA guidelines, 38.5% met muscle-strengthening guidelines, half of the students were of normal weight, and the other half were overweight or obese. Males participated in more PA than females in both categories. The greatest percentage of students were in the maintenance stage of the TTM (38.1%). In regard to PA programming, the largest percentage of students wanted more variety in times and styles for cardio and strength classes. Future campus recreation professionals could consider utilizing a similar survey to identify demographics and stage of change to better design PA programs.
Laboratory Methods in Molecular Epidemiology: Bacterial Infections
Authors: Riley Lee W. 
Published: November 2018

ABSTRACTIn infectious disease epidemiology, the laboratory plays a critical role in diagnosis, outbreak investigations, surveillance, and characterizing biologic properties of microbes associated with their transmissibility, resistance to anti-infectives, and pathogenesis. The laboratory can inform and refine epidemiologic study design and data analyses. In public health, the laboratory functions to assess effect of an intervention. In addition to research laboratories, the new-generation molecular microbiology technology has been adapted into clinical and public health laboratories to simplify, accelerate, and make precise detection and identification of infectious disease pathogens. This technology is also being applied to subtype microbes to conduct investigations that advance our knowledge of epidemiology of old and emerging infectious diseases. Because of the recent explosive progress in molecular microbiology technology and the vast amount of data generated from the applications of this technology, thisMicrobiology SpectrumCurated Collection: Advances in Molecular Epidemiology of Infectious Diseases describes these methods separately for bacteria, viruses, and parasites. This review discusses past and current advancements made in laboratory methods used to conduct epidemiologic studies of bacterial infections. It describes methods used to subtype bacterial organisms based on molecular microbiology techniques, following a discussion on what is meant by bacterial “species” and “clones.” Discussions on past and new genotyping tests applied to epidemiologic investigations focus on tests that compare electrophoretic band patterns, hybridization matrices, and nucleic acid sequences. Applications of these genotyping tests to address epidemiologic issues are detailed elsewhere in other reviews of this series.*This article is part of a curated collection.
Fever duration during treated urinary tract infections and development of permanent renal lesions
Authors: Karavanaki Kyriaki , Koufadaki Athina Maria , Soldatou Alexandra , Tsentidis Charalambos , Sourani Maria , Gougourelas Dimitris , Haliotis Fotis Angelos , Stefanidis Constantinos J 
Published: November 2018

ObjectiveTo assess the effect of the duration of fever after the initiation of treatment (FAT) of febrile urinary tract infections (UTI) on the development of permanent renal lesions based on dimercaptosuccinic acid (DMSA) scintigraphy findings. To evaluate the FAT contribution to permanent renal lesion formation in relation to fever before treatment initiation (FBT), the presence of vesicourinary reflux (VUR), age and severity of infection.MethodsThe inpatient records of 148 children (median age: 2.4 months (11 days to 24 months)) with a first episode of UTI during a 3-year period were analysed. DMSA findings, and clinical and laboratory parameters were evaluated.ResultsAmong the study population, 34/148 (22.97%) children had permanent renal lesions on the DMSA scan 6 months after a single episode of UTI. Twenty-three children (15.5%) had mild, 10 (6.7%) had moderate and 1 (0.6%) child had severe lesions on the DMSA. FAT prolongation >/48 hours was associated with older age (p=0.01) and increased absolute neutrophil count (p=0.042). The likelihood of lesions was significantly increased when FAT was ≥48 hours (R2=0.043, p=0.021). On multiple regression analysis, with the addition of FBT>/72 hours (0.022), the presence of VUR (p<0.001), C-reactive protein (p=0.027) and age (p=0.031), the effect of FAT on lesion development disappeared (p=0.15).ConclusionsProlongation of FAT≥48 hours of febrile UTI in children <2 years significantly contributes to the development of permanent renal lesions. However, delay in treatment initiation >/72 hours, the presence of VUR, older age and infection severity seem to be more significant predictors of the development of renal lesions.
General practitioners’ perspectives on the prevention of cardiovascular disease: systematic review and thematic synthesis of qualitative studies
Authors: Ju Irene , Banks Emily , Calabria Bianca , Ju Angela , Agostino Jason , Korda Rosemary J , Usherwood Tim , Manera Karine , Hanson Camilla S , Craig Jonathan C , Tong Allison 
Published: November 2018

ObjectiveCardiovascular disease (CVD) is a leading cause of morbidity and mortality globally, and prevention of CVD is a public health priority. This paper aims to describe the perspectives of general practitioners (GPs) on the prevention of CVD across different contexts.DesignSystematic review and thematic synthesis of qualitative studies using the Enhancing Transparency of Reporting the Synthesis of Qualitative research (ENTREQ) framework.Data sourcesMEDLINE, Embase, PsycINFO and CINAHL from database inception to April 2018.Eligibility criteria for selecting studiesWe included qualitative studies on the perspectives of GPs on CVD prevention.Data extraction and synthesisWe used HyperRESEARCH to code the primary papers and identified themes.ResultsWe selected 34 studies involving 1223 participants across nine countries. We identified six themes: defining own primary role (duty to prescribe medication, refraining from risking patients’ lives, mediating between patients and specialists, delegating responsibility to patients, providing holistic care); trusting external expertise (depending on credible evidence and opinion, entrusting care to other health professionals, integrating into patient context); motivating behavioural change for prevention (highlighting tangible improvements, negotiating patient acceptance, enabling autonomy and empowerment, harnessing the power of fear, disappointment with futility of advice); recognising and accepting patient capacities (ascertaining patient’s drive for lifestyle change, conceding to ingrained habits, prioritising urgent comorbidities, tailoring to patient environment and literacy); avoiding overmedicalisation (averting long-term dependence on medications, preventing a false sense of security, minimising stress of sickness) and minimising economic burdens (avoiding unjustified costs to patients, delivering practice within budget, alleviating healthcare expenses).ConclusionsGPs sought to empower patients to prevent CVD, but consideration of patients’ individual factors was challenging. Community-based strategies for assessing CVD risk involving other health professionals, and decision aids that address the individuality of the patient’s health and environment, may support GPs in their decisions regarding CVD prevention.
Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study
Authors: Eide Leslie SP , Ranhoff Anette H , Lauck Sandra , Fridlund Bengt , Haaverstad Rune , Hufthammer Karl Ove , Kuiper Karel K J , Nordrehaug Jan Erik , Norekvål Tone Merete 
Published: November 2018

ObjectivesTo determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).DesignProspective cohort study.SettingTertiary university hospital covering the western region of Norway.ParticipantsOctogenarian patients undergoing elective SAVR or TAVI and willing to participate in the study were eligible. Patients unable to speak Norwegian were excluded. Between 2011 and 2013, 143 consecutive patients were included, and data from 136 of them are presented.Primary outcomeDelirium.ResultsLogistic regression analysis shows that lower cognitive function was positively associated with delirium (OR 0.86, CI 0.74 to 0.99, p=0.047). Besides, the interaction term in the model shows that IUC use and delirium differed between SAVR and TAVI patients (p=0.04). The difference corresponded to a weaker association between hours of IUC use and delirium for SAVR (OR 1.01, CI: 0.99 to 1.03, p=0.54) compared with that for TAVI (OR 1.04, CI: 1.01 to 1.08, p=0.004).ConclusionsThe association between IUC use and delirium is stronger for octogenarian patients treated with TAVI than for patients who received SAVR. Our results revealed a previously unknown association between the number of hours an IUC is used and postoperative delirium in octogenarian patients treated with TAVI.
Protocol for a feasibility and acceptability study using a brief ACT-based intervention for people from Southwest Wales who live with persistent pain
Authors: Saracutu Madalina , Edwards Darren J , Davies Helen , Rance Jaynie 
Published: November 2018

IntroductionPersistent pain affects a large percentage of the UK population and its burden has wide ramifications that affect physical, psychological, socioeconomic and occupational status. Pain has a significant impact on people’s well-being and quality of life. Some of the most common comorbidities found in this population are depression and anxiety and also maladaptive behaviours such as fear avoidance and catastrophising.Methods and analysisThis is a protocol for a study assessing the feasibility and acceptability of a novel Acceptance and Commitment Therapy (ACT)-based intervention for people from Southwest Wales who live with persistent pain. A group of 12 participants will be recruited through the Health and Wellbeing Academy (Swansea University). After being referred by an Osteopath, and attending a brief meeting with the researcher, the participants will take part in six sessions over six consecutive weeks. ‘A Mindful Act’ is an ACT-based group programme aiming to teach people how to develop more acceptance and self-compassion, be more mindful and clarify personal values in order to live a more rich and meaningful life. The main outcomes will include the feasibility of the recruitment process and the measurement tools, the acceptability of the intervention for both the participants and the Osteopaths and the adherence to the programme. In order to measure acceptability of the intervention, qualitative interviews will be conducted to provide an insight into peoples’ experiences of taking part. Data will be analysed using Thematic Analysis, with the use of NVIVO 10. In addition, quantitative data will be collected at baseline, on completion of the programme and at 1 month and 3 months follow-up to reveal any differences in psychological flexibility, depression, anxiety, fear avoidance and general health status. The findings will help enhance the intervention by making appropriate modifications to the processes and procedures involved, following the recommendations made by the Medical Research Council framework. A larger scale study is envisaged to follow, in order to investigate the full effectiveness and cost-effectiveness of ‘A Mindful Act’.Ethics and disseminationThis study was approved by the College of Human and Health Sciences Research Ethics Committee at Swansea University in December 2017. The findings will be disseminated through various means including: the first author’s PhD thesis, peer-reviewed journals as well as well as national and international conferences and public events.
Trial of intraoperative cell salvage versus transfusion in ovarian cancer (TIC TOC): protocol for a randomised controlled feasibility study
Authors: Galaal Khadra , Lopes Alberto , Pritchard Colin , Barton Andrew , Wingham Jennifer , Marques Elsa M R , Faulds John , Palmer Joanne , Vickery Patricia Jane , Ralph Catherine , Ferreira Nicole , Ewings Paul 
Published: November 2018

IntroductionOvarian cancer is the leading cause of death from gynaecological cancer, with more than 7000 new cases registered in the UK in 2014. In patients suitable for surgery, the National Institute of Health and Care Excellence guidance for treatment recommends surgical resection of all macroscopic tumour, followed by chemotherapy. The surgical procedure can be extensive and associated with substantial blood loss which is conventionally replaced with a donor blood transfusion. While often necessary and lifesaving, the use of donor blood is associated with increased risks of complications and adverse surgical outcomes. Intraoperative cell salvage (ICS) is a blood conservation strategy in which red cells collected from blood lost during surgery are returned to the patient thus minimising the use of donor blood. This is the protocol for a feasibility randomised controlled trial with an embedded qualitative study and feasibility economic evaluation. If feasible, a later definitive trial will test the effectiveness and cost-effectiveness of ICS reinfusion versus donor blood transfusion in ovarian cancer surgery.Methods and analysisSixty adult women scheduled for primary or interval ovarian cancer surgery at participating UK National Health Service Trusts will be recruited and individually randomised in a 1:1 ratio to receive ICS reinfusion or donor blood (as required) during surgery. Participants will be followed up by telephone at 30 days postoperatively for adverse events monitoring and by postal questionnaire at 6 weeks and 3 monthly thereafter, to capture quality of life and resource use data. Qualitative interviews will capture participants’ and clinicians’ experiences of the study.Ethics and disseminationThis study has been granted ethical approval by the South West–Exeter Research Ethics Committee (ref: 16/SW/0256). Results will be disseminated via peer-reviewed publications and will inform the design of a larger trial.Trial registration numberISRCTN19517317.
Better care: reducing length of stay and bed occupancy on an older adult psychiatric ward
Authors: Adlington Katherine , Brown Juliette , Ralph Laura , Clarke Alan , Bhoyroo Tim , Henderson Michael , Boora Farai , Aurelio Marco , Fawzi Waleed 
Published: November 2018

BackgroundLength of stay and bed occupancy are important indicators of quality of care. Admissions are longer on older adult psychiatric wards as a result of physical comorbidity and complex care needs. The recommended bed occupancy is 85%; levels of 95% or higher are associated with violent incidents on inpatient wards.MethodsWe aimed to reduce length of stay and bed occupancy on Leadenhall ward, a functional older adult psychiatric ward serving a population of just under 40 000 older adults in two of the most deprived areas of the UK.At baseline in October 2015, the average length of stay was 47 days, and bed occupancy was at 77%. We approached the problem using quality improvement methods, established a project team and proceeded to test a number of changes over time in line with the driver diagram we produced.ResultsIn 12 months, length of stay was reduced from an average 47 to an average 30 days and bed occupancy from 77% to 54%.At the end of 2016, the closure of some beds effected this calculation and we added an additional outcome measure of occupied bed days (OBD) better to assess the impact of the work. OBD data show a decrease over the course of the project from 251 to 194 bed days (a reduction of 23%).ConclusionThe most effective interventions to address length of stay and bed occupancy on an older adult functional mental health ward were the daily management round and the high-level management focus on longer-stay patients. The work depended on an effective community team and on the support of the quality improvement programme in the trust, which have led to sustained improvements.
Improving resuscitation decisions: a trust-wide initiative
Authors: Fadel Michael G , Parekh Krishan , Hayden Paul , Krishnan Priya 
Published: November 2018

IntroductionTreatment escalation plans (TEPs) are important to ensure that every patient has their ceiling of care discussed and documented formally. At Medway Foundation Trust, we introduced TEP forms in September 2016 which are to be completed by the relevant consultant within 24 hours of admission.Aims and methodsTo evaluate whether TEP forms had been effective at improving escalation planning and whether they had a subsequent impact in do not attempt cardiopulmonary resuscitation (DNACPR) decision-making. We carried out three plan-do-study-act cycles over a 2-year period across 100 patients in medicine and surgery.ResultsTEP forms were initially found in 66% (66/100) of the patient notes and 34% (34/100) were completed appropriately. There was a 13% relative improvement in resuscitation decision-making, since the introduction of the TEP forms from November 2015 to January 2017. There was also a 12% reduction in inappropriate referrals to critical care during the same period. We decided to revise the TEP form through extensive collaboration and educate all staff members about the importance of escalation planning. This has led to an improvement in TEP discussion and documentation across the entire trust.ConclusionTEPs can be an effective way of considering and communicating ceilings of care. They should encourage doctors to consider DNACPR decisions for patients who otherwise would not have been considered, and therefore may help reduce inappropriate referrals to critical care. The higher completion rates of the new form and increased clarity among staff regarding escalation planning should lead to an improvement in patient safety outcomes and communication between all patients and staff members. We believe it would be feasible to implement our user-friendly TEP form across other National Health Service organisations in order to develop a universal TEP form.