bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geometric Characteristics of Flapping Foils for Enhanced Propulsive Efficiency
Authors: Kelly John M. , Khalid Muhammad Saif Ullah , Han Pan , Dong Haibo 
Published: February 2023

Abstract
The shape of a foil undergoing a combined pitching heaving motion is critical to its design in applications that demand high efficiency and thrust. This study focuses on understanding of how the shape of a foil affects its propulsive performance. We perform two-dimensional numerical simulations of fluid flows around a flapping foil for different governing parameters in the range of biological swimmers and bio-inspired underwater vehicles. By varying the foil shape using a class-shape transformation method, we investigate a broad range of foil-like shapes. In the study, we also show consistent results with previous studies that a thicker leading-edge and sharper trailing-edge makes for a more efficient foil shape undergoing a flapping motion. In addition, we explain that the performance of the foil is highly sensitive to its shape, specifically the thickness of the foil between the 18th and 50th percent along the chord of the foil. Moreover, we elucidate the flow mechanisms behind variations in performance metrics, particularly focused on constructive interference between the vortices generated at the leading-edge with the trailing-edge vortex, as well as the pressure field differences that lead to higher power consumption in less efficient foil shapes.
Randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery following open globe trauma: The ASCOT study
Authors: Casswell Edward J , Cro Suzie , Cornelius Victoria R , Banerjee Philip J , Zvobgo Tapiwa M , Tudor Edwards Rhiannon , Ezeofor Victory , Anthony Bethany , Shahid Syed Mohammed , Bunce Catey , Kelly Joanna , Murphy Caroline , Robertson Elizabeth , Charteris David 
Published: February 2023

Background/aimsTo investigate the clinical effectiveness of adjunctive triamcinolone acetonide (TA) given at the time of vitreoretinal surgery following open globe trauma (OGT).MethodsA phase 3, multicentre, double-masked randomised controlled trial of patients undergoing vitrectomy following OGT comparing adjunctive TA (intravitreal and subtenons) against standard care (2014–2020). The primary outcome was the proportion of patients with at least 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letter improvement in corrected visual acuity (VA) at 6 months. Secondary outcomes included: change in ETDRS, retinal detachment (RD) secondary to PVR, retinal reattachment, macular reattachment, tractional RD, number of operations, hypotony, elevated intraocular pressure and quality of life.Results280 patients were randomised over 75 months, of which 259 completed the study. 46.9% (n=61/130) of patients in the treatment group had a 10-letter improvement in VA compared with 43.4% (n=56/129) of the control group (difference 3.5% (95% CI −8.6% to 15.6%), OR=1.03 (95% CI 0.61 to 1.75), p=0.908)). Secondary outcome measures also failed to show any treatment benefit. For two of the secondary outcome measures, stable complete retinal and macular reattachment, outcomes were worse in the treatment group compared with controls, respectively, 51.6% (n=65/126) vs 64.2% (n=79/123), OR=0.59 (95% CI 0.36 to 0.99), and 54.0% (n=68/126) vs 66.7% (n=82/123), OR=0.59 (95% CI 0.35 to 0.98), for TA vs control.ConclusionThe use of combined intraocular and sub-Tenons capsule TA is not recommended as an adjunct to vitrectomy surgery following OGT.Trial registration numberNCT02873026.
A case–control study on predicting population risk of suicide using health administrative data: a research protocol
Authors: Wang JianLi , Gholi Zadeh Kharrat Fatemeh , Pelletier Jean-François , Rochette Louis , Pelletier Eric , Lévesque Pascale , Massamba Victoria , Brousseau-Paradis Camille , Mohammed Mada , Gariépy Geneviève , Gagné Christian , Lesage Alain 
Published: February 2023

IntroductionSuicide has a complex aetiology and is a result of the interaction among the risk and protective factors at the individual, healthcare system and population levels. Therefore, policy and decision makers and mental health service planners can play an important role in suicide prevention. Although a number of suicide risk predictive tools have been developed, these tools were designed to be used by clinicians for assessing individual risk of suicide. There have been no risk predictive models to be used by policy and decision makers for predicting population risk of suicide at the national, provincial and regional levels. This paper aimed to describe the rationale and methodology for developing risk predictive models for population risk of suicide.Methods and analysisA case–control study design will be used to develop sex-specific risk predictive models for population risk of suicide, using statistical regression and machine learning techniques. Routinely collected health administrative data in Quebec, Canada, and community-level social deprivation and marginalisation data will be used. The developed models will be transformed into the models that can be readily used by policy and decision makers. Two rounds of qualitative interviews with end-users and other stakeholders were proposed to understand their views about the developed models and potential systematic, social and ethical issues for implementation; the first round of qualitative interviews has been completed. We included 9440 suicide cases (7234 males and 2206 females) and 661 780 controls for model development. Three hundred and forty-seven variables at individual, healthcare system and community levels have been identified and will be included in least absolute shrinkage and selection operator regression for feature selection.Ethics and disseminationThis study is approved by the Health Research Ethnics Committee of Dalhousie University, Canada. This study takes an integrated knowledge translation approach, involving knowledge users from the beginning of the process.
Evaluation of an implementation package to deliver the COPD CARE service
Authors: Portillo Edward , Lehmann Molly , Hagen Timothy , Maurer Martha , Kettner Jordyn , Bhardwaj Sonia , Goodrich David , McFarland M Shawn , Virrueta Natasha , Henderson Blake , Birstler Jen , Chui Michelle A 
Published: February 2023

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is estimated to be the leading cause of death in the next 15 years. Patients with COPD suffer from persistent chronic cough, sputum production and exacerbations leading to deteriorating lung function, worsening quality of life and loss of independence. While evidence-based interventions exist to improve the well-being of patients with COPD, incorporation of these interventions into routine clinical care is challenging. Chronic Obstructive Pulmonary Disease Coordinated Access to Reduce Exacerbations (COPD CARE) is a team-based, coordinated care transitions service integrating evidence-based interventions for COPD management within the patient care delivery model to reduce readmissions. This evaluation considers the process of scaling the COPD CARE service across medical facilities using an implementation package designed for service expansion. The implementation package was developed at the United States Veterans Health Administration and implemented at two medical centres. Core dissemination and implementation science methods were applied to guide design and delivery of the implementation package.The aims of this evaluation were to (1) evaluate the impact of the implementation package on use of evidence-based interventions for COPD management and (2) explore clinician perceptions of the implementation package. This prospective mixed-methods quality improvement project included two Plan Do Check Act (PDCA) cycles conducted over a 24-month period. Electronic health record data demonstrated significant improvements in the count of evidence-based interventions incorporated into routine clinical care after training completion (p<0.001), offering preliminary effectiveness of the package to improve uptake of best practices for COPD management. Clinician perceptions of the implementation package, measured by questionnaire at multiple time points, demonstrated significant improvements for all scales at the end of the final PDCA cycle. Clinicians described the implementation package as positively impacting clinician confidence, interprofessional collaboration and patient care delivery.
Development and acceptance of a new adherence monitoring package to identify non-adherent patients with polypharmacy in primary care: a feasibility study
Authors: Dietrich Fine , Zeller Andreas , Allemann Samuel , Arnet Isabelle 
Published: February 2023

BackgroundAdherence to pharmacotherapy is crucial to prevent symptom deterioration in chronic diseases. However, non-adherence to chronic treatments is prevalent, especially in polypharmacy. Practical tools to assess adherence to polypharmacy in primary care are missing.AimsWe aimed to develop an Adherence Monitoring Package (AMoPac) for general practitioners (GPs) to identify patient non-adherence. We tested the feasibility and acceptance of AMoPac in the primary healthcare setting.MethodsAMoPac was developed based on peer-reviewed literature. It consists in (1) electronic monitoring of patients’ medication intakes for 4 weeks, (2) receiving feedback on intake behaviour by the pharmacist and (3) generating an adherence report to communicate to the GPs. A feasibility study was conducted with heart failure patients. GPs’ acceptance of AMoPac was explored with semistructured interviews. Electronic transmission of the reports into the GP’s electronic health record along with laboratory reports stating N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels was analysed.ResultsWe developed AMoPac and tested its feasibility with six GPs and seven heart failure patients. GPs were satisfied with the adherence report including the pharmaceutical-clinical recommendations. Integrated transmission of adherence reports to GPs was not feasible due to technical incompatibilities. Mean taking adherence was 86.4%±12.8% and three patients had low correct dosing-days (69%, 38% and 36%, respectively). NT-proBNP ranged from 102 to 8561 pg/mL and four patients had elevated values (>1000 pg/mL).ConclusionAMoPac is feasible in the primary healthcare setting, excluding the integrated transmission of adherence reports to GPs. The procedure was highly accepted by GPs and patients. AMoPac fills a gap by combining clinical values with adherence data, and therefore, delivers a multifaceted picture of the patient’s behaviour. In case of unmet adherence, our tool might facilitate the selection of patient-centred approaches to optimise pharmacological therapies in chronic heart failure patients.Trial registration numberNCT04326101.
Safe implementation of surgical innovation: a prospective registry of the Versius Robotic Surgical System
Authors: Soumpasis Ilias , Nashef Samer , Dunning Joel , Moran Paul , Slack Mark 
Published: February 2023

ObjectivesTo describe a new, international, prospective surgical registry developed to accompany the clinical implementation of the Versius Robotic Surgical System by accumulating real-world evidence of its safety and effectiveness.InterventionsThis robotic surgical system was introduced in 2019 for its first live-human case. With its introduction, cumulative database enrollment was initiated across several surgical specialties, with systematic data collection via a secure online platform.Main outcome measuresPre-operative data include diagnosis, planned procedure(s), characteristics (age, sex, body mass index and disease status) and surgical history. Peri-operative data include operative time, intra-operative blood loss and use of blood transfusion products, intra-operative complications, conversion to an alternative technique, return to the operating room prior to discharge and length of hospital stay. Complications and mortality within 90 days of surgery are also recorded.ResultsThe data collected in the registry are analyzed as comparative performance metrics, by meta-analyses or by individual surgeon performance using control method analysis. Continual monitoring of key performance indicators, using various types of analyses and outputs within the registry, have provided meaningful insights that help institutions, teams and individual surgeons to perform most effectively and ensure optimal patient safety.ConclusionsHarnessing the power of large-scale, real-world registry data for routine surveillance of device performance in live-human surgery from first use will enhance the safety and efficacy outcomes of innovative surgical techniques. Data are crucial to driving the evolution of robot-assisted minimal access surgery while minimizing risk to patients.Trial registration numberCTRI/2019/02/017872.
Mental health-related healthcare service utilisation and psychotropic drug dispensation trends in British Columbia during COVID-19 pandemic: a population-based study
Authors: Zandy Moe , El Kurdi Sylvia , Samji Hasina , McKee Geoff , Gustafson Reka , Smolina Kate 
Published: February 2023

BackgroundThe impact of the COVID-19 pandemic on the population’s mental health is vital for informing public health policy and decision-making. However, information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited.AimsWe examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared with the prepandemic period.MethodsWe conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits, emergency department visits, hospital admissions and psychotropic drug dispensations. We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). In addition, we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic, stratified by year, sex, age and condition.ResultsBy late 2020, except for emergency department visits, utilisation of healthcare services recovered to prepandemic levels. Between 2019 and 2021, the monthly average rate for overall mental health-related outpatient physician visits, emergency department visits and psychotropic drug dispensations increased significantly by 24%, 5% and 8%, respectively. Notable and statistically significant increases were observed among 10–14 year-olds (44% in outpatient physician visits, 30% in emergency department visits, 55% in hospital admissions and 35% in psychotropic drug dispensations) and 15–19 year-olds (45% in outpatient physician visits, 14% in emergency department visits, 18% in hospital admissions and 34% in psychotropic drug dispensations). Additionally, these increases were more prominent among females than males, with some variation for specific mental health-related conditions.ConclusionsThe increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures. Recovery efforts in British Columbia should consider these findings, especially among the most affected subpopulations, such as adolescents.
Synergistic therapeutic combination with a CAF inhibitor enhances CAR-NK-mediated cytotoxicity via reduction of CAF-released IL-6
Authors: Lee Young Eun , Go Ga-Yeon , Koh Eun-Young , Yoon Han-Na , Seo Minkoo , Hong Seung-Mo , Jeong Ji Hye , Kim Jin-Chul , Cho Duck , Kim Tae Sung , Kim Song Cheol , Jun Eunsung , Jang Mihue 
Published: February 2023

BackgroundCancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) contribute to an impaired functionality of natural killer (NK) cells that have emerged as a promising therapeutic modality. The interaction between CAFs and NK cells within the TME exerts major inhibitory effects on immune responses, indicating CAF-targeted therapies as potential targets for effective NK-mediated cancer killing.MethodsTo overcome CAF-induced NK dysfunction, we selected an antifibrotic drug, nintedanib, for synergistic therapeutic combination. To evaluate synergistic therapeutic efficacy, we established an in vitro 3D Capan2/patient-derived CAF spheroid model or in vivo mixed Capan2/CAF tumor xenograft model. The molecular mechanism of NK-mediated synergistic therapeutic combination with nintedanib was revealed through in vitro experiments. In vivo therapeutic combination efficacy was subsequently evaluated. Additionally, the expression score of target proteins was measured in patient-derived tumor sections by the immunohistochemical method.ResultsNintedanib blocked the platelet-derived growth factor receptor β (PDGFRβ) signaling pathway and diminished the activation and growth of CAFs, markedly reducing CAF-secreted IL-6. Moreover, coadministration of nintedanib improved the mesothelin (MSLN) targeting chimeric antigen receptor-NK-mediated tumor killing abilities in CAF/tumor spheroids or a xenograft model. The synergistic combination resulted in intense NK infiltration in vivo. Nintedanib alone exerted no effects, whereas blockade of IL-6 trans-signaling ameliorated the function of NK cells. The combination of the expression of MSLN and the PDGFRβ+-CAF population area, a potential prognostic/therapeutic marker, was associated with inferior clinical outcomes.ConclusionOur strategy against PDGFRβ+-CAF-containing pancreatic cancer allows improvements in the therapy of pancreatic ductal adenocarcinoma.
Null surface thermodynamics in topologically massive gravity
Authors: Taghiloo Vahid 
Published: February 2023

AbstractWe study three dimensional topologically massive gravity (TMG) in presence of a generic codimension one null boundary. The existence of the boundary is accounted for by enlarging the Hilbert space of the theory by degrees of freedom which only reside at the boundary, the boundary degrees of freedom. The solution phase space of this theory in addition to bulk massive chiral gravitons of the TMG, involves boundary modes which are labeled by surface charges associated with large diffeomorphisms. We show boundary degrees of freedom obey a local thermodynamic description over the solution phase space, null surface thermodynamics, described by a local version of the first law, a local Gibbs–Duhem equation, and local zeroth law. Due to the expansion of the boundary and also the passage of the bulk mode through the boundary, our null surface thermodynamics describes an open boundary system that is generically out of thermal equilibrium.
Adverse Maternal and Infant Outcomes in Women With Chronic Hypertension in France (2010–2018): The Nationwide CONCEPTION Study
Authors: Lailler Grégory , Grave Clémence , Gabet Amélie , Regnault Nolwenn , Deneux‐Tharaux Catherine , Kretz Sandrine , Mounier‐Vehier Claire , Tsatsaris Vassilis , Plu‐Bureau Geneviève , Blacher Jacques , Olié Valérie 
Published: February 2023

Background
It has been suggested that chronic hypertension is a risk factor for negative maternal and fetal outcomes during pregnancy and postpartum. We aimed to estimate the association of chronic hypertension on adverse maternal and infant outcomes and assess the impact of antihypertensive treatment and these outcomes.

Methods and Results
Using data from the French national health data system, we identified and included in the CONCEPTION cohort all women in France who delivered their first child between 2010 and 2018. Chronic hypertension before pregnancy was identified through antihypertensive medication purchases and by diagnosis during hospitalization. We assessed the incidence risk ratios (IRRs) of maternofetal outcomes using Poisson models. A total of 2 822 616 women were included, and 42 349 (1.5%) had chronic hypertension and 22 816 were treated during pregnancy. In Poisson models, the adjusted IRR (95% CI) of maternofetal outcomes for women with hypertension were as follows: 1.76 (1.54–2.01) for infant death, 1.73 (1.60–1.87) for small gestational age, 2.14 (1.89–2.43) for preterm birth, 4.58 (4.41–4.75) for preeclampsia, 1.33 (1.27–1.39) for cesarean delivery, 1.84 (1.47–2.31) for venous thromboembolism, 2.62 (1.71–4.01) for stroke or acute coronary syndrome, and 3.54 (2.11–5.93) for maternal death postpartum. In women with chronic hypertension, being treated with an antihypertensive drug during pregnancy was associated with a significantly lower risk of obstetric hemorrhage, stroke, and acute coronary syndrome during pregnancy and postpartum.

Conclusions
Chronic hypertension is a major risk factor of infant and maternal negative outcomes. In women with chronic hypertension, the risk of pregnancy and postpartum cardiovascular events may be decreased by antihypertensive treatment during pregnancy.
Sex‐Specific Reproductive Factors Augment Cardiovascular Disease Risk in Women: A Mendelian Randomization Study
Authors: Ardissino Maddalena , Slob Eric A. W. , Carter Paul , Rogne Tormod , Girling Joanna , Burgess Stephen , Ng Fu Siong 
Published: February 2023

Background
Observational studies suggest that reproductive factors are associated with cardiovascular disease, but these are liable to influence by residual confounding. This study explores the causal relevance of reproductive factors on cardiovascular disease in women using Mendelian randomization.

Methods and Results

Uncorrelated (
r
2
<0.001), genome‐wide significant (
P
<5×10
−8
) single‐nucleotide polymorphisms were extracted from sex‐specific genome‐wide association studies of age at first birth, number of live births, age at menarche, and age at menopause. Inverse‐variance weighted Mendelian randomization was used for primary analyses on outcomes of atrial fibrillation, coronary artery disease, heart failure, ischemic stroke, and stroke. Earlier genetically predicted age at first birth increased risk of coronary artery disease (odds ratio [OR] per year, 1.49 [95% CI, 1.28–1.74],
P
=3.72×10
−7
) heart failure (OR, 1.27 [95% CI, 1.06–1.53],
P
=0.009), and stroke (OR, 1.25 [95% CI, 1.00–1.56],
P
=0.048), with partial mediation through body mass index, type 2 diabetes, blood pressure, and cholesterol traits. Higher genetically predicted number of live births increased risk of atrial fibrillation (OR for <2, versus 2, versus >2 live births, 2.91 [95% CI, 1.16–7.29],
P
=0.023), heart failure (OR, 1.90 [95% CI, 1.28–2.82],
P
=0.001), ischemic stroke (OR, 1.86 [95% CI, 1.03–3.37],
P
=0.039), and stroke (OR, 2.07 [95% CI, 1.22–3.52],
P
=0.007). Earlier genetically predicted age at menarche increased risk of coronary artery disease (OR per year, 1.10 [95% CI, 1.06–1.14],
P
=1.68×10
−6
) and heart failure (OR, 1.12 [95% CI, 1.07–1.17],
P
=5.06×10
−7
); both associations were at least partly mediated by body mass index.

Conclusions
These results support a causal role of a number of reproductive factors on cardiovascular disease in women and identify multiple modifiable mediators amenable to clinical intervention.
Mobilizing in the Interest of Others
Authors: Levi Margaret , Ugolnik Zachary 
Published: February 2023

Abstract
A new moral political economy will revise capitalist democracy to ensure flourishing for all. Its principles derive from the recognition that humans are social animals who benefit from reciprocity and cooperation. We argue for attention to mobilizing strategies and governance arrangements that facilitate prosocial behavior and overcome the divisions-racial, political, and otherwise-that block awareness of common interests. We advocate for an expanded and inclusive community of fate whose members see their interests and destines as intertwined.