bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of catheter ablation for paroxysmal atrial fibrillation in patients with stable coronary artery disease
Authors: Cui Yi‐Kai , Dong Jian‐Zeng , Du Xin , Hu Rong , He Liu , Long De‐Yong , Bai Rong , Yu Rong‐Hui , Sang Cai‐Hua , Jiang Chen‐Xi , Liu Nian , Li Song‐Nan , Wang Wei , Guo Xue‐Yuan , Zhao Xin , Zuo Song , Tang Ri‐Bo , Ma Chang‐Sheng 
Published: July 2022

AbstractBackgroundAtrial fibrillation (AF) and stable coronary artery disease (SCAD) frequently coexist. This study aimed to assess the long‐term outcome of catheter ablation in patients with paroxysmal AF and SCAD.MethodsIn total, 12,104 patients with paroxysmal AF underwent catheter ablation in the Chinese Atrial Fibrillation Registry between 2011 and 2019 were screened. A total of 441 patients with SCAD were matched with patients without SCAD in a 1:4 ratio. The primary endpoint was AF recurrence after single ablation. The composite secondary endpoints were thromboembolism, coronary events, major bleeding, all‐cause death.ResultsOver a mean follow‐up of 46.0 ± 18.9 months, the recurrence rate in patients with SCAD was significantly higher after a single ablation (49.0% vs. 41.9%,p = .03). The very late recurrence rate of AF in the SCAD group was also significantly higher than that in the control group (38.9% vs. 31.2%;p = .04). In multivariate analysis, adjusted with the female, smoking, duration of AF, previous thromboembolism, COPD, and statins, SCAD was independently associated with AF recurrence (adjusted HR, 1.19 [1.02–1.40],p = .03). The composite secondary endpoints were significantly higher in the SCAD group (12.70% vs. 8.54%,p = .02), mainly due to thromboembolism events (8.16% vs. 4.41%,p < .01).ConclusionsSCAD significantly increased the risk of recurrence after catheter ablation of paroxysmal AF. The incidence of thromboembolic events after catheter ablation of paroxysmal AF in the patients with SCAD was significantly higher than that in those without SCAD.
Epidemiology and outcomes of pediatric transplant‐associated thrombotic microangiopathy in Hong Kong
Authors: Chan Wilson Yau Ki , Ma Alison Lap Tak , Chan Eugene Yu Hin , Kan Amanda Nim Chi , Ng Wai Fu , Lee Pamela Pui Wah , Cheuk Daniel Ka Leung , Chiang Alan Kwok Shing , Leung Wing , Chan Godfrey Chi Fung 
Published: July 2022

AbstractBackgroundTransplant‐associated thrombotic microangiopathy (TA‐TMA) is an under‐recognized yet potentially devastating complication of hematopoietic stem cell transplantation (HSCT) which had increased awareness in recent years. This report summarizes the demographics and outcomes of pediatric TA‐TMA in Hong Kong.MethodsAll patients aged below 18 years who underwent HSCT in the Hong Kong Children's Hospital and were diagnosed to have TA‐TMA during the 2‐year period from April 1, 2019 to March 31, 2021 were included.ResultsA total of 73 transplants (51 allogeneic and 22 autologous) in 63 patients had been performed. Six patients (four males and two females) developed TA‐TMA at a median duration of 2.5 months post‐HSCT. The incidence rate was 9.52%. Of the six TA‐TMA patients, five underwent allogenic one underwent autologous HSCT, respectively. Three of them were histologically proven. All four patients with cyclosporine had stopped the drug once TA‐TMA was suspected. Median six doses of eculizumab were administered to five out of six patients. Three patients died (two due to fungal infection and one due to acute‐on‐chronic renal failure) within 3 months upon diagnosis of TA‐TMA. Among three survivors, two stabilized with mild stage 2 chronic kidney disease (CKD) while the other suffered from stage 5 end‐stage CKD requiring lifelong dialysis.ConclusionIn conclusion, recognition and diagnosis of TA‐TMA are challenging. Early recognition and prompt administration of complement blockage with eculizumab may be beneficial in selected cases. Further prospective research studies are recommended to improve the management and outcomes of TA‐TMA.
Alternative paths of diversification for developing countries
Authors: Eum Wonsub , Lee Jeong‐Dong 
Published: July 2022

AbstractThis study analyzes different diversification options of countries at different economic stages, and complements the previous diversification literature from the perspective of coevolution between production and technological capability. This study points out that path dependence theories concerning diversification patterns of countries cannot give useful policy implications to developing countries, because they can only take either the “high‐risk high‐return” or “low‐risk low‐return” tracks. The analysis includes 84 countries from 1980 to 2005, and studies the close relationship between product space and knowledge space to understand the alternative drivers of product and technological diversification. The results show that countries at different income levels have different factors of diversification. Specifically, production capability of developing countries guides future technological diversification, and technological capability of developed countries leads to product diversification in related products.
Regularization of a Mathematical Model of the Wheatley Heart Valve
Authors: Rebolledo R. J. , McKee S. , Cuminato J. A. , Stewart I. W. , Wheatley D. J. 
Published: July 2022

Abstract
This note considers the mathematical model published in the Journal of Biomechanical Engineering by McKee et al. [McKee, S., Cuminato, J. A., Stewart, I. W., and Wheatley, D. J., 2021, “A Mathematical Representation of the Wheatley Heart Valve,” ASME J. Biomech. Eng., 143(8), p. 081006]. The model presented there suffers from the fact that there is a line discontinuity in the first derivative producing what appears to be a kink in each of the leaflets. This note is concerned with regularizing the shape of the valve while holding to Wheatley's essential idea [Wheatley, D. J., 2016, “Heart Valve,” U.S. Patent No. 9,259,313, UK Patent No. 2,982,340 (2017), European Patent No. 2,979,666 (2017)].
Mathematical Modeling of Material Removal and Surface Roughness in Ultrasonic-Assisted Magnetic Abrasive Flow Machining Process
Authors: Dixit Nitin , Sharma Varun , Kumar Pradeep 
Published: July 2022

Abstract
Ultrasonic-assisted magnetic abrasive flow machining (UAMAFM) process shows enhanced finishing performance compared to conventional abrasive flow machining (AFM). In this present research paper, mathematical models for M˙R and Ra have been developed for the UAMAFM process by considering both steady-state and transient phenomena. The external ultrasonic and magnetic field assistance enhanced the velocity and length of contact of active abrasives, calculated from the kinematic analysis. The resultant finishing forces have also been evaluated by considering these external aids. The steady-state material removal per finishing cycle remains constant and depends on the velocity of motion, length of contact, resulting forces, number of active abrasives, and work material hardness. The transient material removal per finishing cycle was calculated in terms of the volume of irregularities present over the work surface, i.e., initial surface roughness. The mathematical model for surface roughness was developed in terms amount of material removed (MR), and initial (Ra0) and critical surface roughness (Racr). The predicted values of material removed and surface roughness from developed mathematical models agreed with experimental results with a deviation of 7.80% and 2.44%, respectively.
Actuation Arrangement of Rigid Foldable Waterbomb Origami
Authors: Wang Sen , Liang Dongbo , Huang Hailin , Li Bing , Liu Rongqiang , Xi Fengfeng 
Published: July 2022

Abstract
A novel approach is proposed to arrange the actuations of rigid foldable waterbomb origami with multiple facet loops such that the number of actuations equaled the degrees-of-freedom (DOF) of the origami. In this approach, the rigid waterbomb origami was regarded as a combination of three types of six-crease origami units, which is equivalent to spherical 6R mechanisms with three DOF. Then, clear, target, and arrangement parts were created to define the facets of the origami pattern in the proposed extrapolation method. The actuation arrangement for a waterbomb origami pattern, which extended outwards circumferentially from a six-crease origami unit, was completed, and adams software was used to verify the correctness of the arrangement. Finally, an intuitive mathematical method was used to arrange the actuations for this type of waterbomb origami. The proposed approach provided DOF for the rigid foldable waterbomb origami and facilitated an actuation design such that the origami exhibits unique motion and can be normally actuated.
Design of Hybrid Fully Actuated and Self-Adaptive Mechanism for Anthropomorphic Robotic Finger
Authors: Lee Chun-Tse , Chang Jen-Yuan (James) 
Published: July 2022

Abstract
Prior research on robotic hands predominantly focused on high degrees-of-freedom of fully actuated fingers to replicate a natural human hand or on creative designs of underactuated fingers to make a self-adaptive motion. However, in most cases, fully actuated fingers encounter difficulty in grasping unstructured objects, while underactuated fingers experience problems in performing precise grasping motions. To deal with any possible scenarios, this study presents a novel design of an anthropomorphic robotic finger that combines both advantages—fully actuated and self-adaptive (FASA) modes—at once. Actuated by tendons, the FASA finger can grasp objects adaptively and achieve accurate angle positioning with the same mechanical design. Based on the kinetostatic analysis, the guideline for selecting a torsion spring is proposed to fulfill the functions of the FASA finger and attain the optimal design of torsional stiffness, which manifests itself in a series of tests on different configurations of torsion spring. Likewise, the kinematic analysis for the fully actuated mode is given proof that two joints can move independently by controlling two motors. Ultimately, experimental results reflected the capability of the FASA finger to perform not only independent precision angle motion but also self-adaptive grasping motion without any change in mechanical structure.
Monitoring Elite Youth Football Players’ Physiological State Using a Small-Sided Game: Associations With a Submaximal Running Test
Authors: Houtmeyers Kobe C. , Helsen Werner F. , Jaspers Arne , Nanne Sjaantje , McLaren Shaun , Vanrenterghem Jos , Brink Michel S. 
Published: July 2022

Purpose: To examine the utility of a standardized small-sided game (SSG) for monitoring within-player changes in mean exercise heart rate (HRex) when compared with a submaximal interval shuttle-run test (ISRT). Methods: Thirty-six elite youth football players (17 [1] y) took part in 6 test sessions across an in-season period (every 4 wk). Sessions consisted of the ISRT (20-m shuttles, 30″:15″ work:rest ratio, 70% maximal ISRT) followed by an SSG (7v7, 80 × 56 m, 6 min). HRex was collected during both protocols, with SSG external load measured as high-speed running distance (>19.8 km·h–1) and acceleration distance (>2 m·s−2). Data were analyzed using linear mixed-effect models. Results: Controlling for SSG external load improved the model fit describing the SSG–ISRT HRex relationship (χ2 = 12.6, P = .002). When SSG high-speed running distance and SSG acceleration distance were held constant, a 1% point change in SSG HRex was associated with a 0.5% point change in ISRT HRex (90% CI: 0.4 to 0.6). Inversely, when SSG HRex was held constant, the effects of a 100-m change in SSG high-speed running distance and a 21-m change in SSG acceleration distance on ISRT HRex were −1.0% (−1.5 to −0.4) and −0.6% points (−1.1 to 0.0), respectively. Conclusions: An SSG can be used to track within-player changes in HRex for monitoring physiological state. Given the uncertainty in estimates, we advise to only give meaning to changes in SSG HRex >2% points. Additionally, we highlight the importance of considering external load when monitoring SSG HRex.
Unprovoked piriformis myositis presenting in a pregnant patient
Authors: Kennedy Bernard , Botros Karim , Rashid Hibah , Bermingham John 
Published: July 2022

A patient in her mid-30s presented to hospital at 25 weeks’ gestation with acute onset of leg pain.Routine investigations were performed to rule out the common causes of leg and back pain in pregnancy, which were grossly normal. Piriformis pyomyositis was diagnosed on MRI and a collection was drained. Following an initial response to antibiotic therapy, the patient delivered by elective caesarean section, but the pain returned on postnatal day 2 and muscle inflammation was diagnosed again, requiring a repeat course of antibiotics.This case highlights a rare cause of leg pain in a pregnant patient, and the additional complexities of managing cases in the obstetric population.
Cultivating design thinking skills through the biodesign process in Japan
Authors: Kiriyama Hiroyuki , Kakihiana Takaaki , Maeda Yujiro , Sugimoto Munemasa , Machida Megumi , Inoue Tomotaka , Ikeno Fumiaki , Komuro Issei , Ono Minoru 
Published: July 2022

BackgroundThe biodesign process, which originated at Stanford University, has had a significant impact on medical device invention. Design thinking skills are core elements in the biodesign process, but there has been no quantitative evaluation of how design thinking is actually affected by a biodesign course. The purpose of this study was to examine the usefulness of the biodesign process by quantifying design thinking ability.MethodsWe recruited 17 participants who had studied a systematic biodesign process in Japan and 20 participants who were unfamiliar with the biodesign process. All participants took the design thinking test and we evaluated their design thinking skills using a combination of the creation score and the evaluation score.ResultsThe average age of the participants was 34.4 years and 84% were male. Participants who had taken the biodesign program generated more ideas than other participants (5.3±1.9 ideas vs 3.7±2.3 ideas; p=0.01). They also had significantly higher design thinking score, especially creation score, than those who had not taken the program (design thinking score, 220.1±39.7 vs 194.6±32.1; p=0.02; creation score, 91.3±23.0 vs 70.7±20.2; p=0.03).ConclusionThe findings suggest that the biodesign process can cultivate design thinking skills, especially the ability to visualise needs and create solutions. Exposure of more people to the biodesign process may accelerate innovation in the medical technology field.
Exploring physician approaches to conflict resolution in end-of-life decisions in the adult intensive care unit: protocol for a systematic review of qualitative research
Authors: Johal Harleen Kaur , Birchley Giles , Huxtable Richard 
Published: July 2022

IntroductionConflict is unfortunately well-documented in the adult intensive care unit (AICU). In the context of end-of-life (EOL) decision-making (ie, the withdrawal or withholding of life-sustaining treatment), conflict commonly occurs when a consensus cannot be reached between the healthcare team and the patient’s family on the ‘best interests’ of the critically ill, incapacitated patient. While existing literature has identified potential methods for conflict resolution, it is less clear how these approaches are perceived and used by stakeholders in the EOL decision-making process. We aim to explore this by systematically reviewing and synthesising the published evidence, which addresses the following research question: what does existing qualitative research reveal about physician approaches to addressing conflict arising in EOL decisions in the AICU?Methods and analysisPeer-reviewed qualitative studies (retrieved from MEDLINE, Project Muse, Scopus, EMBASE, Web of Science, PsycINFO, CINAHL, and LILACS) examining conflict and dispute resolution in the context of EOL decisions in the AICU setting will be included. Two reviewers will independently screen either all or a randomly selected sample of studies, with a third reviewer independently screening studies of uncertain eligibility. The ‘thematic synthesis’ approach will be employed to analyse the resulting data. The quality of included papers will be assessed using the 2018 Mixed-Methods Assessment Tool. The ‘Grading of Recommendations, Assessment, Development, and Evaluations-Confidence in the Evidence from Reviews of Qualitative research’ approach will be used to assess our confidence in the findings.Ethics and disseminationEthical approval is not required for this review, as only published data will be included. We anticipate that the findings will be of interest to healthcare professionals working in AICUs and individuals working in bioethics, given the ethically contentious nature of EOL decisions. The findings will be disseminated at academic conferences and through open-access publication in a peer-reviewed journal.PROSPERO registration numberCRD42021193769.
From registration, protocol to report: are COVID-19-related RCTs in mainland China consistent? A systematic review of clinical trial registry and literature
Authors: Chen Yu , Yan Ruiqing 
Published: July 2022

ObjectiveTo provide a comprehensive review of registered COVID-19-related randomised controlled trials (RCTs) in mainland China and evaluate the transparency of reporting through comparison of registrations, protocols and full reports.DesignSystematic review of trial registrations and publications.Data sourcesInternational Clinical Trials Registry Platform, Chinese Clinical Trial Registry, ClinicalTrials.gov, the ISRCTN registry and EU Clinical Trial Register were accessed on 1 February 2022. Publications were searched in PubMed, Embase, Cochrane Library, Google Scholar, CNKI.net and Wanfangdata from 10 February 2022 to 12 February 2022.Eligibility criteriaEligible trials were COVID-19 related RCTs carried out in mainland China. Observational studies, non-randomised trials and single-arm trials were excluded.Data extraction and synthesisTwo reviewers independently extracted data from registrations, publications and performed risk of bias assessment for trial reports. Information provided by registrations and publications was compared. The findings were summarised with descriptive statistics.ResultsThe number of eligible studies was 415. From these studies 20 protocols and 77 RCT reports were published. Seven trials published both protocol and RCT full report. Between registrations and publications, discrepancy or omission was found in sample size (7, 35.0% for protocols and 47, 61.0% for reports, same below), trial setting (13, 65.0% and 43, 55.8%), inclusion criteria (12, 60.0% and 57, 74.0%), exclusion criteria (10, 50.0% and 54, 70.1%), masking method (9, 45.0% and 35, 45.5%) and primary outcome or time frame of primary outcome measurement (14, 70.0% and 51, 66.2%). Between protocols and full reports, 5 (71.4%) reports had discrepancy in primary outcome or time frame of primary outcome measurement.ConclusionsDiscrepancy among registrations, protocols and reports revealed compromised transparency in reporting of COVID-19-related RCTs in mainland China. The importance of trial registration should be further emphasised to enhance transparent RCT reporting.
Individuals’ beliefs about the biopsychosocial factors that contribute to their chronic musculoskeletal pain: protocol for a qualitative study in the UK
Authors: Dunn Michael , Rushton Alison B , Soundy Andrew , Heneghan Nicola R 
Published: July 2022

IntroductionChronic musculoskeletal pain (CMP) is described as pain that persists for longer than 3 months. At present, no research is available that understands why CMP develops and continues from the perspective of the individual. Research is needed to establish if there are any consistent biopsychosocial factors perceived as contributing to CMP and what informs such beliefs. Understanding individual beliefs will inform more effective communication between clinicians and patients about their CMP, as well as informing future research into the epidemiology of CMP. Interpretative phenomenological analysis will be used as a methodological framework as it explores how individuals make sense of their world through personal experiences and perceptions while preserving individual nuance. The aim of this study is to understand individuals’ beliefs and perceptions about the biological, psychological and social factors, which contribute to the development and maintenance of their CMP.Methods and analysisA qualitative study informed by the Consolidated Criteria for Reporting Qualitative Research using interpretative phenomenological analysis and semistructured interviews. A maximum variation purposive sample of 6–12 adults with CMP will be recruited from the general public in the UK. One semistructured interview will be conducted with each participant via an online video platform with interviews transcribed verbatim. The interview schedule (codesigned with expert patients and informed by existing evidence) identifies three domains of important questions; (1) patient beliefs on why they developed and continue to experience CMP; (2) the relationship between their biopsychosocial experiences and CMP; and (3) the origin of their beliefs. Strategies such as ‘member checking’ will be employed to ensure trustworthiness.Ethics and disseminationEthical approval was granted by the Research Ethics Office at the University of Birmingham (reference ERN_21-0813). Informed consent will be obtained from all participants. The study findings will be submitted for publication in a peer-reviewed journal and for presentation at conferences.
Getting going on time: reducing neurophysiology set-up times in order to contribute to improving surgery start and finish times
Authors: Pridgeon Michael , Proudlove Nathan 
Published: July 2022

At the Walton Centre we conduct a relatively large number of complex and lengthy elective (booked) spinal operations. Recently, we have had a particular problem with half or more of these sessions finishing late, resulting in staff discontent and greater use of on-call staff.These operations require patient monitoring by neurophysiology clinical scientists. Before the surgeon can start the operation, in-theatre neurophysiological measurements are required to establish a baseline. We reasoned that reducing this set-up time would reduce the risk of surgery starting late, and so the whole session finishing later than expected.In this project we redesigned the neurophysiology parts of in-theatre patient preparation. We conducted five Plan-Do-Study-Act cycles over 3 months, reducing the duration of pre-surgery preparation from a mean of 70 min to around 50 min. We saw improvements in surgical start times and session finish times (both earlier by roughly comparable amounts). The ultimately impact is that we saw on-time session finishes improve from around 50% to 100%. Following this project, we have managed to sustain the changes and the improved performance.The most impactful change was to conduct in-theatre neurophysiology patient preparation simultaneously with anaesthesia, rather than waiting for this to finish; when we performed this with a pair of clinical scientists, we were able to complete neurophysiology patient preparation by the time the anaesthetist was finished, therefore not introducing delays to the start of surgery. A final change was to remove a superfluous preparatory patient-baseline measurement.This is a very challenging and complex environment, with powerful stakeholders and many factors and unpredictable events affecting sessions. Nevertheless, we have shown that we can make improvements within our span of influence that improve the wider process. While using pairs of staff requires greater resource, we found the benefit to be worthwhile.