bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress of Additive Manufacturing Technology and Its Medical Applications
Authors: Bastin Anne , Huang Xiao 
Published: September 2022

Abstract
Additive manufacturing (AM), also known as three-dimensional (3D) printing, is a disruptive technology that is revolutionizing many industries. It is gaining considerable attention, particularly in the medical field as it renders the possibilities of building new devices or modifying existing devices to match a patient's anatomy and to produce anatomically exact models, supporting health professionals with diagnostics and surgery preparation. In addition, the free-form building capability of AM allows the designer to have a complete control over the internal architecture of the device, along with tailored mechanical properties, such as compression strength, stiffness, and many surface features. As the processes of AM become well-understood, there is more control over the consistency and quality of the printed parts, positioning this technology for medical applications. With more and more medically approved 3D-printed devices entering the market, the purpose of this paper is to give an overview of the regulatory pathway to the Food and Drug Administration approval of a medical device, along with common AM processes used in the medical industry. To conclude, medical devices that are enabled by AM technology and associated companies will be highlighted.
Numerical Investigation and Experiment on Natural Circulation Resistance and Energy Characteristics in a Circulating Axial Pump
Authors: Pu Kexin , Miao Hongjiang , Li Juanhong , Huang Bin , Yuan Faxu , Wu Peng , Wu Dazhuan 
Published: September 2022

Abstract
The influence of angle matching in rotor–stator interference (RSI) zone on natural circulation resistance (NCR) of circulating pump in natural circulation condition is illustrated by numerical method, and the analysis and optimization method of natural circulation based on loss coefficient curve are established through experiments. The mechanism and analysis formula of runaway speed are extracted, and the distribution diagram of Euler head density function (EHDF) is obtained to carry out image processing and analysis of secondary flow. Then, the optimal design interval of setting angle of impeller outlet under low flow resistance is acquired. As for the natural circulation loss of static parts, the optimal design interval of guide vane inlet angle and outlet angle with low flow resistance is obtained by analyzing the EHDF distribution diagram of the whole flow parts, which accounts for the position and reason of resistance. In this paper, the mechanism between runaway speed and loss coefficient curve is revealed and the resistance is optimized through the design and analysis of the RSI region, which provides theoretical methods for the analysis of the impeller performance of axial-flow circulating pump. Furthermore, it is a reference for the optimization design of natural circulation system.
Design of Solar Powered Greywater Treatment Unit for Residential Applications
Authors: Waris Abdul , Ghaith Fadi A. 
Published: September 2022

Abstract
Many countries around the world depend primarily on seawater desalination process which is an energy-intensive process and incorporates high electricity consumption. In United Arab Emirates (UAE), desalinated seawater accounts for almost 89.9% of the country’s water needs. The average residential water consumption is 550 liters per capita per day which is almost 82% higher than the world average.
This paper aims to design a greywater treatment plant which is fully powered by solar photovoltaic (PV) panels. The proposed water treatment plant consists of a three-step filtration process to treat greywater. Initially, the collected greywater from households is pumped to a multimedia filter to reduce the level of turbidity followed by pumping the water at high pressure through Reverse Osmosis unit and finally passing the water in the chlorination chamber to remove odor and prevent microbial growth.
The proposed system was implemented to the case study of a villa community located in Dubai which comprises 38 villas and accommodates a total of about 152 residents. The proposed water treatment plant has a capacity of producing about 83 m3 of clean water per day at a high recovery rate of 67%. The solar system proved to be efficient by providing energy of 57397 kWh which was enough to power entirely the greywater treatment plant.
Cost analysis was carried out to assess the economic feasibility of the proposed plant. The system resulted in a tangible reduction in carbon dioxide emissions of 204 ton/year.
Wind Farm Clustering Methods for Power Forecasting
Authors: Goudarzi Navid , Ziaei Dorsa 
Published: September 2022

Abstract
This paper initiates the development of a hybrid model for wind farm output power forecasting based on spatiotemporal parameters of a studied site. The time-dependency of local wind patterns is addressed by developing three wind farm clustering, K-means, Agglomerative, and Density-Based Spatial Clustering of Applications with Noise. Clustered wind turbines obtain a more accurate representation for wind power forecasting. The results for this work will be later used to extract key features based on singular value decomposition (SVD) and build the forecast model. the emphasis in this paper is on the clustering method and not the forecasting algorithms. Hourly-wind data of an onshore wind farm in the US for one year are used for developing this model. The results will be further used in improving wind clustering algorithms, feature identification, and time-dependency analyses of short- to medium wind forecasting.
Vitamin D, parathyroid hormone, glucose metabolism and incident diabetes in the multiethnic study of atherosclerosis
Authors: Williams Amaris , Zhao Songzhu , Brock Guy , Kline David , Echouffo-Tcheugui Justin Basile , Effoe Valery S , Bertoni Alain G , Michos Erin D , de Boer Ian H , Kestenbaum Bryan , Golden Sherita H , Joseph Joshua J 
Published: September 2022

IntroductionHigher concentrations of serum 25-hydroxyvitamin D (25(OH)D) and lower concentrations of parathyroid hormone (PTH) are associated with lower insulin resistance and incident diabetes in non-Hispanic White and Hispanic Americans. Results are mixed in other populations, with no observational studies in a large multiethnic cohort. The association of serum 25(OH)D with diabetes may vary by adiposity level.Research design and methodsAmong 5611 participants in the Multi-Ethnic Study of Atherosclerosis without diabetes at baseline, cross-sectional associations of serum 25(OH)D with homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA-β were examined using linear regressions. The association of 25(OH)D with incident diabetes over 9 years was examined using Cox proportional hazard regression.ResultsBlack Americans had the highest proportion of individuals with 25(OH)D<20 ng/mL (61%) and White Americans had the least (17%). Serum 25(OH)D was inversely associated with HOMA-IR in fully adjusted models (−0.34% difference in HOMA-IR per ng/mL higher 25(OH)D, p<0.0001). Longitudinally, a 1 ng/mL higher serum 25(OH)D was associated with 2% lower risk of incident diabetes (HR 0.982, CI 0.974 to 0.991), and a 1 pg/mL higher serum PTH was associated with 1% higher risk of incident diabetes (HR 1.007, CI 1.004 to 1.010), both prior to adjustment for waist circumference. After adjusting for waist circumference, a 1 ng/mL higher 25(OH)D was associated with 1% lower risk of incident diabetes (HR 0.991, CI 0.983 to 1.000). The magnitude of association of serum 25(OH)D with incident diabetes was largest at lower waist circumference (p for interaction=0.025). There was no heterogeneity by race/ethnicity (p=0.317).ConclusionsSerum 25(OH)D is inversely associated with insulin resistance and incident diabetes in a diverse cohort, including non-Hispanic White, Black, Hispanic and Chinese Americans. Future research should explore mechanisms for the interaction between serum 25(OH)D and adiposity in this relationship.
Safety of routine childhood vaccine coadministration versus separate vaccination
Authors: Bauwens Jorgen , de Lusignan Simon , Weldesselassie Yonas Ghebremichael , Sherlock Julian , Künzli Nino , Bonhoeffer Jan 
Published: September 2022

IntroductionAs new vaccines are developed more vaccine coadministrations vaccines are being offered to make delivery more practical for health systems and patients. We compared the safety of coadministered vaccines with separate vaccination for 20 coadministrations by considering nine types of adverse events following immunisation (AEFI).MethodsReal-life immunisation and adverse event data for this observational cohort study were extracted from the Oxford-Royal College of General Practitioners Research and Surveillance Centre for children registered in the database between 2008 and 2018. We applied the self-controlled case series method to calculate relative incidence ratios (RIR) for AEFI. These RIRs compare the RI of AEFI following coadministration with the RI following separate administration of the same vaccines.ResultsWe assessed 3 518 047 adverse events and included 5 993 290 vaccine doses given to 958 591 children. 17% of AEFI occurred less and 11% more frequently following coadministration than would have been expected based on the RIs following separate vaccinations, while there was no significant difference for 72% of AEFI. We found amplifying interaction effects for AEFI after five coadministrations comprising three vaccines: for fever (RIR 1.93 (95% CI 1.63 to 2.29)), rash (RIR 1.49 (95% CI 1.29 to 1.74)), gastrointestinal events (RIR 1.31 (95% CI 1.14 to 1.49)) and respiratory events (RIR 1.27 (1.17–1.38)) following DTaP/IPV/Hib+MenC+ PCV; gastrointestinal events (RIR 1.65 (95% CI 1.35 to 2.02)) following DTaP/IPV/Hib+MenC+ RV; fever (RIR 1.44 (95% CI 1.09 to 1.90)) and respiratory events (RIR 1.40 (95% CI 1.25 to 1.57)) following DTaP/IPV/Hib+PCV+ RV; gastrointestinal (RIR 1.48 (95% CI 1.20 to 1.82)) and respiratory events (RIR 1.43 (95% CI 1.26 to 1.63)) following MMR+Hib/MenC+PCV; gastrointestinal events (RIR 1.68 (95% CI 1.07 to 2.64)) and general symptoms (RIR 11.83 (95% CI 1.28 to 109.01)) following MMR+MenC+PCV. Coadministration of MMR+PCV led to more fever (RIR 1.91 (95% CI 1.83 to 1.99)), neurological events (RIR 2.04 (95% CI 1.67 to 2.49)) and rash (RIR 1.06 (95% CI 1.01 to 1.11)) compared with separate administration, DTaP/IPV/Hib+MMR to more musculoskeletal events (RIR 3.56 (95% CI 1.21 to 10.50)) and MMR+MenC to more fever (RIR 1.58 (95% CI 1.37 to 1.82)). There was no indication that unscheduled coadministrations are less safe than scheduled coadministrations.ConclusionReal-life RIRs of AEFI justify coadministering routine childhood vaccines according to the immunisation schedule. Further research into the severity of AEFI following coadministration is required for a complete understanding of the burden of these AEFI.
Operationalising fairness in medical AI adoption: detection of early Alzheimer’s disease with 2D CNN
Authors: Heising Luca , Angelopoulos Spyros 
Published: September 2022

ObjectivesTo operationalise fairness in the adoption of medical artificial intelligence (AI) algorithms in terms of access to computational resources, the proposed approach is based on a two-dimensional (2D) convolutional neural networks (CNN), which provides a faster, cheaper and accurate-enough detection of early Alzheimer’s disease (AD) and mild cognitive impairment (MCI), without the need for use of large training data sets or costly high-performance computing (HPC) infrastructures.MethodsThe standardised Alzheimer’s Disease Neuroimaging Initiative (ADNI) data sets are used for the proposed model, with additional skull stripping, using the Brain Extraction Tool V.2approach. The 2D CNN architecture is based on LeNet-5, the Leaky Rectified Linear Unit activation function and a Sigmoid function were used, and batch normalisation was added after every convolutional layer to stabilise the learning process. The model was optimised by manually tuning all its hyperparameters.ResultsThe model was evaluated in terms of accuracy, recall, precision and f1-score. The results demonstrate that the model predicted MCI with an accuracy of 0.735, passing the random guessing baseline of 0.521 and predicted AD with an accuracy of 0.837, passing the random guessing baseline of 0.536.DiscussionThe proposed approach can assist clinicians in the early diagnosis of AD and MCI, with high-enough accuracy, based on relatively smaller data sets, and without the need of HPC infrastructures. Such an approach can alleviate disparities and operationalise fairness in the adoption of medical algorithms.ConclusionMedical AI algorithms should not be focused solely on accuracy but should also be evaluated with respect to how they might impact disparities and operationalise fairness in their adoption.
Predicting surgical department occupancy and patient length of stay in a paediatric hospital setting using machine learning: a pilot study
Authors: Barak Corren Yuval , Merrill Joshua , Wilkinson Ronald , Cannon Courtney , Bickel Jonathan , Reis Ben Y 
Published: September 2022

ObjectiveEarly and accurate prediction of hospital surgical-unit occupancy is critical for improving scheduling, staffing and resource planning. Previous studies on occupancy prediction have focused primarily on adult healthcare settings, we sought to develop occupancy prediction models specifically tailored to the needs and characteristics of paediatric surgical settings.Materials and methodsWe conducted a single-centre retrospective cohort study at a surgical unit in a tertiary-care paediatric hospital in Boston, Massachusetts, USA. We developed a hierarchical modelling framework for predicting next-day census using multiple types of data—from bottom-up patient-specific orders and procedures to top-down temporal variables and departmental admission statistics.ResultsThe model predicted upcoming admissions and discharges with a median error of 17%–21% (2–3 patients per day), and next-day census with a median error of 7% (n=3). The primary factors driving these predictions included day of week and scheduled surgeries, as well as procedure duration, procedure type and days since admission. We found that paediatric surgical procedure duration was highly predictive of postoperative length of stay.DiscussionOur hierarchical modelling framework provides an overview of the factors driving capacity issues in the paediatric surgical unit, highlighting the importance of both top-down temporal features (eg, day of week) as well as bottom-up electronic health records (EHR)derived features (eg, orders for patient) for predicting next-day census. In the practice, this framework can be implemented stepwise, from top to bottom, making it easier to adopt.ConclusionModelling frameworks combining top-down and bottom-up features can provide accurate predictions of next-day census in a paediatric surgical setting.
Designing an electronic medical record alert to identify hospitalised patients with HIV: successes and challenges
Authors: El-Nahal Walid , Grader-Beck Thomas , Gebo Kelly , Holmes Elizabeth , Herne Kayla , Moore Richard , Thompson David , Berry Stephen 
Published: September 2022

ObjectivesElectronic medical record (EMR) tools can identify specific populations among hospitalised patients, allowing targeted interventions to improve care quality and safety. We created an EMR alert using readily available data elements to identify hospitalised people with HIV (PWH) to facilitate a quality improvement study intended to address two quality/safety concerns (connecting hospitalised PWH to outpatient HIV care and reducing medication errors). Here, we describe the design and implementation of the alert and analyse its accuracy of identifying PWH.MethodsThe EMR alert was designed to trigger for at least one of four criteria: (1) an HIV ICD-10-CM code in a problem list, (2) HIV antiretroviral medication(s) on medication lists, (3) an HIV-1 RNA assay ordered or (4) a positive HIV-antibody result. We used manual chart reviews and an EMR database search to determine the sensitivity and positive predictive value (PPV) of the overall alert and its individual criteria.ResultsOver a 24-month period, the alert functioned as intended, notifying an intervention team and a data abstraction team about admissions of PWH. Manual review of 1634 hospitalisations identified 18 PWH hospitalisations, all captured by the alert (sensitivity 100%, 95% CI 82.4% to 100.0%). Over the 24 months, the alert triggered for 1191 hospitalisations. Of these, 1004 were PWH hospitalisations, PPV=84.3% (95% CI 82.2% to 86.4%). Using fewer criteria (eg, using only ICD-10-CM codes) identified fewer PWH but increased PPV.ConclusionAn EMR alert effectively identified hospitalised PWH for a quality improvement intervention. Similar alerts might be adapted as tools to facilitate interventions for other chronic diseases.
Effect of digital-enabled multidisciplinary therapy conferences on efficiency and quality of the decision making in prostate cancer care
Authors: Ronmark Erik , Hoffmann Ralf , Skokic Viktor , de Klerk-Starmans Maud , Jaderling Fredrik , Vos Pieter , Gayet Maudy C W , Hofstraat Hans , Janssen Marco , Akre Olof , Vincent Per Henrik 
Published: September 2022

ObjectivesTo investigate the impact on efficiency and quality of preprostatectomy multidisciplinary therapy conferences (MDT) at Karolinska University Hospital related to the use of a digital solution compared with standard of care. Further, to explore whether gains in MDT efficiency and quality impact oncological or functional patient outcomes.MethodsWe conducted a prospective, observational study of preoperative prostate cancer MDT at Karolinska between February 2017 and March 2021, including 1329 patients. We compared efficiency and quality of the standard MDT and the MDT using the digital solution IntelliSpace Precision Medicine Multidisciplinary Team Orchestrator (ISPM) based on the previously used MDT-MODe approach. Clinical and patient-reported functional outcomes were derived from the medical records and the Swedish National Prostate Cancer Register.ResultsWhile ISPM was used during the MDT meeting, the time spent per patient was reduced by 24% (p<0.001) and most of the MDT-MODe items were scored significantly higher. There was a reduction in pelvic lymph-node dissection procedures in the ISPM cohort (p=0.001) and an increased proportion of unilateral nerve-sparing procedures (p=0.005), while all other outcome-related measures were not significantly different between the two patient groups.Discussion and conclusionTo increase the value of the MDT, all data relevant for treatment decision need to be purposefully presented and compiled, which also enables secondary use of the data.The use of a digital solution during preoperative MDTs for prostate cancer decision making at Karolinska University Hospital improved the efficiency and quality of this multidisciplinary team meeting without impacting patient outcomes.
4 Early identification of high-risk individuals for combination monoclonal antibody therapy is feasible by SARS-CoV-2 anti-spike antibody specific lateral flow assay
Authors: Pallett Scott JC , Rayment Michael , Randell Paul , Davies Gary W , Moore Luke SP 
Published: September 2022

BackgroundCombination monoclonal antibody therapy has recently been approved for prevention and treatment of severe COVID-19 infection in the UK. Available data suggests benefit is limited to those yet to mount an effective immune response from natural infection or vaccination, but concern exists around ability to make timely assessment of immune status of community-based patients.MethodsHealthcare workers were invited to undergo paired laboratory-based and rapid point-of- care (POC) lateral flow anti-spike antibody testing. Three commercial POC tests were selected to represent currently available testing methods: a split IgM/IgG anti-spike antibody test, an anti-receptor binding domain total antibody test and an anti-spike neutralisation assay. Qualitative POC colourmetric band intensities were independently scored and correlated with quantitative IgG neutralising antibody titres (Abbott Architect SARS-CoV-2 IgG Quant II chemiluminescent microparticle immunoassay [CMIA]). CMIA titres were correlated with the World Health Organisation international reference standard for neutralising antibody. Negative controls were carried out using 2018 pre-pandemic sera and post-pandemic individuals with negative CMIA results (target population).Results190 individuals (median 40 years, IQR 29-49; 76.2% female) underwent paired testing, with a further 40 pre-pandemic sera tested. Assays demonstrated high performance characteristics: split IgM/IgG assay sensitivity 96.2% (95%CI 92.4.5–98.5), specificity 100.0% (95%CI 91.8–100.0); anti-receptor binding domain total antibody assay sensitivity 100.0% (95%CI 95.5–100.0), specificity 100.0% (95%CI 69.2–100.0). The neutralising antibody assay had a specificity of 97.0% (95%CI 84.2–99.9%) and strongly correlated with neutralising antibody titre (p<0.001). Probability for matched paired results was significant (McNemar’s p<0.001) while band intensity correlated strongly with neutralising titres (p<0.0001). Positive and negative predictive values for total antibody and neutralising assays were both >99%.ConclusionsPOC assays were found to be reliable predictors of both antibody status and broadly of neutralising antibody titre. Anti-S POC assays have potential to act as suitable alternatives for rapid identification of community patient immune status at presentation.
Evaluation of the introduction of QOF quality improvement modules in English general practice: early findings from a rapid, qualitative exploration of implementation
Authors: Bramwell Donna , Hotham Sarah , Peckham Stephen , Checkland Kath , Forbes Lindsay J L 
Published: September 2022

BackgroundA 2018 review of the English primary care pay-for-performance scheme, the Quality and Outcomes Framework, suggested that it should evolve to better support holistic, patient-centred care and leadership for quality improvement (QI). From 2019, as part of the vision of change, financially incentivised QI cycles (initially in prescribing safety and end-of-life care), were introduced into the scheme.ObjectivesTo conduct a rapid evaluation of general practice staff attitudes, experiences and plans in relation to the implementation of the first two QI modules. This study was commissioned by NHS England and will inform development of the QI programme.MethodsSemistructured telephone interviews were conducted with 25 practice managers from a range of practices across England. Interviews were audio recorded with consent and transcribed verbatim. Anonymised data were reflexively thematically analysed using the framework method of analysis to identify common themes across the interviews.ResultsParticipants reported broadly favourable views of incentivised QI, suggesting the prescribing safety module was easier to implement than the end-of-life module. Additional staff time needed and challenges of reviewing activities with other practices were reported as concerns. Some highlighted that local flexibility and influence on subject matter may improve the effectiveness of QI. Several questioned the choices of topic, recognising greater need and potential for improving quality of care in other clinical areas.ConclusionPractices supported the idea of financial incentivisation of QI, however, it will be important to ensure that focus on QI cycles in specific clinical areas does not have unintended effects. A key issue will be keeping up momentum with the introduction of new modules each year which are time consuming to carry out for time poor General Practitioners (GPs)/practices.