bluuebunny/crossref_metadata_2025_split huggingface dataset:
On the Origins of Vorticity in a Simulated Tornado-Like Vortex
Authors: Dahl Johannes M. L. , Fischer Jannick 
Published: January 2023

Abstract
The authors explore the dynamical origins of rotation of a mature tornado-like vortex (TLV) using an idealized numerical simulation of a supercell thunderstorm. Using 30-min forward parcel trajectories that terminate at the base of the TLV, the vorticity dynamics are analyzed for n = 7 parcels. Aside from the integration of the individual terms of the traditional vorticity equation, an alternative formulation of the vorticity equation and its integral, here referred to as vorticity source decomposition, is employed. This formulation is derived on the basis of Truesdell’s “basic vorticity formula,” which is obtained by first formulating the vorticity in material (Lagrangian) coordinates, and then obtaining the components relative to the fixed spatial (Eulerian) basis by applying the vector transformation rule. The analysis highlights surface drag as the most reliable vorticity source for the rotation at the base of the vortex for the analyzed parcels. Moreover, the vorticity source decomposition exposes the importance of small amounts of vorticity produced baroclinically, which may become significant after sufficient stretching occurs. Further, it is shown that ambient vorticity, upon being rearranged as the trajectories pass through the storm, may for some parcels directly contribute to the rotation of the TLV. Finally, the role of diffusion is addressed using analytical solutions of the steady Burgers–Rott vortex, suggesting that diffusion cannot aid in maintaining the vortex core.
Pseudo-Kussmaul's Sign in Atrioventricular Nodal Reentry Tachycardia: A Prospective, Cohort Study
Authors: Jose Benny , Rane Sameer , Kevadiya Hiren , Dubey Gajendra , Bohora Shomu , Prajapati Jayesh 
Published: January 2023

Aims To study the respiratory variation of right atrial (RA) pressures at baseline and during atrioventricular nodal reentry tachycardia (AVNRT). Methods Of the 23 patients screened, 16 participants with typical AVNRT were included in the study. After ensuring adequate hydration, baseline RA pressures were measured as the height of ‘a’ and ‘v’ waves. The patients were asked to take deep breaths, and the measurements were taken in both inspiration and expiration. Results Of the 16 participants, 14(87.5%) showed a normal fall in the height of ‘a’ and ‘v’ waves with inspiration, 1(6.25%) showed no change and 1(6.25%) showed a rise in height at baseline, p <0.01. During induced AVNRT, the ‘a’ and ‘v’ wave heights increased in 8(50%), remained same in 6(37.5%) and showed a normal fall in 2(12.5%), p = 0.07 for ‘a’ waves and p = 0.09 for ‘v’ waves. When the magnitude and direction of change in ‘a’ and ‘v’ wave height at baseline was compared with AVNRT, it showed a significant difference with 13(81.25%) participants demonstrating positive Pseudo-Kussmaul's sign, p <0.01. Mean age was numerically higher in those with a more considerable inspiratory rise in RA pressures but was not statistically significant, χ2(2) = 3.1, p = 0.21. Conclusions Pseudo-Kussmaul's sign does occur in a substantial number of patients during AVNRT. Clinical appreciation of this phenomenon is possible in half to three-fourth of patients, provided the mean RA pressures are low enough for the variation to be visible in the neck.
Puncture Capsulotomy Technique for Hip Arthroscopy: Midterm Functional Outcomes
Authors: Eberlin Christopher T. , Kucharik Michael P. , Abraham Paul F. , Nazal Mark R. , Conaway William K. , Varady Nathan H. , Martin Scott D. 
Published: January 2023

Background: The most common surgical approaches in hip arthroscopy are interportal and T-capsulotomy. However, these methods may introduce capsular instability. Puncture capsulotomy preserves capsuloligamentous integrity by avoiding iatrogenic transection of the iliofemoral capsular ligament. Purpose: To present minimum 2-year functional outcomes for patients who underwent arthroscopic treatment for acetabular labral tears and concomitant femoroacetabular impingement using the puncture capsulotomy technique. Study Design: Case series; Level of evidence, 4. Methods: The authors conducted a retrospective review of prospectively collected data on patients who underwent arthroscopic acetabular labral tear treatment between December 2013 and May 2019. Included were patients aged ≥18 years who underwent hip arthroscopy by a single surgeon and completed a minimum of 2 years of patient-reported outcome measure (PROM) surveys. Intraoperatively, patients underwent hip arthroscopy via puncture capsulotomy to treat labral tears and any concomitant femoroacetabular impingement. Clinical outcome data consisted of PROMs. Results: A total of 163 hips were included; the mean patient follow-up was 30.4 months (range, 24-60 months; 95% CI, 28.5-32.3 months). Patients had a mean age of 37.9 years (range, 36.1-39.6 years), with a mean body mass index of 25.9 (range, 25.2-26.5). There were significant improvements in mean [95% CI] baseline to final follow-up scores for the 33-Item International Hip Outcome Tool (iHOT-33) (39.6 [36.8-42.4] vs 76.1 [72.7-79.6]), Hip Outcome Score–Activities of Daily Living (70.0 [67.0-73.0] vs 89.3 [87.3-91.3]), modified Harris Hip Score (60.1 [57.9-62.4] vs 84.9 [82.5-87.2]), and Hip Outcome Score–Sports Specific Subscale (41.8 [37.9-45.6] vs 75.7 [71.7-79.7]) ( P < .001 for all). Additionally, the mean [95% CI] visual analog scale pain scores were noted to significantly improve throughout the duration of the postoperative period (from 6.3 [5.9-6.7] to 2.2 [1.8-2.6]; P < .001). There were no incidences of infection, avascular necrosis of the femoral head, dislocation/instability, or femoral neck fracture. At the 2-year follow-up, 81.0%, 62.0%, and 58.9% of hips achieved previously published clinically meaningful iHOT-33 thresholds for minimally clinically important difference, Patient Acceptable Symptom Score, and substantial clinical benefit, respectively. Conclusion: Puncture capsulotomy demonstrated significantly improved functional and clinically meaningful outcomes at a minimum 2-year follow-up, along with a minimal complication rate.
Progressive Failure Analysis of Composite/Aluminum Riveted Joints Subjected to Pull-Through Loading
Authors: Yang Yuxing , Bao Yongjie , Liu Xueshu , Wang Jinlong , Du Fengming 
Published: January 2023

AbstractOut-of-plane mechanical properties of the riveted joints restrict the performance of the wing box assembly of airplane. It is necessary to investigate the pull-through performance of the composite/metal riveted joints in order to guide the riveting design and ensure the safety of the wing box assembly. The progressive failure mechanism of composite/aluminum riveted joint subjected to pull-through loading was investigated by experiments and finite element method. A progressive damage model based on the Hashin-type criteria and zero-thickness cohesive zone method was developed by VUMAT subroutine, which was validated by both open-hole tensile test and three-point bending test. Predicted load-displacement response, failure modes and damage propagation were analysed and compared with the results of the pull-through tests. There are 4 obvious characteristic stages on the load-displacement curve of the pull-through test and that of the finite element model: first load take-up stage, damage stage, second load take-up stage and failure stage. Relative error of stiffness, first load peak and second load peak between finite element method and experiments were 8.1%, − 3.3% and 10.6%, respectively. It was found that the specimen was mainly broken by rivet-penetration fracture and delamination of plies of the composite laminate. And the material within the scope of the rivet head is more dangerous with more serious tensile damages than other regions, especially for 90° plies. This study proposes a numerical method for damage prediction and reveals the progressive failure mechanism of the hybrid material riveted joints subjected to the pull-through loading.
Illuminating the biosynthesis pathway genes involved in bioactive specific monoterpene glycosides in Paeonia veitchii Lynch by a combination of sequencing platforms
Authors: Zhang Shaoshan , Qu-Bie Jun-zhang , Feng Ming-kang , Qu-Bie A-xiang , Huang Yanfei , Zhang Zhi-feng , Yan Xin-jia , Liu Yuan 
Published: January 2023

AbstractBackgroundPaeonia veitchiiLynch, a well-known herb from the Qinghai-Tibet Plateau south of the Himalayas, can synthesize specific monoterpene glycosides (PMGs) with multiple pharmacological activities, and its rhizome has become an indispensable ingredient in many clinical drugs. However, little is known about the molecular background ofP. veitchii, especially the genes involved in the biosynthetic pathway of PMGs.ResultsA corrective full-length transcriptome with 30,827 unigenes was generated by combining next-generation sequencing (NGS) and single-molecule real-time sequencing (SMRT) of six tissues (leaf, stem, petal, ovary, phloem and xylem). The enzymes terpene synthase (TPS), cytochrome P450 (CYP), UDP-glycosyltransferase (UGT), and BAHD acyltransferase, which participate in the biosynthesis of PMGs, were systematically characterized, and their functions related to PMG biosynthesis were analysed. With further insight into TPSs, CYPs, UGTs and BAHDs involved in PMG biosynthesis, the weighted gene coexpression network analysis (WGCNA) method was used to identify the relationships between these genes and PMGs. Finally, 8 TPSs, 22 CYPs, 7 UGTs, and 2 BAHD genes were obtained, and these putative genes were very likely to be involved in the biosynthesis of PMGs. In addition, the expression patterns of the putative genes and the accumulation of PMGs in tissues suggested that all tissues are capable of biosynthesizing PMGs and that aerial plant parts could also be used to extract PMGs.ConclusionWe generated a large-scale transcriptome database across the major tissues inP. veitchii, providing valuable support for further research investigatingP. veitchiiand understanding the genetic information of plants from the Qinghai-Tibet Plateau. TPSs, CYPs, UGTs and BAHDs further contribute to a better understanding of the biology and complexity of PMGs inP. veitchii. Our study will help reveal the mechanisms underlying the biosynthesis pathway of these specific monoterpene glycosides and aid in the comprehensive utilization of this multifunctional plant.
Between empathy and anger: healthcare workers’ perspectives on patient disengagement from antiretroviral treatment in Khayelitsha, South Africa - a qualitative study
Authors: Nhemachena Tsephiso , Späth Carmen , Arendse Kirsten D. , Lebelo Keitumetse , Zokufa Nompumelelo , Cassidy Tali , Whitehouse Katherine , Keene Claire M. , Swartz Alison 
Published: January 2023

AbstractBackground & objectivesThe benefits of long-term adherence to antiretroviral therapy (ART) are countered by interruptions in care ordisengagementfrom care. Healthcare workers (HCWs) play an important role in patient engagement and negative or authoritarian attitudes can drive patients to disengage. However, little is known about HCWs’ perspectives on disengagement. We explored HCWs’ perspectives on ART disengagement in Khayelitsha, a peri-urban area in South Africa with a high HIV burden.MethodSemi-structured interviews were conducted with 30 HCWs in a primary care HIV clinic to explore their perspectives of patients who disengage from ART. HCWs interviewed included clinical (doctors and nurses) and support staff (counsellors, social workers, data clerks, security guards, and occupational therapists). The interview guide asked HCWs about their experience working with patients who interrupt treatment and return to care. Transcripts were audio-recorded, transcribed, and analysed using an inductive thematic analysis approach.ResultsMost participants were knowledgeable about the complexities of disengagement and barriers to sustaining engagement with ART, raising their concerns that disengagement poses a significant public health problem. Participants expressed empathy for patients who interrupted treatment, particularly when the challenges that led to their disengagement were considered reasonable by the HCWs. However, many also expressed feelings of anger and frustration towards these patients, partly because they reported an increase in workload as a result. Some staff, mainly those taking chronic medication themselves, perceived patients who disengage from ART as not taking adequate responsibility for their own health.ConclusionLifelong engagement with HIV care is influenced by many factors including disclosure, family support, and HCW interactions. Findings from this study show that HCWs had contradictory feelings towards disengaged patients, experiencing both empathy and anger. Understanding this could contribute to the development of more nuanced interventions to support staff and encourage true person-centred care, to improve patient outcomes.
An intervention design for promoting quality of life among patients with multiple sclerosis: a protocol with a planning approach for a mixed methods study
Authors: Homayuni Atefeh , Hosseini Zahra 
Published: January 2023

Abstract
Background
Multiple sclerosis is a chronic progressive disease of the central nervous system that affects the patients' quality of life. The disease's complications reduce the quality of life in patients by creating physical, psychological, social and economic problems for the patient and his/her family and reducing the patient's individual and social functioning. The aim of the present study is designing, implementing and evaluating an intervention based on the PRECEDE-PROCEED model to promote the quality of life in people with multiple sclerosis. This paper summarizes the study protocol.

Methods
We will use the PRECEDE-PROCEED model for designing the study. In the first step, the factors affecting quality of life in people with multiple sclerosis will be determined by a qualitative study. In the second step, these factors will be prioritized based on their importance and variability, then behavioral and environmental factors of the most important priority will be identified. In the third step, the predisposing, enabling and reinforcing factors related to the identified priority will be determined by a qualitative directed content analysis. In the fourth step, a questionnaire will be designed and psychometric based on the results of the previous step. The fifth step will be about planning to implement the intervention. In the sixth step, the intervention will be implemented and its effectiveness will be evaluated by process, impact and outcome evaluations.

Discussion
The results of this study will provide information about patients' needs and concerns and thus will contribute to policymakers, government, community, health professionals and families to take the necessary measures to improve quality of life in these patients.
Prevalence and correlates of adolescent pregnancy, motherhood and adverse pregnancy outcomes in Uttar Pradesh and Bihar
Authors: Shri Neha , Singh Mayank , Dhamnetiya Deepak , Bhattacharyya Krittika , Jha Ravi Prakash , Patel Priyanka 
Published: January 2023

AbstractPregnancy during adolescence is a major risk factor for adverse pregnancy outcomes. Further, Motherhood during the adolescent period is identified as a major global health burden. Considering the widely known importance of the negative impact of adolescent pregnancy, motherhood at an early age, and adverse pregnancy outcomes, this paper aims to provide insight into correlates of teen pregnancy, adolescent motherhood and adverse pregnancy outcome. This study utilizes the data from UDAYA survey conducted in Uttar Pradesh and Bihar. The eligible sample size for the study was 4897 married adolescent girls between the ages of 15 and 19 years. Bivariate analysis with a chi-square test of association and Multivariable logistic regression analysis was performed to fulfill the aim of the study. Our study shows that a major proportion of married adolescents (61%) got pregnant before the age of 20 years and around 42% of all adolescent married women gave birth to a child before reaching the age of 20 years. Adolescents who married before the age of 18 years were 1.79 times more likely to experience pregnancy (OR: 1.79; CI: 1.39–2.30) and 3.21 times more likely to experience motherhood (OR: 3.21; CI: 2.33–4.43). In the present study, women who experienced physical violence were at higher risk for having an adverse pregnancy outcome (OR: 1.41; CI: 1.08–1.84) than those who did not experience physical violence. To conclude, regional and national level efforts focused on improving early marriage, education and empowering women and girls can be beneficial.
Predictors for achieving adequate antenatal care visits during pregnancy: a cross-sectional study in rural Northwest Rwanda
Authors: Dusingizimana Theogene , Ramilan Thiagarajah , Weber Janet L. , Iversen Per Ole , Mugabowindekwe Maurice , Ahishakiye Jeannine , Brough Louise 
Published: January 2023

Abstract
Background
Inadequate antenatal care (ANC) in low-income countries has been identified as a risk factor for poor pregnancy outcome. While many countries, including Rwanda, have near universal ANC coverage, a significant proportion of pregnant women do not achieve the recommended regimen of four ANC visits. The present study aimed to explore the factors associated with achieving the recommendation, with an emphasis on the distance from household to health facilities.

Methods
A geo-referenced cross-sectional study was conducted in Rutsiro district, Western province of Rwanda with 360 randomly selected women. Multiple logistic regression analysis including adjusted odd ratio (aOR) were performed to identify factors associated with achieving the recommended four ANC visits.

Results
The majority (65.3%) of women had less than four ANC visits during pregnancy. We found a significant and negative association between distance from household to health facility and achieving the recommended four ANC visits. As the distance increased by 1 km, the odds of achieving the four ANC visits decreased by 19% (aOR = 0.81, P = 0.024). The odds of achieving the recommended four ANC visits were nearly two times higher among mothers with secondary education compared with mothers with primary education or less (aOR = 1.90, P = 0.038). In addition, mothers who responded that their household members always seek health care when necessary had 1.7 times higher odds of achieving four ANC visits compared with those who responded as unable to seek health care (aOR = 1.7, P = 0.041). Furthermore, mothers from poor households had 2.1 times lower odds of achieving four ANC visits than mothers from slightly better-off households (aOR = 2.1, P = 0.028).

Conclusions
Findings from the present study suggest that, in Rutsiro district, travel distance to health facility, coupled with socio-economic constraints, including low education and poverty can make it difficult for pregnant women to achieve the recommended ANC regimen. Innovative strategies are needed to decrease distance by bringing ANC services closer to pregnant women and to enhance ANC seeking behaviour. Interventions should also focus on supporting women to attain at least secondary education level as well as to improve the household socioeconomic status of pregnant women, with a particular focus on women from poor households.
Vulvovaginal yeast infections, gestational diabetes and pregnancy outcome
Authors: Blomberg Leeni , Backman Katri , Kirjavainen Pirkka V. , Karvonen Anne M. , Harju Maijakaisa , Keski-Nisula Leea 
Published: January 2023

Abstract
Background
The primary aim was to evaluate the association between gestational diabetes and blood glucose levels and vulvovaginal yeast infections in pregnancy. Secondly, we clarified the possible associations between maternal and prenatal factors, and birth outcomes and yeast infections.

Methods
Three thousand nine hundred sixty-five pregnant women of the Kuopio Birth Cohort Study (KuBiCo) reported vulvovaginal yeast infections during pregnancy, via electronic questionnaires. Maternal and prenatal data, as well as clinical obstetric and early neonatal outcomes were registered during and after birth. The oral glucose tolerance test was performed on 3,079 women during pregnancy. Logistic regression analysis evaluated the possible multivariable associations between yeast infections, gestational diabetes and other prenatal and maternal factors.

Results
No association was detected between gestational diabetes or blood glucose levels and vulvovaginal yeast infections during pregnancy. In multivariable analysis, women with yeast infections were more often multiparous, with higher education and had used more often antibiotics during pregnancy compared to others. No significant associations were detected in multivariable analysis between infections, the mode of delivery, preterm birth, birth weight or Apgar scores.

Conclusions
Women with reported vulvovaginal yeast infections managed generally well during pregnancy. They had no more gestational diabetes or higher blood glucose levels and their newborns managed equally well during early neonatal period.
Accuracy of the Arabic HCL - 32 and MDQ in detecting patients with bipolar disorder
Authors: Ouali Uta , Zgueb Yosra , Jouini Lamia , Aissa Amina , Jomli Rabaa , Ouertani Abdelhafidh , Omrani Adel , Nacef Fethi , Carta Mauro G. , Preti Antonio 
Published: January 2023

Abstract
Background
Studies about the two most used and validated instruments for the early detection of Bipolar Disorder (BD), the 32 - item Hypomania Checklist (HCL - 32) and the Mood Disorder Questionnaire (MDQ), are scarce in non-Western countries. This study aimed to explore the reliability, factor structure, and criterion validity of their Arabic versions in a sample of Tunisian patients diagnosed with mood disorders.

Methods
The sample included 59 patients with BD, 86 with unipolar Major Depressive Disorder (MDD) and 281 controls. Confirmatory factor analysis was applied to show that a single global score was an appropriate summary measure of the screeners in the sample. Receiver Operating Characteristic analysis was used to assess the capacity of the translated screeners to distinguish patients with BD from those with MDD and controls.

Results
Reliability was good for both tools in all samples. The bifactor implementation of the most reported two-factor model had the best fit for both screeners. Both were able to distinguish patients diagnosed with BD from putatively healthy controls, and equally able to distinguish patients diagnosed with BD from patients with MDD.

Conclusion
Both screeners work best in excluding the presence of BD in patients with MDD, which is an advantage in deciding whether or not to prescribe an antidepressant.