bluuebunny/crossref_metadata_2025_split huggingface dataset:
BENCH TESTING OF A TUNABLE ANKLE-FOOT ORTHOSIS WITH ADJUSTABLE STIFFNESS AND NEUTRAL ANGLE
Authors: Jiang Tianshu , Durfee William 
Published: June 2023

Abstract
Cerebral palsy is the most common childhood motor disability that effects 0.3% of children in the US and two-thirds of them have gait impairment. An ankle-foot orthosis (AFO) is commonly prescribed as a gait assistance. The function of an AFO is maximized when its stiffness and neutral angle are optimally prescribed to address each user’s issue. However, the prescription process is not standardized and is subjective to the prescribing clinician. Only one-third of AFOs improved the user’s gait while another one-third negatively affected the gait. A tunable AFO is developed to allow clinicians to test a range of stiffness and neutral angle of a passive AFO, making the prescription more likely to have a positive effect. The design of tunable AFO has a weight of about a typical plastic AFO and a dimension designed for children. It covers 90% range of stiffness and neutral angle of prescribed AFOs. It can withstand the torque applied during walking. Mechanisms of adjusting both parameters operate fast and are controlled by a microprocessor. A benchtop prototype was built to test the adjustment mechanisms. Both mechanisms were validated.
EXPERIMENTAL VALIDATION OF A COMPUTATIONAL KNEE MODEL OF TKR IMPLANT PLACEMENT
Authors: Henry Aaron , Goodchild Gordon , Greenwald Jon , Meftah Morteza , Moreno Michael , Robbins Andrew 
Published: June 2023

Abstract
The goal of this work was to experimentally validate a computational model for TKRs to improve implant alignment accuracy and assess potential implant misalignment during preoperative planning. Initial validation of the model was achieved by comparing ligament strain energies between the computational model and a physical knee model comprised of bone and ligament analogues. Experimental validation would be considered met when the computational model strain energies were within 10% of the measured values for all six physical knees. Physical and computational knee models were created with six variations of implant alignment to test the robustness of the computational model. Strain energy errors were well within the 10% threshold across knee range of motion.
DESIGN THINKING TO PROTOTYPE DEVELOPMENT: CREATING AN IMPROVED HEALTHCARE POWERED AIR-PURIFYING RESPIRATOR
Authors: Beam Elizabeth , Marsh Evan , Wester Noah , Lowndes Bethany 
Published: June 2023

Abstract
An interprofessional team embarked on the design and prototyping of an improved powered air-purifying respirator for healthcare. They used 3D modeling to move their ideas from a list of key expectations to a virtual prototype. The design thinking concept of rapid prototyping and empathy interviewing ensured this design met the needs of the stakeholders who would use the product. Several significant changes in the design resulted from the rapid prototyping interviews. This process was enhanced by using a virtual reality software to allow the team to “see” the product and comment on the design integrating both VR headsets and videoconferencing for feedback and collaboration. The design project is now ready for physical prototyping and further human factors analysis.
BIOINFORMATX : BIOLOGICAL DATA AND EMR INTEGRATION FOR A PATIENT FACING HEART FAILURE APPLICATION
Authors: Reichert Ryan , Bhattaram Rohan , Basheer Yusairah 
Published: June 2023

Abstract
CHF exacerbations are the second leading cause of hospitalizations in the United States. The two most common causes of CHF exacerbations are medication and diet nonadherence. BioinformatX is a patient facing application whose aim is to improve heart failure management and decrease hospitalizations. Specifically, BioinformatX incorporates biological patient data from a wearable device directly into the EMR. With remote access to patients’ activity, HR, oxygen saturation, EKG, and fluid status, providers can detect and intervene on acute, decompensated CHF exacerbations before patients need to be hospitalized. Through this application, providers can schedule sooner primary care appointments or make medication adjustments. Additionally, the application uses patient-specific data to recommend tailored exercise and diet adjustments.
CAPAPP: SMARTPHONE-BASED CAPILLARY REFILL INDEX ASSESSMENT IN HEALTHY CHILDREN
Authors: Strutt Jonathan , Narayanswamy Girish , Park Chunjong , Sarda Devesh , Wu Sixuan , Thompson Matthew , Harvey Lauren , Hedstrom Rachel , Kodet Amy , Patel Shwetak , Mariakakis Alex 
Published: June 2023

Abstract
Capillary refill time is the time it takes for blanched skin tissue under pressure to return to its normal state when that pressure is released. The test is commonly performed on the fingertip by clinicians to assess for signs of septic, traumatic, or hypovolemic shock. Current methods of capillary refill time measurement are typically subjective, coarse-grained, and clinician dependent.
A more standardized and objective measurement of capillary refill time has been shown to improve the diagnosis of pediatric dehydration but has typically required specialized equipment. We have developed a digital version of the capillary refill test utilizing only a smartphone to increase access to capillary refill assessment. Our aim is to determine the accuracy and precision of this smartphone-based measure in a population of healthy pediatric subjects.
DESIGN OF BABY CUSHION FOR STROLLER USING FINITE ELEMENT SIMULATION
Authors: Jung Soonmoon , Kim Jaemin , Lee Youngho , Song Hyeyeong , Kang Yeeun , Hong Junghwa 
Published: June 2023

Abstract
Infants spend most of the day sleeping anywhere. In the past, most parents put their infants to sleep in the prone position, but recently they put their infants to sleep in the prone position because of an issue of sudden infant death syndrome. When infants sleep in a supine position for a long time, occipital bone deformation is occurred because of pressure at the occipital region. To prevent minimize the pressure on the infant’s head and body, through the finite element simulation using the infant model, a baby cushion for the stroller was designed using the central composite design (CCD) method. The maximum contact pressure between the designed cushion and the infant model was 22.8 mmHg and this value is about 50 % lower than the pressure that occurred between the infant model and the general cushion. It can be helpful to reduce the possibility of a baby’s head deformation and other body disorders.
PREVENTING THE PROGRESSION OF DIABETIC FOOT ULCERS: ADDRESSING PATIENT COMPLIANCE WITH LOW-COST, BEHAVIOR-MODIFYING WEARABLES
Authors: Rizk Carine , Reid Koby , Tran Khue , Bass Hannah 
Published: June 2023

Abstract
Over 34.2M Americans have diabetes and $237B is spent on direct costs of diabetes each year. Of this, $15B is spent on foot ulcer treatment alone as more than half of people with diabetes develop some type of neuropathy, the primary modifiable risk factor of ulcers in this population. Currently, patients with diabetic peripheral neuropathy (DPN) rely on early hotspot identification, padded soles, offloading boots, and diabetic shoes, with compliance being the major issue. Through expert interviews, there is a need for a better method to slow and prevent the progression of hot spots and other complications in patients with DPN. Our team is proposing DiaSense, a wearable device that replaces the lost sensation of pain with a safe and actionable stimulus that modifies gait to offload hotspots. The discrete design was guided by experiences from patients, podiatrists, and vascular surgeons to improve patient compliance, satisfaction, and recovery. Early user-feedback demonstrated useful validation that our device modifies walking behavior in healthy participants, and helps justify a larger study with patients who have diabetic peripheral neuropathy.
SURROGATE MODELS OF BLOOD FLOW DYNAMICS IN BRAIN ANEURYSMS USING DYNAMIC MODE DECOMPOSITION
Authors: Le Trung Bao , Nguyen Tam , Huynh Phat , Le Trung Quoc 
Published: June 2023

Abstract
The evolution of blood flow is vital in understanding the pathogenesis of brain aneurysms. Several past studies have shown evidence for a turbulent inflow jet at the aneurysm neck. Even though there is a great need for analyzing inflow jet dynamics in clinical practice, data summarized in non-invasive modalities such as Magnetic Resonance Imaging or Computed Tomography are usually limited in spatial and temporal resolutions, and thus cannot account for the hemodynamics. In this work, Dynamic Mode Decomposition (DMD) is used to pinpoint the dominant modes of the inflow jet in patient-specific models of internal sidewall aneurysms utilizing high-resolution data from Computational Fluid Dynamics. The purpose of this thesis is to prove that the dynamic modes are not only governed by the hemodynamics of the parent artery but by the inflow jet interaction with the distal wall. Our work indicates that DMD is an essential tool for analyzing blood flow patterns of brain aneurysms and is a promising tool to be used in in-vivo context.
NON-TRADITIONAL TRADEMARK AND DESIGN PATENT STRATEGIES FOR MEDICAL DEVICES
Authors: Baird Steve , Smock Greg , Weseman Draeke , Abdo Jake 
Published: June 2023

Abstract
This paper discusses non-traditional trademarks and design patents as essential Intellectual Property assets for medical device companies. The paper presents a strategy for layering the time-limited protection offered by design patents with the perpetual protection afforded to trademarks as an effective strategy for permanent exclusivity of non-functional aspects of medical device products.
A COMPARISON OF THE PRESSURE FAILURE OF TWO COLORECTAL ANASTAMOSES STAPLING TECHNIQUES
Authors: Fahmy Youssef , Trabia Mohamed , Ward Brian , Gallup Lucas , Elks Whitney 
Published: June 2023

Abstract
Anastomotic leakage (AL) is a serious complication that effects thousands of patients undergoing colorectal surgery annually. Stapling is generally used to perform anastomoses. Two common anastomosis techniques are the End to End (EE), and End to Side (ES). Currently there is no experimental approach to compare the effectiveness of these two techniques against AL. This work proposes an ex-vivo experimental setup of burst testing of anastomoses using porcine tissues. Twelve pigs were used with three specimens harvested from the colon of each of them: EE, ES, and a control specimen. Failure of the anastomoses were monitored, and the corresponding leakage pressures were recorded. Preliminary results indicated that ES led to higher strength than EE.
EFdA efficiently suppresses HIV replication in the male genital tract and prevents penile HIV acquisition
Authors: Kovarova Martina , Wessel Sarah E. , Johnson Claire E. , Anderson Shelby V. , Cottrell Mackenzie L. , Sykes Craig , Cohen Myron S. , Garcia J. Victor 
Published: June 2023

ABSTRACT

Sexually transmitted HIV infections in heterosexual men are acquired through the penis. Low adherence to condom usage and the fact that 40% of circumcised men are not protected indicate the need for additional prevention strategies. Here, we describe a new approach to evaluate the prevention of penile HIV transmission. We demonstrated that the entire male genital tract (MGT) of bone marrow/liver/thymus (BLT) humanized mice is repopulated with human T and myeloid cells. The majority of the human T cells in the MGT express CD4 and CCR5. Direct penile exposure to HIV leads to systemic infection including all tissues of the MGT. HIV replication throughout the MGT was reduced 100-1,000-fold by treatment with 4′-ethynyl-2-fluoro-2′-deoxyadenosine (EFdA), resulting in the restoration of CD4
+
T cell levels. Importantly, systemic preexposure prophylaxis with EFdA effectively protects from penile HIV acquisition.

IMPORTANCE

Over 84.2 million people have been infected by the human immunodeficiency virus type 1 (HIV-1) during the past 40 years, most through sexual transmission. Men comprise approximately half of the HIV-infected population worldwide. Sexually transmitted HIV infections in exclusively heterosexual men are acquired through the penis. However, direct evaluation of HIV infection throughout the human male genital tract (MGT) is not possible. Here, we developed a new
in vivo
model that permits, for the first time, the detail analysis of HIV infection. Using BLT humanized mice, we showed that productive HIV infection occurs throughout the entire MGT and induces a dramatic reduction in human CD4 T cells compromising immune responses in this organ. Antiretroviral treatment with novel drug EFdA suppresses HIV replication in all tissues of the MGT, restores normal levels of CD4 T cells and is highly efficient at preventing penile transmission.
Timing of adverse events in patients undergoing acute and elective hip arthroplasty surgery: a multicentre cohort study using the Global Trigger Tool
Authors: Magnéli Martin , Kelly-Pettersson Paula , Rogmark Cecilia , Gordon Max , Sköldenberg Olof , Unbeck Maria 
Published: June 2023

ObjectiveTo explore timing in relation to all types of adverse events (AEs), severity and preventability for patients undergoing acute and elective hip arthroplasty.DesignA multicentre cohort study using retrospective record review with Global Trigger Tool methodology in combination with data from several registers.Setting24 hospitals in 4 major regions of Sweden.ParticipantsPatients ≥18 years, undergoing acute or elective total or hemiarthroplasty of the hip, were eligible for inclusion. Reviews of weighted samples of 1998 randomly selected patient records were carried out using Global Trigger Tool methodology. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country.ResultsThe cohort consisted of 667 acute and 1331 elective patients. Most AEs occurred perioperatively and postoperatively (n=2093, 99.1%) and after discharge (n=1142, 54.1%). The median time from the day of surgery to the occurrence of AE was 8 days. The median days for different AE types ranged from 0 to 24.5 for acute and 0 to 71 for elective patients and peaked during different time periods. 40.2% of the AEs, both major and minor, occurred within postoperative days 0–5 and 86.9% of the AEs occurred within 30 days. Most of the AEs were deemed to be of major severity (n=1370, 65.5%) or preventable (n=1591, 76%).ConclusionsA wide variability was found regarding the timing of different AEs with the majority occurring within 30 days. The timing and preventability varied regarding the severity. Most of the AEs were deemed to be preventable and/or of major severity. To increase patient safety for patients undergoing hip arthroplasty surgery, a better understanding of the multifaceted nature of the timing of AEs in relation to the occurrence of differing AEs is needed.
From the international tobacco control arena to the local context: a qualitative study on the tobacco advertising, promotion and sponsorship legislative environment in Sudan and the challenges characterising it
Authors: Tselengidis Arsenios , Adams Sally , Freeman Becky , Mostafa Aya , Astuti Putu Ayu Swandewi , Cranwell Jo 
Published: June 2023

ObjectivesThe aim of the study was to assess the Sudanese tobacco advertising, promotion and sponsorship (TAPS) legislative environment and the challenges characterising it. We formulated three research questions: What is the TAPS policy context in Sudan? What circumstances led to the development of the current legislative text? Finally, what was the involvement of the different actors in these events?DesignWe conducted a qualitative analysis using the Health Policy Triangle model to frame the collection and extraction of publicly available information from academic literature search engines, news media databases or websites of national and international organisations, as published by February 2021. The thematic framework approach was employed to code and analyse the textual data and the generated themes were used to map connections across the data and to explore relationships among the generated subthemes and themes.SettingSudan.DataUsing a combination of the keywords “Sudan” and “tobacco advertising” (or “tobacco marketing” or “tobacco promotion”), we collected publicly available documents in the English language. We included 29 documents in the analysis.ResultsThree themes underpin the Sudanese legislative environment on TAPS: (1) limited and outdated TAPS data, (2) stakeholder involvement and tobacco industry interference and (3) TAPS legislation not aligned with the WHO Framework Convention on Tobacco Control Secretariat recommendations.ConclusionsFindings from this qualitative analysis suggest that recommendations to move forward in Sudan should include the systematic and periodic collection of TAPS surveillance data, addressing any remaining legislative content loopholes and protecting policy-making from tobacco industry interference. In addition, best practices from other low-income and middle-income countries with good TAPS monitoring systems, such as Egypt, Bangladesh and Indonesia, or with protective provisions against tobacco industry interference, such as Thailand and the Philippines, could be considered for adaptation and implementation.
Patients’ experiences of living with patellar instability before and after surgery: a qualitative interview study
Authors: Hysing-Dahl Trine , Inderhaug Eivind , Faleide Anne Gro Heyn , Magnussen Liv Heide 
Published: June 2023

ObjectivesTo explore the experience of living with patellar instability before and after surgery.DesignQualitative individual semistructured interviews of patients with patellar instability using a four-step thematic cross-case analysis strategy (systematic text condensation).SettingTwo orthopaedic units within two large Hospitals in Norway.ParticipantsA convenience sample of 15 participants, aged between 16 and 32 years, who had undergone surgery for patellar instability within the last 6–12 months.ResultsParticipants offered rich and detailed descriptions of the impact and lived experience of patellar instability, including fear of new dislocations, increased awareness of the knee and adaptations to avoidance behaviour in everyday life both before and after surgery. The four major themes that emerged from the data were: (1) fear of patella dislocations governs everyday life activities, (2) adaptation to avoidance behaviour, (3) feeling different, misunderstood and stigmatised affects self-esteem and (4) feeling stronger, but still not fully confident in the knee after surgery.ConclusionsThese findings offer insight into the experience of living with patellar instability. Patients reported that the instability had major impacts on their everyday life, affecting ability to participate in social life and physical activities both before and after surgery. This may imply that an increased attention towards cognitive interventions may be useful in the management of patellar instability.Trial registration numberNCT05119088.
A Quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit in a low-and-middle-income country
Authors: Al Bizri Ayah , Hanna Wakim Rima , Obeid Alaa , Daaboul Tania , Charafeddine Lama , Mounla Nabil , Nakad Pascale , Yunis Khalid 
Published: June 2023

BackgroundPremature and sick neonates in the neonatal intensive care unit (NICU) are in need of central lines placing them at high risk of contracting a central line-associated bloodstream infection (CLABSI). CLABSI extends length of stay to 10–14 days post negative cultures and increases morbidity, use of multiple antibiotics, mortality and hospital cost. To reduce CLABSI rate at the American University of Beirut Medical Center NICU, the National Collaborative Perinatal Neonatal Network developed a quality improvement project to reduce CLABSI rate by 50% over a 1-year period and to sustain reduced CLABSI rate.MethodsCentral line insertion and maintenance bundles were implemented for all infants admitted to the NICU necessitating central lines placement. Bundles included hand washing, wearing protective material and sterile drapes during central lines insertion and maintenance.ResultsCLABSI rate decreased by 76% from 4.82 (6 infections; 1244 catheter days) to 1.09 (2 infection; 1830 catheter days) per 1000 CL days after 1 year. Following the bundles’ success in reducing CLABSI rate, they were incorporated permanently to NICU standard procedure and bundle checklists were added to the medical sheets. CLABSI rate was maintained at 1.15 per 1000 CL days during the second year. It then decreased to 0.66 per 1000 CL days in the third year before reaching zero in the fourth year. In total, zero CLABSI rate was sustained for 23 consecutive months.ConclusionReducing CLABSI rate is necessary to improving newborn quality of care and outcome. Our bundles were successful in drastically reducing and sustaining a low CLABSI rate. It was even successful in achieving a zero CLABSI unit for 2 years.
Efficacy and safety of Y-2 sublingual tablet for patients with acute ischaemic stroke: protocol of a phase III randomised double-blind placebo-controlled multicentre trial
Authors: Fu Yu , Tang Renhong , Chen Rong , Wang Anxin , Ren Jinsheng , Zhu Shunwei , Feng Xiaofei , Fan Dongsheng 
Published: June 2023

Background and purposeClinical studies have demonstrated that edaravone dexborneol can improve the functional outcomes in patients with acute ischaemic stroke (AIS). The present clinical trial aimed at testing the efficacy and safety of Y-2 sublingual tablet on 90-day functional outcome in patients with AIS.Methods and designThis is a randomised, double-blind, placebo-controlled, multicentre, parallel-group trial of Y-2 sublingual tablet on patients with AIS.An estimated 914 patients at age of 18–80 years with AIS within 48 hours after symptom onset from 40 hospitals will be randomly assigned to receive Y-2 sublingual tablet or placebo for 14 days. Patients are at score 6–20 points on National Institutes of Health Stroke Scale (NIHSS) and had a modified Rankin Scale (mRS) ≤1 before this stroke, except mechanical thrombectomy and neuroprotective agents treatment.Study outcomesThe primary outcome is the proportion of patients with mRS ≤1 on day 90 after randomisation. Secondary efficacy outcomes include mRS score on day 90, the proportion of patients with mRS ≤2 on day 90; the change of NIHSS score from baseline to day 14 and the proportion of patients with NIHSS score ≤1 at the days 14, 30 and 90.DiscussionThis trial will provide valuable evidence for the efficacy and safety of Y-2 sublingual table for improving 90 days the functional outcomes in patients with AIS.Trial registration numberNCT04950920.
Kβ to Kα X-ray intensity ratio and K–L vacancy transfer probability of Mn following electron capture decay
Authors: Gudennavar S.B. , Bubbly S.G. 
Published: June 2023

Kα and Kβ X-rays of Mn following electron capture (EC) decay of 55Fe were detected using Amptek XR-100 T-CdTe X-ray detector spectrometer. Measured Kα and Kβ X-ray intensities of Mn were used to determine the Kβ to Kα intensity ratio and total K–L total vacancy transfer probability. These values were compared with the theoretical, semiempirical, and others’ experimental values obtained via EC decay as well as photoionization. The X-ray intensity ratio of Mn was found to be higher by 1.5% from the relativistic Hartree-Slater theoretical value. This deviation may be attributed to the exchange interactions occurring between the 3p and 3d shell electrons as well as the recoil effect of the nucleus due to neutrino emission.