bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation on Redundancy-Induced Rigidity Enhancement of a Parallel Manipulator
Authors: Fang Han-liang , Tang Teng-fei , He Zhen , Zhang Jun 
Published: August 2022

Abstract
Redundantly actuated parallel manipulator (RAPM) has been proved to have comparative advantages of higher rigidity and higher payload over other parallel manipulators. This paper is to quantitatively reveal the effect of redundancy on rigidity enhancement of a previously invented 2UPR&1RPS&1RPU RAPM. For this purpose, three critical issues are clarified, i.e., establishing a sufficient accurate stiffness model, constructing a reasonable index frame for evaluating rigidity performance, and quantifying the effect of redundancy on the rigidity enhancement. First, drawing on the screw theory, a hierarchical method is presented to establish a semi-analytic stiffness model at the joint level for the proposed RAPM. Subsequently, based on the stiffness matrix, a set of local and global stiffness indices are constructed to evaluate the rigidity of parallel manipulators. Finally, the stiffness indices of the 2UPR&1RPS&1RPU RAPM and its non-redundantly actuated forms are predicted and compared to reveal the effort of redundancy. The present work is expected to provide a useful frame for quantitatively assessing redundancy-induced rigidity enhancement in redundantly actuated parallel manipulators.
Experimental Investigation of the Humidification Parameters in a Vertically Aligned Triple Pad Multistage Evaporative Cooler
Authors: Salins Sampath Suranjan , Kumar Shiva , Kota Reddy S.V. , Ajith Krishna 
Published: August 2022

Abstract
The present work involves designing and fabricating the three-stage humidifier test rig where three Celdek 7090 packings are arranged vertically at equidistance, forming a multistage humidifier. Water flowrate and airflow rates are regulated to obtain required humidification under both single-pad and three-pad configurations. Output variables like the coefficient of performance, evaporation rate, cooling effect, cooling efficiency, and pressure drop are determined. Results indicated that three-stage packing gave high performance compared to the single stage. Changes in temperature, change in humidity, saturation efficiency, and coefficient of performance values are 6.5 °C, 44%, 80%, and 2.1, respectively, are the maximum values noticed for the multistage humidifier. The study indicated that with the increase in the rate of water flow, there is a rise in performance parameters till a water flowrate of 0.6 l per minute, and after this value, performance deteriorates. Even though multistage performs better than a single stage, as the number of stages increases, the stage-wise performance declines.
Missed opportunities in the treatment of Turner syndrome: a case discussion and review of the guidelines
Authors: Howarth Sophie , Quinton Richard 
Published: August 2022

A woman in her 50s with Turner syndrome was referred to the endocrine clinic, having been unaware of her diagnosis until she received a shielding letter from the UK government during the COVID-19 pandemic. Despite a neonatal diagnosis of Turner syndrome on her general practitioner record and despite having undergone laparoscopic examination for absent puberty and primary amenorrhoea aged 18 years, she had not received any prior hormone treatment or cardiovascular screening.Though Turner syndrome is rare, recent data from the UK Biobank suggest that it may be underdiagnosed. Clinicians should be aware of the clinical features and associated complications of Turner syndrome to avoid delayed diagnosis and missed opportunities for treatment.In this report, we discuss the clinical features of this rare syndrome and current guidelines for screening and treatment. We stress the importance of peer-to-peer support and information sharing through patient-led groups, such as the Turner Syndrome Support Society.
The 12-Item Hypoglycemia Impact Profile (HIP12): psychometric validation of a brief measure of the impact of hypoglycemia on quality of life among adults with type 1 or type 2 diabetes
Authors: Broadley Melanie , Chatwin Hannah , Søholm Uffe , Amiel Stephanie A , Carlton Jill , De Galan Bastiaan E , Hendrieckx Christel , McCrimmon Rory J , Skovlund Søren E , Pouwer Frans , Speight Jane 
Published: August 2022

IntroductionThe aim of this study was to determine the psychometric properties of the 12-Item Hypoglycemia Impact Profile (HIP12), a brief measure of the impact of hypoglycemia on quality of life (QoL) among adults with type 1 (T1D) or type 2 diabetes (T2D).Research design and methodsAdults with T1D (n=1071) or T2D (n=194) participating in the multicountry, online study, ‘Your SAY: Hypoglycemia’, completed the HIP12. Psychometric analyses were undertaken to determine acceptability, structural validity, internal consistency, convergent/divergent validity, and known-groups validity.ResultsMost (98%) participants completed all items on the HIP12. The expected one-factor solution was supported for T1D, T2D, native English speaker, and non-native English speaker groups. Internal consistency was high across all groups (ω=0.91–0.93). Convergent and divergent validity were satisfactory. Known-groups validity was demonstrated for both diabetes types, by frequency of severe hypoglycemia (0 vs ≥1 episode in the past 12 months) and self-treated episodes (<2 vs 2–4 vs ≥5 per week). The measure also discriminated by awareness of hypoglycemia in those with T1D.ConclusionsThe HIP12 is an acceptable, internally consistent, and valid tool for assessing the impact of hypoglycemia on QoL among adults with T1D. The findings in the relatively small sample with T2D are encouraging and warrant replication in a larger sample.
Determinants of physical activity among 6856 individuals with diabetes: a nationwide cross-sectional study
Authors: Mortensen Sofie Rath , Kristensen Peter Lund , Grøntved Anders , Ried-Larsen Mathias , Lau Cathrine , Skou Søren T 
Published: August 2022

IntroductionThe aims of this cross-sectional study were to (1) describe habitual physical activity and adherence to WHO recommendations, and (2) investigate the association of comorbidity, obesity, stress, and health-related quality of life (HRQoL) with moderate to vigorous physical activity (MVPA) among individuals with diabetes.Research design and methodsThis study included 6856 participants with diabetes from the Danish National Health Survey from 2017. The primary outcome measure was weekly MVPA. Exposures included self-reported number of conditions, body mass index (BMI), perceived stress, and HRQoL. Mean difference in MVPA across exposures was estimated by multiple linear regression analyses.ResultsForty per cent of individuals with diabetes were not adherent to WHO recommendations for physical activity. Individuals with diabetes had higher BMI, more comorbidities, higher perceived stress, and lower HRQoL. Individuals with three or more comorbidities were significantly associated with lower weekly MVPA (−0.48 hours/week, 95% CI −0.88 to −0.07) compared with individuals with no comorbidity. Furthermore, overweight or obese (class I–III) individuals engaged in significantly less weekly MVPA (obese class III vs normal weight: −1.98 hours/week, 95% CI −2.49 to −1.47). Higher perceived stress was significantly associated with lower weekly MVPA (−1.76 hours/week, 95% CI −2.18 to −1.34) versus low perceived stress. Finally, having low physical and mental HRQoL was associated with lower weekly MVPA (−0.93 hours/week, 95% CI −1.19 to −0.66 and −0.39 hours/week, 95% CI −0.71 to −0.08 respectively vs moderate or high HRQoL).ConclusionsWe found that 40% of individuals with diabetes do not engage regularly in adequate physical activity. Comorbidities, higher BMI, higher perceived stress, and lower HRQoL were associated with less engagement in physical activity. This study suggests that subgroups of individuals with diabetes are at higher risk of physical inactivity.
Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study
Authors: Tan Monique , He Feng , Morris Joan K , MacGregor Graham 
Published: August 2022

IntroductionIn China, salt intake is among the highest in the world (~11 g/day) and cardiovascular disease (CVD) accounts for 40% of deaths. We estimated the potential impact of reducing salt intake on CVD events in China, via systolic blood pressure (SBP).MethodsTo develop our model, we extracted the effect of salt reduction on SBP from a meta-regression of randomised trials and a population study, and that of SBP on CVD risk from pooled cohort studies.ResultsReducing population salt intake in China by 1 g/day could lower the risk for ischaemic heart disease by about 4% (95% uncertainty interval 1.8%–7.7%) and the risk for stroke by about 6% (2.4%–9.3%). Should this reduced salt level be sustained until 2030,~9 million (M) (7M–10.8M) CVD events could be prevented, of which ~4M (3.1M–4.9M) would have been fatal. Greater and gradual salt intake reductions, to achieve WHO’s target of 30% reduction by 2025 or the Chinese government’s target of ≤5 g/day by 2030, could prevent ~1.5 or 2 times more CVD events and deaths, respectively. Should the prolonged effect of salt reduction over several years be accounted for, all estimates of CVD events and deaths prevented would be 25% greater on average.ConclusionBringing down the high salt intake levels in China could result in large reductions in CVD. An easily achievable reduction of 1 g/day could prevent ~9M CVD events by 2030. Urgent action must be taken to reduce salt intake in China.
Effect of voluntary Health Star Rating labels on healthier food purchasing in New Zealand: longitudinal evidence using representative household purchase data
Authors: Bablani Laxman , Ni Mhurchu Cliona , Neal Bruce , Skeels Christopher L , Staub Kevin E , Blakely Tony 
Published: August 2022

Front-of-pack labelling (FoPL) aims to promote healthier diets by altering consumer food purchasing behaviour. We quantify the impact of the voluntary Health Star Rating (HSR) FoPL adopted by New Zealand (NZ) in 2014, on (i) the quantity of foods purchased by HSR scores and food groups and (ii) the quantities of different nutrients purchased.We used Nielsen HomeScan household purchasing panel data over 2013–2019, linked to Nutritrack packaged food composition data. Fixed effects analyses were used to estimate the association of HSR with product and nutrient purchasing. We controlled for NZ-wide purchasing trends and potential confounding at the household and product level.In 2019, HSR-labelled products accounted for 24% (2890) of 12 040 products in the dataset and 32% of purchasing volume. Of HSR-labelled products, 1339 (46%) displayed a rating of 4.0–5.0 stars and 556 (19%) displayed a rating of 0.5–2.0 stars.We found little or no association between HSR labelling and the quantities of different foods purchased. Introduction of HSR was, however, associated with lower sodium (−9%, 95% CI −13% to −5%), lower protein (−3%, 95% CI −5% to 0%) and higher fibre (5%, 95% CI 2% to 7%) purchases when purchased products carrying an HSR were compared with the same products prior to introduction of the programme.Robust evidence of HSR labelling changing consumer purchasing behaviour was not observed. The positive effect on nutrient purchasing of HSR-labelled foods likely arises from reformulation of products to achieve a better HSR label.
Study protocol: Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)
Authors: James Fiona , Goh Michelle S Y , Mouhtouris Effie , Vogrin Sara , Chua Kyra Y L , Holmes Natasha E , Awad Andrew , Copaescu Ana-Maria , De Luca Joseph F , Zubrinich Celia , Gin Douglas , Cleland Heather , Douglas Abby , Kern Johannes S , Katelaris Constance H , Thien Francis , Barnes Sara , Yun James , Tong Winnie , Smith William B , Carr Andrew , Anderson Tara , Legg Amy , Bourke Jack , Mackay Laura K , Aung Ar Kar , Phillips Elizabeth J , Trubiano Jason 
Published: August 2022

IntroductionSevere cutaneous adverse reactions (SCAR) are a group of T cell-mediated hypersensitivities associated with significant morbidity, mortality and hospital costs. Clinical phenotypes include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalised exanthematous pustulosis (AGEP). In this Australasian, multicentre, prospective registry, we plan to examine the clinical presentation, drug causality, genomic predictors, potential diagnostic approaches, treatments and long-term outcomes of SCAR in Australia and New Zealand.Methods and analysisAdult and adolescent patients with SCAR including SJS, TEN, DRESS, AGEP and another T cell-mediated hypersensitivity, generalised bullous fixed drug eruption, will be prospectively recruited. A waiver of consent has been granted for some sites to retrospectively include cases which result in early mortality. DNA will be collected for all prospective cases. Blood, blister fluid and skin biopsy sampling is optional and subject to patient consent and site capacity. To develop culprit drug identification and prevention, genomic testing will be performed to confirm human leukocyte antigen (HLA) type and ex vivo testing will be performed via interferon-γ release enzyme linked immunospot assay using collected peripheral blood mononuclear cells. The long-term outcomes of SCAR will be investigated with a 12-month quality of life survey and examination of prescribing and mortality data.Ethics and disseminationThis study was reviewed and approved by the Austin Health Human Research Ethics Committee (HREC/50791/Austin-19). Results will be published in peer-reviewed journals and presented at relevant conferences.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000241134).
Watch me grow integrated (WMG-I): protocol for a cluster randomised controlled trial of a web-based surveillance approach for developmental screening in primary care settings
Authors: Eapen Valsamma , Liaw Siaw-Teng , Lingam Raghu , Woolfenden Susan , Jalaludin Bin , Page Andrew , Kohlhoff Jane , Scott James G , Lawson K D , Lam-Cassettari Christa , Heussler Helen , Descallar Joseph , Karlov Lisa , Ong Natalie , Colditz Paul B , Littlewood Robyn , Murphy Elisabeth , Deering April , Short Kate , Garg Pankaj , Blight Victoria , Rodgers Kim , Chalmers Lucille , Webb Kerri-Lyn , Atkins Heidi , Newcomb Dana , Beswick Rachael , Thomas Clare , Marron Catherine , Chambers Aaron , Scheinpflug Sue , Statham Matt , Samaranayake Dimuthu , Chay Paul , Tam Chun Wah Michael , Khan Feroza , Mendoza Diaz Antonio , Cibralic Sara , Winata Teresa , Pritchard Margo 
Published: August 2022

IntroductionThe increasing prevalence of developmental disorders in early childhood poses a significant global health burden. Early detection of developmental problems is vital to ensure timely access to early intervention, and universal developmental surveillance is recommended best practice for identifying issues. Despite this, there is currently considerable variation in developmental surveillance and screening between Australian states and territories and low rates of developmental screening uptake by parents. This study aims to evaluate an innovative web-based developmental surveillance programme and a sustainable approach to referral and care pathways, linking primary care general practice (GP) services that fall under federal policy responsibility and state government-funded child health services.Methods and analysisThe proposed study describes a longitudinal cluster randomised controlled trial (c-RCT) comparing a ‘Watch Me Grow Integrated’ (WMG-I) approach for developmental screening, to Surveillance as Usual (SaU) in GPs. Forty practices will be recruited across New South Wales and Queensland, and randomly allocated into either the (1) WMG-I or (2) SaU group. A cohort of 2000 children will be recruited during their 18-month vaccination visit or opportunistic visit to GP. At the end of the c-RCT, a qualitative study using focus groups/interviews will evaluate parent and practitioner views of the WMG-I programme and inform national and state policy recommendations.Ethics and disseminationThe South Western Sydney Local Health District (2020/ETH01625), UNSW Sydney (2020/ETH01625) and University of Queensland (2021/HE000667) Human Research Ethics Committees independently reviewed and approved this study. Findings will be reported to the funding bodies, study institutes and partners; families and peer-reviewed conferences/publications.Trial registration numberANZCTR12621000680864.
Endothelial failure and rejection in recipients of corneas from the same donor
Authors: Downward Lewis , Ahmed Mahmoud , Hopkinson Cathy , Romano Vito , Curnow Elinor , Kaye Stephen B 
Published: August 2022

ObjectiveTo determine whether patients who receive corneas from the same donor have similar risks of endothelial failure and rejection.Methods and AnalysisPatients with Fuchs endothelial dystrophy (FED) and pseudophakic bullous keratopathy (PBK) who received their first corneal transplant between 1999 and 2016 were analysed. Patients receiving corneas from donors who donated both corneas for the same indication were defined as ‘paired’. Gray’s test was used to compare the cumulative incidence of endothelial failure and rejection within 5 years post-transplant for ‘paired’ and ‘unpaired’ groups. Cox regression models were fitted to determine whether there was an association between recorded donor characteristics (endothelial cell density (ECD), age and sex and endothelial graft failure and rejection.Results10 838 patients were analysed of whom 1536 (14%) were paired. The unpaired group comprised 1837 (69%) recipients of single corneal donors and 7465 (69%) donors who donated both corneas for another indication. ECD was lower for unpaired single cornea donors (p<0.01). There was no significant difference in endothelial graft failure or rejection between paired and unpaired groups for FED (p=0.37, p=0.99) or PBK (p=0.88, p=0.28) nor for donor ECD, age, sex and paired donation after adjusting for transplant factors (across all models p>0.16 for ECD, p>0.32 for donor age, p>0.14 for sex match and p>0.17 for the donor effect).ConclusionThe absence of a significant difference in graft outcome for corneal transplants for FED and PBK between paired and unpaired donors may reflect a homogeneous donor pool in the UK.
Prevalence of Fabry disease-causing variants in the UK Biobank
Authors: Gilchrist Mark , Casanova Francesco , Tyrrell Jess S , Cannon Stuart , Wood Andrew R , Fife Nicole , Young Katherine , Oram Richard A , Weedon Michael N 
Published: August 2022

BackgroundFabry disease is an X-linked lysosomal storage disorder resulting from deficiency of the alpha-galactosidase A enzyme leading to accumulation of globotriaosylceramide in multiple organ sites with prominent cardiovascular and renal involvement. Global prevalence estimates of Fabry disease based on clinical ascertainment range from 1 in 40 000 to 1 in 170 000. We aimed to determine the prevalence of Fabry disease-causing variants in UK Biobank.MethodsWe soughtGLAgene variants in exome sequencing data from 200 643 individuals from UK Biobank. We used ACMG/AMP guidelines (American College of Medical Genetics/Association for Molecular Pathology) to classify pathogenicity and compared baseline biomarker data, hospital ICD-10 (International Classification of Diseases version-10) codes, general practitioner records and self-reported health data with those without pathogenic variants.ResultsWe identified 81GLAcoding variants. We identified eight likely pathogenic variants on the basis of being rare (<1/10 000 individuals) and either previously reported to cause Fabry disease, or being protein-truncating variants. Thirty-six individuals carried one of these variants. In the UK Biobank, the prevalence of likely pathogenic Fabry disease-causing variants is 1/5732 for late-onset disease-causing variants and 1/200 643 for variants causing classic Fabry disease.ConclusionFabry disease-causingGLAvariants are more prevalent in an unselected population sample than the reported prevalence of Fabry disease. These are overwhelmingly variants associated with later onset. It is possible the prevalence of later-onset Fabry disease exceeds current estimates.
Examining the incidence of acute stress in pediatric trauma patients
Authors: Schauss Eraina , Hawes Kiersten , Roberts Sydnie , Clayton Joseph Mitchell , Li Chi , Littlejohn Alexandria , Bartelli Debra , Williams Regan 
Published: August 2022

ObjectivePediatric patients can be significantly impacted emotionally by exposure to acute trauma which may negatively impact long-term functioning and lead to an increase in overall distress. This study reports on the incidence of acute stress disorder among pediatric trauma patients in a hospital setting in the southeastern region of the USA.MethodsPediatric patient mental health assessments were conducted using the Childhood Stress Disorders Checklist- Short Form (CSDC-SF) as part of a new integrated behavioral health standard of care within the Trauma Services Division of a level 1 pediatric hospital. Mental health consultations occurred at bedside on inpatient hospital admission into trauma services, or at the outpatient hospital clinic after discharge for injuries treated in the emergency department.ResultsAssociations among type of trauma, child age, and sex were explored in a sample of 617 children (58.9% male) aged 2–18 years (Mage=10.27). The sample was primarily ethnic minorities (56.1% black/African-American, 5% Hispanic/Latinx). Fifteen per cent or more of trauma reports were for burns (26%), motor vehicle accident (22.7%), and recreational sports or leisure activity-related injury (17.5%). Sixty-four per cent of children scored ≥1 on the CSDC-SF, indicating symptoms consistent with acute stress disorder. Higher scores were associated with female sex, age, and injury type.Level of evidenceLevel IV study provides evidence of the link between traumatic injury and mental health symptoms in a pediatric population. Findings highlight the critical need for mental health screening and provision of integrated mental health counseling services at time of acute pediatric trauma.
Competition Effects on Audit Quality and Pricing in a Non-Big 4 Market
Authors: Azizkhani Masoud , Sami Heibatollah , Amirkhani Kourosh , Monroe Gary S. 
Published: August 2022

Synopsis The research problem Adding to the literature on audit market competition, this study examined how increasing competition affects audit pricing and audit quality in an emerging market where regulatory policies have resulted in increased competition (less market concentration) in the audit market, and Big 4 auditors are banned. The test hypotheses H1: Audit market concentration (competition) is positively (negatively) associated with audit fees. H2: Audit market competition is associated with audit quality. Target population Various stakeholders including regulators, auditors, firm managers, and users of financial reports. Adopted methodology Multivariate analysis using ordinary least squares and logit regressions. Analyses Using the Herfindahl index to measure competition in the audit market at the national level, we used a sample of listed firms from the emerging Iranian audit market, which is characterized by increase in audit market competition as a result of a regulatory change and a lack of market concentration because the audit market does not include Big 4 audit firms or any dominant local audit firms to examine the impact of competition on audit pricing and audit quality. Findings We found that higher (lower) levels of audit market competition measured using the Herfindahl index are associated with lower (higher) audit fees and higher (lower) levels of abnormal accruals. These results suggest that increased competition in audit markets in developing economies generates audit fee pressure, which negatively affects audit quality.