bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermal Design and Testing of a Passive Helmet Heat Exchanger With Additively Manufactured Components
Authors: Cage Kailyn , Vaughn-Cooke Monifa , Fuge Mark , Lucero Briana , Spernjak Dusan , Bernardin John 
Published: September 2018

Additive manufacturing (AM) processes allow for complex geometries to be developed in a cost- and time-efficient manner in small-scale productions. The unique functionality of AM offers an ideal collaboration between specific applications of human variability and thermal management. This research investigates the intersection of AM, human variability and thermal management in the development of a military helmet heat exchanger. A primary aim of this research was to establish the effectiveness of AM components in thermal applications based on material composition. Using additively manufactured heat pipe holders, the thermal properties of a passive evaporative cooler are tested for performance capability with various heat pipes over two environmental conditions.
This study conducted a proof-of-concept design for a passive helmet heat exchanger, incorporating AM components as both the heat pipe holders and the cushioning material targeting internal head temperatures of ≤ 35°C. Copper heat pipes from 3 manufactures with three lengths were analytically simulated and experimentally tested for their effectiveness in the helmet design. A total of 12 heat pipes were tested with 2 heat pipes per holder in a lateral configuration inside a thermal environmental chamber. Two 25-hour tests in an environmental chamber were conducted evaluating temperature (25°C, 45°C) and relative humidity (25%, 50%) for the six types of heat pipes and compared against the analytical models of the helmet heat exchangers.
Many of the heat pipes tested were good conduits for moving the heat from the head to the evaporative wicking material. All heat pipes had Coefficients of Performance under 3.5 when tested with the lateral system. Comparisons of the analytical and experimental models show the need for the design to incorporate a re-wetting reservoir. This work on a 2-dimensional system establishes the basis for design improvements and integration of the heat pipes and additively manufactured parts with a 3-dimensional helmet.
Structural Design of Hybrid Processing Unit Chassis for Airborne Electronic Systems
Authors: Santoro Daniele , Lecci Umberto , Quadrini Fabrizio , Santo Loredana 
Published: September 2018

Defence&Aerospace applications greatly benefit from the weight reduction of their payloads. On one hand, a reduced weight leads to lower fuel consumption and thus a greater flight range. On the other, higher load factors reduce the overall flight envelope. In the case of mast mounted naval or terrestrial units (e.g shelters), mass budgets are strongly limit. The need of producing very light structures leads to the use of composite materials but drawbacks arise from the definition of a robust design methodology.
The present work aims at defying an integrated experimental-numerical approach to design complex composite structures. The unit chassis of a hybrid processing unit for airborne application is taken as case study. Material properties are extracted from laboratory tests and integrated with nominal data. A finite element model is calibrated and used to predict the behavior of a chassis wall under harmonic load condition.
Cooling Process for Directional Solidification in Directed Energy Deposition
Authors: Ishiyama Keiya , Koike Ryo , Kakinuma Yasuhiro , Suzuki Tetsuya , Mori Takanori 
Published: September 2018

Additive manufacturing (AM) for metals has attracted attention from industry because of its great potential to enhance production efficiency and reduce production costs. Directed energy deposition (DED) is a metal AM process suitable to produce large-scale freeform metal products. DED entails irradiating the baseplate with a laser beam and launching the metal powder onto the molten spot to produce a metal part on the baseplate. Because the process enables powder from different materials to be used, DED is widely applicable to valuable production work such as for a dissimilar material joint, a graded material, or a part with a special structure.
With regard to parts with a special structure, directional solidification can prospectively be used in the power plant and aerospace industries because it can enhance the stiffness in a specific direction via only a simple process. However, conventional approaches for directional solidification require a special mold in order to realize a long-lasting thermal gradient in the part. On the other hand, from the viewpoint of thermal distribution in a produced part, DED is able to control the gradient by controlling the position of the molten pool, i.e., the position of the laser spot. Moreover, unlike casting, the thermal gradient can be precisely oriented in the expected direction, because the laser supplies heat energy on the regulated spot.
In this study, the applicability of DED to directional solidification in Inconel® 625 is theoretically and experimentally evaluated through metal structure observation and Vickers hardness measurements. Furthermore, the effect of two different cooling processes on directional solidification is also considered with the aim of improving the mechanical stiffness of a part produced by DED. The observations and experimental results show that both the cooling methods (baseplate cooling and intermittent treatment with coolant) are able to enhance the hardness while retaining the anisotropy.
Layerwise In-Process Quality Monitoring in Laser Powder Bed Fusion
Authors: Imani Farhad , Gaikwad Aniruddha , Montazeri Mohammad , Rao Prahalada , Yang Hui , Reutzel Edward 
Published: September 2018

The goal of this work is to understand the effect of process conditions on part porosity in laser powder bed fusion (LPBF) Additive Manufacturing (AM) process, and subsequently, detect the onset of process conditions that lead to porosity from in-process sensor data. In pursuit of this goal, the objectives of this work are two-fold:
(1) Quantify the count (number), size and location of pores as a function of three LPBF process parameters, namely, the hatch spacing (H), laser velocity (V), and laser power (P).
(2) Monitor and identify process conditions that are liable to cause porosity through analysis of in-process layer-by-layer optical images of the build invoking multifractal and spectral graph theoretic features.
This is important because porosity has a significant impact on the functional integrity of LPBF parts, such as fatigue life. Furthermore, linking process conditions to sensor signatures and defects is the first-step towards in-process quality assurance in LPBF. To achieve the first objective, titanium alloy (Ti-6Al-4V) test cylinders of 10 mm diameter × 25 mm height were built under differing H, V, and P settings on a commercial LPBF machine (EOS M280). The effect of these parameters on count, size and location of pores was quantified based on X-ray computed tomography (XCT) images. To achieve the second objective, layerwise optical images of the powder bed were acquired as the parts were being built. Spectral graph theoretic and multifractal features were extracted from the layer-by-layer images for each test part. Subsequently, these features were linked to the process parameters using machine learning approaches. Through these image-based features, process conditions under which the parts were built was identified with the statistical fidelity over 80% (F-score).
Prevalence of depression in patients with type 2 diabetes mellitus in Spain (the DIADEMA Study) : results from the MADIABETES cohort
Authors: Salinero-Fort Miguel Angel , Gómez-Campelo P , San Andrés-Rebollo F Javier , Cárdenas-Valladolid Juan , Abánades-Herranz Juan C , Carrillo de Santa Pau Enrique , Chico-Moraleja Rosa M , Beamud-Victoria Domingo , de Miguel-Yanes Jose M , Jimenez-Garcia Rodrigo , López-de-Andres Ana , Ramallo-Fariña Yolanda , De Burgos-Lunar Carmen 
Published: September 2018

ObjectiveTo estimate the prevalence of depression in patients diagnosed with type 2 diabetes mellitus (T2DM), and to identify sociodemographic, clinical and psychological factors associated with depression in this population. Additionally, we examine the annual incidence rate of depression among patients with T2DM.MethodsWe performed a large prospective cohort study of patients with T2DM from the Madrid Diabetes Study. The first recruitment drive included 3443 patients. The second recruitment drive included 727 new patients. Data have been collected since 2007 (baseline visit) and annually during the follow-up period (since 2008).ResultsDepression was prevalent in 20.03% of patients (n=592; 95% CI 18.6% to 21.5%) and was associated with previous personal history of depression (OR 6.482; 95% CI 5.138 to 8.178), mental health status below mean (OR 1.423; 95% CI 1.452 to 2.577), neuropathy (OR 1.951; 95% CI 1.423 to 2.674), fair or poor self-reported health status (OR 1.509; 95% CI 1.209 to 1.882), treatment with oral antidiabetic agents plus insulin (OR 1.802; 95% CI 1.364 to 2.380), female gender (OR 1.333; 95% CI 1.009 to 1.761) and blood cholesterol level (OR 1.005; 95% CI 1.002 to 1.009). The variables inversely associated with depression were: being in employment (OR 0.595; 95% CI 0.397 to 0.894), low physical activity (OR 0.552; 95% CI 0.408 to 0.746), systolic blood pressure (OR 0.982; 95% CI 0.971 to 0.992) and social support (OR 0.978; 95% CI 0.963 to 0.993). In patients without depression at baseline, the incidence of depression after 1 year of follow-up was 1.20% (95% CI 1.11% to 2.81%).ConclusionsDepression is very prevalent among patients with T2DM and is associated with several key diabetes-related outcomes. Our results suggest that previous mental status, self-reported health status, gender and several diabetes-related complications are associated with differences in the degree of depression. These findings should alert practitioners to the importance of detecting depression in patients with T2DM.
Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics
Authors: van Beusekom Ilse , Bakhshi-Raiez Ferishta , de Keizer Nicolette F , Dongelmans Dave A , van der Schaaf Marike 
Published: September 2018

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.
Effectiveness and acceptability ofmyo-inositol nutritional supplement in the prevention of gestational diabetes (EMmY): a protocol for a randomised, placebo-controlled, double-blind pilot trial
Authors: Amaefule Chiamaka Esther , Drymoussi Zoe , Dodds Julie , Sweeney Lorna , Pizzo Elena , Daru Jahnavi , Robson John , Poston Lucilla , Khalil Asma , Myers Jenny , Harden Angela , Hitman Graham A , Khan Khalid , Zamora Javier , Huda Mohammed S B , Thangaratinam Shakila 
Published: September 2018

IntroductionGestational diabetes increases maternal and offspring complications in pregnancy and cardiovascular complications in the long term. The nutritional supplementmyo-inositol may prevent gestational diabetes; however, further evaluation is required, especially in multiethnic high-risk mothers. Our pilot trial onmyo-inositol to prevent gestational diabetes will evaluate trial processes, assess acceptability to mothers and obtain preliminary estimates of effect and cost data prior to a large full-scale trial.Methods and analysisEMmY is a multicentre, placebo-controlled, double-blind, pilot, randomised trial, with qualitative evaluation. We will recruit pregnant women at 12–15+6weeks’ gestation, with gestational diabetes risk factors, from five maternity units in England between 2018 and 2019. We will randomise 200 women to take either 2 g ofmyo-inositol powder (intervention) or placebo, twice daily until delivery. We will assess rates of recruitment, randomisation, adherence to intervention and follow-up. Gestational diabetes will be diagnosed at 24–28 weeks as per the National Institute for Health and Care Excellence (NICE) criteria (fasting plasma glucose: ≥5.6 mmol/L and 2-hour plasma glucose: ≥7.8 mmol/L). We will assess the effects ofmyo-inositol on glycaemic indices at 28 weeks and on other maternal, fetal and neonatal outcomes at postnatal discharge. Qualitative evaluation will explore the acceptability of the trial and the intervention among women and healthcare professionals. Cost data and health-related quality of life measures will be captured. We will summarise feasibility outcomes using standard methods for proportions and other descriptive statistics, and where appropriate, report point estimates of effect sizes (eg, mean differences and relative risks) and associated 95% CIs.Ethics and disseminationEthical approval was obtained through the London Queen Square Research Ethics Committee (17/LO/1741). Study findings will be submitted for publication in peer-reviewed journals. Newsletters will be made available to participants, healthcare professionals and members of Katie’s Team (a patient and public advisory group) to disseminate.Trial registration numberISRCTN48872100.Protocol version and dateVersion 4.0, 15 January 2018.
Acceptability of a German multicentre healthcare research study: a survey of research personnels’ attitudes, experiences and work load
Authors: Blecha Sebastian , Brandstetter Susanne , Dodoo-Schittko Frank , Brandl Magdalena , Graf Bernhard M , Bein Thomas , Apfelbacher Christian 
Published: September 2018

ObjectivesThe DACAPO study as a multicentre nationwide observational healthcare research study investigates the influence of quality of care on the quality of life in patients with acute respiratory distress syndrome. The aim of this study was to investigate the acceptability to the participating research personnels by assessing attitudes, experiences and workload associated with the conduct of the DACAPO study.Design, setting and participantsA prospective anonymous online survey was sent via email account to 169 participants in 65 study centres. The questionnaire included six different domains: (1) training for performing the study; (2) obtaining informed consent; (3) data collection; (4) data entry using the online documentation system; (5) opinion towards the study and (6) personal data. Descriptive data analysis was carried out.ResultsA total of 78 participants took part (46%) in the survey, 75 questionnaires (44%) could be evaluated. 51% were senior medical specialists. 95% considered the time frame of the training as appropriate and the presentation was rated by 93% as good or very good. Time effort for obtaining consent, data collection and entry was considered by 41% as a burden. Support from the coordinating study centre was rated as good or very good by more than 90% of respondents. While the DACAPO study was seen as scientifically relevant by 81%, only 45% considered the study results valuable for improving patient care significantly.ConclusionCollecting feedback on the acceptability of a large multicentre healthcare research study provided important insights. Recruitment and data acquisition was mainly performed by physicians and often regarded as additional time burden in clinical practice. Reducing the amount of data collection and simplifying data entry could facilitate the conduct of healthcare research studies and could improve motivation of researchers in intensive care medicine.Trial registration numberNCT02637011; Pre-results.
Fever is associated with higher morbidity and clot burden in patients with acute pulmonary embolism
Authors: Saad Muhammad , Shaikh Danial H , Mantri Nikhitha , Alemam Ahmed , Zhang Aiyi , Adrish Muhammad 
Published: September 2018

BackgroundFever is considered as a presenting symptom of pulmonary embolism (PE). We aim to evaluate the association between PE and fever, its clinical characteristics, outcomes and role in prognosis.MethodsA retrospective chart review of patients who were hospitalised with the diagnosis of acute PE was conducted. Patients in whom underlying fever could also be attributable to an underlying infection were also excluded.ResultsA total of 241 patients met the study criteria. 63 patients (25.7%) had fever within 1 week of diagnosis of PE of which four patients had fever that could be due to underlying infection and were excluded. Patients in PE with fever group were younger compared with PE without fever group (52.52 vs 58.68, p=0.012) and had higher incidence of smoking (44.1% vs 20.9%, p<0.001). Patients in PE with fever group were more likely to require intensive care admission (69.5% vs 35.7%, p<0.001), had a longer hospital length of stay (19.80 vs 12.20, p<0.001) and higher requirement of mechanical ventilation (30.5% vs 6.6%, p<0.001) compared with those without fever. PE with fever group were more likely to have massive and submassive PE (55.9% vs 36.8%, p=0.015) and had higher incidence of deep vein thrombosis (33.3% vs 17.4%, p=0.0347) compared with PE without fever. In a univariate model, there was higher likelihood of in-hospital mortality in PE with fever group compared with PE without fever (22.0% vs 10.4%, p=0.039).ConclusionPatients with acute PE and fever have higher morbidity and clot burden.
Guideline-defined futility or patient-reported outcomes to assess treatment success after TAVI: what to use? Results from a prospective cohort study with long-term follow-up
Authors: van Mourik Martijn Stefan , Vendrik Jeroen , Abdelghani Mohammad , van Kesteren Floortje , Henriques Jose P S , Driessen Antoine H G , Wykrzykowska Joanna J , de Winter Robbert J , Piek Jan J , Tijssen Jan G , Koch Karel T , Baan Jan , Vis M Marije 
Published: September 2018

ObjectiveTranscatheter aortic valve implantation (TAVI) provides a significant symptom relief and mortality reduction in most patients; however, a substantial group of patients does not experience the same beneficial results according to physician-determined outcomes.MethodsSingle-centre prospective design; the population comprises all consecutive patients undergoing TAVI in 2012–2017. TAVI futility was defined as the combined endpoint of either no symptomatic improvement or mortality at 1 year. We actively gathered telephone follow-up using a predefined questionnaire.ResultsGuideline defined TAVI futility was present in 212/741 patients. Multivariate regression showed lower albumin and non-transfemoral approach to be predictive for futility. In addition to these, chronic obstructive pulmonary disease, lower estimated glomerular filtration rate, atrial fibrillation, low-flow–low-gradient aortic stenosis and lower Body Mass Index were predictive for 1-year mortality. Patients who showed symptomatic benefit estimated the percentage in which their symptoms were remedied higher than patients who did not (80% vs 60%, p<0.001). Guideline-defined TAVI futility occurs frequently, contrasting with patient-reported outcome measures (PROMs). The vast majority in both groups would again choose for TAVI treatment.ConclusionLower albumin and non-transfemoral access route were predictors for guideline-defined TAVI futility, defined as mortality within 1 year or no objective symptomatic improvement in New York Heart Association class. Futility according to this definition occurred frequently in this study, contrasting with much more positive PROMs. The majority of patients would undergo a TAVI again, underlining the patients’ experienced value of TAVI and putting the definition of TAVI futility further on debate. In the near future, less-strict criteria for TAVI futility, that is, using a shorter warranted life expectancy and incorporating patients’ perceived outcomes, should be used.
ЗАСТОСУВАННЯ КВЕСТУ ЯК ТЕХНОЛОГІЇ ПРАКТИКО- ОРІЄНТОВАНОГО НАВЧАННЯ СТУДЕНТІВ МЕДИЧНИХ ВИШІВ
Authors: Kravets N. Ya. , Shevchyk L. O. 
Published: September 2018

Мета роботи – обґрунтування доцільності застосування квест-технологій з метою урізноманітнення навчального процесу, активізації пізнавальної діяльності, розширення сфери інтересів студентів медичних вишів України.Основна частина. У процесі роботи зі студентами найбільш доречно залучати такі форми спільного обговорення проблеми і вироблення загального рішення, котрі дозволяють не лише висловлювати свою думку, погляд і оцінку, а й почути аргументи партнера, часом відмовитися від своєї точки зору або істотно змінити її.Однією з таких технологій, яка вчить знаходити необхідну інформацію, піддавати її аналізу, систематизувати та вирішувати поставлені задачі, власне і є квест.Висновки. Завдяки проведенню інтелектуального квесту студенти мають можливість не лише перевірити власний рівень залишкових знань, дізнатися чимало нових цікавих фактів, а й можуть структурувати вже наявні знання.Роль викладача в ході квесту зводиться до коректного формування змісту завдань; підготовки та розподілення ролей для студентів; створення сприятливих умов у групі для висловлювання власної думки кожного з учасників; ознайомлення студентів з чітко сформованими правилами інтерактивної гри та спрямування їх у правильну сторону розвитку подій.