bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrence of ventricular fibrillation in out‐of‐hospital cardiac arrest: Clinical evidence and underlying ionic mechanisms
Authors: Pandit Sandeep V. , Lampe Joshua W. , Silver Annemarie E. 
Published: April 2024

AbstractDefibrillation remains the optimal therapy for terminating ventricular fibrillation (VF) in out‐of‐hospital cardiac arrest (OHCA) patients, with reported shock success rates of ∼90%. A key persistent challenge, however, is the high rate of VF recurrence (∼50–80%) seen during post‐shock cardiopulmonary resuscitation (CPR). Studies have shown that the incidence and time spent in recurrent VF are negatively associated with neurologically‐intact survival. Recurrent VF also results in the administration of extra shocks at escalating energy levels, which can cause cardiac dysfunction. Unfortunately, the mechanisms underlying recurrent VF remain poorly understood. In particular, the role of chest‐compressions (CC) administered during CPR in mediating recurrent VF remains controversial. In this review, we first summarize the available clinical evidence for refibrillation occurring during CPR in OHCA patients, including the postulated contribution of CC and non‐CC related pathways. Next, we examine experimental studies highlighting how CC can re‐induce VF via direct mechano‐electric feedback. We postulate the ionic mechanisms involved by comparison with similar phenomena seen in commotio cordis. Subsequently, the hypothesized contribution of partial cardiac reperfusion (either as a result of CC or CC independent organized rhythm) in re‐initiating VF in a globally ischaemic heart is examined. An overview of the proposed ionic mechanisms contributing to VF recurrence in OHCA during CPR from a cellular level to the whole heart is outlined. Possible therapeutic implications of the proposed mechanistic theories for VF recurrence in OHCA are briefly discussed.
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An Incremental Interpolation Scheme With Discrete Cosine Series Expansion for Multimaterial Topology Optimization
Authors: Wang Zhanyu , Hu Xiaonan , Wang Hongyan , Zeng Qingliang , Bo Renheng , Fang Daining 
Published: April 2024

Abstract
Topology optimization is a powerful tool for structural design, while its computational cost is quite high due to the large number of design variables, especially for multilateral systems. Herein, an incremental interpolation approach with discrete cosine series expansion (DCSE) is established for multilateral topology optimization. A step function with shape coefficients (i.e., ensuring that no extra variables are required as the number of materials increases) and the use of the DCSE together reduces the number of variables (e.g., from 8400 to 120 for the optimization of the clamped–clamped beam with four materials). Remarkably, the proposed approach can effectively bypass the checkerboard problem without using any filter. The enhanced computational efficiency (e.g., a ∼89.2% reduction in computation time from 439.1 s to 47.4 s) of the proposed approach is validated via both 2D and 3D numerical cases.
An Analytical Friction Model for Handling and Spreading of Carbon Fiber Tows for Composite Prepregging Applications
Authors: Garofalo James , Walczyk Daniel 
Published: April 2024

Abstract
A novel co-extrusion system for continuous fiber-reinforced thermoplastic composites in filament and narrow-tape format was designed, fabricated, and tested. The new modified pultrusion process, called In Situ Impregnation, impregnates continuous dry fiber reinforcement tows in situ with thermoplastic matrix for applications ranging from 3D printing using robotic manipulation to automated fiber placement. The technical goal of the system is to directly co-extrude and impregnate a reinforcement fiber tow (carbon) with thermoplastic matrix injected by an extruder fed with thermoplastic pellets. This approach uses inexpensive materials instead of “prepreg” tow in order to streamline the additive manufacturing process, cut costs for advanced composites manufacturing, and deliver fully customizable fiber orientation. The purpose of this paper is to discuss analytical modeling of friction and fiber tensioning in the system which allows for the full impregnation of the fibers. Experiments were conducted on a working pultrusion system where load was adjusted through the tensioning system to better understand the amount of friction throughout the system, the magnitude of tension in the fiber tow, and to validate the models. The resulting friction model can be used by machine designers to estimate the tension in tows, ropes, fibers, etc. in similar tensioning devices, and estimate automated system specifications such as motor requirements. A brief description of the new manufacturing process is also provided. Future work includes commercialization of the technology, automation of the manufacturing system, and further modeling work to predict fiber spreading behavior based on geometric factors.
An Open–Closed Flow Separation in a Compressor Radial Diffuser
Authors: Duquesne Pierre , Dombard Jerome , Poujol Nicolas , Giauque Alexis 
Published: April 2024

Abstract
Large eddy simulations (LES) results are used to track flow separation zones in a splittered vaned radial diffuser near the compressor best efficiency at high rotation speed. The topology analysis reveals some closed separations at the corner of the blade and hub or shroud surface. In addition, an open–closed flow separation at the main blade pressure side is observed for the first time. The surface separation has the shape of a sheet at the blade mid-span, and the associated separation line is delimited only at its downstream extremity by a trailing edge node. This flow separation process is robust to a small shift in operating condition, and the separation surface remains essentially unchanged. A large flowrate variation converts the open–closed separation into a more classic closed separation. The evolution in time of the separation surface is also observed, and the authors conclude to the unsteady existence of the open–closed separation.
Virion-incorporated CD14 enables HIV-1 to bind LPS and initiate TLR4 signaling in immune cells
Authors: Persaud Arvin T. , Khela Jasmin , Fernandes Claire , Chaphekar Deepa , Burnie Jonathan , Tang Vera A. , Colpitts Che C. , Guzzo Christina 
Published: April 2024

ABSTRACT

HIV-1 has a broad range of nuanced interactions with the immune system, and the incorporation of cellular proteins by nascent virions continues to redefine our understanding of the virus-host relationship. Proteins located at the sites of viral egress can be selectively incorporated into the HIV-1 envelope, imparting new functions and phenotypes onto virions, and impacting viral spread and disease. Using virion capture assays and western blot, we show that HIV-1 can incorporate the myeloid antigen CD14 into its viral envelope. Virion-incorporated CD14 remained biologically active and able to bind its natural ligand, bacterial lipopolysaccharide (LPS), as demonstrated by flow virometry and immunoprecipitation assays. Using a Toll-like receptor 4 (TLR4) reporter cell line, we also demonstrated that virions with bound LPS can trigger TLR4 signaling to activate transcription factors that regulate inflammatory gene expression. Complementary assays with THP-1 monocytes demonstrated enhanced secretion of inflammatory cytokines like tumor necrosis factor alpha (TNF-α) and the C-C chemokine ligand 5 (CCL5), when exposed to LPS-loaded virus. These data highlight a new type of interplay between HIV-1 and the myeloid cell compartment, a previously well-established cellular contributor to HIV-1 pathogenesis and inflammation. Persistent gut inflammation is a hallmark of chronic HIV-1 infection, and contributing to this effect is the translocation of microbes across the gut epithelium. Our data herein provide proof of principle that virion-incorporated CD14 could be a novel mechanism through which HIV-1 can drive chronic inflammation, facilitated by HIV-1 particles binding bacterial LPS and initiating inflammatory signaling in TLR4-expressing cells.

IMPORTANCE

HIV-1 establishes a lifelong infection accompanied by numerous immunological changes. Inflammation of the gut epithelia, exacerbated by the loss of mucosal T cells and cytokine dysregulation, persists during HIV-1 infection. Feeding back into this loop of inflammation is the translocation of intestinal microbes across the gut epithelia, resulting in the systemic dissemination of bacterial antigens, like lipopolysaccharide (LPS). Our group previously demonstrated that the LPS receptor, CD14, can be readily incorporated by HIV-1 particles, supporting previous clinical observations of viruses derived from patient plasma. We now show that CD14 can be incorporated by several primary HIV-1 isolates and that this virion-incorporated CD14 can remain functional, enabling HIV-1 to bind to LPS. This subsequently allowed CD14
+
virions to transfer LPS to monocytic cells, eliciting pro-inflammatory signaling and cytokine secretion. We posit here that virion-incorporated CD14 is a potential contributor to the dysregulated immune responses present in the setting of HIV-1 infection.
Miocene vanishing of the Central American Seaway between the Panamá Arc and the South American Plate
Authors: Vallejo-Hincapié Felipe , Pardo-Trujillo Andrés , Barbosa-Espitia Ángel , Aguirre Daniela , Celis Sergio A. , Giraldo-Villegas Carlos A. , Plata-Torres Ángelo , Trejos-Tamayo Raúl , Salazar-Ríos Andrés , Flores José-Abel , Aubry Marie-Pierre , Gallego Fabián , Delgado Eduardo , Foster David 
Published: April 2024

Abstract
A controversy has developed in recent years regarding the timing of the closure of the Central American Seaway. This tectonic event significantly impacted oceanic circulation between the tropical Pacific and Atlantic oceans and resulted in the formation of a land bridge connecting the South and North American continents. The long-held view of a Pliocene age (ca. 3 Ma) for the closure of the Central American Seaway has been challenged by the proposal that the Panamá Arc collided with South America during the Middle Miocene (15–13 Ma) as a deep oceanic gap between them closed along the Uramita suture zone. However, direct geologic evidence from this suture zone to support either interpretation has been lacking. Here, we report on a comprehensive study of three stratigraphic transects across the Uramita suture zone, using a host of methodologies including sedimentological, ichnological, micropaleontological, U-Pb detrital geochronological, and provenance analyses. Our data reveal that lower offshore to slope conditions prevailed in the Central American Seaway along the suture zone during the latest Early to earliest Middle Miocene (16.4–15.1 Ma) and that oceanic conditions there ceased to exist between the Middle and Late Miocene. These results agree with the Middle Miocene age proposed for the Central American Seaway closure along the tectonic boundary. However, other deeper portions of the Central American Seaway persisted in western Colombia, which challenges the notion of a Central American Seaway confined to the suture zone between the Panamá Arc and South American Plate during the Middle Miocene.
Niobium ore genesis in a capsule
Authors: Williams-Jones A.E. , Vasyukova O.V. , Kostyuk A.V. 
Published: April 2024

Abstract
Experiments were conducted to test the hypothesis that carbonatite-hosted Nb deposits owe their origin to the metasomatic alteration of K-feldspar-rich fenite by carbonatitic magma. This involved reacting K-feldspar with a synthetic mixture of CaCO3, MgCO3, Mg(OH)2, CaF2, and Nb2O5. At the experimental conditions, a phlogopite-rich calcite-bearing metasomatic rind containing pyrochlore formed on the K-feldspar. This supports the above hypothesis and also explains the origin of fenite-associated glimmerite, the association of glimmerite with calcite carbonatite, and the genesis of the carbonatite-hosted ores that supply the bulk of the world's niobium.
Building consensus on common features and interoperability use cases for community health information systems: a Delphi study
Authors: Holeman Isaac , Citrin David , Albirair Mohamed , Puttkammer Nancy , Ballard Madeleine , DeRenzi Brian , O'Donovan James , Wasunna Beatrice 
Published: April 2024

IntroductionInformation systems for community health have become increasingly sophisticated and evidence-based in the last decade and they are now the most widely used health information systems in many low-income and middle-income countries. This study aimed to establish consensus regarding key features and interoperability priorities for community health information systems (CHISs).MethodsA Delphi study was conducted among a systematically selected panel of CHIS experts. This impressive pool of experts represented a range of leading global health institutions, with gender and regional balance as well as diversity in their areas of expertise. Through five rounds of iterative surveys and follow-up interviews, the experts established a high degree of consensus. We supplemented the Delphi study findings with a series of focus group discussions with 10 community health worker (CHW) leaders.ResultsCHISs today are expected to adapt to a wide range of local contextual requirements and to support and improve care delivery. While once associated with a single role type (CHWs), these systems are now expected to engage other end users, including patients, supervisors, clinicians and data managers. Of 30 WHO-classified digital health interventions for care providers, experts identified 23 (77%) as being important for CHISs. Case management and care coordination features accounted for more than one-third (14 of 37, 38%) of the core features expected of CHISs today, a higher proportion than any other category. The highest priority use cases for interoperability include CHIS to health management information system monthly reporting and CHIS to electronic medical record referrals.ConclusionCHISs today are expected to be feature-rich, to support a range of user roles in community health systems, and to be highly adaptable to local contextual requirements. Future interoperability efforts, such as CHISs in general, are expected not only to move data efficiently but to strengthen community health systems in ways that measurably improve care.
Innovation adoption, use and implementation in emergency departments during the COVID-19 pandemic
Authors: Huilgol Shreya S , Berdahl Carl T , Qureshi Nabeel , Cohen Catherine C , Mendel Peter , Fischer Shira H 
Published: April 2024

IntroductionDuring a public health emergency like the COVID-19 pandemic, emergency department (ED) clinicians may be able to save more lives if they rapidly identify and implement innovations that are safe and effective. However, there is little research examining clinician decision-making around innovation implementation during public health emergencies and when evidence-based information is limited.ObjectiveThe goals of this study were to understand how ED clinicians decided to implement innovations and to describe the facilitators and challenges they faced during implementation.MethodsWe conducted 3 pilot interviews and 13 focus group discussions with clinicians from eight hospital-based EDs across the USA. Seventeen physicians, seven advanced practice providers, 18 nurses and seven respiratory therapists participated. We used inductive and deductive techniques to perform content and thematic analysis of focus group transcripts.ResultsParticipants cited social media, clinician autonomy, limited resources, organisational culture, supportive leadership and outside experiences as facilitators of trying innovations. Challenges in trying new innovations included limited evidence-based information, evolving guidelines, fear, moral distress and clinician pushback. Facilitators of using innovations in practice included leadership advocating for continued use, signs of patient improvement, ease of adoption and adequate resources. Challenges were the lack of familiarity, no established protocol and limited information dissemination about best practices.ConclusionOur study highlights factors that influenced innovation adoption and implementation in EDs during the COVID-19 pandemic, including how fear and moral distress affected decision-making. Organisations can support the implementation of promising innovations by selecting strong leaders, ensuring clinician psychological safety, providing protocols and resources and highlighting successes.
Determinants of normal haemoglobin concentration among under-five children in Sub-Saharan Africa: a Positive deviance inquiry using cross-sectional study design
Authors: Seifu Beminate Lemma , Tesema Getayeneh Antehunegn , Tebeje Tsion , Legesse Bruck Tesfaye , Yehuala Tirualem Zeleke , Wuneh Abel Gebre , Tadese Zinabu Bekele , Mare Kusse Urmale 
Published: April 2024

BackgroundLow haemoglobin level in children is linked with short-term and long-term consequences including developmental delay. Globally, over half of the children under the age of five years had low haemoglobin concentration. However, there is limited research on the prevalence and determinants of normal haemoglobin concentration among under-five children in sub-Saharan Africa.ObjectiveTo assess determinants of normal haemoglobin concentration among under-five children in SSA.DesignCross-sectional study design using a positive deviance approachSetting33 SSA countries.Participants129 408 children aged 6–59 monthsPrimary and secondary outcome measuresA multilevel Poisson regression model with robust variance was fitted to identify determinants of normal haemoglobin concentration. An adjusted prevalence ratio with a 95% CI was reported to declare the statistical significance.ResultThe pooled prevalence of normal haemoglobin concentration among under-five children in SSA was 34.9% (95% CI: 34.6% to 35.1%). High maternal education, middle and rich household wealth, female child, frequent antenatal care visits, non-anaemic mothers, taking anthelmintic drugs and normal nutritional status were associated with increased odds of normal haemoglobin concentration. On the other hand, higher birth order, having fever and diarrhoea, rural residence were associated with lower odds of normal haemoglobin levels.ConclusionAccording to our finding, only four out of 10 under-five children in SSA had a normal haemoglobin level. This finding proved that anaemia among children in SSA remains a serious public health concern. Therefore, improving maternal education, provision of drugs for an intestinal parasite and early detection and treatment of maternal anaemia, febrile illness and diarrhoeal disease is important.
Prospective cohort study of long-term neurological outcomes in retired elite athletes: the Advanced BiomaRker, Advanced Imaging and Neurocognitive (BRAIN) Health Study protocol
Authors: Zimmerman Karl A , Hain Jessica A , Graham Neil S N , Rooney Erin Jane , Lee Ying , Del-Giovane Martina , Parker Thomas D , Friedland Daniel , Cross Matthew J , Kemp Simon , Wilson Mathew G , Sylvester Richard J , Sharp David J 
Published: April 2024

IntroductionAlthough limited, recent research suggests that contact sport participation might have an adverse long-term effect on brain health. Further work is required to determine whether this includes an increased risk of neurodegenerative disease and/or subsequent changes in cognition and behaviour. The Advanced BiomaRker, Advanced Imaging and Neurocognitive Health Study will prospectively examine the neurological, psychiatric, psychological and general health of retired elite-level rugby union and association football/soccer players.Methods and analysis400 retired athletes will be recruited (200 rugby union and 200 association football players, male and female). Athletes will undergo a detailed clinical assessment, advanced neuroimaging, blood testing for a range of brain health outcomes and neuropsychological assessment longitudinally. Follow-up assessments will be completed at 2 and 4 years after baseline visit. 60 healthy volunteers will be recruited and undergo an aligned assessment protocol including advanced neuroimaging, blood testing and neuropsychological assessment. We will describe the previous exposure to head injuries across the cohort and investigate relationships between biomarkers of brain injury and clinical outcomes including cognitive performance, clinical diagnoses and psychiatric symptom burden.Ethics and disseminationRelevant ethical approvals have been granted by the Camberwell St Giles Research Ethics Committee (Ref: 17/LO/2066). The study findings will be disseminated through manuscripts in clinical/academic journals, presentations at professional conferences and through participant and stakeholder communications.
What impact have the IOC medical consensus statements made on athlete health? A survey of medical commissions from National Olympic/Paralympic Committees and International Sports Federations
Authors: Fortington Lauren Victoria , Badenhorst Marelise , Derman Wayne , Emery Carolyn , Pasanen Kati , Schwellnus Martin , Verhagen Evert , Finch Caroline F 
Published: April 2024

BackgroundThe International Olympic Committee (IOC) Medical and Scientific Commission has supported collating and sharing evidence globally by developing sports medicine consensus statements (‘Statements’'). Publishing the Statements requires substantial resources that must be balanced by use and impact on policy and practice. This study aimed to gain a better understanding of awareness and uptake of the Statements globally through a survey of the National Olympic Committees (NOC), National Paralympic Committees (NPC) and International Federations (IF).MethodA cross-sectional survey of medical commission representatives from NOCs/NPCs/IFs. A structured questionnaire was distributed through the IOC head office, informed by prior research. Questions comprised a mix of closed and open-text responses with results presented descriptively by organisation type and total.Results55 responses were included: 29 (52%) from NOC/NPC representatives (response rate 14%) and 26 (47%) from IF representatives (response rate 63%). All Statements had been used by at least one respondent, with the Statement addressing concussion ranked highest (used by 33/55). The main barriers to use were financial limitations (n=21), club/sport culture and behaviours (n=19) and lack of understanding from coaches/team sport personnel (n=19). Participants believed the Statements were a successful strategy for improving athlete health (n=39/51 agree or strongly agree).ConclusionThere was clear support for the continued development of sports medicine guidance, including in the format of these Statements. To ensure Statements lead to demonstrable health benefits for athletes, input from athletes, coaches and supporting staff is needed, as well as clearer identification of the purpose and audience of each topic developed.