bluuebunny/crossref_metadata_2025_split huggingface dataset:
G-Lattices: A Novel Lattice Structure and Its Generative Synthesis Under Additive Manufacturing Constraints
Authors: Armanfar Arash , Gunpinar Erkan 
Published: May 2022

Abstract
This paper introduces a novel strut-based lattice structure that is called G-Lattices and a method for their generative synthesis. Given additive manufacturing (AM), user and geometrical constraints, G-Lattices can automatically be generated via a particle tracing algorithm, which places/moves particles in a lattice unit cell. As a proof of concept, several G-Lattices are manufactured through an AM machine. Additionally, the proposed G-Lattice synthesis method is customized for the models under vertical loading, which are validated through finite element method experiments and have greater strength over volume ratios compared to conventional lattice structures.
The Unsteady Topology of Corner Separations
Authors: Dawkins Ivo , Taylor James , Ottavy Xavier , Miller Rob 
Published: May 2022

Abstract
As a compressor is throttled three-dimensional separations develop in the corners between the blades and annulus endwall. Surprisingly, little is understood about the unsteady topology of these separations. One of the problems in studying corner separations is that it is often difficult to understand whether a particular flow structure in the separation is inherent to the separation itself or due to the response of the separation to changes in the inlet flow. In this paper, a novel experimental approach is taken to isolate the corner separation from external influences. A cascade is designed with the specific aim of precisely controlling the inlet flow.
Contrary to earlier work, it is shown that the key saddle and focus pair, which describes the time-mean topology of the corner separation on the endwall, moves smoothly and continuously as the incidence of the flow is raised. This behavior is shown to be the result of the time-resolved topology of the flow field, which comprises numerous saddle and focus pairs that are produced stochastically in regions of high shear strain rate. Most importantly, the separation is shown to exhibit an extremely low-frequency behavior, changing in topology over timescales that are approximately 80 times the convection time through the blade passage. The behavior is shown to be intrinsic to the separation and causes the separation, for periods, to completely disappear from the endwall. This underlying unsteady structure of the separation is shown to have implications for the ability of RANS-based design codes to be able to accurately predict corner separations.
Applicability of five nutritional screening tools in Chinese patients undergoing colorectal cancer surgery: a cross-sectional study
Authors: Xie Bingxin , Sun Yefei , Sun Jian , Deng Tingting , Jin Baodi , Gao Jia 
Published: May 2022

ObjectivesTo identify the most appropriate nutritional risk screening tool for patients undergoing colorectal cancer surgery, five nutritional screening tools, including the Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST) and Nutritional Risk Index (NRI), were employed to evaluate the nutritional risk at admission and short-term clinical outcome prediction.DesignA cross-sectional study.SettingA comprehensive affiliated hospital of a university in Shenyang, Liaoning Province, China.Participants301 patients diagnosed with colorectal cancer were continuously recruited to complete the study from October 2020 to May 2021.Primary and secondary outcome measuresWithin 48 hours of hospital admission, five nutritional screening tools were used to measure the nutritional risk and to determine their relationship with postoperative short-term clinical outcomes.ResultsThe nutritional risk assesed by the five tools ranged from 25.2% to 46.2%. Taking the Subject Global Assessment as the diagnostic standard, MNA-SF had the best consistency (κ=0.570, p<0.001) and MST had the highest sensitivity (82.61%). Multivariate Logistic regression analysis after adjusting confounding factors showed that the NRS 2002 score ≥3 (OR 2.400, 95% CI 1.043 to 5.522) was an independent risk factor for postoperative complications and was the strongest predictor of postoperative complications (area under the curve 0.621, 95% CI 0.549 to 0.692). The scores of NRS 2002 (r=0.131, p<0.001), MNA-SF (r=0.115, p<0.05) and NRI (r=0.187, p<0.05) were poorly correlated with the length of stay. There was no correlation between the five nutritional screening tools and hospitalisation costs (p>0.05).ConclusionsCompared with the other four nutritional screening tools, we found that NRS 2002 is the most appropriate nutritional screening tool for Chinese patients with colorectal cancer.
Influence of social support on return to work after total hip or total knee arthroplasty: a prospective multicentre cohort study
Authors: Kamp Tamara , Stevens Martin , Van Beveren Jan , Rijk Paul C , Brouwer Reinoud , Bulstra Sjoerd , Brouwer Sandra 
Published: May 2022

ObjectivesThere is strong evidence that social support is an important determinant of return to work (RTW). Little is known about the role of social support in RTW after total hip or knee arthroplasty (THA/TKA). Objective was to examine the influence of preoperative and postoperative perceived social support on RTW status 6 months postoperatively.DesignA prospective multicentre cohort study was conducted.SettingOrthopaedic departments of four Dutch medical centres; a tertiary university hospital, two large teaching hospitals and a general hospital.ParticipantsPatients planned to undergo THA/TKA, aged 18–63 and employed preoperatively were included.Main outcome measuresQuestionnaires were filled out preoperatively and 3 and 6 months postoperatively and included questions to assess patients’ perceived social support targeting three sources of social support: from home (friends, family), from work (coworkers, supervisors) and from healthcare (occupational physician, general practitioner, other caregivers). Control variables included age, gender, education, type of arthroplasty and comorbidities. RTW was defined as having fully returned to work 6 months postoperatively. Univariate and multivariate logistic regression analyses were conducted.ResultsEnrolled were 190 patients (n=77 THA, n=113 TKA, median age was 56 years, 56% women). The majority returned to work (64%). Preoperatively, social support from the occupational physician was associated with RTW (OR 2.53, 95% CI 1.15 to 5.54). Postoperatively, social support from the occupational physician (OR 3.04, 95% CI 1.43 to 6.47) and the supervisor (OR 2.56, 95% CI 1.08 to 6.06) was associated with RTW.ConclusionsThis study underscores the importance of work-related social support originating from the occupational physician and supervisor in facilitating RTW after primary THA/TKA, both preoperatively and postoperatively. Further research is needed to confirm our results and to understand the facilitating role of social support in RTW, as arthroplasty is being performed on a younger population for whom work participation is critical.
Assessing knowledge, acceptability and social implications of a peer-to-peer HIV self-testing kit distribution model among adolescents aged 15–24 in Zambia and Uganda—HISTAZU: a mixed-method study protocol
Authors: Ssemata Andrew Sentoogo , Bwalya Chiti , Muhumuza Richard , Ndekezi Denis , Mbewe Madalitso , Simwinga Musonda , Bond Virginia , Seeley Janet 
Published: May 2022

IntroductionHIV self-testing (HIVST) across sub-Saharan African countries may be acceptable as it overcomes significant barriers to clinic-based HIV testing services such as privacy and confidentiality. There are a number of suggested HIVST distribution models. However, they may not be responsive to the testing service needs of adolescents and young people (AYP). We will investigate the knowledge, acceptability and social implications of a peer-to-peer distribution model of HIVST kits on uptake of HIV prevention including pre-exposure prophylaxis, condoms, and voluntary medical male circumcision and testing services and linkage to anti-retroviral therapy among AYP aged 15–24 in Zambia and Uganda.Methods and analysisWe will conduct an exploratory mixed methods study among AYP aged 15–24 in Uganda and Zambia. Qualitative data will be collected using audio-recorded in-depth interviews (IDIs), focus group discussions (FGDs), and participant observations. All IDIs and FGDs will be transcribed verbatim, coded and analysed through a thematic-content analysis. The quantitative data will be collected through a structured survey questionnaire derived from the preliminary findings of the qualitative work and programme evaluation quantitative data collected on uptake of services from a Zambian trial. The quantitative phase will evaluate the number of AYP reached and interested in HIVST and the implication of this on household social relations and social harms. The quantitative data will be analysed through bivariate analyses. The study will explore any social–cultural and study design barriers or facilitators to uptake of HIVST.Ethics and disseminationThis study is approved by the Uganda Virus Research Institute Research and Ethics committee, Uganda National Council for Science and Technology, University of Zambia Biomedical Ethics Committee, Zambia National Health Research Authority and the London School of Hygiene and Tropical Medicine. Dissemination activities will involve publications in peer-reviewed journals, presentations at conferences and stakeholder meetings in the communities.
063  Anti-MOG and anti AQP4 antibodies in pediatric acquired memyelinating syndromes (ADS): an Indian cohort
Authors: Sankhyan Naveen , Rawat Amit , Vyas Sameer , Sahu Jitendra , Priyanka Chandana , Saini Lokesh , Saini Arushi , Suthar Renu , Sukhija Jaspreet , Murlidharan Jayashree 
Published: May 2022

AimTo determine positivity to myelin oligodendrocyte glycoprotein (MOG-Ab) and aquaporin-4 antibod- ies (AQP4-Ab) in children with Pediatric Acquired Demyelinating Syndromes (ADS).MethodProspectively, in one centre, between May 2018 and Sep 2019, children (6 mo- 15 yrs) with suspected ADS were enrolled and tested for MOG-Ab and AQP4-Ab. Children with a proven non-immune mediated neurological disease were enrolled as controls.ResultsSeventy-nine children with suspected ADS were screened and 72 enrolled. There were 29 with acute disseminated encephalomyelitis (ADEM), 22 with optic neuritis and 19 with myelitis. Fourteen (19.4%, 95% CI 11–30.5) tested positive for one antibody [12 ( 17%, 95% CI 9–27) tested positive for MOG-Ab and two ( 3%, 95% CI 0.3–10) for AQP4-Ab]. None of the 62 controls tested positive for any antibody. Among those with first event, 7/58 (9%, 95% CI 3–19%) were MOG-Ab positive and two AQP4-Ab positive, whereas, 7/14 (50%, 23–77%) with recurrent events were MOG-Ab positive. All four with multiphasic ADEM were MOG Ab (4/4) positive. One of the 19 with myelitis was MOG-Ab positive.ConclusionsDetected in one in five children, MOG-Ab are the most common antibodies detected in Pediatric ADS, especially in relapsing disease. AQP4-Ab are rare in children with ADS.drnsankhyan@yahoo.co.in
065  Paraneoplastic glycine receptor antibody positive progressive encephalomyeli- tis with rigidity and myoclonus with breast cancer
Authors: Sumangala Salini , Bose Smriti , Marie-Watts Lisa , Jacob Saiju 
Published: May 2022

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is an autoimmune condition character- ised by various neurological symptoms associated with the dysfunction of the brain stem and spinal cord. PERM has been recognised as a paraneoplastic syndrome, its effects due mainly to the cross reaction of onconeural antibodies against the tumour also affecting neuronal cells.Interestingly, PERM can also present as an isolated syndrome not linked to malignancy. It must be noted however, that tumours may present much later than the syndrome and the aggressive nature of PERM may lead to patient mortality before the tumour can be identified clinically. Paradoxically, the treatment of malignancy can induce remission of PERM as will be illustrated in this case report.A 45-year-old lady initially presented with paraesthesia in both lower limbs followed by leg spasms. There was also difficulty with voiding and constipation. All the initial investigations were negative and the pos- sibility of functional neurological syndrome was made. Few weeks later, patient was readmitted and on this occasion transferred to the neuroscience centre. The patient had features of increased reflexes (including clonus) and also exhibited features of autonomic dysfunction such as heat intolerance, tachy- cardia, hypertension and bowel and urinary dysfunction.Glycine receptor positive progressive encephalomyelitis with rigidity and myoclonus (PERM) was diagnosed and investigations including PET scan confirmed an underlying breast cancer. Initial improvement with immunotherapy was sustained after cancer chemotherapy and surgery.saiju.jacob@uhb.nhs.uk
070  What is seronegative neuromyelitis optica spectrum disorder?
Authors: Gibbons Emily , Campgana Giovanna , O’Connell Karen , Yeo Tianrong , Whittam Daniel , Karthikeayan Venkatra- man , Leite Maria Isabel , Palace Jacqueline , Jacob Anu , Huda Saif 
Published: May 2022

BackgroundMost but not all cases of Neuromyelitis Optica Spectrum Disorder (NMOSD) are associated with Aquaporin-4 (AQP4) or myelin oligodendrocyte glycoprotein (MOG) antibodies.ObjectiveTo determine the clinical characteristics of seronegative NMOSDMethodRetrospective review of seronegative NMOSD in Liverpool and Oxford between January 2010–2020ResultsOf NMOSD=727, 49(7%) were seronegative. The male to female ratio was 1:2.5 and median age at onset was 36(5–57) years. In 2/3 of patients the index presentation was myelitis=22 or myelitis+optic neuritis=11. In 26/33 (79%), longitudinally extensive myelitis was present. Optic neuritis=9 (4 bilateral) and brain involvement=7 were also seen. Relapsing disease was observed in 39/49(80%) of patients. The median annualised attack rate was 0.58 over a median disease duration of 78 (3–258) months. Unmatched CSF oligoclonal bands (CSF-OCBs) were detected in 4/38(11%) and 31/49(63%) fulfilled multiple sclerosis (MS) diagnostic criteria. Immunosuppression (typically Mycophenolate and Rituximab) was used in 34/49(69%). Median last EDSS was 4 (1–10) with death recorded in 5/49 (10%) patients.ConclusionSeronegative NMOSD is uncommon. Longitudinal myelitis with/without optic neuritis is a common initial presentation. Similar to AQP4-IgG, NMOSD disability and mortality rates are high. Absence of unmatched CSF-OCB and typical brain lesions help to distinguish this disease from MS.emily.gibbons@doctors.org.uk
Somatic copy number variant mutations in alpha-synuclein and genome-wide in brains of synucleinopathy cases
Authors: Perez-Rodriguez Diego , Kayla Maria , Leija-Salazar Melissa , Lashley Tammaryn , Warner Thomas , Gentleman Steve , Schapira Anthony , Holton Janice , Jaunmuktane Zane , Proukakis Christos 
Published: May 2022

Synucleinopathies are mostly sporadic neurodegenerative disorders, and include Parkinson’s disease (PD), and multiple system atrophy (MSA). Inherited copy number variants (CNVs) ofSNCA(α-synuclein) are rare causes of familial disease. There is increasing evidence for somatic mutations in the human brain, and we have hypothesized a role for these in synucleinopathies.We further investigated somatic CNVs in brains from synucleinopathy cases, using Fluorescent in-situ Hybri- disation forSNCAgains, and single-cell whole genome sequencing for the first time in a synucleinopathy. In the cingulate cortex, mosaicism forSNCAgains was higher in MSA and PD than controls in neurons (> 2% in both diseases), and for MSA also in non-neurons. In MSA substantia nigra (SN), we notedSNCAgains in> 3% of cells. Cells with CNVs were more likely to have α-synuclein inclusions, in a pattern corresponding to cell categories mostly relevant to the disease: dopaminergic neurons in Lewy-body cases, and other cells in striatonigral degeneration-dominant MSA (MSA-SND). HigherSNCACNV mosaicism in typical MSA-SND SN non-dopaminergic cells may correlate with younger onset, and in PD cingulate neurons with younger death. Whole genome sequencing of 169 single cells from two MSA cases showed somatic CNVs in ~ 30%. Neurons had gains and losses, and other cells almost exclusively gains.We propose that somaticSNCACNVs contribute to the aetiology and pathogenesis of synucleinopathies, and that genome-wide somatic CNVs merit further studyc.proukakis@ucl.ac.uk
074  Long-term effect of idebenone in reducing respiratory function decline in patients with Duchenne muscular dystrophy
Authors: Servais L , Mayer OH , McDonald CM , Voit T , Mercuri E , Buyse GM 
Published: May 2022

Two placebo-controlled trials of 52-week duration showed that idebenone consistently reduced respira- tory function decline rate in patients with DMD. Long-term data from the DELPHI-Extension (DELPHI-E) study and SYROS (DELOS patients who transitioned to idebenone under an Expanded Access Program) are now presented. The aim was to assess the consistency of the long-term effect of idebenone.11 DELPHI-E and 18 SYROS patients with abnormal (<80%) forced vital capacity (as percent predicted, FVC%p) were treated with idebenone for an average of 2.0 and 4.2 years respectively. Annualized FVC%p decline rates were compared to untreated patients from SYROS or matched external controls.Mean (SD) baseline age was 13.6 (2.3) and 13.3 (2.7) years in DELPHI (N=11) and DELOS (N=18), respec- tively, and FVC%p was 47.2% (19.7%) and 58.7% (17.6%). For the first 2-year period, the average annual decline rate was comparable in treated patients (4.5% and 5.4% in DELPHI-E and SYROS) and lower than in untreated SYROS patients and external controls (7.9% untreated and 8.1% in CINRG-DNHS). During years 3–6, the annual decline rate was consistently lower than for matched controls.Treatment with idebenone resulted in a sustained reduction in the rate of decline in respiratory function. laurent.servais@paediatrics.ox.ac.uk
078  Myotonic dystrophy service redesign: report on a patient engagement event
Authors: Dent James , Akintade Sola , Kelly Phillip , Roberts Mark , Lilleker James 
Published: May 2022

IntroductionInternational consensus-based care recommendations for Myotonic Dystrophy Type 1 (DM1) have been published recently. Audit of the DM1 service at the Manchester Centre for Clinical Neurosciences (MCCN) against these was presented at the 2019 ABN. Significant scope for improve- ment was identified.MethodsAs part of DM1 service redesign at MCCN an engagement event was organised. Opinions of patients, carers and relatives on service provision and areas for improvement were explored. With reference to published care recommendations, attendees participated in structured small group discus- sions. Responses were recorded by a facilitator and thematic analysis performed.ResultsIn total, 69 service-users attended. Themes emerging included a perceived lack of support between consultant appointments, inadequate access to specialist therapy services, a lack of awareness of available support services, and an inadequate understanding of DM1 by healthcare professionals. Suggestions for improvement included setting up joint appointments and patient forums for group discus- sion, increased use of telephone/online appointments, and setup of a more responsive service facilitated by a specialist nurse.ConclusionThese findings have been incorporated in to the DM1 service redesign programme at MCCN, which has included the recent appointment of a neuromuscular specialist nurse. Re-audit of the service is planned.james.dent@doctors.org.uk
081  Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy
Authors: Ashraghi Mohammad , Raithatha Anish , Lord Christopher , Limback-Stanic Clara , Viegas Stuart , Amiras Dimitri 
Published: May 2022

ObjectiveWe propose the use of ultrasound-guided muscle biopsy as a viable method of obtaining muscle specimen to aid the diagnosis of myopathy. We retrospectively review the diagnostic accuracy and patient feedback of ultrasound-guided muscle biopsies in our neuromuscular service.MethodMul- tidisciplinary team meeting reviewed select patients and agreed on those suitable for ultrasound-guided muscle biopsy. They underwent biopsy using direct ultrasound guidance and a modified Bergström needle. The specimens were sent for histopathological analysis and patients were given a feedback form.Results10 patients underwent 11 ultrasound-guided muscle biopsies. Of these 11, 1 was processed incorrectly, but all others were suitable for analysis. All of those processed correctly aided diagnosis. All patient feedback was rated good or excellent. In 4 patients with a previous unsuccessful surgical biopsy, ultrasound-guided biopsy was successful in obtaining suitable muscle. Of those 4 patients, 2 preferred ultrasound-guided biopsy and 2 did not state a preference.DiscussionOur ultrasound-guided muscle biopsy technique offers an alternative to surgical biopsy. It yields high quality specimens that aids diagnosis and receives good patient feedback. It can be performed as a day-case and does not require theatre space. Fur- thermore, direct visualization of structures minimizes complications and allows biopsy of otherwise difficult targets.ConclusionUtilisation of ultrasound-guided modified Bergström needle technique for muscle biopsy provides comparable success rates to other techniques, and has several benefits compared to alternative techniques.m.ashraghi@nhs.net
Rare genetic modifiers of Huntington’s disease reveal novel pathological mechanisms
Authors: Massey Tom , McAllister Branduff , Binda Caroline , Donaldson Jasmine , Chughtai Uroosa , Holmans Peter , Jones Lesley 
Published: May 2022

Huntington’s disease (HD) is a progressive, untreatable neurodegenerative disorder that presents with a variable array of motor, psychiatric, cognitive and behavioural symptoms. HD is caused by a CAG repeat expansion in theHTTgene over a threshold length of 35 repeats, with longer repeats associated with earlier onset disease. Other genes, often associated with DNA repair, are known to modify HD onset. By exome sequencing 500 individuals with very early or late onset HD we identifiedcisandtransmodifiers of HD onset.Cismodifiers involved the DNA sequence just 3’ to the CAG repeat: alteration of the canonical 5’-CAACAG-3’ to pure CAG was always associated with early onset HD (p = 2.77 x 10-7) whereas extra CAA trinucleotides were associated with late onset HD (p = 3.48 x 10-6). Significanttransmodifiers included non-synonymous damaging variants in FAN1, a DNA repair nuclease. These variants were mostly associated with early onset HD and increased repeat expansion in a stem cell model of HD. Purified variant proteins showed significantly reduced DNA binding and nuclease activitiesin vitro. Overall these results link genetic modifiers in humans to a molecular mechanism of repeat expansion that represents an exciting novel therapeutic target.thomas.massey78@gmail.com