bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Engineering Approach for Estimating the Radiation Efficiency of Orthogonally Stiffened Plates
Authors: Knuth Christopher , Squicciarini Giacomo , Thompson David 
Published: January 2023

AbstractA systematic investigation of the sound radiation of orthogonally stiffened plates is presented using a numerical procedure that combines the finite element method with the Rayleigh integral. Results are computed for stiffened plates with different numbers of stiffeners, stiffener depth, and plate thickness to investigate the dependence on the most important parameters. Differences between the radiation efficiency of stiffened plates and unstiffened panels are seen. In the monopole region, the result depends on the mode that dominates the response. For excitation within a bay, the radiation efficiency is reduced to that of the single bay if the stiffeners are stiff enough. If excited on a stiffener, the plate tends to radiate sound over its full surface area. In the short-circuiting region, on average, the radiation efficiency is equal to that of a smaller bay-sized panel with clamped edges, regardless of the excitation position. Results from the systematic study of 120 numerical cases are used to develop asymptotic formulae for the radiation efficiency of stiffened plates based on existing formulae for unstiffened panels. For all tested configurations, the average difference between the formulae and the numerical calculations was 0.3 dB over the whole frequency spectrum, with a standard deviation of ± 1.5 dB. Between the frequency bands, the mean value varied between −2 and 3 dB, with a standard deviation of up to ± 1.5 dB in the monopole region and up to ± 5 dB in the short-circuiting region.
Accelerating Hybrid Systems Differential Dynamic Programming
Authors: Nganga John N. , Wensing Patrick M. 
Published: January 2023

Abstract
This letter presents approaches that reduce the computational demand of including second-order dynamics sensitivity information into optimization algorithms for robots in contact with the environment. A full second-order differential dynamic programming (DDP) algorithm is presented where all the necessary dynamics partial derivatives are computed with the same complexity as DDP’s first-order counterpart, the iterative linear quadratic regulator (iLQR). Compared to linearized models used in iLQR, DDP more accurately represents the dynamics locally, but it is not often used since the second-order partials of the dynamics are tensorial and expensive to compute. This work illustrates how to avoid the need for computing the derivative tensor by instead leveraging reverse-mode accumulation of derivatives, extending previous work for unconstrained systems. We exploit the structure of the contact-constrained dynamics in this process. The performance of the proposed approaches is benchmarked with a simulated model of the MIT Mini Cheetah executing a bounding gait.
The “Face” of Coach Development: A Systematic Review of the Role of the Coach Developer
Authors: Jones Timothy , Allen Justine , Macdonald Stephen 
Published: January 2023

The purpose of this paper was to systematically review the peer-reviewed literature on the role of the coach developer (CD). Three questions guided this review: (a) who is the CD, (b) what do they do, and (c) how do they do it? Using five electronic databases—SPORTDiscus, ERIC, PsycInfo, Web of Science, and Scopus—a total of 595 articles were initially found with 42 identified as appropriate for inclusion following PRISMA guidelines. A further 11 were added, via the screening of reference lists and during the process of writing, to total 53 articles. Data analysis comprised of content analysis to describe and identify gaps in the research, and reflexive thematic analysis to facilitate the analysis of the findings from the included studies. Content analysis findings show an increase in researching this role and a breadth of methodology and theoretical frameworks being employed. Utilising reflexive thematic analysis, seven themes were generated to understand the who, what, and how of the CD. Findings suggest a diverse and contextualised appreciation of the various roles the CD undertakes as encompassed by the International Council for Coaching Excellence (ICCE) umbrella term definition. The discussion reveals the complexity of the role as CDs navigate who they are, what they do, and how they do it. Recommendations are made for future research to mediate knowledge gaps and move towards alignment and understanding of this key figure.
Study of the medical service efficiency of county-level public general hospitals based on medical quality constraints: a cross-sectional study
Authors: Li Jing , Guo Binbin , Huang Xiaojun , Wang Huakang , Zuo Guangyan , Lu Wei 
Published: January 2023

ObjectivesSince the new medical reform in 2009, county-level hospitals in China have achieved rapid development, but health resource waste and shortage issues still exist.DesignWe applied the meta-frontier and slacks-based measurement-undesirable data envelopment analysis model to measure the medical service efficiency with or without medical quality constraints of the county-level public general hospitals (CPGHs). The assessment includes four inputs, three desirable outputs and one undesirable output. We conducted the assessment via Max-DEA V.8.19 software. Moreover, we analyse the factors affecting CPGHs’ medical service efficiency based on the fractional response model.SettingA total of 77 sample CPGHs were selected from Shanxi province in China from 2013 to 2018.ResultsThe results of this study showed that the efficiency level of county-level public hospitals in Shanxi Province is relatively low overall (the mean value of efficiency is 0.61 without quality constraints and 0.63 under quality constraints). This showed that ignoring medical quality constraints will result in lower efficiency and lower health resource usage for high medical quality hospitals. The medical service efficiency of CPGHs differs greatly among different regions. Under the meta-frontier, the hospitals in the central region had the highest efficiency (efficiency score 0.70), followed by those in the south (efficiency score 0.63) and the hospitals in the north had the lowest efficiency (efficiency score 0.54). Factors that have larger impacts on the service efficiency of county public hospitals are the average length of hospital stay, per capita disposable income and financial subsidy income.ConclusionsTo improve CPGHs’ medical service efficiency, the government should increase investment in the northern region, and hospitals should improve the management level and allocate human resources rationally.
Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis
Authors: Chen Xinxin , You Jiuhong , Ma Hui , Zhou Mei , Huang Cheng 
Published: January 2023

ObjectiveTo investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for fibromyalgia (FM).DesignA systematic review and meta-analysis.Data sourcesPubMed, EMBASE, Cochrane Library, Web of Science, VIP (China Science and Technology Journal Database), CNKI (China National Knowledge Infrastructure) and WanFang database were searched from from inception to 22 October 2022.Eligibility criteriaWe included clinical trials (randomised controlled and non-randomised controlled trials) of HBOT for FM.Data extraction and synthesisTwo researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Collaboration checklists and the Methodological Index for Non-randomised Studies were used to assess the risk of bias. Meta-analysis was performed by RevMan V.5.4.1 software. Random effect models were used for meta-analysis.ResultsNine studies were included in this review, with a total of 288 patients. For pain assessment, we combined the results of the Visual Analogue Scale and Widespread Pain Index. The results showed that HBOT could relieve the pain of FM patients compared with the control intervention (standardised mean difference=−1.56, 95% CI (−2.18 to –0.93),p<0.001,I2=51%). Most included studies reported that HBOT ameliorated tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM. Adverse events occurred in 44 of 185 patients (23.8%). Twelve patients (6.5%) withdrew because of adverse reactions. No serious adverse events or complications were observed.ConclusionsHBOT might have a positive effect in improving pain, tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM, with reversible side effects. Low pressure (less than 2.0 atmospheric absolute) may be beneficial to reduce adverse events in FM. Further studies should be carried out to evaluate the optimal protocol of HBOT in FM.PROSPERO registration numberCRD42021282920.
Intraoperative infusion of dexmedetomidine for prevention of postoperative delirium in elderly patients undergoing craniotomy: a protocol of randomised clinical trial
Authors: Cui Qianyu , Ma Tingting , Liu Minying , Shen Zhongyuan , Li Shu , Zeng Min , Liu Xiaoyuan , Zhang Liyong , Peng Yuming 
Published: January 2023

IntroductionPostoperative delirium (POD) is a common surgical complication. The incidence is 19% in neurological procedures, and advanced age is a risk factor for neurological procedures. Many studies have shown that dexmedetomidine (DEX) reduced the incidence of delirium after non-cardiac surgery in elderly patients. However, there are few studies focus on the effect of DEX on POD in elderly patients undergoing neurosurgery.Methods and analysisThis is a randomised, double-blinded, paralleled-group and controlled trial. Patients older than 65 years and scheduled for elective craniotomy will be randomly assigned to the DEX group and the control group. After endotracheal intubation, patients in the DEX group will be administered with continuous DEX infusion at rate of 0.4 µg/kg/hour until the surgical haemostasis. In the control group, patients will receive the identical volume of normal saline in the same setting. The primary outcome is the incidence of POD during the first 5 days. Delirium will be evaluated through a combination of three methods, including the Richmond Agitation Sedation Scale (RASS), the confusion assessment method for ICU (CAM-ICU) and the 3 min diagnostic interview for CAM (3D-CAM). The RASS, CAM-ICU and 3D-CAM will be evaluated two times per day (08:00–10:00 and 18:00–20:00 hours) during the first postoperative 5 days. Secondary outcomes include pain severity score, quality of recovery, quality of sleep, cognitive function, psychological health state, intraoperative data, physiological status, length of stay in ICU and hospital, hospitalisation costs, non-delirium complications, and 30-day all-cause mortality.Ethics and disseminationThe protocol (V.4.0) has been approved by the medical ethics committee of Beijing Tiantan Hospital, Capital Medical University (KY2021-194-03). The findings of the study will be disseminated in a peer-reviewed journal and at a scientific conference.Trial registration numberNCT05168280.
Changes in consultation mode during different phases of the COVID-19 pandemic in Croatian family medicine: a cross-sectional study
Authors: Vučak Jasna , Popovic Branislava , Ljubotina Aleksandar , Vojvodić Željko , Sabljak Diana , Zavidić Tina 
Published: January 2023

ObjectivesTo describe the changes in the type, length and reasons for consultations in primary healthcare during the COVID-19 pandemic in Croatia. This study aimed to test a hypothesis regarding the increased workload of general practitioners (GPs) by introducing more virtual consultations (VCs).DesignThe study design was cross-sectional and comprised two phases: retrospective and prospective. The retrospective phase included data from April, May and June of 2019, 2020 and 2021, and the prospective phase included data from 2 weeks in June 2021. Additionally, the number, length and reasons for face-to-face consultations (FTFC), VCs and telephone consultations (TCs) with nurses were collected.Setting and participantsOverall, 6 GPs from different regions in Croatia with 10 125 enlisted patients.Main outcomes measuresThe retrospective phase compared data for consultation types obtained from electronic medical records. The prospective phase collected the number, length and reasons for FTFCs, VCs and TCs with nurses.ResultsFTFCs decreased from 58.1% of the total number of visits in 2019 to 41.2% in 2020, while VC increased from 41.9% in 2019 to 58.8% in 2020. Furthermore, an eightfold increase in email consultations was recorded. The average lengths of an FTFC and TC were 7.13±3.38 and 4.01±2.09 min, respectively; FTFCs were significantly longer than TCs (t=7.038, p<0.0001). There was an increase in the total workload (9.4%) in 2021 compared with 2019.ConclusionCroatian GPs faced changes in work organisation along with increased workload during the pandemic. Despite the shortening of time in FTFCs, the workload has increased due to the increase in VCs. An appropriate legal framework should be implemented for this new form of consultation. Future research is needed to address the impact of these changes on healthcare quality.
Overcoming roadblocks in clinical innovation via high fidelity simulation: use of a phantom simulator to achieve FDA and IRB approval of a clinical trial of fetal embolization of vein of Galen malformations
Authors: Orbach Darren B , Wilkins-Haug Louise E , Benson Carol B , Rangwala Shivani D , Pak Christopher , Saffarzadeh Mona , Weinstock Peter 
Published: January 2023

BackgroundVein of Galen malformation (VOGM) is a rare, life-threatening vascular malformation in neonates and is treated with embolization. However, even at the most experienced centers, patients face high mortality and morbidity. In utero treatment options have been limited by lack of animal models or simulations.ObjectiveTo create a novel ultrasound phantom simulator for a preclinical feasibility study of in utero fetal intervention for VOGM.MethodsNovel phantoms were designed and built in two configurations of spherical and windsock shape from cryogel material to mimic the salient vasculature of the fetal VOGM, based on real-patient fetal MR imaging dimensions. Critical anatomy was realistically mimicked within this model and transtorcular ultrasound-guided coil deployment was simulated. Each phantom model was assessed before and after treatment to evaluate coil mass deposition within the target.ResultsThe two phantoms underwent pretreatment T2-weighted MR imaging assessment, ultrasound-guided embolization, post-treatment MR and fluoroscopic imaging, and visual inspection of the sliced phantoms for target embolization verification. Postoperative MR scans confirmed realistic compact deposition of the coil masses within the central cavity. Phantom embolization results were submitted as part of the institutional review board and US Food and Drug Administration investigative device exemption approval for a first-in-humans clinical trial of fetal intervention for VOGM.ConclusionsA phantom simulator for fetal intervention of VOGM produces lifelike results during trial interventions, removing obstacles to feasibility and safety evaluations, typically precluded by non-availability of appropriate animal models. The study provides a proof of concept for potentially wider applications of medical simulation to enable novel procedural advancements in neurointerventions.
Gallic acid markedly stimulates GLUT1-mediated glucose uptake by the AsPC-1 pancreatic cancer cell line
Authors: Torres Sílvia M. , Carmo Francisca P. , Monteiro Luís C. , Silva Cláudia , Andrade Nelson , Martel Fátima 
Published: January 2023

Phenolic acids are recognized as chemopreventive and chemotherapeutic agents. Altered glucose and glutamine metabolism are recognized hallmarks of cancer cells. We aimed to test the influence of phenolic acids on glucose and glutamine cellular uptake by a breast (MCF-7) and a pancreatic (AsPC-1) cancer cell line. Several phenolic acids (caffeic, ferrulic, proctocatechuic, coumaric and gallic acid) affected 3H-glutamine and/or 3H-deoxy-d-glucose (3H-DG) uptake. Gallic acid (100 µM) caused a 3-fold increase in 3H-DG uptake by AsPC-1 cells, associated with a 3.7-fold increase in lactic acid production. Gallic acid stimulated GLUT1-mediated 3H-DG uptake and increased the affinity of this transporter for 3H-DG. We further verified that gallic acid does not change GLUT1 transcription rates and cellular redox state and that its effect does not involve PI3K, mTOR and MAP kinases and is not associated with a proproliferative effect. Gallic acid also increased 3H-DG uptake by MCF-7 cells, although less potently. Further investigation is necessary to elucidate the cellular pathways involved in this effect of gallic acid.
Dysregulation and Epigenetic Reprogramming of NRF2 Signaling Axis Promote Acquisition of Cisplatin Resistance and Metastasis in Head and Neck Squamous Cell Carcinoma
Authors: Osman Abdullah A. , Arslan Emre , Bartels Mason , Michikawa Chieko , Lindemann Antje , Tomczak Katarzyna , Yu Wangjie , Sandulache Vlad , Ma Wencai , Shen Li , Wang Jing , Singh Anand K. , Frederick Mitchell J. , Spencer Nakia D. , Kovacs Jeffery , Heffernan Timothy , Symmans William F. , Rai Kunal , Myers Jeffrey N. 
Published: January 2023

AbstractPurpose:Cisplatin (CDDP)-based chemotherapy is a first-line treatment for patients with advanced head and neck squamous cell carcinomas (HNSCC), despite a high rate of treatment failures, acquired resistance, and subsequent aggressive behavior. The purpose of this study was to study the mechanism of CDDP resistance and metastasis in HNSCC. We investigated the role of NRF2 pathway activation as a driven event for tumor progression and metastasis of HNSCC.Experimental Design:Human HNSCC cell lines that are highly resistant to CDDP were generated. Clonogenic survival assays and a mouse model of oral cancer were used to examine the impact of NRF2 activation in vitro and in vivo on CDDP sensitivity and development of metastasis. Western blotting, immunostaining, whole-exome sequencing, single-cell transcriptomic and epigenomic profiling platforms were performed to dissect clonal evolution and molecular mechanisms.Results:Implantation of CDDP-resistant HNSCC cells into the tongues of nude mice resulted in a very high rate of distant metastases. The CDDP-resistant cells had significantly higher expression of NRF2 pathway genes in the presence of newly acquired KEAP1 mutations, or via epigenomic activation of target genes. Knockdown of NRF2 or restoration of the wild-type KEAP1 genes resensitized resistant cells to CDDP and decreased distant metastasis (DM). Finally, treatment with inhibitor of glutaminase-1, a NRF2 target gene, alleviated CDDP resistance.Conclusions:CDDP resistance and development of DM are associated with dysregulated and epigenetically reprogrammed KEAP1–NRF2 signaling pathway. A strategy targeting KEAP1/NRF2 pathway or glutamine metabolism deserves further clinical investigation in patients with CDDP-resistant head and neck tumors.
Considerations for Drug Development in Myelodysplastic Syndromes
Authors: Sekeres Mikkael A. , Kim Nina , DeZern Amy E. , Norsworthy Kelly J. , Garcia Jacqueline S. , de Claro R. Angelo , Theoret Marc R. , Jen Emily Y. , Ehrlich Lori A. , Zeidan Amer M. , Komrokji Rami S. 
Published: January 2023

Abstract
Myelodysplastic syndromes (MDS) have historically been challenging diseases for drug development due to their biology, preclinical modeling, and the affected patient population. In April 2022, the FDA convened a panel of regulators and academic experts in MDS to discuss approaches to improve MDS drug development. The panel reviewed challenges in MDS clinical trial design and endpoints and outlined considerations for future trial design in MDS to facilitate drug development to meaningfully meet patient needs. Challenges for defining clinical benefit in patients with MDS include cumbersome response criteria, standardized transfusion thresholds, and application and validation of patient reported outcome instruments. Clinical trials should reflect the biology of disease evolution, the advanced age of patients with MDS, and how patients are treated in real-world settings to maximize the likelihood of identifying active drugs. In patients with lower-risk disease, response criteria for anemic patients should be based on baseline transfusion dependency, improvement in symptoms, and quality of life. For higher-risk patients with MDS, trials should include guidance to prevent dose reductions or delays that could limit efficacy, specify minimal durations of treatment (in the absence of toxicity or progression), and have endpoints focused on overall survival and durable responses. MDS trials should be designed from the outset to allow the practicable application of new therapies in this high-needs population, with drugs that can be administered and tolerated in community settings, and with endpoints that meaningfully improve patients’ lives over existing therapies.
Tissue-Resident Memory T Cells in Pancreatic Ductal Adenocarcinoma Coexpress PD-1 and TIGIT and Functional Inhibition Is Reversible by Dual Antibody Blockade
Authors: Pearce Hayden , Croft Wayne , Nicol Samantha M. , Margielewska-Davies Sandra , Powell Richard , Cornall Richard , Davis Simon J. , Marcon Francesca , Pugh Matthew R. , Fennell Éanna , Powell-Brett Sarah , Mahon Brinder S. , Brown Rachel M. , Middleton Gary , Roberts Keith , Moss Paul 
Published: January 2023

AbstractPancreatic ductal adenocarcinoma (PDAC) has a poor clinical outlook. Responses to immune checkpoint blockade are suboptimal and a much more detailed understanding of the tumor immune microenvironment is needed if this situation is to be improved. Here, we characterized tumor-infiltrating T-cell populations in patients with PDAC using cytometry by time of flight (CyTOF) and single-cell RNA sequencing. T cells were the predominant immune cell subset observed within tumors. Over 30% of CD4+ T cells expressed a CCR6+CD161+ Th17 phenotype and 17% displayed an activated regulatory T-cell profile. Large populations of CD8+ tissue-resident memory (TRM) T cells were also present and expressed high levels of programmed cell death protein 1 (PD-1) and TIGIT. A population of putative tumor-reactive CD103+CD39+ T cells was also observed within the CD8+ tumor-infiltrating lymphocytes population. The expression of PD-1 ligands was limited largely to hemopoietic cells whilst TIGIT ligands were expressed widely within the tumor microenvironment. Programmed death-ligand 1 and CD155 were expressed within the T-cell area of ectopic lymphoid structures and colocalized with PD-1+TIGIT+ CD8+ T cells. Combinatorial anti–PD-1 and TIGIT blockade enhanced IFNγ secretion and proliferation of T cells in the presence of PD-1 and TIGIT ligands. As such, we showed that the PDAC microenvironment is characterized by the presence of substantial populations of TRM cells with an exhausted PD-1+TIGIT+ phenotype where dual checkpoint receptor blockade represents a promising avenue for future immunotherapy.