bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficient Computation of Large Deformation of Spatial Flexure-Based Mechanisms in Design Optimizations
Authors: Dwarshuis Koen , Aarts Ronald , Ellenbroek Marcel , Brouwer Dannis 
Published: June 2022

Abstract
Design optimizations of flexure-based mechanisms take a lot of computation time, in particular when large deformations are involved. In an optimization procedure, statically deformed configurations of many designs have to be obtained, while finding the statically deformed configuration itself requires tens to hundreds of load step iterations. The kinematically started deformation method (KSD-method) (Dwarshuis, K. S., Aarts, R. G. K. M., Ellenbroek, M. H. M., and Brouwer, D. M., 2020, “Kinematically Started Efficient Position Analysis of Deformed Compliant Mechanisms Utilizing Data of Standard Joints,” Mech. Mach. Theory, 152, p. 103911) computes deformed configurations fast by starting the computation from an approximation. This approximation is obtained by allowing the mechanism only to move in the compliant motion-direction, based on kinematic equations, using data of the flexure joints in the mechanism. This is possible as flexure-based mechanisms are typically designed to be kinematically determined in the motion directions. In this paper, the KSD-method is extended such that it can also be applied without joint-data, such that it is not necessary to maintain a database with joint-data. This paper also shows that the method can be used for mechanisms containing joints that allow full spatial motion. Several variants of the KSD-method are presented and evaluated for accuracy and required computation time. One variant, which uses joint-data, is 21 times faster and shows errors in stress and stiffness below 1% compared to a conventional multibody analysis on the same model. Another variant, which does not use joint-data, reduces the computation time by a factor of 14, keeping errors below 1%. The KSD-method is shown to be helpful in design optimizations of complex flexure mechanisms for large range of motion.
Time-Domain Simulation of Second-Order Diffracted Forces on Marine Structures in Multidirectional Irregular Seas
Authors: Ren Zhihao , Teng Bin , Cong Longfei 
Published: June 2022

Abstract
A new method for the accurate discrete technique of directional spectra is proposed for the simulation of the second-order incident potential of directional seas, and a second-order time-domain analysis program is developed for nonlinear wave forces on marine structures in multidirectional irregular seas. The boundary-value problems for the diffracted potential are solved by a higher-order boundary element method (HOBEM). The fourth-order Adams–Bashforth–Moulton method combined with the Newton–Raphson iteration is implemented for time integration. The present method is validated by comparison with the published frequency-domain results for a bottom-mounted vertical cylinder in bichromatic bidirectional waves. The second-order diffracted forces on a truncated cylinder are examined for different combinations of storms and swell seas, and major efforts are focused on investigating the effects of wave directionality, directional spreading, and the spectral peak frequency of mixed seas.
Correlation Between Tribological and Vibration Behaviors in Sliding Lubricated Contacts
Authors: Ta Thi-Na , Horng Jeng-Haur , Hwang Yunn-Lin 
Published: June 2022

Abstract
The tribological and vibration behaviors of a lubricated system are often studied separately. However, in recent years, the combination of tribology and mechanical vibration significantly contributes in analyzing and solving many practical problems. The main objective of this study is to establish empirical equations that describe friction–-vibration interactions under dynamic (sliding) lubricated contacts. The effects of operating conditions on the tribological and vibration behaviors of lubricating oils having different viscosities were experimentally investigated using a four-ball wear test machine. The results indicated that the vibration velocity tends to increase with the sliding velocity. With a lower combination of ratio of the vibration velocity to the sliding velocity and the specific film thickness, lower friction coefficients were observed in the boundary and mixed lubrication regimes. The mean wear scar diameters exhibited positive correlations with the amplitudes of vibration accelerations. The empirical equations provide basic information for the prediction of friction variation by measuring vibration signals.
Unusual δ26Mg values in oceanic crust basalts from the South China Sea
Authors: Liao Renqiang , Zhu Hongli , Zhang Lipeng , Li He , Li Congying , He Yongsheng , Sun Weidong , Liu He 
Published: June 2022

Abstract
Whether or not oceanic crust basalts are affected by plate subduction is a hot topic of debate. The South China Sea is one of the largest marginal basins in the western Pacific Ocean and has been surrounded by subduction of the Pacific plate and Indian plate, yet, to date, no study has clearly shown evidence of subduction in the geochemistry of volcanism in the basin due to a lack of sampling of igneous crust basalts on the seafloor. The International Ocean Discovery Program Expedition 349 cored seafloor basalts near the fossil spreading ridges of the eastern (Site U1431) and southwestern (Site U1433 and U1434) subbasins in the South China Sea. The recovered basalt samples indicated a pyroxenite-bearing peridotite mantle source. Here, we report Mg isotopic data from 14 of these oceanic crust basalt samples. The δ26Mg values of most basalts from the three drill holes were higher (up to −0.10‰) than that of the average mantle (−0.25‰). The lack of correlations of δ26Mg with geochemical indices of magmatic processes (e.g., MgO, CaO/Al2O3, La/Sm, Nb/Zr) suggests that crystal fractionation and partial melting had insignificant effects on the Mg isotopic compositions of the South China Sea basalts. Thus, the variations in Mg isotopes were inherited from their mantle sources. Considering the highly varied Ce/Pb ratios and elevated 87Sr/86Sr values but mantle-like 143Nd/144Nd values, we propose that the varied δ26Mg values were likely caused by metasomatism of subduction-released fluids. The coupling of Mg and Sr-Fe isotopes provides robust evidence that the high-δ26Mg values of the South China Sea basalts resulted from mixing among pyroxenite-bearing peridotite mantle, the nearby Hainan plume materials, and subducting serpentinite-released fluids. Therefore, these Mg isotopes suggest that the mantle source of the South China Sea basalts was influenced by subducted materials, providing further evidence of the initial expansion, formation, and evolution of the South China Sea during plate subduction.
Mechanism of crustal thickening and exhumation of southern Lhasa terrane during the Late Cretaceous: Evidence from high-pressure metamorphic rocks of the Eastern Himalayan Syntaxis
Authors: Zhang Yanling , Yin Changqing , Davis Donald W. , Li Shun , Qian Jiahui , Zhang Jian , Gao Peng , Wu Shangjing , Li Wangchao , Xia Yanfei 
Published: June 2022

AbstractThe mechanism of Late Cretaceous crustal thickening and exhumation of the southern Lhasa terrane is critical for understanding the tectonic evolution of the Tibetan Plateau. High-pressure metamorphic rocks from the lower crust are good candidates for addressing this issue. In this study, we focus on Late Cretaceous, high-pressure, garnet-bearing amphibolites from the Nyingchi Complex of the Eastern Himalayan Syntaxis and present an integrated study of geochronology, petrography, mineral chemistry, and thermodynamic modeling. Petrographic data determine three metamorphic stages (M1–M3). The M1 stage is characterized by a peak mineral assemblage of garnet + hornblende + albite + rutile + muscovite + quartz, which is followed by a post-peak (M2) assemblage of garnet + hornblende + plagioclase + epidote + biotite + rutile + quartz. The late retrograde stage (M3) is defined by hornblende + plagioclase symplectites surrounding garnet porphyroblasts. Mineral chemistry, with thermodynamic modeling, constrains the P-T conditions of the M1–M3 stages to 14–19 kbar/660–720 °C, 8–10 kbar/650–660 °C, and &lt;7 kbar/&lt;600 °C, respectively. Metamorphic zircons yield a concordant age at 90 Ma, which indicates the formation of garnet-bearing amphibolites. These results indicate a P-T-t path involving near-isothermal decompression for garnetbearing amphibolites, which suggests that the Nyingchi Complex underwent peak-pressure metamorphism (M1) at 90 Ma, followed by rapid exhumation to the depth of 32–26 km along the subduction channel. Moreover, the garnet-bearing amphibolites are considered to be the product of high-pressure metamorphism of mafic crust at the base of the Gangdese belt. Hence, the crust of the Gangdese belt experienced significant crustal thickening of up to 60 km at 90 Ma.
Association among high blood pressure health literacy, social support and health-related quality of life among a community population with hypertension: a community-based cross-sectional study in China
Authors: Wang Yujie , Chen Ting , Gan Wei , Yin Jinyu , Song Li , Qi Huan , Zhang Qinghua 
Published: June 2022

ObjectivesThe prevalence of hypertension is increasing worldwide. Hypertensive patients in China have limited high blood pressure health literacy (HBP-HL) and social support (SS), which may have an impact on health-related quality of life (HRQoL) and lead to poorer clinical outcomes. However, the potential mechanism of HBP-HL, SS and HRQoL remains unclear. The aim of this study was to investigate the association among HBP-HL, SS and HRQoL among community patients with hypertension in China.DesignA community-based cross-sectional survey.SettingThe community health service center in Huzhou, China.Participants406 community patients with hypertension were investigated from June to October 2019.Primary outcome measuresHRQoL was assessed using the Quality of Life Instruments for Chronic Diseases-Hypertension V2.0, HBP-HL was assessed with the HBP-Health Literacy Scale into Chines and SS was assessed with the Social Support Rating Scale.ResultsCompared with moderate level of HRQoL and SS, HBP-HL of community hypertensive patients was significantly deficient. Overall, 93 patients (23.2%) lacked HBP-HL, 308 patients (76.8%) had a medium level of HBP-HL, and none of them had sufficient HBP-HL. Correlation analysis showed that HBP-HL, SS and HRQoL were positively correlated (p<0.01). The significant differences in HRQoL and SS were detected in HBP-HL level (p<0.001). In multiple linear regression models, HRQoL was significantly associated with ‘Print HL’ and ‘Medication Label’ of HBP-HL (p<0.05) and all three dimensions of SS (p<0.05). In addition, The bootstrap method was used to examine the indirect effect among variables. The results showed that SS played a mediating role between HBP-HL and HRQoL (p<0.001).ConclusionThere is an association among HBP-HL, SS and HRQoL in community hypertension patients. HBP-HL can directly affect HRQoL, and through SS mediate the HRQoL. Community intervention for hypertension management should consider HBP-HL promotion and social engagement as the breakthrough points to increase the impact on patients’ HRQoL.
Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial
Authors: Kilbride Cherry , Warland Alyson , Stewart Victoria , Aweid Basaam , Samiyappan Arul , Ryan Jennifer , Butcher Tom , Athanasiou Dimitrios A , Baker Karen , Singla-Buxarrais Guillem , Anokye Nana , Pound Carole , Gowing Francesca , Norris Meriel 
Published: June 2022

IntroductionUpper limb (UL) rehabilitation is most effective early after stroke, with higher doses leading to improved outcomes. For the stroke survivor, the repetition may be monotonous. For clinicians, providing a clinically meaningful level of input can be challenging. As such, time spent engaged in UL activity among subacute stroke survivors remains inadequate. Opportunities for the stroke survivor to engage with UL rehabilitation in a safe, accessible and engaging way are essential to improving UL outcomes following stroke. The NeuroBall is a non-immersive virtual reality (VR) digital system designed for stroke rehabilitation, specifically for the arm and hand. The aim of the Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke study is to determine the safety, feasibility and acceptability of the NeuroBall as a rehabilitation intervention for the UL in subacute stroke.Methods and analysisA feasibility randomised controlled trial (RCT) will compare the NeuroBall plus usual care with usual care only, in supporting UL rehabilitation over 7 weeks. Twenty-four participants in the subacute poststroke phase will be recruited while on the inpatient or early supported discharge (ESD) stroke pathway. Sixteen participants will be randomised to the intervention group and eight to the control group. Outcomes assessed at baseline and 7 weeks include gross level of disability, arm function, spasticity, pain, fatigue and quality of life (QoL). Safety will be assessed by recording adverse events and using pain, spasticity and fatigue scores. A parallel process evaluation will assess feasibility and acceptability of the intervention. Feasibility will also be determined by assessing fidelity to the intervention. Postintervention, semistructured interviews will be used to explore acceptability with 12 participants from the intervention group, four from the usual care group and with up to nine staff involved in delivering the intervention.Ethics and disseminationThis trial has ethical approval from Brunel University London’s Research Ethics Committee 25257-NHS-Oct/2020-28121-2 and the Wales Research Ethics Committee 5 Bangor (Health and Care Research Wales) REC ref: 20/WA/0347. The study is sponsored by Brunel University London. Contact: Dr Derek Healy, Chair, University Research Ethics committee (Derek.healy@brunel.ac.uk). Trial results will be submitted for publication in peer-reviewed journals, presented at national and international conferences and distributed to people with stroke.Trial registration numberISRCTN11440079; Pre-results.
1032 Mobile phones for homeless patients in the emergency department, a lifeline to connect with vital support services during the COVID-19 pandemic
Authors: Herrmann Simone , Harrison Hooi-Ling , Parkinson Sophie , Russell Hannah 
Published: June 2022

Aims/Objectives/BackgroundDuring the COVID-19 pandemic most of London’s homeless day centres and hostels had to close, essential support services and GP practices were only contactable by phone or online. This created a precarious situation for vulnerable street homeless, leaving them with limited access to food, safe places or health care. Homeless patients attending our ED within hours could access homeless team support. However, an audit in our ED in May 2020 revealed that 70–80% of our homeless patients attended out of hours. We identified this shortfall in care, so conducted a pilot project to supply mobile phones to 30 homeless patients to facilitate a follow-up with our homeless team. This is the first study of this kind in an emergency department in the UK.Methods/DesignTwo grants from the GSTT charity and the Society of Catholic Medical Missionaries charity covered the purchase of 30 mobile phones. The phones were given together with contact numbers to 30 rough sleepers attending our department out of hours, who did not have access to a phone or an allocated support worker. In addition, we forwarded the patient‘s details and mobile number to our homeless team who contacted the patient the next working day after discharge.Results/ConclusionsAll 30 phones were given out during a 3 month period. ED staff referred 21 of the 30 patients to the homeless team. The homeless team was able to contact 17 patients. 4 patients were eligible for council housing and 3 patients received alternative accommodation with charities. 6 patients were referred to other services including the first fit clinic, domestic violence service, the HIV clinic and the community mental health team. These outcomes are significant and life changing for these individuals and, considering the low cost of one phone (£26 per phone including top-up), application for further funding has been submitted.
1116 Diagnostic accuracy of point-of-care lung ultrasound for COVID-19: a meta-analysis of 19 studies including 3954 patients
Authors: Matthies Ashley , Trauer Michael , Chopra Karl , Jarman Robert 
Published: June 2022

Aims/Objectives/BackgroundThere is a growing evidence-base concerning the role of Point-of-Care (POC) lung ultrasound (LUS) for the diagnosis of COVID-19. LUS is well-established for many respiratory illnesses and may convey several advantages over conventional imaging modalities and single initial reverse-transcriptase polymerase chain reaction (RT-PCR) testing for COVID-19.The purpose of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of LUS for the diagnosis of COVID-19. This is the first meta-analysis in this evolving area of research and combines data from almost 4,000 patients.Methods/DesignThis work was synthesised according to the PRISMA guidelines. A research question was formulated according to the PICOTS framework and a search strategy was developed in accordance with existing guidance. A screening and selection tool was used to identify studies from the initial search. All prospective and retrospective trials of adult patients comparing LUS to either RT-PCR testing, chest CT or a final clinical diagnosis were included.Data analysis was performed in R. Random effects bivariate binomial models were used to estimate overall sensitivity, specificity, and the hierarchical summary receiver operating characteristic (HSROC) curve for LUS. The QUADAS-2 tool was used to assess the quality of included studies.Abstract 1116 Figure 1Forest plot of LUS sensitivityAbstract 1116 Figure 2Forest plot of LUS specificityAbstract 1116 Figure 3Random effects meta-analysisResults/Conclusions19 studies were included in the meta-analysis, providing data for 3,954 patients in total. LUS demonstrated an overall (pooled) sensitivity of 87.3% (95% CI 83.4–90.5) and specificity of 70.0% (61.6–76.4). The overall positive and negative likelihood ratios were 3.04 (2.27–4.06) and 0.16 (0.12–0.22) respectively. Heterogeneity between studies was found to be high, with I2values of 72.6% (59.2–91.7) and 87% (83.5–95.9) for sensitivity and specificity respectively.LUS was found to be highly sensitive in a high prevalence population and may improve detection of COVID-19 pneumonia compared to CXR. In patients requiring hospital admission a normal LUS should prompt consideration of alternative diagnoses.
755 Research priorities for prehospital care of older patients with injuries: scoping review
Authors: Harthi Naif , Goodacre Steve , Sampson Fiona , Alharbi Rayan 
Published: June 2022

Introduction and purposeThe use of ambulance services by older patients with injuries increases within the impacts of ageing-related changes leading to adverse patient outcomes. There is increasing recognition of the importance of prehospital trauma care for older patients, but little systematic research to guide practice. We aimed to review the published evidence on prehospital trauma care for older patients, determine the scope of existing research and identify research gaps in the literature.MethodsA systematic scoping review guided by the Arksey and O’Malley framework reported in line with the PRISMA-ScR checklist. A systematic search was conducted of Scopus, CINAHL, MEDLINE, PubMed and Cochrane library databases to identify articles published between (2001–2021) years. Inclusion and exclusion criteria were applied independently by two reviewers. Data were extracted, charted and summarised from eligible articles.Results65 studies were identified and reviewed, and 25 included. Five categories were identified: ‘field triage, ‘ageing impacts’, ‘decision-making’, ‘paramedic’ awareness’ and ‘paramedic’s behaviour’. Undertriage & overtriage (sensitivity & specificity) were commonly cited as poorly investigated field-triage subthemes. Ageing-related physiologic changes, comorbidities and polypharmacy were the most widely researched. Inaccurate decision-making and poor early identification of major injuries were identified as potentially influencing patient outcomes. More research is required into paramedic knowledge of geriatric care & ageing changes and the potential impact of paramedic care.ConclusionThis is the first study reviewing the published evidence on prehospital trauma care for older patients and identifying research priorities for future research. This review has identified the prehospital triage for older trauma victims and studies of paramedic knowledge of older trauma care as key priorities. Investigating and understanding these can improve providing prehospital care of the older patient with injuries for positive patient outcomes.
833 Using the GEMLR as a proxy for global health engagement of emergency care practitioners
Authors: Jafar Anisa , Prager Gabrielle , Jones Pete , Bromley Claire , Kennedy Harriet , Ndiaye Haarith , Ingham Jack 
Published: June 2022

Aims/Objectives/BackgroundThere is broad involvement of emergency medicine (EM) practitioners in global EM (GEM) research. However this work is often siloed, reducing efficiency of collaboration and impeding healthy critical appraisal. The purpose of this novel longitudinal study is to identify the GEM research undertaken by those in EM. Quantifying, displaying and understanding the ‘who’, ‘what’ and ‘where’ of such research is a key step to facilitate collaboration and highlight important gaps to ultimately drive quality in GEM research as a whole.Methods/DesignThe Global Emergency Medicine Literature Review (GEMLR) is an annual summary of the top-ranked GEM literature. A spreadsheet of all papers identified by each initial search (before ranking) is freely available. We searched the past six years of GEMLR’s 3,634 initial titles to identify authors with EM affiliations. We also collected data on author institutions, country focus, topic, funding sources and if co-authorship included local collaborators.Results/ConclusionsFrom 2014–2019 the GEMLR found over 800 individual papers with at least one EM affiliated author. Authors were from over 600 different institutions (see figure 1) and research focused on over 100 countries.Abstract 833 Figure 1Author spreadApproximately 60% had no funding/documented and 5% papers did not include a local author.There are limitations, including the GEMLR search strategy and EM practitioners omitting their EM affiliations (a take home message, if we wish to strengthen EM’s perceived research presence). However this study serves as a robust start-point to map GEM research engagement. Interestingly, the study demonstrates a modest UK author slice with 20 being identified, contributing to 12 papers over 6 years.Further analysis will target the sociodemographic association between the most/least researched countries, expanding to include further years of data. Using a data visualisation strategy we will make the work accessible online to provide leverage in areas of much-needed GEM research growth.