bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-situ variable stiffness strategy for a planar tensegrity manipulator using quadratic programming
Authors: Chen Yanghui , Luo Jiahui , Liu Jiafu , Xu Xiaoming , Jiang Jianping , Chu Weimeng 
Published: February 2025

Abstract
Tensegrity manipulators are rigid-flexible coupling elastic mechanisms with complex stiffness characteristics. By changing the prestress levels of tensile cables, the manipulators become versatile mechanisms with variable stiffness, offering both improved carrying capacity and significant compliance. However, it is difficult to achieve the desirable pose and desired stiffness simultaneously for tensegrity manipulators due to the strong correlation between the equilibrium pose and the prestress state. This paper proposes an in-situ variable stiffness strategy for the dual-triangle planar tensegrity manipulator (DTPTM), which can change the manipulator's stiffness without changing its pose. First, a static model is developed for the tensegrity manipulator under external constraints in terms of natural coordinates. Then, the tangent stiffness matrix is derived and reduced based on the statics model and the corresponding null space matrix. By constructing the objective function, the variable stiffness strategy is established as a quadratic programming problem to vary the stiffness of all joints. Based on the numerical results, we analyze the range of variable stiffness for the dual-triangle tensegrity (DTT) module and discuss the feasibility of the variable stiffness strategy. Finally, the variable stiffness strategy is verified by various simulation results and validated by hardware experiments of the 2-degree-of-freedom manipulator prototype.
Heart2Heart: a digital peer support programme for people with heart disease: protocol for a community-based, investigator-blinded randomised controlled trial conducted in Australia
Authors: Redfern Julie , Li Emily , Maiorana Andrew , Zecchin Robert , Hyun Karice K , Shi Wendan , Weddell Joseph , Liang Shuang , Candelaria Dion , Briffa Tom , Bauman Adrian , Figtree Gemma , Hackett Maree L , Law Chi Kin , Tu Qiang , Lindley Richard , Gallagher Robyn 
Published: February 2025

IntroductionCardiac rehabilitation is known to reduce morbidity and improve quality of life in people living with heart disease, however, adherence, access and completion of these programmes is suboptimal. Peer support may offer an opportunity to close this service gap. The aim of the study is to determine whether the effectiveness of a digital peer support programme for people living with heart disease is effective in improving social connectedness, clinical and patient-reported outcomes and experience measures.Methods and analysisHeart2Heart is a community-based randomised controlled trial with 6 months follow-up for the primary outcome and 6 and 12 months for secondary outcomes. Approximately 752 adults with a diagnosis of heart disease in the past 12 months will be recruited from the general community and Australian cardiac rehabilitation programmes. Control group will participate in usual care, while intervention group will have access to a 6 months intervention that enables peer support via an interactive mobile application, in addition to usual care. The intervention includes online discussion groups, access to resources and facilitated conversations with health professionals. Primary outcome is social connectedness at 6 months follow-up. Secondary outcomes (6 and 12 months) will be all-cause/cardiovascular disease hospital admissions, all-cause mortality, lifestyle (sufficiently physically active, not smoking, sufficient fruit and vegetable consumption), proportion taking prescribed medications and health service utilisation (medical appointments, cardiac rehabilitation, participation in any other in-person peer support activities). Patient-reported outcome and experience measures including self-efficacy, quality of life, satisfaction and programme engagement will be analysed at 6 months. Process measures will include application analytics, barriers and facilitators to engagement with the intervention from participant’s perspective. An intention-to-treat analysis will be used.Ethics and disseminationEthical clearance was obtained from Western Sydney Local Health District Ethics Committee. Heart2Heart has potential to improve social connectedness and provide a valuable addition to traditional cardiac rehabilitation.Trial registration numberACTRN12624000386538.
Characteristics, outcomes and complications among nonagenarians and centenarians admitted to intensive care: a scoping review protocol
Authors: Suh Je Min , Raykateeraroj Nattaya , Churilov Benjamin , Pilcher David , Bellomo Rinaldo , Lee Dong Kyu , Weinberg Laurence 
Published: February 2025

IntroductionNonagenarians and centenarians, compared with other age groups, often exhibit distinct physiological characteristics and a higher prevalence of comorbidities, thus further complicating their care in intensive care unit (ICU) settings. Despite the increasing number of such patients being admitted to ICUs, comprehensive research and studies on their characteristics, outcomes and complications during their ICU stays remain lacking. This scoping review will comprehensively address the following question: What are the characteristics, outcomes, complications and mortality rates among nonagenarians and centenarians admitted to ICUs, including their preadmission health status, reasons for admission, duration of hospital/ICU stays, and factors associated with adverse outcomes? The key objectives are to map the breadth and depth of the available evidence and identify key concepts, gaps and variations in research focus. Finally, we aim to highlight well-studied areas suitable for systematic synthesis, point to underexplored topics warranting further investigation and propose standardised approaches to research design and reporting in this domain.Methods and analysisWe will conduct a systematic search of MEDLINE, Embase and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. All studies and publications reporting data on patients aged ≥90 years will be included, from an unlimited timeline to 31 August 2024. Studies reporting the characteristics, outcomes and complications of nonagenarians and centenarians admitted to ICUs will be included. The data will be analysed and summarised descriptively through a narrative approach. Qualitative data related to quality-of-life outcomes will be analysed thematically, as applicable.Ethics and disseminationEthics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
Development of a core outcome set for paediatric achalasia: a joint ERNICA, ESPGHAN and EUPSA study protocol
Authors: Neville Jonathan J , den Uijl Iris , Irvine Willemijn , Eaton Simon , Gottrand Frederic , Hall Nigel J 
Published: February 2025

IntroductionAchalasia is a rare disease in children. Studies investigating the efficacy of interventions and disease outcomes in paediatric achalasia are predominantly retrospective, consist of small cohorts and report heterogeneous outcomes. The variation in the use and definition of reported outcomes impedes meta-analysis, which is problematic in a rare paediatric condition. Similarly, there is a risk of under-reporting patient-relevant outcomes, such as quality of life. To overcome these issues, a minimum set of important and patient-relevant outcomes should be reported in all studies of paediatric achalasia. Core outcome sets (COS) are a standardised set of outcomes that can guide further research and facilitate data pooling and meta-analysis. The development of a COS in rare paediatric disease is essential, prior to conducting efficacy studies or creating a disease registry, to ensure that the most important outcomes are reported. Currently, no COS exists for children with achalasia. In this study, we aim to define a COS for paediatric achalasia for use in clinical research.Methods and analysisThis study will consist of three parts. The first will be a systematic review of the literature, evaluating the outcomes and outcome definitions reported in published clinical research studies investigating paediatric achalasia. Second, a three-stage Delphi consensus process will be undertaken to identify and prioritise outcomes. This process will involve healthcare professionals, patients and parent representatives. Third, a consensus meeting will be held, during which the final COS will be defined.DisseminationThe results of this study will be disseminated to stakeholders via the European Reference Network for Rare Inherited Congenital Anomalies, European Society for Pediatric Gastroenterology Hepatology and Nutrition, European Paediatric Surgeons’ Association, and patient groups. The COS will be published in a peer-reviewed journal and uploaded to the Core Outcome Measures in Effectiveness Trials (COMET) initiative website.Trial registration numberThe study was pre-registered with the COMET initiative in July 2024 (https://www.comet-initiative.org/Studies/Details/2568). The systematic review component of the study was pre-registered on PROSPERO (CRD42024509855).
Improving stroke pathway efficiency: outcomes of a quality improvement collaborative across a national stroke network
Authors: Walsh Roisin , Nowlan Naomi , Griffin Emma , McElroy Sinead , O'Grada Colm , Power Sarah , O'Hare Alan , Crockett Matthew , Thornton John , Nicholson Patrick 
Published: February 2025

BackgroundTimely endovascular thrombectomy (EVT) is crucial for improving outcomes in acute ischemic stroke (AIS). This study evaluated the effectiveness of a national quality improvement collaborative (QIC) in reducing process times for potential EVT candidates across a national stroke network.MethodsA pre-post intervention design using a modified Breakthrough Series approach was implemented across 24 hospitals. Multidisciplinary teams participated in monthly learning sessions and action periods focused on reducing ‘Door to Decision’ (time from hospital arrival to EVT decision) to under 30 min. Mixed-effects linear models and mixed-effects ANOVA were used to analyse the impact of the QI program on Door to Decision and Door to CT times, comparing intervention and control cohorts.ResultsThe QI program significantly reduced Door to Decision time in the intervention cohort by 15.9% (p<0.001) from a mean of 92.8 min to 78.9 min. Door to CT time also decreased by 15.6% (p<0.001). No significant changes were observed in the control cohort. Mixed-ANOVA revealed a significant interaction effect for both Door to Decision (p<0.004) and Door to CT (p<0.04), indicating that the QI program impacted these times as compared with the control group. The QIC effectively improved the efficiency of stroke care pathways across a national stroke network. This effect was sustained across the network and over time. This success was facilitated by a bottom-up approach, fostering collaboration and shared learning within and across hospitals.ConclusionsThis study demonstrates the effectiveness of a collaborative, network-wide QI program in reducing critical process times for AIS patients. Continued efforts to sustain these improvements and optimize stroke care pathways are warranted.
Efficacy and Safety of Stellate Ganglion Block for Treating Angina Pectoris: A Systematic Review and Meta‐Analysis
Authors: Wei Ying , Xiong Jian , Li Xiao , Ling Fayang , Zhao Yi , Sun Yuxin , Yao Jin , Hu Jinqun , Yang Liyuan , Liu Yu , Qi Wenchuan , Liang Fanrong 
Published: February 2025

Purpose: This systematic review and meta‐analysis of randomized controlled trials (RCTs) is aimed at assessing the clinical efficacy and safety of stellate ganglion block (SGB) for angina pectoris (AP).Methods: PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were comprehensively searched for RCTs investigating SGB treatment for AP. The retrieval time was from the establishment date of each database to October 10, 2024. The Cochrane risk of bias assessment tool was used to determine the methodological quality. Review Manager 5.4 software was employed for data analysis, and GRADEpro GDT software was utilized to evaluate the quality of evidence.Results: Ultimately, six RCTs were included, encompassing 373 patients with angina. The overall methodological quality of the included studies was moderate, with the evaluation of evidence quality showing 12 low‐quality and five extremely low‐quality studies. The meta‐analysis results demonstrated that compared with the control group, the experimental group had lower frequency and duration of AP, visual analog scale score, heart rate, detection rate of S‐T segment elevation ≥ 0.1 mV on electrocardiogram (ECG) after 24 h of treatment, detection rate of abnormal T waves on ECG after 24 h of treatment, and S‐T segment displacement on ECG after treatment. Furthermore, the experimental group exhibited lower serum Cardiac Troponin I levels, a decreased incidence of acute myocardial infarction (AMI) and rehospitalization, and improved clinical efficacy. However, none of the included studies reported SGB‐related adverse events.Conclusion: SGB is effective in alleviating myocardial injury and reducing the incidence of AMI and rehospitalization in patients with AP. Nevertheless, the limited number and relatively low quality of included studies emphasize the requirement for more high‐quality research to verify these conclusions.
Factors Affecting the Outcome of Vitrectomy With Internal Limiting Membrane Peeling for Myopic Foveoschisis
Authors: Yang Lie , Wang Jialin , Zhao Lu , Zhou Zhuohua , Huang Yingxiang , Wang Yanling 
Published: February 2025

Purpose: To evaluate the short‐ and long‐term effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling on visual acuity and macular morphology in myopic foveoschisis (MF) patients and to identify potential prognostic factors.Methods: We retrospectively analyzed the clinical data of patients with MF who underwent PPV with ILM peeling by the same senior fundus surgeon at Beijing Friendship Hospital from January 2016 to December 2022. The peeling was strategically centered on the macular fovea, extending to encompass the superotemporal and inferotemporal vascular arcades. Univariate analysis and multivariate logistic regression analysis were conducted to screen out the prognostic factors.Results: 36 eyes of 36 consecutive patients were analyzed in total. Best‐corrected visual acuity (BCVA) improved significantly from 1.10 ± 0.61 logMAR to 0.78 ± 0.58 logMAR (p = 0.031). 23 eyes (63.89%) had postoperative BCVA improved ≥ 2 Snellen lines. The mean central fovea thickness (CFT) decreased from 427.14 ± 255.91 μm to 155.85 ± 67.33 μm (p < 0.001). 18 and 16 eyes achieved partial and complete retinal reattachment, respectively, as follows. The twelfth month postoperatively was a threshold to influence the resolution of MF significantly, but it did not affect the visual outcome. Multiple logistic regression showed CFT (OR = 1.007, 95% CI = 1.001, 1.013, p value = 0.034) remained significant to predict the complete retina resolution. For visual acuity, integrated ellipsoid zone (EZ) band (OR = 0.239, 95% CI = 0.073, 0.783, p value = 0.018) might be a significant predictive factor. Subgroup analysis further indicated that in eyes with an intact EZ band, a poorer baseline BCVA was associated with an increase in postoperative BCVA (p = 0.015). Conversely, in those with disrupted EZ band, all included factors showed no significant difference.Conclusion: The study observed trends in the recovery pattern of the retina following surgery and suggested potential factors that may be associated with improvements in both visual acuity and retinal reattachment. The findings may offer some guidance to ophthalmic surgeons in considering the timing of surgery, although further research is needed to confirm these trends as definitive predictors.
Meanings of Sexuality in Marriage and Their Associated Factors
Authors: Hien Le Thu , Truong Nguyen Phu , Thao Ta Thi 
Published: February 2025

Abstract
This cross-sectional study examines the meanings of marital sexuality among 180 Vietnamese couples aged 20–40, and their associated factors. The meanings of marital sexuality included: sex as an indicator of couple cohesion and personal image, sex as a reproductive means, and sex as a means for personal pleasure. The results show that the longer the marriage, the higher the level that couples agreed on marital sexuality as a reproductive means and sexual pleasure. The number of children and premarital sex significantly predicted the agreements of marital sexuality as an indicator of couple cohesion and personal image. Being younger and having been married for a longer time were found to be the significant predictors of agreements on marital sexuality as a reproductive means and a means for personal pleasure. The study results highlight the importance of sexuality and its perceived meanings among married couples, and its practical implications in couple counseling and family therapy.
The value of precipitation forecasts to anticipate floods
Authors: Busker Tim , van den Hurk Bart , de Moel Hans , Aerts Jeroen C.J.H. 
Published: February 2025

Abstract
Recent disasters have highlighted the severe local impacts of extreme precipitation, including flash floods, landslides, and urban inundation. Despite significant investments in early-warning systems, these events often catch many people off-guard, emphasizing the need for better translation of warnings into early actions. In this study, we directly address this gap by translating precipitation forecasts from the ECMWF, specifically the Extreme Forecast Index (EFI) and Shift of Tails (SOT), to concrete triggers for early action. Our analysis reveals that such actions, triggered with a 2 to 3-day lead time, have a high Potential Economic Value (PEV) across large parts of Europe. The SOT forecasts generally have higher economic value than EFI, especially at longer lead times. However, the effectiveness of both disappears across most of Europe with a 5-day lead. These results are based on comparing forecasts to the E-OBS dataset for extreme rainfall (> 5-year return period) over 8 years. We apply the optimal warning thresholds found in this analysis to the rainfall event that triggered the July 2021 Western Europe flood disaster. Our results indicate that the EFI and SOT forecasts provided accurate and timely warnings at least 2-3 days in advance, aligning with flood impacts recorded in the EM-DAT dataset. Notably, on a 1-day lead time, the SOT forecasts accurately pointed to the Ahr catchment in Germany with highly exceptional values, providing strong indications of the disaster that unfolded there. This study underscores the value of these rainfall indicators and calls for further testing on more high-impact events.
Measurement of the Service Trade Cost Between China and RCEP Countries and Its Impact on Global Value Chains
Authors: Chu Xiaofei , Li Wenlong , Wang Meng , Li Leyi 
Published: February 2025

This article measures the trade cost in services between China and Regional Comprehensive Partnership Agreement (RCEP) countries from 2005 to 2021 using the Novy gravity model and analyses the impact of services trade costs on the participation of RCEP countries using a two-way fixed-effects model. The results show that bilateral service costs show a downward trend, but the external effects of service costs are quite significant. The impact of services trade costs on the global value chain (GVCs) is negative, suggesting that reducing services trade costs can facilitate countries’ participation in GVCs. The impact of various factors on GVC participation (GVCPAR) is also markedly heterogeneous across countries. Based on the conclusions of the research results, three recommendations are finally put forward to provide some support for RCEP countries to reduce the cost of trade in services and increase the participation in GVCs. JEL Codes: F14, F13, F60
Utilization of Psychiatric Clinical Rating Scales in Tertiary Care Teaching Hospital: A Retrospective Descriptive Study in a Naturalistic Setting
Authors: Ranganathan Pranesh Ram , Ramasamy Sureshkumar 
Published: February 2025

Background: Considering the importance of clinical rating scales in psychiatric evaluation and their academic relevance, this study assessed the extent to which they were utilized in a tertiary care teaching hospital during patients’ hospital stays. Methods: We did a consecutive sampling of patients’ records and retrieved data from medical records of the patients admitted with the diagnoses of schizophrenia, bipolar affective disorder (BPAD), and depressive disorder in the psychiatry wards. Data regarding the use of clinical rating scales (Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), or Hamilton Depression Rating Scale (HDRS)) each week was collected and analyzed accordingly. Results: Out of 50 case records retrieved, the majority (60%) were male. The sample mean age was 37.76 ± 12.78 years. Forty percent of the sample records had schizophrenia, 38% had BPAD-mania, and 22% had depressive disorders. The sample had an average inpatient hospital stay of 17.68 ± 8.25 days. At baseline, only 54% were administered respective clinical rating scales. At the end of the first week, 42% were assessed using clinical rating scales. At the end of the second and third weeks, only 35.9.1% and 13.3% of patients were monitored by rating scales, and the utilization rate declined further, with a downward slump in subsequent weeks. Conclusions: Utilization of clinical rating scales was found to be low in our tertiary care teaching hospital. Postgraduate trainees need more exposure and formal training in applying psychiatric rating scales for better patient care.
Spontaneous retroperitoneal hemorrhage due to rupture of a renal angiolipoma in a 37-week pregnancy: a case of Wünderlich syndrome
Authors: Rodríguez Albarracín Mario , Agudelo Cañon Kelly , Montoya Hurtado Laura , Manrique Porras Brenda 
Published: February 2025

Introduction Wünderlich syndrome is defined as spontaneous, non-traumatic retroperitoneal bleeding, often associated with the rupture of a renal angiomyolipoma. Though rare, this condition is life-threatening if not treated promptly. The syndrome is particularly uncommon during pregnancy, posing significant challenges in diagnosis and management due to overlapping symptoms with other obstetric emergencies. Case Presentation We report the case of a 25-year-old woman at 37 weeks of gestation who presented to the emergency department with hypovolemic shock, left flank pain, and fetal bradycardia. A large retroperitoneal hematoma was discovered during an emergency caesarean section, later identified as secondary to a ruptured renal angiomyolipoma. Despite the critical presentation, a total nephrectomy was performed successfully, and both mother and child had favorable outcomes. Conclusion This case highlights the importance of considering Wünderlich syndrome in differential diagnoses of acute abdominal pain during pregnancy, especially in the presence of shock and renal masses. Prompt interdisciplinary management is crucial for positive maternal and fetal outcomes.