bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Lower Limb Exoskeleton for Walking Assistance Using Energy Recycled From Human Knee Joint
Authors: Chen Bing , Shi Chenpu , Zheng Chengwang , Zi Bin , Zhao Ping , Li Yuan 
Published: October 2022

Abstract
This paper illustrates the design and testing of a lower limb exoskeleton for walking assistance. First, the biomechanics of the human knee and ankle joints during walking and the strategy of energy recycling and releasing are introduced. Next, the hardware design of the exoskeleton is described. The exoskeleton is primarily composed of a waist module, a knee module, and an ankle module. Two clutch mechanisms are designed for one-way motion transmission, and an energy storage spring is designed to store the energy recycled from the human knee motion. Additionally, the modeling of the human-exoskeleton system is presented. Finally, experiments are conducted to verify the effectiveness of the developed exoskeleton. The experimental results demonstrate that the exoskeleton has the potential to recycle the negative work from the wearer’s knee flexion during the late stance phase and knee extension during the swing phase to assist the wearer’s ankle plantarflexion during the stance phase. During a gait cycle, reductions of 11.6% and 15.6% of the average muscle activities of the gastrocnemius and soleus are observed, respectively. In addition, the peak gastrocnemius and soleus activities during the push-off stage are reduced by 16.9% and 42.6%, respectively.
Magnetohydrodynamic Natural Convection of Water in an L-Shaped Container Filled With an Aluminum Metal Foam
Authors: Al-Damook Amer , Azzawi Itimad D. J. 
Published: October 2022

Abstract
The current research employed computational simulation to assess magnetohydrodynamic (MHD) natural convection in an L-shaped container with a metal foam, which has a variety of engineering applications. The originality of this study is the use of numerical simulation combined with multi-objective optimization in terms of cooling rate enhancement and entropy generation reduction to investigate the optimal natural convection regimes. The influence of varied aspect ratios (AR), tilted angles of the container (θ), Hartmann number (Ha), and porosities (Φ) on the cooling rate with regard to the average Nusselt number (Nuave), Nusselt number enhancement (NNE), dimensionless surface temperature ([Ts]) and entropy generation (S) were evaluated. According to the findings of this study, little effect was found to be exerted by the MHD and θ on the Nuave, Ts, and S except for a porosity of 0.9. Furthermore, the Nuave and NNE enhance while the Ts and S reduce as the aspect ratio AR increases. In this case, the maximum increase in NNE was 8.78 times, with the greatest reductions in Ts and S as AR = 0.8, Φ = 0.1, θ = 0 deg, and Ha = 0 compared to the least favorable design. Thus, this optimum investigation of the CFD yields a novel approach and valuable recommendations for the optimum design of cooling in an L-shaped container.
Investigation into financial conflicts of interest and screening for atrial fibrillation in the UK: a cross-sectional study
Authors: McCartney Margaret , McCutcheon Calum , Cooke Millie , MacDonald Ronald , Mekwi Lena , Noruddin Ummi Haji , O'Keeffe Mary 
Published: October 2022

ObjectiveTo understand the relationship between financial conflicts of interest and recommendations for atrial fibrillation (AF) screening in the UK, via examining (1) if the UK media recommend for or against screening for AF, and (2) the financial conflicts of interests of AF screening commentators.DesignCross-sectional study.Setting/participantsReferences in UK mainstream media, Twitter, the UK’s National Health Service (NHS), patient information websites and major UK heart-related charities regarding screening for AF between1 January 2018 and 31 July 2021.Outcome measuresProportion of references advocating for, against and presenting balanced/neutral views on screening. Proportion of references citing commentators with financial conflicts of interest.Results217 media stories were identified, containing 284 comments about screening for AF. 185/217 (85.3%) of articles were in favour, 9 (4.1%) were against and 23 (10.6%) were balanced. Quotations within were located from 194 commentators; 44 were quoted more than once. 41/44 (93.2%) were in favour of screening. Of these 41, 37 (90.2%) had a direct or indirect financial conflict of interest, including that due to a work role. Two were balanced and one was negative. 2553 tweets using 3 hashtags promoting screening were analysed. 2119 (83%) of the most impactful tweets promoting AF screening were by industry or organisations with industry funding. Of 23 NHS organisations holding information about funding and promoting AF screening online, 22 (96%) had industry funding. 9 (90%) of the top 10 patient information websites promoting AF screening had industry funding. Four main UK patient charities in this sector promoting screening received industry funding.ConclusionsThe vast majority of UK media promotes screening for AF, in contrast to the position of the independent UK National Screening Committee, which recommends against screening. Most commentators, internal NHS organisations and UK charities promoting screening had a direct or indirect financial conflict of interest. Independent information was rare. The reasons for this are unknown. Readers should consider the potential for the impact of financial conflicts on recommendations to screen.
Development of an intervention (PICASO) to optimise the palliative care capacity of social workers in Flanders: a study protocol based on phase I of the Medical Research Council framework
Authors: Taels Brent , Hermans Kirsten , Van Audenhove Chantal , Cohen Joachim , Hermans Koen , Declercq Anja 
Published: October 2022

IntroductionAn important challenge for future palliative care delivery is the growing number of people with palliative care needs compared with the limited qualified professional workforce. Existing but underused professional potential can further be optimised. This is certainly the case for social work, a profession that fits well in multidisciplinary palliative care practice but whose capacities remain underused. This study aims to optimise the palliative care capacity of social workers in Flanders (Belgium) by the development of a Palliative Care Program for Social Work (PICASO).Methods and analysisThis protocol paper covers the steps of the development of PICASO, which are based on phase I of the Medical Research Council framework. However, additional steps were added to the original framework to include more opportunities for stakeholder involvement. The development of PICASO follows an iterative approach. First, we will identify existing evidence by reviewing the international literature and describe the problem by conducting quantitative and qualitative research among Flemish social workers. Second, we will further examine practice and identify an appropriate intervention theory by means of expert panels. Third, the process and outcomes will be depicted in a logic model.Ethics and disseminationEthical approval for this study was given by the KU Leuven Social and Societal Ethics Committee (SMEC) on 14 April 2021 (reference number: G-2020-2247-R2(MIN)). Findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
Understanding the use of evidence in the WHO Classification of Tumours: a protocol for an evidence gap map of the classification of tumours of the lung
Authors: del Aguila Mejía Javier , Armon Subasri , Campbell Fiona , Colling Richard , Chechlinska Magdalena , Kowalewska Magdalena , Pollán Marina , Holdenrieder Stefan , Tan Puay Hoon , Cree Ian , Indave Ruiz Blanca Iciar 
Published: October 2022

IntroductionThere are gaps in the evidence base of tumour classification despite being essential for cancer diagnosis, treatment and patient care. The WHO in charge of the production of an updated international classification, the WHO Classification of Tumours (WCT), aims to adapt evidence gap map (EGM) methodology to inform future editions of the WCT, by providing a visual summary of the existing evidence.Methods and analysisBibliographical references used in the WCT fifth edition of Tumours of the Lung (Thoracic Tumours volume) will be used as search results of a literature search. A descriptive analysis of the cited evidence for tumour types and descriptors will be drafted and plotted in EPPI-Reviewer to develop a visual evidence map. The resulting EGM will reflect the number of cited studies in the size of the spheres, and the level of evidence by applying a four-colour code (red=low level evidence, orange=moderate level, green=high level and blue=unclassifiable). Overview of the findings will be provided in narrative form and a report will discuss the overall stage of cited research in the WCT and will include analysis of gaps, under-researched categories of tumour descriptors and pockets of low-level evidence.Ethics and disseminationNo ethics approval will be required as this is a study of previously published material. Findings of the EGM will be published and used to guide editors, stakeholders and researchers for future research planning and related decision-making, especially for the development of future editions of the WCT.PROSPERO registration numberCRD42022302327.
Improving quality of surgical and anaesthesia care in sub-Saharan Africa: a systematic review of hospital-based quality improvement interventions
Authors: Brima Nataliya , Morhason-Bello Imran O , Charles Vandy , Davies Justine , Leather Andy JM 
Published: October 2022

ObjectivesTo systematically review existing literature on hospital-based quality improvement studies in sub-Saharan Africa that aim to improve surgical and anaesthesia care, capturing clinical, process and implementation outcomes in order to evaluate the impact of the intervention and implementation learning.DesignWe conducted a systematic literature review and narrative synthesis.SettingLiterature on hospital-based quality improvement studies in sub-Saharan Africa reviewed until 31 December 2021.ParticipantsMEDLINE, EMBASE, Global Health, CINAHL, Web of Science databases and grey literature were searched.InterventionWe extracted data on intervention characteristics and how the intervention was delivered and evaluated.Primary and secondary outcome measuresImportantly, we assessed whether clinical, process and implementation outcomes were collected and separately categorised the outcomes under the Institute of Medicine quality domains. Risk of bias was not assessed.ResultsOf 1573 articles identified, 49 were included from 17/48 sub-Saharan African countries, 16 of which were low-income or lower middle-income countries. Almost two-thirds of the studies took place in East Africa (31/49, 63.2%). The most common intervention focus was reduction of surgical site infection (12/49, 24.5%) and use of a surgical safety checklist (14/49, 28.6%). Use of implementation and quality improvement science methods were rare. Over half the studies measured clinical outcomes (29/49, 59.2%), with the most commonly reported ones being perioperative mortality (13/29, 44.8%) and surgical site infection rate (14/29, 48.3%). Process and implementation outcomes were reported in over two thirds of the studies (34/49, 69.4% and 35, 71.4%, respectively). The most studied quality domain was safety (44/49, 89.8%), with efficiency (4/49, 8.2%) and equitability (2/49, 4.1%) the least studied domains.ConclusionsThere are few hospital-based studies that focus on improving the quality of surgical and anaesthesia care in sub-Saharan Africa. Use of implementation and quality improvement methodologies remain low, and some quality domains are neglected.PROSPERO registration numberCRD42019125570
Randomised controlled trials in hand surgery: a scoping review
Authors: Heikkinen Juuso , Das De Soumen , Jokihaara Jarkko , Jaatinen Kati , Buchbinder Rachelle , Karjalainen Teemu 
Published: October 2022

ObjectivesTo identify the evidence gaps that exist regarding the efficacy or effectiveness of hand surgery.SettingA scoping review. We systematically searched MEDLINE, Embase and CENTRAL databases to identify all hand surgical randomised controlled trials from inception to 7 November 2020.ResultsOf the 220 identified randomised controlled trials, none were fundamental efficacy trials, that is, compared surgery with placebo surgery. 172 (78%) trials compared the outcomes of different surgical techniques, and 143 (65%) trials were trauma related. We identified only 47 (21%) trials comparing surgery with non-operative care or injection.ConclusionThe evidence supporting use of surgery especially for chronic hand conditions is scarce. To determine optimal care for people with hand conditions, more resources should be aimed at placebo-controlled trials and pragmatic effectiveness trials comparing hand surgery with non-operative care.PROSPERO registration numberCRD42019122710.
Protocol for the development of SPIRIT and CONSORT extensions for randomised controlled trials with surrogate primary endpoints: SPIRIT-SURROGATE and CONSORT-SURROGATE
Authors: Manyara Anthony Muchai , Davies Philippa , Stewart Derek , Weir Christopher J , Young Amber , Butcher Nancy J , Bujkiewicz Sylwia , Chan An-Wen , Collins Gary S , Dawoud Dalia , Offringa Martin , Ouwens Mario , Ross Joseph S , Taylor Rod S , Ciani Oriana 
Published: October 2022

IntroductionRandomised controlled trials (RCTs) may use surrogate endpoints as substitutes and predictors of patient-relevant/participant-relevant final outcomes (eg, survival, health-related quality of life). Translation of effects measured on a surrogate endpoint into health benefits for patients/participants is dependent on the validity of the surrogate; hence, more accurate and transparent reporting on surrogate endpoints is needed to limit misleading interpretation of trial findings. However, there is currently no explicit guidance for the reporting of such trials. Therefore, we aim to develop extensions to the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) reporting guidelines to improve the design and completeness of reporting of RCTs and their protocols using a surrogate endpoint as a primary outcome.Methods and analysisThe project will have four phases: phase 1 (literature reviews) to identify candidate reporting items to be rated in a Delphi study; phase 2 (Delphi study) to rate the importance of items identified in phase 1 and receive suggestions for additional items; phase 3 (consensus meeting) to agree on final set of items for inclusion in the extensions and phase 4 (knowledge translation) to engage stakeholders and disseminate the project outputs through various strategies including peer-reviewed publications. Patient and public involvement will be embedded into all project phases.Ethics and disseminationThe study has received ethical approval from the University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee (project no: 200210051). The findings will be published in open-access peer-reviewed publications and presented in conferences, meetings and relevant forums.
Association between practice coding of chronic kidney disease (CKD) in primary care and subsequent hospitalisations and death: a cohort analysis using national audit data
Authors: Cleary Faye , Kim Lois , Prieto-Merino David , Wheeler David , Steenkamp Retha , Fluck Richard , Adlam David , Denaxas Spiros , Griffith Kathryn , Loud Fiona , Hull Sally , Caplin Ben , Nitsch Dorothea 
Published: October 2022

ObjectiveTo examine the association between practice percentage coding of chronic kidney disease (CKD) in primary care with risk of subsequent hospitalisations and death.DesignRetrospective cohort study using linked electronic healthcare records.Setting637 general practitioner (GP) practices in England.Participants167 208 patients with CKD stages 3–5 identified by 2 measures of estimated glomerular filtration rate <60 mL/min/1.73 m2, separated by at least 90 days, excluding those with coded initiation of renal replacement therapy.Main outcome measuresHospitalisations with cardiovascular (CV) events, heart failure (HF), acute kidney injury (AKI) and all-cause mortalityResultsParticipants were followed for (median) 3.8 years for hospital outcomes and 4.3 years for deaths. Rates of hospitalisations with CV events and HF were lower in practices with higher percentage CKD coding. Trends of a small reduction in AKI but no substantial change in rate of deaths were also observed as CKD coding increased. Compared with patients in the median performing practice (74% coded), patients in practices coding 55% of CKD cases had a higher rate of CV hospitalisations (HR 1.061 (95% CI 1.015 to 1.109)) and HF hospitalisations (HR 1.097 (95% CI 1.013 to 1.187)) and patients in practices coding 88% of CKD cases had a reduced rate of CV hospitalisations (HR 0.957 (95% CI 0.920 to 0.996)) and HF hospitalisations (HR 0.918 (95% CI 0.855 to 0.985)). We estimate that 9.0% of CV hospitalisations and 16.0% of HF hospitalisations could be prevented by improving practice CKD coding from 55% to 88%. Prescription of antihypertensives was the most dominant predictor of a reduction in hospitalisation rates for patients with CKD, followed by albuminuria testing and use of statins.ConclusionsHigher levels of CKD coding by GP practices were associated with lower rates of CV and HF events, which may be driven by increased use of antihypertensives and regular albuminuria testing, although residual confounding cannot be ruled out.
Mast cell-T cell axis alters development of colitis-dependent and colitis-independent colorectal tumours: potential for therapeutically targeting via mast cell inhibition
Authors: Sakita Juliana Y , Elias-Oliveira Jefferson , Carlos Daniela , de Souza Santos Emerson , Almeida Luciana Yamamoto , Malta Tathiane M , Brunaldi Mariângela O , Albuquerque Sergio , Araújo Silva Cleide Lúcia , Andrade Marcus V , Bonato Vania L D , Garcia Sergio Britto , Cunha Fernando Queiroz , Cebinelli Guilherme Cesar Martelossi , Martins Ronaldo B , Matthews Jason , Colli Leandro , Martin Francis L , Uyemura Sergio A , Kannen Vinicius 
Published: October 2022

BackgroundColorectal cancer (CRC) has a high mortality rate and can develop in either colitis-dependent (colitis-associated (CA)-CRC) or colitis-independent (sporadic (s)CRC) manner. There has been a significant debate about whether mast cells (MCs) promote or inhibit the development of CRC. Herein we investigated MC activity throughout the multistepped development of CRC in both human patients and animal models.MethodsWe analyzed human patient matched samples of healthy colon vs CRC tissue alongside conducting a The Cancer Genome Atlas-based immunogenomic analysis and multiple experiments employing genetically engineered mouse (GEM) models.ResultsAnalyzing human CRC samples revealed that MCs can be active or inactive in this disease. An activated MC population decreased the number of tumor-residing CD8 T cells. In mice, MC deficiency decreased the development of CA-CRC lesions, while it increased the density of tumor-based CD8 infiltration. Furthermore, co-culture experiments revealed that tumor-primed MCs promote apoptosis in CRC cells. In MC-deficient mice, we found that MCs inhibited the development of sCRC lesions. Further exploration of this with several GEM models confirmed that different immune responses alter and are altered by MC activity, which directly alters colon tumorigenesis. Since rescuing MC activity with bone marrow transplantation in MC-deficient mice or pharmacologically inhibiting MC effects impacts the development of sCRC lesions, we explored its therapeutic potential against CRC. MC activity promoted CRC cell engraftment by inhibiting CD8+ cell infiltration in tumors, pharmacologically blocking it inhibits the ability of allograft tumors to develop. This therapeutic strategy potentiated the cytotoxic activity of fluorouracil chemotherapy.ConclusionTherefore, we suggest that MCs have a dual role throughout CRC development and are potential druggable targets against this disease.
Aneurysm healing after endovascular treatment in the Helsinki sidewall aneurysm model: a systematic review
Authors: Rinaldo Lorenzo , Arturo Larco Jorge L , Kadirvel Ramanathan , Kallmes David F 
Published: October 2022

AimsIntracranial aneurysms are treated with a variety of endovascular devices including coils, stents, and flow diverters. The mechanisms by which these devices result in aneurysm occlusion and subsequent healing have been the subject of significant research using various animal models. The murine Helsinki aneurysm model is a sidewall aneurysm created by the end-to-side anastomosis of a donor aortic graft onto the abdominal aorta of a recipient animal. The aim of this systematic review is to assess the efficacy of different endovascular devices for the treatment of the Helsinki model aneurysm.MethodsWe performed a systematic review of Pubmed in accordance with PRISMA guidelines, yielding eight studies detailing the results of endovascular treatment of this preclinical aneurysm model. Studies were included if they provided rates of complete aneurysm occlusion after treatment.ResultsIn these studies, aneurysms were treated with coiling (n=81, 7 studies), stenting (n=67, 3 studies), stent-coiling (n=13, 1 study), and flow diversion (n=49, 2 studies). The results of each individual study are discussed with the goal of providing a measure of the relative efficacy of different endovascular devices for the treatment of this particular model aneurysm. We also pay special attention to insights into the mechanisms underlying aneurysm healing after different forms of endovascular therapy.ConclusionThe data presented here may be useful to investigators attempting to demonstrate superiority of novel endovascular devices relative to previous device iterations using this preclinical model.