bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multivariate and wavelet-based analysis on the wall pressure fluctuations for propellers in ground effect
Authors: Kamliya Jawahar Hasan , Hanson Liam , Meloni Stefano , Azarpeyvand Mahdi 
Published: September 2024

This study, conducted at the University of Bristol’s aeroacoustic facility, explores the aeroacoustic characteristics of a 10-inch APC propeller in pusher configuration within ground effect conditions. Tested at a rotational speed of 7000 r/min, the propeller’s performance was evaluated at varying distances from the ground. Wall pressure fluctuations near the propeller were measured at eight radial points, complemented by far-field acoustic measurements. Consistent with previous research, distinctive thrust and torque behaviours were observed when operating both in and out of ground effect. Notably, a significant noise increase of approximately 5 dB was observed on the ground’s reflected side, while a reduction of about 14 dB was detected on the shielded side. Higher-order statistical analysis such as skewness and kurtosis revealed substantial effects of tip vortex impingement in ground effect conditions. This study applies two-point statistics and the Corcos model to analyze propeller-induced wall pressure fluctuations. The coherence function effectively captures the intricate dynamics of pressure variations across different spatial locations and frequencies. This approach offers novel insights into the behaviour of boundary layers and flow-induced pressures in the context of propellers operating in the ground effect. Wavelet decomposition was utilized to differentiate the influences of the boundary layer and the acoustic field. This comprehensive analysis highlights the intricate dynamics of propeller operation in ground effect, contributing valuable insights to the field of aeroacoustic research.
Comparative study: High performance polymers of polyphenylene sulfide and polyethylenimine using Taguchi-Topsis optimization approaches
Authors: Öktem Hasan , Konada Naresh Kumar , Karasungur Halit 
Published: September 2024

The role of high-performance thermoplastic products is increasing in the present days because of its excellent physical and mechanical properties and also capable of withstanding critical loads and temperatures. In this study, an attempt was made to improve the mechanical and physical properties of two polymers PPS (Polyphenylene Sulfide) and PEI (Polyethylenimine) by addition of glass fiber as a reinforcement fiber. The glass fiber (GF) content considered as 40 wt% for both the polymers. Injection molding method was used for fabrication of PPS and PEI samples. After fabrication, mechanical tests such as tensile, impact and dimensional shrinkage (%) of samples were calculated. Taguchi and Topsis analysis techniques were applied for evaluation of major influencing parameters and determining the best experiment to be performed on the machine. After conducting the test, PPS polymer exhibited better mechanical strength values and lower shrinkage (%) compared to PEI. The best input parameters kept on the machine were observed to be gate way type, temperature and pressure. The conditions of gate way type 2, temperature 320°C, and a pressure of 100 bar are obtained as the best input parameters to be fixed on the machine for achieving higher values of mechanical strength and lower dimensional shrinkage for both PPS and PEI polymers. Out of these two polymers, PPS exhibited better mechanical and physical properties combining with GF. This polymer can extend its usage as a high-performance polymer for various industrial applications.
Endovascular Treatment of Aortoiliac Aneurysms With the Bell-Bottom Technique: A Systematic Review and Meta-Analysis
Authors: Volteas Panagiotis , Giannopoulos Stefanos , Koudounas Georgios , Asencio Anthony , Chandrashekar Anirudh , Karkos Christos , Virvilis Dimitrios 
Published: September 2024

Objective Aneurysmal degeneration of the common iliac artery (CIA) can pose a challenge to achieve distal landing zone sealing at the time of endovascular abdominal aortic aneurysm repair (EVAR). The aim of this study was to summarize the current literature regarding the bell-bottom technique (BBT) for ectatic CIAs during EVAR. Methods This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible articles were identified through a comprehensive search of PubMed, Scopus, and Cochrane Central published until April 2023. A meta-analysis was conducted using the random effects model and the I2 statistic was used to assess for heterogeneity. The primary endpoints were type Ib/III endoleak, graft occlusion/limb embolization, and reintervention rate. Secondary endpoints included perioperative adverse events and mortality. Results Overall, twenty-six studies and 4332 patients with flared limbs were included. The pooled estimate for type Ib/III endoleak was 4% (95% CI: 2-6, I2 = 85.6%), for reintervention rate was 9% (95% CI: 6-12, I2 = 90.4%), and for overall mortality was 10% (95% CI: 4-19, I2 = 97.3%). No aneurysm related deaths were recorded. Comparative analysis showed similar type Ib/III endoleak, graft occlusion, and reintervention rates between the EVAR BBT, iliac branch endoprosthesis (IBE), and embolization of the internal iliac artery followed by extension of the iliac limb to the external iliac artery (EIE) groups. Conclusions The use of flared limbs could be considered a reasonable first line choice for EVAR cases with CIA ectasia as it is simpler, allows for future IBE or EIE and does not increase the risk for type Ib/III endoleak or graft occlusion. Further comparative studies with longer follow-up are needed.
Perfusion deficit and vessel wall characteristics to predict recurrent ischemic events in medically treated patients with chronic symptomatic anterior circulation large vessel occlusion
Authors: Zhou Chun , Cao Yue-Zhou , Jia Zhen-Yu , Zhao Lin-Bo , Lu Shan-Shan , Xu Xiao-Quan , Shi Hai-Bin , Liu Sheng 
Published: September 2024

Background To investigate the association between perfusion deficit, vessel wall characteristics, and risk of recurrent ischemic events in medically treated patients with chronic symptomatic anterior circulation large vessel occlusion. Methods We retrospectively reviewed chronic symptomatic patients due to anterior circulation large vessel occlusion in our center. All patients received multiparametric magnetic resonance imaging (including perfusion-weighted imaging and high-resolution vessel wall imaging) within 4 weeks to 3 months after symptom onset. The association between baseline clinical or imaging variables and recurrent ischemic events was assessed in bivariate models and multivariable logistic regression to identify independent predictors of recurrence. Results Among 71 enrolled patients, 21.1% (15/71) patients had recurrent ischemic events (nine ischemic strokes and six transient ischemic attacks) during a 2-year follow-up. In bivariate models, hypertension, occlusion with hyperintense signals, the presence of intraluminal thrombus, Tmax >4 s volume, Tmax >6 s volume, Tmax >8 s volume, and Tmax >10 s volume were associated with recurrence (all p < 0.05). In multivariate analysis, hypertension ( p = 0.039, OR 10.057 (95% CI, 1.123–90.048)), higher deficit volume of Tmax >4 s ( p = 0.011, OR 1.012 (95% CI, 1.003–1.021)) and occlusion with hyperintense signal ( p = 0.030, OR 6.732 (95% CI, 1.200–37.772)) were still independent predictors of recurrent ischemic events. Conclusions Besides hypertension history, higher deficit volume of Tmax >4 s and occlusion with hyperintense signal determined using multiparametric MRI are strongly associated with risk for recurrent ischemic events in medically treated patients with chronic symptomatic anterior circulation large vessel occlusion. Future studies are needed to determine the utility of revascularization strategies in such high-risk patients.
A prospective, randomized, controlled, interventional clinical trial to evaluate the safety and efficacy of the medical monopoint reperfusion system for aspiration thrombectomy in acute ischemic stroke patients (SUMMIT MAX): Trial rationale and design
Authors: Dabus Guilherme , Puri Ajit S , McGuinness Ben , Priest Ryan A , Rai Ansaar T , Gross Bradley A , Zaidat Osama O , Hanel Ricardo A , Shazam Hussain M , Shaikh Hamza A , English Joey D , Nguyen Thanh N 
Published: September 2024

Background Treatment of large vessel occlusion (LVO) using mechanical thrombectomy with or without intravenous thrombolysis has demonstrated better outcomes compared to medical treatment alone. Large-bore aspiration catheters have been recently introduced. Their effectiveness and safety have not been demonstrated in a randomized trial. The SUMMIT MAX study is designed to address this question. Methods SUMMIT MAX is a randomized controlled trial where the effectiveness and safety of the large-bore Monopoint Reperfusion system (Route 92 Medical, San Mateo, CA), will be compared to the currently largest available FDA-cleared aspiration thrombectomy device the AXS Vecta Aspiration system (Stryker Neurovascular, Fremont, CA). The study is a multi-center, prospective, randomized, controlled, interventional, open label clinical trial. The hypothesis is that the effectiveness measured by the recanalization rate (modified thrombolysis in cerebrovascular infarction - mTICI) and safety measured by symptomatic intracranial hemorrhage rate (sICH) of the medical monopoint reperfusion system is non-inferior to the AXS Vecta Aspiration system. Results Up to 250 subjects are enrolled with at least 50% of subjects enrolled by US sites. The primary effectiveness endpoint is successful arterial revascularization defined as an mTICI score ≥ 2b after use of the assigned device adjudicated by an independent core lab. The primary safety endpoint is defined as sICH within 24 h (−8/+24) post-procedure. Secondary endpoints include successful arterial revascularization defined as a mTICI score ≥ 2b after use of the assigned device with or without adjunctive therapy; device-related serious adverse events; all asymptomatic hemorrhages; time from groin puncture to final angiogram; and rate of first pass effect defined as mTICI 2b after first pass with the assigned device stratified by age (≤85, ≥ 86). Conclusion SUMMIT MAX is a randomized controlled trial comparing the effectiveness and safety of a new large bore class of aspiration devices to the currently largest FDA-cleared aspiration device available.
Can wound blush be used as an indicator for termination of endovascular procedures in chronic limb-threatening ischemia patients?
Authors: Shahat Mohammed , Taha Ashraf G , Elnaggar Ashraf , Aboloyoun Hesham 
Published: September 2024

Introduction Predicting the outcomes of endovascular revascularization of chronic limb-threatening ischemia (CLTI) patients with foot wounds can be challenging. Angiographic wound blush (WB) assessment has been found to be a helpful tool to assess wound perfusion. The aim of this study is to evaluate WB during endovascular revascularization of CLTI patients and its effects on treatment outcomes. Methods This prospective study included all CLTI patients with foot wounds who underwent successful endovascular revascularization of infrainguinal arterial disease between 2019 and 2021. Patients were grouped according to the WB status into positive WB (group A) and negative WB (group B). Both groups were compared for demographics, comorbidities, clinical picture, and 12-month limb-based patency (LBP) and amputation-free survival (AFS) rates. Results The study included 69 patients of Rutherford classes 5 (46.4%) and 6 (53.6%), with the main arterial lesion located at the femoropopliteal (58%) or infrapopliteal (42%) segments. Completion angiography showed positive WB in 38 (55.1%) patients and negative WB in 31 (44.9%) patients. Both groups were comparable regarding patient presentation, site of the main arterial lesion, and distribution of foot lesions in relation to the feeding artery. The overall 12-month LBP and AFS rates were 21.7% and 39.1%, respectively, with significantly better rates in group A than in group B (LBP, 31.6% vs 9.7%, p = 0.001 and AFS, 54.1% vs 22.2%, p = 0.006, respectively). Successful angiosome-based direct flow to the foot was achieved in 38 patients (55.1%), resulting in significantly better 12-month AFS rates than those with indirect revascularization (54.8% vs 26.3%, p = 0.036, respectively), despite the comparable 12-LBP rates between the direct and indirect revascularization groups (29% vs 15.8%, p = 0.133, respectively). Multivariate logistic regression analysis identified smoking as a significant predictor of a major amputation, whereas positive WB and successful direct revascularization were significant predictors of limb salvage. Conclusions WB can serve as a predictor for AFS and LBP during endovascular revascularization of CLTI patients with foot wounds. A positive WB may guide the decision to conclude an endovascular procedure, potentially avoiding unnecessary complicated maneuvers to recanalize more vessels. Conversely, a negative WB may suggest the need for further revascularization attempts to augment wound perfusion and healing.
The effect of virtual reality distraction on haemodialysis patients’ pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial
Authors: Elzeky Mohamed EH , Salameh Basma , Reshia Fadia Ahmed Abdelkader , Sabry Alaa A , Shahine Noha FM , Mohamed Eman A 
Published: September 2024

Background: Pain and anxiety during arteriovenous fistula (AVF) puncture are crucial factors affecting haemodialysis (HD) patients’ quality of life. Aim: The aim of this study is to assess the effect of virtual reality (VR) distraction on pain, anxiety, satisfaction and haemodynamics during AVF puncture. Methods: This randomised controlled trial study was conducted in a Haemodialysis unit at Mansoura University Hospital. Ninety-six patients were randomly divided into the intervention ( n = 48) and control ( n = 48) groups. Six minutes prior to the puncture, patients in the intervention group used VR glasses to experience a 360° ‘Relax River VR tour’, whereas patients in the control group received no intervention. Results: Following the intervention, pain, anxiety, systolic blood pressure and heart rate were significantly lower, and satisfaction scores were significantly higher in the intervention group than in the control group ( p < 0.05). Conclusion: VR distraction may help alleviate pain, anxiety and increase satisfaction. It may be considered a safe and cost-effective non-pharmacological therapy for HD patients undergoing AVF puncture.
Predictors of labor pain management among pregnant women in Ethiopia: A systematic review and meta-analysis
Authors: Geltore Teketel Ermias , Hadaro Tesfahun Simon , Oshine Woldetsadik , Bekele Merkin , Foto Lakew Lafebo 
Published: September 2024

Background: Labor pain is the nastiest conceivable pain women are involved in during labor and delivery. In this way, the end of labor pain is frequently outlined by myths and equivocalness. Hence, giving a compelling absence of pain in labor remained a challenge specifically in developing countries including Ethiopia. Objectives: This systematic review and meta-analysis aimed to explore the pooled prevalence of labor analgesia and associated factors to pregnant women in Ethiopia. Design: A systematic review and meta-analysis were utilized in agreement with the Preferred Reporting Items for Systematic Reviews. Data Sources: PubMed/Medline, SCOPUS, EMBASE, Web of Science, Google Scholars, and the Cochrane Library and supplemented it with manual were deliberately looked at until January 1–30, 2024. Methods: Two authors independently extricated all principal information utilizing standardized data extraction designs, and the analysis was done utilizing STATA version 17. Heterogeneity over the studies was evaluated utilizing I2 measurement. The funnel plot and Egger’s weighted regression tests were utilized to assess subjective and objective publication biases respectively. Also, the pooled effect of labor pain management and the associations were evaluated utilizing a random-effects model. Results: The general pooled prevalence of labor analgesia in the present study was 23.3% with a (95% confidence interval (CI): 13.5, 33.1). Maternal age (odds ratio (OR): 1.91; 95% CI: 1.11, 2.77), parity of the mother (OR: 0.28; 95% CI: 0.06, 0.63), history of pregnancy misfortune (OR: 0.12; 95% CI: 0.11, 0.36), length of labor (OR: 2.09; 95% CI: 1.06, 3.13), and awareness about labor analgesia (OR: 1.91; 95% CI: 0.34, 3.49) were significantly related with labor analgesia among pregnant women in Ethiopia. Conclusions: The generally pooled prevalence of labor analgesia among pregnant women in Ethiopia was low. Maternal age, parity of the mother, history of pregnancy loss, length of labor, and awareness of labor analgesia were factors influencing labor analgesia among pregnant women in Ethiopia. This finding proposes exceptional consideration to make laboring mothers free of pain by scaling up the strategies and utilizing labor pain administration in a way that universally recognized standards are met. Registration number: PROSPERO CRD: 42024525636
Understanding HIV service preferences of South African women 30–49 years old missing from or linked to care: An exploratory study of Gauteng and Limpopo provinces
Authors: Moolla Aneesa , Galvin Michael , Mongwenyana Constance , Miot Jacqui , Magolego William , Leshabana Patricia , Ngcobo Nkosinathi , Naidoo Nalini , Coetzee Lezanie 
Published: September 2024

Background: The HIV epidemic in sub-Saharan Africa has a disproportionate gender impact, with women bearing the brunt of the epidemic. South Africa carries the largest share of the global HIV burden, with similar trends seen for women due to unequal socio-cultural and economic status. Objectives: This study aims to understand 30–49 year-old women’s barriers and facilitators to accessing HIV services in order to maximize health in resource limited settings and reach women missing from HIV care. Design: Employing a convenience sampling strategy, we recruited, informed, and consented participants at clinics and public areas. Interviews were conducted in respondent’s preferred languages, transcribed verbatim, translated into English if needed, and thematically analyzed using grounded theory. Methods: We conducted 81 interviews with women aged 30–49 either missing from care ( n = 21), having unknown HIV status ( n = 30) or linked to care ( n = 30) within two sites: City of Johannesburg district, Gauteng Province and Mopani district, Limpopo Province. Results: Participants missing from care reported negative staff attitudes, queues, family rejection, medication side effects, and painful blood tests as key deterrents. Participants with an unknown status were deterred by fear of being diagnosed as HIV positive and family rejection, which was similar to women missing from care who often dropped out from care due to actual family rejection. Participants linked to care reported that long queues and staff shortages were challenges but stayed in care due to a will to live for themselves and their children, in addition to counselling and feeling emotionally supported. Interestingly, participants missing from care often accessed medication from friends but, similarly to those with unknown status, noted that they would access care if attended to by supportive nurses and by having non-clinical HIV services. Conclusions: The accounts of women in this research highlight significant improvements needed to address inequities in the fight against HIV in South Africa. Additionally, the healthcare service access preferences of women aged 30–49 need to be further explored quantitatively in order to design policy relevant interventions.
High serum levels of ustekinumab are associated with better clinical outcomes during maintenance treatment for inflammatory bowel disease
Authors: González-Antuña Jaime , Valdés-Delgado Teresa , Maldonado-Pérez Belén , Belvis-Jiménez María , Castro-Laria Luisa , Merino-Bohórquez Vicente , Calleja-Hernández Miguel Ángel , Castro-Martínez Paula , Charpentier Cloe , Argüelles-Arias Federico 
Published: September 2024

Background: Ustekinumab (UST) is an effective treatment option in Crohn’s disease (CD) and ulcerative colitis (UC). However, it still remains unclear if therapeutic drug monitoring could be helpful to guide clinicians. Objectives: The aim of our study was to analyze the relationship between UST through levels (USTTL) and clinical outcomes in real-world inflammatory bowel disease (IBD) patients. Design: We performed a unicentric retrospective study including patients with IBD under UST treatment with at least one level determination. Methods: The following variables were analyzed at the initiation of UST and at each USTTL measurement: clinical response and remission using the Harvey–Bradshaw Index (HBI) for CD and the Partial Mayo Score (pMayo) for UC; biochemical response and remission using fecal calprotectin and C-reactive protein, among others. Two periods were considered: P1 (time between induction and the first determination of USTTL) and P2 (time between USTTL1 and the second determination of USTTL). Results: We included 125 patients, 117 with CD. In P1, 62.4% of patients were on subcutaneous maintenance, and the median USTTL1 was 3.1 μg/mL (1.6–5.3). In 44.8% of CD patients (48/117), clinical remission was achieved, with USTTL1 significantly higher than those who did not achieve remission (3.7 μg/mL (2.3–5.4) vs 2.3 μg/mL (1.1–5.2); p = 0.04). In the 46 patients with two determinations, statistically significant differences were found between variables in P2 versus P1: clinical remission (73.9% vs 21.7%; p = 0.001); USTTL (7.2 μg/mL (4.7–11.7) vs 3.4 μg/mL (1.9–6.4); p < 0.001), HBI (4 (4–4.3) vs 8 (4–9); p < 0.001), pMayo (1 (1–3.3) vs 4.5 (3–5); p = 0.042), and corticosteroid use (26.1% vs 41.3%; p = 0.024). Receiver-Operating-Characteristic (ROC) curves were calculated for clinical remission in P2, with USTTL cutoff value of 6.34 μg/mL for clinical remission and a high rate of intensified patients (98%). Conclusion: High serum levels of UST were associated with clinical remission during treatment for IBD under intensification treatment, with a cutoff point of 6.3 μg/mL.