bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Functionally Graduated Materials Concept to Predict the Damage of Heat-Treated Elbows Under Bending and Pressure Loading
Authors: Telli Fatna , Mokhtari Mohamed , Abdelouahed Elamine , Benzaama Habib , Khedim Kaoutar 
Published: April 2023

Abstract
Elbows in pressurized tubular structures are increasingly stressed by loadings with radial and tangential stresses. These stresses are completely different from those of straight tubular structures. Through the finite element method and using the ABAQUS computer code, the damage of a tubular structure in X60 of an elbow attached by straight parts stressed in internal pressure and in the moment of bending in closing is analyzed in this work. As a proposal for reinforcement, this structure is previously heat-treated and partially at the level of the elbow. The formulation of the heat-treated X60 material is based on the concept of functional graded materials (FGM), where the graduation by volume fraction between the metal in its base and that previously heat-affected named heat affected zone (HAZ) is under a power function of a parameter named volume fraction index (n). The graded properties of HAZ in the base metal along the thickness of the tubular structure are introduced by a row of finite elements using a proposed meshing technique. The elastic–plastic behavior of the HAZ-base metal mixture under the Voce model follows the equivalent stress flow theory of Von Mises. The technique of extended finite element technique (XFEM) in the damage and the mesh proposed in the graduation, were used to evaluate the various parameters, such as: the internal pressure and the heat treatment (surface and index n). The latter condition the response of the structure and the level of its damage.
Estimating paleotidal constituents from Pliocene “tidal gauges”—an example from the paleo-Orinoco Delta, Trinidad
Authors: Chen Si , Kvale Erik P. , Steel Ronald J. , Olariu Cornel , Zhang Jinyu 
Published: April 2023

The Neogene Orinoco Delta is one of the typical river deltas where both the records of modern and ancient tidal processes can be studied. A ∼5 m.y./&gt;10-km-thick succession on the island of Trinidad contains remnants of paleo-Orinoco deltaic deposition preserving both tide- and wave-influenced delta lobes within the same time intervals, just like the modern Orinoco Delta that has both wave-dominated and tidal-dominated lobes. The tide-influenced delta lobes and estuaries preserve some spectacular tidal bedding signals, including tidal rhythmites. The tidal record encoded within the tidal rhythmites is preserved well enough that the primary tidal constituents responsible for the tidal currents that deposited the rhythmic facies can be inferred.
Lower to upper Pliocene tidal rhythmites were examined in two main paleo-Orinoco sub-environments: (1) estuarine and delta lobe deposits of Morne L’Enfer Formation at Erin Bay, and (2) abandoned tidal channels associated with tide-influenced delta-front deposits from the Telemaque Sandstone Member of the Manzanilla Formation at Matura Bay. Both wave- and river-current signals are also present in most of the study areas.
Tidal constituent analysis of unusually well-preserved paleo-Orinoco tidal rhythmites reveals a hierarchy of tidal signals that include semidiurnal, diurnal, fortnightly (neap−spring), monthly (perigee−apogee), semi-yearly, and possibly seasonal and yearly cycles that span thickness intervals ranging from millimeters to meters.
The tidal constituents were dominated by, in decreasing importance, M2, S2, and likely K1 rather than O1. The modern tidal data clearly show that K1 is more important in terms of tide-generating potential than O1, as was likely so in the Pliocene. In both the rock and modern records, N2 is more significant than O1, P1, and K2 in terms of tide-generating potential. The comparison between the constituent analysis of the ancient tidal record and the modern tidal measurements reveals their similarities in tidal patterns and constituent types. From this, we deduce that the tidal constituents responsible for the Pliocene Orinoco Delta tides were mixed semidiurnal tidal cycles similar to those found today in Trinidad (Atlantic type of synodically dominated) rather than the Caribbean (tropically dominated) type.
Understanding challenges as they impact on hospital-level care for pre-eclampsia in rural Ethiopia: a qualitative study
Authors: Robbins Tanya , Shennan Andrew , Sandall Jane , Eshetu Guangul Tigist , Demissew Rahel , Abdella Ahmed , Mayston Rosie , Hanlon Charlotte 
Published: April 2023

ObjectiveTo explore hospital-level care for pre-eclampsia in Ethiopia, considering the perspectives of those affected and healthcare providers, in order to understand barriers and facilitators to early detection, care escalation and appropriate management.SettingA primary and a general hospital in southern Ethiopia.ParticipantsWomen with lived experience of pre-eclampsia care in the hospital, families of women deceased due to pre-eclampsia, midwives, doctors, integrated emergency surgical officers and healthcare managers.ResultsThis study identified numerous systemic barriers to provision of quality, person-centred care for pre-eclampsia in hospitals. Individual staff efforts to respond to maternal emergencies were undermined by a lack of consistency in availability of resources and support. The ways in which policies were applied exacerbated inequities in care. Staff improvised as a means of managing with limited material or human resources and knowledge. Social hierarchies and punitive cultures challenged adequacy of communication with women, documentation of care given and supportive environments for quality improvement.ConclusionsQuality care for pre-eclampsia requires organisational change to create a safe space for learning and improvement, alongside efforts to offer patient-centred care and ensure providers are equipped with knowledge, resources and support to adhere to evidence-based practice.
Therapeutic effects of vasopressin on cardiac arrest: a systematic review and meta-analysis
Authors: Yan Wenqing , Dong Weihua , Song Xin , Zhou Wenqiang , Chen Zhi 
Published: April 2023

ObjectiveTo demonstrate the therapeutic effect of vasopressin as an alternative treatment for cardiac arrest.DesignSystematic review and meta-analysis.MethodsPubMed, EMBASE, the Cochrane Library and Web of Science were searched for randomised controlled trials. The intervention included administration of vasopressin alone or vasopressin combined with epinephrine or vasopressin, steroids and epinephrine (VSE) versus epinephrine combined with placebo as control group. The primary outcome was the return of spontaneous circulation (ROSC). The secondary outcomes included mid-term survival and mid-term good neurological outcome. We conducted subgroup analyses of the primary outcome based on different settings, different study drug strategies and different types of initial rhythm.ResultsTwelve studies (n=6718) were included, of which eight trials (n=5638) reported the data on patients with out-of-hospital cardiac arrest and four trials (n=1080) on patients with in-hospital cardiac arrest (IHCA). There were no significant differences between intravenous vasopressin and placebo in the outcomes of ROSC (relative risk (RR): 1.11; 95% CI: 0.99 to 1.26), mid-term survival (RR: 1.23; 95% CI: 0.90 to 1.66) and mid-term good neurological outcome (RR: 1.20; 95% CI: 0.77 to 1.87). However, in the subgroup analysis, intravenous vasopressin as part of VSE can significantly improve the rate of ROSC (RR: 1.32; 95% CI: 1.18 to 1.47) but not the rate of mid-term survival (RR: 2.15; 95% CI: 0.75 to 6.16) and mid-term good neurological outcome (RR: 1.80; 95% CI: 0.81 to 4.01) for patients with IHCA.ConclusionsOur study failed to demonstrate increased benefit from vasopressin with or without epinephrine compared with the standard of care. However, vasopressin as a part of VSE is associated with the improvement of ROSC in patients with IHCA, and the benefit on mid‐term survival or mid-term good neurological outcome is uncertain. Larger trials should be conducted in the future to address the effect of vasopressin only, vasopressin plus epinephrine or VSE on cardiac arrest.PROSPERO registration numberCRD42021293347.
Self-medication among adults with chronic health conditions: a population-based cross-sectional survey in Saudi Arabia
Authors: Alwhaibi Monira , Bin Malik Shatha , Alswailem Leena , Alruthia Yazed 
Published: April 2023

ObjectivesThis study aimed to assess the prevalence of self-medication (SM), the reasons for SM and the relationship between chronic health conditions and SM among adult individuals.SettingThis was an online questionnaire-based cross-sectional study disseminated on different social media platforms in Saudi Arabia.ParticipantsSaudi Arabia sample of adult individuals aged 18 and above.Primary and secondary outcome measuresPrimary outcome was SM, measured using the following question: ‘During the past 6 months, have you used any medicines or dietary supplements, or herbal medicines or vitamins not prescribed or recommended by a doctor?’ A positive answer indicates a self-medicated participant.ResultsOut of 1645 individuals who viewed the study link, 1295 participants completed the survey with a response rate of 95.1%. Overall, 989 (76.4%) participants reported practicing SM in the past 6 months. SM was higher among younger participants, women, those with higher education levels and high income, and working in the health field. About 198 (73.3%) who have chronic conditions practised SM for chronic health conditions, such as (hypertension and hypercholesterolemia). Previous experience with the same illness (n=530, 25.7%) and attempting to save time (n=466, 22.6%) were the main reasons behind SM, according to the participants. Adverse drug events were reported by 204 (20.6%) of self-medicating individuals and 274 (64.9%) of them reported discontinuing SM.ConclusionsThe findings of this study indicate a high prevalence rate of SM among the adult population in Saudi Arabia. Individuals with chronic health conditions reported a high rate of SM. Launching public education campaigns to improve public awareness of the harms of SM if misused, especially among those with chronic health conditions, is essential.
How to diagnose COVID-19 in family practice? Usability of complete blood count as a COVID-19 diagnostic tool: a cross-sectional study in Turkey
Authors: Bayraktar Mustafa , Tekin Erdal , Kocak Mehmet Nuri 
Published: April 2023

ObjectiveCOVID-19 is currently diagnosed in hospital settings. An easy and practical diagnosis of COVID-19 is needed in primary care. For this purpose, the usability of complete blood count in the diagnosis of COVID-19 was investigated.DesignRetrospective, cross-sectional study.SettingSingle-centre study in a tertiary university hospital in Erzurum, Turkey.ParticipantsBetween March 2020 and February 2021, patients aged 18–70 years who applied to the hospital and underwent both complete blood count and reverse-transcription-PCR tests for COVID-19 were included and compared. Conditions affecting the test parameters (oncological–haematological conditions, chronic diseases, drug usage) were excluded.Outcome MeasureThe complete blood count and COVID-19 results of eligible patients identified using diagnostic codes [U07.3 (COVID–19) or Z03.8 (observation for other suspected diseases and conditions)] were investigated.ResultsOf the 978 patients included, 39.4% (n=385) were positive for COVID-19 and 60.6% (n=593) were negative. The mean age was 41.5±14.5 years, and 53.9% (n=527) were male. COVID-19-positive patients were found to have significantly lower leucocyte, neutrophil, lymphocyte, monocyte, basophil, platelet and immature granulocyte (IG) values (p<0.001). Neutrophil/lymphocyte, neutrophil/monocyte and IG/lymphocyte ratios were also found to be significantly decreased (p<0.001). With logistic regression analysis, low lymphocyte count (OR 0.695; 95% CI 0.597 to 0.809) and low red cell distribution width-coefficient of variation (RDW-CV) (OR 0.887; 95% CI 0.818 to 0.962) were significantly associated with COVID-19 positivity. In receiver operating characteristic analysis, the cut-off values of lymphocyte and RDW-CV were 0.745 and 12.35, respectively.ConclusionAlthough our study was designed retrospectively and reflects regional data, it is important to determine that low lymphocyte count and RDW-CV can be used in the diagnosis of COVID-19 in primary care.
Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
Authors: Yelland Lisa N , Sullivan Thomas R , Gibson Robert A , Simmonds Lucy A , Thakkar Sagar K , Huang Fang , Devaraj Surabhi , Best Karen P , Zolezzi Irma Silva , Makrides Maria 
Published: April 2023

ObjectivesThe risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity.DesignExploratory analyses of a multicentre, double-blind randomised trial.Setting6 tertiary care centres in four states in Australia.Participants5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.InterventionsFish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks’ gestation.Outcome measuresEarly preterm birth (EPTB, <34 weeks’ gestation) and preterm birth (PTB, <37 weeks’ gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics.ResultsOmega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10–0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49–0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45–0.86).ConclusionsOur results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation.Trial registration numberACTRN12613001142729.
Physical activity interventions implemented for older people in sub-Saharan Africa: protocol for a scoping review
Authors: Naidoo Shane , Otoo Samuel , Naidoo Niri 
Published: April 2023

IntroductionThe global population of older people (OP) is on an upward trajectory, with predictions that the number of OP would surpass the population of younger people by 2050. In sub-Saharan Africa (SSA), death from infectious diseases in the younger population and lower fertility rates are influencing a double burden contributing to an exponential growth in the ageing population. Non-communicable diseases (NCDs) are the leading cause of mortality and disability in the population of OP in SSA. Physical activity (PA) has been proven to have positive benefits in reducing the prevalence of NCDs in OP. The objective of this scoping review is to summarise the evidence on the feasibility and effectiveness of PA interventions that have been implemented among OP to address PA levels, blood pressure, blood glucose levels, cognitive function, quality of life and body mass index in SSA.Methods and analysisThe Joanna Briggs Insitute (JBI) methodology will be followed for this scoping review. An electronic search of PubMed, EBSCOhost (Academic Search Premier AfricaWide Information, CINAHL, Health Sources Premier Academic/Nursing), Scopus and ProQuest (grey literature) will be done from 2010 onwards to identify reports of randomised controlled studies published in English using relevant keywords. 2010 was selected as the cut-off point for inclusion in order to focus only on relatively recent evidence, as it is more likely to remain relevant and applicable to present-day settings. The searches will be performed by the primary reviewer in conjunction with a senior librarian. Full independent review of the uploaded articles will be done by two reviewers, by title and abstract, and thereafter by full text, based on specified inclusion and exclusion criteria. The reference list of included articles will be scanned for additional relevant articles. Disagreements will be arbitrated by a third reviewer. Results will be presented in a descriptive form as well as in tabular, graphical and diagrammatic formats, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews.Ethics and disseminationThe review will be extracting and reporting on data from published literature so there is no requirement for ethics approval. The findings of the review will be submitted for publication in a peer-reviewed journal.
External validation of the Manchester Acute Coronary Syndromes ECG risk model within a pre-hospital setting
Authors: Alotaibi Ahmed , Alghamdi Abdulrhman , Martin Glen P , Carlton Edward , Cooper Jamie G , Cook Eloïse , Siriwardena Aloysius Niroshan , Phillips John , Thompson Alexander , Bell Steve , Kirby Kim Lucy , Rosser Andy , Pennington Elspeth , Body Richard 
Published: April 2023

ObjectivesThe Manchester Acute Coronary Syndromes ECG (MACS-ECG) prediction model calculates a score based on objective ECG measurements to give the probability of a non-ST elevation myocardial infarction (NSTEMI). The model showed good performance in the emergency department (ED), but its accuracy in the pre-hospital setting is unknown. We aimed to externally validate MACS-ECG in the pre-hospital environment.MethodsWe undertook a secondary analysis from the Pre-hospital Evaluation of Sensitive Troponin (PRESTO) study, a multi-centre prospective study to validate decision aids in the pre-hospital setting (26 February 2019 to 23 March 2020). Patients with chest pain where the treating paramedic suspected acute coronary syndrome were included. Paramedics collected demographic and historical data and interpreted ECGs contemporaneously (as ‘normal’ or ‘abnormal’). After completing recruitment, we analysed ECGs to calculate the MACS-ECG score, using both a pre-defined threshold and a novel threshold that optimises sensitivity to differentiate AMI from non-AMI. This was compared with subjective ECG interpretation by paramedics. The diagnosis of AMI was adjudicated by two investigators based on serial troponin testing in hospital.ResultsOf 691 participants, 87 had type 1 AMI and 687 had complete data for paramedic ECG interpretation. The MACS-ECG model had a C-index of 0.68 (95% CI: 0.61 to 0.75). At the pre-determined cut-off, MACS-ECG had 2.3% (95% CI: 0.3% to 8.1%) sensitivity, 99.5% (95% CI: 98.6% to 99.9%) specificity, 40.0% (95% CI: 10.2% to 79.3%) positive predictive value (PPV) and 87.6% (87.3% to 88.0%) negative predictive value (NPV). At the optimal threshold for sensitivity, MACS-ECG had 50.6% sensitivity (39.6% to 61.5%), 83.1% specificity (79.9% to 86.0%), 30.1% PPV (24.7% to 36.2%) and 92.1% NPV (90.4% to 93.5%). In comparison, paramedics had a sensitivity of 71.3% (95% CI: 60.8% to 80.5%) with 53.8% (95% CI: 53.8% to 61.8%) specificity, 19.7% (17.2% to 22.45%) PPV and 93.3% (90.8% to 95.1%) NPV.ConclusionNeither MACS-ECG nor paramedic ECG interpretation had a sufficiently high PPV or NPV to ‘rule in’ or ‘rule out’ NSTEMI alone.
Impact of the COVID-19 pandemic on sick leave among healthcare workers: a register-based observational study
Authors: Reme Bjørn-Atle , Grøsland Mari , Gjefsen Hege , Magnusson Karin 
Published: April 2023

ObjectivesTo assess the impact of the COVID-19 pandemic on sick leave among healthcare workers (HCWs) in primary and specialist care and examine its causes.MethodsUsing individual-level register data, we studied monthly proportions of sick leave (all-cause and not related to SARS-CoV-2 infection) from 2017 to February 2022 for all HCWs in primary (N=60 973) and specialist care (N=34 978) in Norway. First, we estimated the impact of the pandemic on sick leave, by comparing the sick leave rates during the pandemic to sick leave rates in 2017–2019. We then examined the impact of COVID-19-related workload on sick leave, by comparing HCWs working in healthcare facilities with different levels of COVID-19 patient loads.ResultsHCWs had elevated monthly rates of all-cause sick leave during the COVID-19 pandemic of 2.8 (95% CI 2.67 to 2.9) and 2.2 (95% CI 2.07 to 2.35) percentage points in primary and specialist care. The corresponding increases for sick leave not related to SARS-CoV-2 infection were 1.2 (95% CI 1.29 to 1.05) and 0.7 (95% CI 0.52 to 0.78) percentage points. All-cause sick leave was higher in areas with high versus low COVID-19 workloads. However, after removing sick leave episodes due to SARS-CoV-2 infections, there was no difference.ConclusionsThere was a substantial increase in sick leave among HCWs during the pandemic. Our results suggest that the increase was due to HCWs becoming infected with SARS-CoV-2 and/or sector-wide effects, such as strict infection control measures. More differentiated countermeasures should, therefore, be evaluated to limit capacity constraints in healthcare provision.
Extreme heat and work injuries in Kuwait’s hot summers
Authors: Alahmad Barrak , Al-Hemoud Ali , Al-Bouwarthan Mohammed , Khraishah Haitham , Kamel Mohamed , Akrouf Qassem , Wegman David H , Bernstein Aaron S , Koutrakis Petros 
Published: April 2023

BackgroundHot, desert Gulf countries are host to millions of migrant workers doing outdoor jobs such as construction and hospitality. The Gulf countries apply a summertime ban on midday work to protect workers from extreme heat, although without clear evidence of effectiveness. We assessed the risk of occupational injuries associated with extreme hot temperatures during the summertime ban on midday work in Kuwait.MethodsWe collected daily occupational injuries in the summer months that are reported to the Ministry of Health’s Occupational Health Department for 5 years from 2015 to 2019. We fitted generalised additive models with a quasi-Poisson distribution in a time series design. A 7-day moving average of daily temperature was modelled with penalised splines adjusted for relative humidity, time trend and day of the week.ResultsDuring the summertime ban, the daily average temperature was 39.4°C (±1.8°C). There were 7.2, 7.6 and 9.4 reported injuries per day in the summer months of June, July and August, respectively. Compared with the 10th percentile of summer temperatures in Kuwait (37.0°C), the average day with a temperature of 39.4°C increased the relative risk of injury to 1.44 (95% CI 1.34 to 1.53). Similarly, temperatures of 40°C and 41°C were associated with relative risks of 1.48 (95% CI 1.39 to 1.59) and 1.44 (95% CI 1.27 to 1.63), respectively. At the 90th percentile (42°C), the risks levelled off (relative risk 1.21; 95% CI 0.93 to 1.57).ConclusionWe found substantial increases in the risk of occupational injury from extremely hot temperatures despite the ban on midday work policy in Kuwait. ‘Calendar-based’ regulations may be inadequate to provide occupational heat protections, especially for migrant workers.