bluuebunny/crossref_metadata_2025_split huggingface dataset:
The novel strategy of electrical arc furnace design and control approach for voltage flicker investigation
Authors: Thakre Mohan P. , C. Tapre Pawan , P. Kadam Deepak , Sharma Mousam , Somnath Kadlag Sunil , Vilas Mahadik Yogesh 
Published: October 2023

Voltage flickers and harmonics are power quality (PQ) problems in the electric system during a variation and arc furnace (AF) adaptability. AF creations must determine a harmonic and flicker. This article evaluates complex AF systems. This article presents a newly established time domain (TD) static become to on an AF's V-I attributes (VIA). Static arc configurations are useful for harmonic analyses, but dynamic methods are needed for PQ studies, especially voltage flicker analysis. The MATLAB-based dynamic AF configuration is simulated for four different configurations. A response with configurations 1 and 4 varies from the real AF outcomes. The simulation results and numerical finding shows that configurations 2 and 3 are much more appropriate and produce better results for minimum 3rd harmonics for arc current, arc voltage, and point of common coupling (PCC) voltage. The novelty of this configuration is that the energy transferred to the load by the AF during the cycle of operation has been identified, making the developed scheme more reliable and dependent on the load's operational conditions. After that, effective applications of these configurations and other configurations' accuracy should be clarified.
Appraising the Causal Role of Risk Factors in Coronary Artery Disease and Stroke: A Systematic Review of Mendelian Randomization Studies
Authors: Georgiou Andrea N. , Zagkos Loukas , Markozannes Georgios , Chalitsios Christos V. , Asimakopoulos Alexandros G. , Xu Wei , Wang Lijuan , Mesa‐Eguiagaray Ines , Zhou Xuan , Loizidou Eleni M. , Kretsavos Nikolaos , Theodoratou Evropi , Gill Dipender , Burgess Stephen , Evangelou Evangelos , Tsilidis Konstantinos K. , Tzoulaki Ioanna 
Published: October 2023

BACKGROUND
Mendelian randomization (MR) offers a powerful approach to study potential causal associations between exposures and health outcomes by using genetic variants associated with an exposure as instrumental variables. In this systematic review, we aimed to summarize previous MR studies and to evaluate the evidence for causality for a broad range of exposures in relation to coronary artery disease and stroke.

METHODS AND RESULTS
MR studies investigating the association of any genetically predicted exposure with coronary artery disease or stroke were identified. Studies were classified into 4 categories built on the significance of the main MR analysis results and its concordance with sensitivity analyses, namely, robust, probable, suggestive, and insufficient. Studies reporting associations that did not perform any sensitivity analysis were classified as nonevaluable. We identified 2725 associations eligible for evaluation, examining 535 distinct exposures. Of them, 141 were classified as robust, 353 as probable, 110 as suggestive, and 926 had insufficient evidence. The most robust associations were observed for anthropometric traits, lipids, and lipoproteins and type 2 diabetes with coronary artery; disease and clinical measurements with coronary artery disease and stroke; and thrombotic factors with stroke.

CONCLUSIONS
Despite the large number of studies that have been conducted, only a limited number of associations were supported by robust evidence. Approximately half of the studies reporting associations presented an MR sensitivity analysis along with the main analysis that further supported the causality of associations. Future research should focus on more thorough assessments of sensitivity MR analyses and further assessments of mediation effects or nonlinearity of associations.
Uric Acid Levels, Number of Standard Modifiable Cardiovascular Risk Factors, and Prognosis in Patients With Coronary Artery Disease: A Large Cohort Study in Asia
Authors: Cui Kongyong , Song Yanjun , Yin Dong , Song Weihua , Wang Hongjian , Zhu Chenggang , Feng Lei , Fu Rui , Jia Lei , Lu Ye , Zhang Dong , Song Chenxi , Yang Yuejin , Dong Qiuting , Dou Kefei 
Published: October 2023

Background
Serum uric acid (UA) is correlated closely with traditional cardiovascular risk factors, which might interfere with the action of UA, in patients with coronary artery disease. We performed this study to evaluate the prognostic effect of UA levels in individuals with different numbers of standard modifiable cardiovascular risk factors (SMuRFs).

Methods and Results
In this prospective study, we consecutively enrolled 10 486 patients with coronary artery disease. They were stratified into 3 groups according to the tertiles of UA concentrations and, within each UA tertile, further classified into 3 groups by the number of SMuRFs (0–1 versus 2–3 versus 4). The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs), including death, myocardial infarction, stroke, and unplanned revascularization. Over a median follow‐up of 2.4 years, 1233 (11.8%) MACCEs were recorded. Patients with high UA levels developed significantly higher risk of MACCEs than those with low UA levels. In addition, UA levels were positively associated with MACCEs as a continuous variable. More importantly, in patients with 0 to 1 SMuRF, the risks of MACCEs were significantly higher in the high‐UA‐level group (adjusted hazard ratio [HR], 1.469 [95% CI, 1.197–1.804]) and medium‐UA‐level group (adjusted HR, 1.478 [95% CI, 1.012–2.160]), compared with the low‐UA‐level group, whereas no significant association was found between UA levels and the risk of MACCEs in participants with 2 to 3 or 4 SMuRFs.

Conclusions
In patients with coronary artery disease who received evidence‐based secondary prevention therapies, elevated UA levels might affect the prognosis of individuals with 0 to 1 SMuRF but not that of individuals with ≥2 SMuRFs.
On the Imperfect ἐβίβασκεν (Homeric Hymn to Apollo 133) and the Causative Forms of the Paradigm of βαίνω
Authors: Delgado José Miguel Jiménez , Zamora Patricia García 
Published: October 2023

Abstract
The imperfect ἐβίβασκεν (h.Ap. 133) has generally been considered an Ionic imperfect of βίβημι / βιβάω. However, its morphosemantic characteristics instead suggest an imperfect of βιβάσκω, a derivative of the former with the suffix -σκω. This present is used in the classical period with a causative value, but in the archaic period was documented in an inchoative sense. This evolution forms part of the development of a causative present corresponding to the sigmatic aorist of βαίνω that involved different formations until the creation of βιβάζω.
(Re)defining Esotericism
Authors: Engler Steven , Gardiner Mark Q. 
Published: October 2023

Abstract
This article moves past discussing definitions of esotericism to clarifying the nature of definition itself. After reviewing different approaches to definition, we argue that rigid definitions (which propose necessary and sufficient conditions) are problematic, and that fluid definitions (which seek to clarify, explain, teach etc.) are a better alternative. We then discuss homeostatic property cluster definitions, which are like family-resemblance definitions, but with explicit justification for the particular set of defining criteria. We propose a related but more flexible stable property cluster definition of esotericism. It is intended as a useful focus for ongoing discussion, not as a candidate for the single correct definition. Throughout the article, we contrast meaning realism and meaning antirealism (not ontological realism/antirealism), making a case that the latter is more useful in this context. We end by suggesting that our definitional approach has value for exploring both the global spread of western esotericisms and, more importantly, the extent to which esotericism intersects with the semantic fields of comparable categories in other languages and cultures.
Engaging Residents in Community Change: The Critical Role of Trust in the Development of a Promise Neighborhood
Authors: Geller Joanna D. , Doykos Bernadette , Craven Krista , Bess Kimberly D. , Nation Maury 
Published: October 2023

Background Currently, there is great enthusiasm surrounding place-based initiatives for school reform, such as the Harlem Children's Zone, Promise Neighborhoods, and other initiatives that attend to the multiple contexts that influence child development. However, past efforts to bridge schools, families, and communities have been undermined by mistrust between and among stakeholders. Although trust is a building block for effective collaboration, there is little deliberate attention to cultivating it. Purpose The purpose of this paper is to use a case example of a low-income neighborhood currently developing a Promise Neighborhoods initiative to explore how variations in trust between and among community residents, local institutions, and school staff in the problem definition and assessment phase may threaten or facilitate the success of the initiative. Setting We conducted this study in a low-income, predominantly African-American neighborhood in a midsize southeastern city. Participants There were 44 participants, including parents, school administrators and staff, service providers, and high school students. Research Design We used qualitative research methods, including eight focus groups and observations. Data Collection and Analysis Focus groups were audio-recorded and transcribed verbatim. Multiple researchers coded the transcripts. Trust emerged as a key theme through open coding, and we used focused coding to explore this theme in detail. Findings The findings corroborate previous studies that have found relatively low levels of relational trust between residents, between residents and local institutions, and between residents and school staff. Additionally, we identified “seeds of trust” that indicate opportunities to cultivate trusting relationships between stakeholders that can be developed and replicated in this neighborhood and others undertaking similar initiatives. Conclusions Promise Neighborhoods and similar initiatives should intentionally address low levels of trust through activities such as community asset mapping, programs with a deliberate relational focus, and partnerships with agencies that address the systematic roots of trust.
The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee
Authors: Inoue Atsuo , Arai Yuji , Nakagawa Shuji , Yoshihara Yasushi , Kobayashi Masashi , Takahashi Kenji 
Published: October 2023

Background The improvement of flexion contracture is important in knee arthroplasty since residual flexion contracture postoperatively is associated with decreased quality of life and patient satisfaction. In this study, we investigated the effect of bi-cruciate stabilized (BCS)-type total knee arthroplasty (TKA) as compared to posterior stabilized (PS)-type TKA on osteoarthritic primary knees with flexion contractures. Methods 59 TKAs from January 2014 to December 2020, of which 30 were PS-type TKAs (NexGen LPS-flexⓇ; 76.3 years, BMI 27.5) and 29 BCS-type TKAs (Journey IIⓇ; 72.5 years, BMI 28.6), were performed for knee osteoarthritis with preoperative flexion contracture of 15° or greater. Full extension was obtained intraoperatively during all TKAs. Clinical outcomes, radiological evaluations, and the amount of additional distal femoral osteotomy during TKA were evaluated in a retrospective study design. Results The range of motion improved in the both groups. Postoperative flexion contracture was significantly improved in the BCS group. Knee Society Score improved significantly in both groups, with no difference between the two groups. The amount of additional distal femoral osteotomy was 2.5 ± 1.3 mm for the PS group, and 1.8 ± 1.5 mm for the BCS group, showing a significant difference ( p = 0.04). Discussion The BCS-type TKA significantly improved preoperative flexion contracture and reduced the amount of additional distal femoral osteotomy compared to PS-type TKA. This is attributed to the anterior cam in the BCS-type TKA, which leads to a smaller amount of protrusion of the posterior femoral condyle from the posterior margin of the tibial component in the BCS-type in knee extension, as compared to the PS-type.
Safety and Outcomes With Combination Therapy With Sarilumab and Baricitinib for Severe COVID-19 Respiratory Infection in Cancer Patients
Authors: Velez Ana Paula , Handley Guy , Morison Austin , Katzman Ju Hee , kinkhova Olga , Quiltz Rod , Greene John , Pasikhova Yanina 
Published: October 2023

Objectives This study aims to describe the clinical outcomes of combination therapy with sarilumab and baricitinib for severe novel Coronavirus-19 (COVID-19) infection in cancer patients. With this study, we aim to evaluate the role of expanded immunotherapy for severely ill patients with COVID-19 respiratory infections with limited options. The secondary objective is to assess the safety of combination therapy with sarilumab and baricitinib for severe COVID-19 infection. Methods This was a retrospective cohort study of patients admitted to Moffitt Cancer Center with COVID-19 infection between January 2020 and April 2022. Our research received a waiver to sign consent by the patients according to our institutional IRB because it was free of any risk for the patients and respected the patient’s privacy. Following the Institutional IRB approval and relevant Equator guidelines, we collected information on patients with severe COVID-19 infection and received sarilumab and baricitinib. We evaluated the survival rate and safety of combination therapy. All the patient’s information was de-identified to protect their information according to Health Insurance Portability and Accountability Act (HIPAA). Results Four patients were included in the data analysis. Two survived, and two of them died (Table 1). All the patients that survived were previously vaccinated. Among the two patients who died, one was vaccinated, and the other was unvaccinated. All the patients tolerated the combination therapy well, and none of the patients who survived developed secondary infections or COVID-19-associated complications beyond 12 months of discharge. Conclusion Our study explores the potential safe combination use of different immune modulators targeting multiple pathways of the inflammatory cascade for severe and refractory COVID-19 respiratory infections in high-risk oncology patients. The small number of patients in our observational study was a limitation. A larger sample of patients will be needed to conclude more precisely the efficacy of the combination therapy of sarilumab and baricitinib for refractory cases of severe COVID-19 respiratory infection. Moreover, exploring other cytokine release signaling pathway targets may be the key to significantly reducing inflammation and further pulmonary fibrosis with chronic unbearable respiratory sequela.
Physical activity levels before and after the COVID-19 restrictions among Danish adolescents: a retrospective cohort study
Authors: Eilertsen Martin , Riis Allan , Nielsen Anne , Riel Henrik 
Published: October 2023

Aims: It has been suggested that the COVID-19 restrictions may have negatively impacted physical activity (PA) levels, especially among adolescents, who often use organised sports to support their intrinsic motivation for staying active. This study aimed to investigate whether adolescents were less physically active after the COVID-19 restrictions compared with before and examine whether participation in organised sports has changed since the COVID-19 restrictions. Methods: This was a retrospective cohort study of Danish adolescents aged 15 to 19 years. Data was collected using a questionnaire in SurveyXact. The primary variable of interest was moderate or high-intensity PA frequency before and after COVID-19 restrictions (from March 11, 2020, to September 10, 2021). Secondary variables of interest included whether the PA was self-organised (e.g. running, hiking, going to a gym or cycling) or part of an organised sport delivered by a club or other association, before versus after the restrictions. Results: A total of 324 participants responded to the questionnaire. The relative risk of not performing PA at least twice per week after COVID-19 restrictions compared with before was significantly larger (1.44; 95%CI: 1.19 to 1.85, p = 0.005). Before the lockdowns, 190 (59%) were engaged in organised sports compared with 152 (47%) after the restrictions (relative risk: 1.51, 95%CI: 1.19 to 1.92, p < 0.001). Conclusions: Compared with activity levels before the pandemic, adolescents became significantly less physically active following the COVID-19 restrictions, beyond what is typically observed during adolescence. These results emphasise a need for strategies to increase PA levels among adolescents to minimise the long-term negative effects of physical inactivity during adolescence.
A Choice-Based Design Approach to Influence Beneficial Use of a Green Space by Family Caregivers at a Tertiary Care Hospital in India
Authors: Phatak Sanat , Parikh Avani , Saraf Shashank , Mehta Jyoti , Garda Laila , Wadia Shirin 
Published: October 2023

Objectives, Purposes, and Aims: Principles of behavioral economics are now being used across fields in changing human behavior toward perceived benefit. We studied the effectiveness of simple, cost-effective design cues based on these principles, in encouraging use of a neglected outdoor space in a hospital. Background: Benefits of access to nature and green spaces are established in healthcare; however, we found utilization of an outdoor space to be suboptimal. Presenting choices in different ways is known to influence user choice. Methods: We designed four design interventions based to nudge relative-caregivers waiting outside the operation theater toward utilizing an adjoining outdoor balcony. These included making the terrace prominent, reducing indoor sensory stimulation, adding stereotypical elements, and improving usability. We measured usage via video camera data and satisfaction using questionnaires. Results: The number of users and average time per person spent on the balcony increased over the consecutive intervention periods as compared to baseline (trend p < .01 for both), mainly driven by the addition of stereotypical elements. There were no adverse events in the balcony. There was no difference in the satisfaction related outcomes on questionnaire; a larger percentage of positive comments tended to be related to the balcony in the final intervention. Conclusions: Cost-effective design cues nudged patient-caregivers toward spending more time with nature, thus changing behavior toward that with perceived benefits.
Surgical Options for Diabetic Toe Ulcers and Osteomyelitis Technical Tips and a Decision-Making Algorithm
Authors: Yammine Kaissar 
Published: October 2023

Introduction. Diabetic foot ulcers (DFUs) reflect a pivotal event that could lead to serious complications such as amputation and death. Although conservative surgery was reported to have better outcomes when compared to nonsurgical standard of care of forefoot wounds, the surgical management of diabetic toe ulcers (DTUs) is hardly researched. Methods. The aim of this study is to describe the types and techniques of surgical procedures that could be needed when managing DTU. The proposed surgical techniques were based on their outcomes following an evidence-based search of the literature. Results. Six major types of procedures could be used to treat DTUs; (1) interphalangeal joint resection arthroplasty, (2) phalangectomy or internal pedal amputation, (3) distal Syme amputation, (4) percutaneous toe flexor tenotomy, (5) toe fillet flap, and (6) toe amputation. Details on technical tips are described. Conclusion. Based on the location, ulcer grade of the ulcer and the status of the surrounding soft tissue, a surgical decision-making algorithm is proposed to assist surgeons when managing such prevalent conditions. Levels of Evidence: Level V: Expert review
Testicular torsion in Sub-Saharan Africa: a scoping review
Authors: Nedjim Saleh Abdelkerim , Biyouma Marcella D. C. , Mahamat Mahamat Ali , Douglas Arthur , Mbwambo Orgeness Jasper , Mbarouk Mohamed , Hervé Remadji Yanhdet , Salissou Mahamane , Gallouo Messian , Traoré Aboubacar , Ouima Justin Dieudonné ZIBA , Djoua Yannick Joël , Oyibo Ugbede , Rimtebaye Kimassoum , Ouchemi Choua , Angwafor Fru Fobuzshi 
Published: October 2023

AbstractTesticular torsion is a surgical emergency caused by rotation of the vascular pedicle of the testicle around its axis. If left untreated, testicular necrosis can set in, necessitating orchiectomy and loss of the testicle. The authors of this article reviewed articles on testicular torsion published in sub-Saharan Africa. The aim of this work is to establish the patient profile, consultation delay and orchiectomy rate in the sub-Saharan context. Data from the review will be compared with large non-sub-Saharan series and journals. Twenty-three articles were selected for review. All these articles were published between 1985 and 2022. A total of 1410 patients were included in the review. The average age was 19.7 years. The majority of patients were from urban areas. Risk factors for torsion were identified in 9 publications. The mode of hospital admission varied. Acute scrotal pain was the main symptomatology reported. The mean time in hours between onset of symptoms and consultation was 52.5 h. The left side was affected in 46.04% and the right in 49.81%. Four authors reported referral to a health center, and 8 authors reported scrotal ultrasonography. The rate of orchiectomy performed was found in 21 publications, the mean for the review as a whole was 46.4% with extremes of 13.2 and 72%. The orchiectomy rate was 52.4% in studies that reported an initial referral to a health center (patient transfer), versus 36.9% in studies that did not. In studies reporting ultrasound, the orchiectomy rate was 52.5%, compared with 36.9% in those not reporting ultrasound. On the basis of these results, we can formulate the following recommendations and actions: (i) further study of this pathology in sub-Saharan countries; (ii) raise public awareness of this pathology; (iii) train and retrain community workers and health center managers; and (iv) train general practitioners and surgeons in emergency scrototomy, orchidopexy and orchidectomy.