bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compression generated by cortical screws in an artificial bone model of an equine medial femoral condylar cyst
Authors: Moreno Caitlin R. , Santschi Elizabeth M. , Janes Jennifer , Liu Jie , Kim Do‐Gyoon , Litsky Alan S. 
Published: April 2022

AbstractObjectiveDetermine compression generated by lag and neutral screws over 12 h using two bone analogs.Study designExperimental study.Sample populationBone analogs were made of composite synthetic bone (CSB) or three‐dimensional printed polylactic acid (PLA). Analogs had a 2 mm exterior shell with a 10 mm thick internal layer of open‐cell material.MethodsBone analogs were opposed, making a 4‐sided box with open ends. A central channel contained the sensor and the screws passed through it to engage both paired analogs. Four screw/analog conditions were tested: neutral and lag screw with bicortical engagement, neutral and lag screw with unicortical engagement. All screws were tightened to 2 Nm torque and compression values recorded at 0, 0.5, 1, 2, 6, and 12 h (six trials per condition). Medians were compared across groups for statistical significance.ResultsThere was no difference in median compression between lag and neutral bicortical screws. For PLA, greater median compression was generated by neutral (median 437 N) and lag (median 379 N) bicortical screws compared to neutral unicortical screws (median 208 N, p < .001); lag bicortical screws generated greater median compression than lag unicortical screws (median 265 N, p = .012). For CSB, lag bicortical screws (median 293 N) generated greater median compression than neutral unicortical screws (median 228 N, p = .008).ConclusionLag and neutral screws generated similar compression. Bicortical screws had higher median compression than unicortical screws in bone analogs.Clinical significanceNeutral screws generate compression in cancellous bone analogs that can be increased with bicortical bone engagement.
Tribo-Erosion Performance of GFRP Composite Panels in Both Offshore and Onshore Environmental Conditions
Authors: Singh Amanpreet , Singh Gurmeet , Kumar Satish , Sehgal Satbir S. 
Published: April 2022

Abstract
The erosion wear due to raindrop plays a vital role in the service life of wind turbine components, especially blades. Furthermore, the rain impact angle and the environmental conditions have a major impact on erosion wear. In the present work, the rain erosion performance of glass fiber reinforced polyester (GFRP) blade material in offshore and onshore environmental conditions has been studied. A whirling arm test rig was created and used to conduct the erosion tests on both offshore and onshore conditions. To simulate the offshore and onshore environmental conditions, experiments were carried out using both fresh and saltwater. The trail runs were carried out for time duration (30–90 min) at different impact angles (0—90 deg) by running the whirling arm tester at different impact velocities (30–70 m/s). During the experimentation, the impact velocity varied from 30 to 70 m/s. The impact angle was taken as 0 deg, 30 deg, 45 deg, 60 deg, and 90 deg, respectively. The results showed that erosion wear in the offshore conditions was more in all the cases as compared to onshore conditions. Furthermore, the maximum mass loss was at 45-deg impact angles for both conditions, which was further endorsed by Scanning Electron Microscope (SEM) analysis. Very little work has been reported on the optimization of erosion wear response of Offshore and Onshore wind turbines by using different design of experiment techniques. The erosion testing reveals that the GFRP blades exhibit a ductile erosion mechanism, which was further explained by using three-dimensional surface plots with the help of Image J software.
Wear Analysis and Tool Life Modeling in Micro Drilling of Inconel 718 Superalloy
Authors: Agrawal Vipul , Gajrani Kishor Kumar , Mote Rakesh G. , Barshilia Harish C. , Joshi Suhas S. 
Published: April 2022

Abstract
Aircraft engine parts, specifically blades, discs, and sheets are primarily made up of Inconel 718, which required drilled holes for assembly. Drilling holes in Inconel 718 is very difficult due to its high hardness, especially microdrilling. The primary studies majorly used uncoated drills for microdrilling Inconel 718, which leads to low tool life due to frequent tool wear. Microdrills bearing different coatings have not been investigated for their efficiency and mechanism of wear in microdrilling of super alloys. Also, time-dependent prediction of cutting tool wear has not been addressed adequately. In this study, a theoretical model to predict tool wear in drilling as a function of time and to evaluate tool life of anti-abrasion-, TiAlSiN-, and TiAlN-coated drills are presented. Considering feed rate and cutting speed as independent variables microdrilling experiments were conducted. In addition, the model estimates the progression of abrasion wear in various sections of the drill and the section with highest wear-rate was considered for calculation of drill life. Life of uncoated and coated drills were also calculated using a failure criterion of 31.3 μm and Taylor’s tool life exponents. Finally, a comparison of the experimental and modelling results was done to validate the model. It was observed that the model and experimental results are in good agreement at low and medium cutting speed. Both the coatings increased the life of the drills compared to uncoated drills. The wear-rate is highest at the corner of the drill. The mode of failure for TiAlSiN-coated drill was noticed to be corner chipping and for TiAlN-coated tool was built-up-edge (BUE) formation followed by flank chipping.
New constraints on the timing and character of the Laramide Orogeny and associated gold mineralization in SE California, USA
Authors: Cawood Tarryn K. , Moser Amy , Borsook Ariel , Rooney Alan D. 
Published: April 2022

Abstract
The timing of deformation and associated gold mineralization in SE California, USA, is contentious, partly due to the challenges involved with dating ductile deformation. We therefore combine modern geo- and thermochronology with field and microscopic observations to show that the Cargo Muchacho Mountains preserve evidence of northward thrusting in a kilometer-scale ductile shear zone during the Late Cretaceous Laramide Orogeny, accompanied by hydrothermal fluid flow, gold mineralization, and pegmatite emplacement. Penetrative strain was largely accommodated within the Jurassic metavolcaniclastic Tumco Formation, whereas intrusive Jurassic granitoids behaved as competent bodies. Quartz microstructures suggest deformation at ~500 °C, which is consistent with fabrics defined by amphibolite facies minerals. The timing of thrusting is constrained by dynamically recrystallized titanite with a U-Pb age of 68 ± 1 Ma and late syn-kinematic pegmatites that yield U-Pb zircon ages of 65.0 ± 4.2–63.2 ± 4.8 Ma. Syn-kinematic fluid flow was focused into a lateral thrust ramp where the shear zone foliation was deflected around a relatively rigid pluton, creating zones rich in magnetite-quartz veins and epidote, and precipitating gold associated with pyrite and chalcopyrite. Dating of these sulfides via Re-Os yields an age of 64.7 ± 0.8 Ma, which confirms a Laramide age for the gold mineralization. Together, apatite from the pegmatites and a nearby Jurassic granite yields a U-Pb age of 60.4 ± 3.5 Ma, reflecting cooling to below 530–450 °C. Comparison with published studies suggests that thick-skinned deformation in the Cargo Muchacho Mountains was driven by flat-slab subduction of the conjugate Hess Plateau, which occurred several million years after and to the south of flat-slab subduction of the conjugate Shatsky Rise. This suggests that the conjugate Hess Plateau may have been subducted up to several hundred kilometers farther north than previously thought. Metamorphic devolatilization of underplated Orocopia Schist likely generated the gold-bearing hydrothermal fluids, and anatexis of the schist formed the peraluminous pegmatites, which highlights the importance of schist underplating and devolatilization along much of the Californian and Mexican cordillera.
Trends in diabetic eye disorders and associated comorbidities in Taiwan: a 10-year nationwide population-based cohort study
Authors: Lin Chia-Chen , Lee Chia-Yi , Huang Jing-Yang , Hsu Sheng-Min , Hung Jia-Horung , Yang Shun-Fa 
Published: April 2022

Background/aimsIn-depth analysis is needed to investigate trends in diabetic retinopathy (DR), diabetic macular oedema (DME) and associated comorbidities in patients with type 2 diabetes mellitus (T2DM) so that we can better understand their prevalence and incidence.MethodsA retrospective population-based study was conducted using data from Taiwan’s National Health Insurance Research Database from 2005 to 2015, and T2DM, DR and associated comorbidities were identified based on diagnostic codes. We used a standardised incidence rate with age and sex adjustment to estimate the prevalence and incidence of DR, proliferative DR (PDR), advanced PDR (aPDR) and DME, while the difference in each study period was calculated as the annual percentage change. We used the absolute standardised difference to analyse changes in related comorbidities in different periods.ResultsThe population of patients with DM increased over 50% between 2005 and 2015, while the prevalence and incidence of DR decreased, as did the incidence of PDR and aPDR. However, the prevalence and incidence of DME increased over the course of 10 years, with an upward trend in all forms of DR. The percentage of patients with hyperlipidaemia in DME and all DR increased, and the percentage of patients with end-stage renal disease (ESRD) was also elevated in DME.ConclusionThe prevalence and incidence of DR, PDR and aPDR decreased with time in patientsT2DM, while the ratio of DME increased gradually. The incidence of hyperlipidaemia also increased in all forms of diabetic eye disorders, while ESRD increased solely in DME.
Long-term leisure-time physical activity and risk of all-cause and cardiovascular mortality: dose–response associations in a prospective cohort study of 210 327 Taiwanese adults
Authors: Martinez-Gomez David , Cabanas-Sanchez Veronica , Yu Tsung , Rodriguez-Artalejo Fernando , Ding Ding , Lee I-Min , Ekelund Ulf 
Published: April 2022

ObjectivesWe aimed to investigate the dose–response associations of long-term leisure-time physical activity (LTPA) obtained from repeated measures with all-cause and cardiovascular disease (CVD) mortality outcomes in Taiwanese adults.MethodsWe included 210 327 participants with self-reported LTPA at least in two medical examinations (867 968 data points) for up to 20 years (median, IQR: 4.8 years, 2.3–9.0). Dose–response relationships were modelled with restricted cubic spline functions and Cox regressions HRs (95% CIs) adjusted for main covariates.ResultsDuring up to 23 years of follow-up (3 655 734 person-years), 10 539 participants died, of which 1919 of CVD. We observed an inverse, non-linear dose–response association between long-term LTPA and all-cause and CVD mortality. Compared with the referent (0 metabolic equivalent of task (MET) hours/week), insufficient (0.01–7.49 MET hours/week), recommended (7.50–15.00 MET hours/week) and additional (>15 MET hours/week) amounts of LTPA had a lower mortality risk of 0.74 (0.69–0.80), 0.64 (0.60–0.70) and 0.59 (0.54–0.64) for all-cause mortality and 0.68 (0.60–0.84), 0.56 (0.47–0.67) and 0.56 (0.47–0.68) for CVD mortality. When using only baseline measures of LTPA, the corresponding mortality risk was 0.88 (0.84–0.93), 0.83 (0.78–0.88) and 0.78 (0.73–0.83) for all-cause and 0.91 (0.81–1.02), 0.78 (0.68–0.89) and 0.80 (0.70–0.92) for CVD mortality.ConclusionLong-term LTPA was associated with lower risks of all-cause and CVD mortality. The magnitude of risk reductions was larger when modelling repeated measures of LTPA compared with one measure of LTPA at baseline.
Estimating the contribution of transmission in primary healthcare clinics to community-wide TB disease incidence, and the impact of infection prevention and control interventions, in KwaZulu-Natal, South Africa
Authors: McCreesh Nicky , Karat Aaron S , Govender Indira , Baisley Kathy , Diaconu Karin , Yates Tom A , Houben Rein MGJ , Kielmann Karina , Grant Alison D , White Richard 
Published: April 2022

BackgroundThere is a high risk ofMycobacterium tuberculosis(Mtb) transmission in healthcare facilities in high burden settings. WHO guidelines on tuberculosis (TB) infection prevention and control (IPC) recommend a range of measures to reduce transmission in healthcare settings. These were evaluated primarily based on evidence for their effects on transmission to healthcare workers in hospitals. To estimate the overall impact of IPC interventions, it is necessary to also consider their impact on community-wide TB incidence and mortality.MethodsWe developed an individual-based model ofMtbtransmission in households, primary healthcare (PHC) clinics, and all other congregate settings. The model was parameterised using data from a high HIV prevalence community in South Africa, including data on social contact by setting, by sex, age, and HIV/antiretroviral therapy status; and data on TB prevalence in clinic attendees and the general population. We estimated the proportion of disease in adults that resulted from transmission in PHC clinics, and the impact of a range of IPC interventions in clinics on community-wide TB.ResultsWe estimate that 7.6% (plausible range 3.9%–13.9%) of non-multidrug resistant and multidrug resistant TB in adults resulted directly from transmission in PHC clinics in the community in 2019. The proportion is higher in HIV-positive people, at 9.3% (4.8%–16.8%), compared with 5.3% (2.7%–10.1%) in HIV-negative people. We estimate that IPC interventions could reduce incident TB cases in the community in 2021–2030 by 3.4%–8.0%, and deaths by 3.0%–7.2%.ConclusionsA non-trivial proportion of TB results from transmission in clinics in the study community, particularly in HIV-positive people. Implementing IPC interventions could lead to moderate reductions in disease burden. We recommend that IPC measures in clinics should be implemented for their benefits to staff and patients, but also for their likely effects on TB incidence and mortality in the surrounding community.
Followership: an undervalued concept in effective teams within the military and NHS
Authors: Adams Thomas , Gibson A 
Published: April 2022

IntroductionLeadership is accepted as a crucial component of effective working within teams. Followership’s contribution to successful performance is increasingly recognised but understudied. This study evaluated followership levels in military doctors at different stages of their careers and made recommendations for how followership concepts can be used to develop the self and better understand the challenges of small team working.MethodsA self-report study in which Kelley’s followership questionnaire was distributed to 64 military doctors in three cohorts. 53 results were assessed using Kelley’s followership framework. Subgroup analysis was undertaken to look at differences depending on service, age, gender and career stage.ResultsThe study demonstrated a predominant exemplary followership style within military doctors. No statistical difference was identified at the 0.05 level in followership by career stage, age, gender or service in the sample group.ConclusionThis study gives insight into the attributes of doctors within the Defence Medical Services and laid out a methodology for further cohort evaluations of followership. It made recommendations on the areas of the field that require further research and how followership concepts may be included in further development courses and reporting for military medical personnel.
Traumatic brain injury during COVID-19 pandemic—time-series analysis of a natural experiment
Authors: Rajalu Banu Manickam , Indira Devi Bhagavatula , Shukla Dhaval P , Shukla Lekhansh , Jayan Mini , Prasad Krishna , Jayarajan Deepak , Kandasamy Arun , Murthy Pratima 
Published: April 2022

ObjectivesThis study aims to find if the incidence and pattern of traumatic brain injury (TBI) changed during the COVID-19pandemic. We also aim to build an explanatory model for change in TBI incidence using Google community mobility and alcohol sales data.DesignA retrospective time-series analysis.SettingEmergency department of a tertiary level hospital located in a metropolitan city of southern India. This centre is dedicated to neurological, neurosurgical and psychiatric care.ParticipantsDaily counts of TBI patients seen between 1 December 2019 and 3 January 2021 (400 days); n=8893. To compare the profile of TBI cases seen before and during the pandemic, a subset of these cases seen between 1 December 2019 and 31 July 2020 (244 days), n=5259, are studied in detail.ResultsAn optimal changepoint is detected on 20 March 2020 following which the mean number of TBI cases seen every day has decreased and variance has increased (mean 1=29.4, variance 1=50.1; mean 2=19.5, variance 2=59.7, loglikelihood ratio test: χ2=130, df=1, p<0.001). Two principal components of community mobility, alcohol sales and weekday explain the change in the number of TBI cases (pseudo R2=58.1). A significant decrease in traffic accidents, falls, mild/moderate injuries and, an increase in assault and severe injuries is seen during the pandemic period.ConclusionsDecongestion of roads and regulation of alcohol sales can decrease TBI occurrence substantially. An increase in violent trauma during lockdown needs further research in the light of domestic violence. Acute care facilities for TBI should be maintained even during a strict lockdown as the proportion of severe TBI requiring admission increases.
From basic to advanced computerised intravenous to oral switch for paracetamol and antibiotics: an interrupted time series analysis
Authors: Quintens Charlotte , Coenen Marie , Declercq Peter , Casteels Minne , Peetermans Willy E , Spriet Isabel 
Published: April 2022

ObjectivesEarly switch from intravenous to oral therapy of bioequivalent drugs has major advantages but remains challenging. At our hospital, a basic clinical rule was designed to automatically alert the physician to review potential intravenous to oral switch (IVOS). A rather low acceptance rate was observed. In this study, we aimed to develop, validate and investigate the effect of more advanced clinical rules for IVOS, as part of a centralised pharmacist-led medication review service.Design and settingA quasi-experimental study was performed in a large teaching hospital in Belgium using an interrupted time series design.InterventionA definite set of 13 criteria for IVOS, focusing on the ability of oral absorption and type of infection, was obtained by literature search and validated by a multidisciplinary expert panel. Based on these criteria, we developed a clinical rule for paracetamol and one for ten bioequivalent antibiotics to identify patients with potentially inappropriate intravenous prescriptions (PIVs). Postintervention, the clinical rule alerts were reviewed by pharmacists, who provided recommendations to switch in case of eligibility.Primary and secondary outcome measuresA regression model was used to assess the impact of the intervention on the number of persistent PIVs between the preintervention and the postintervention period. The total number of recommendations, acceptance rate and financial impact were recorded for the 8-month postintervention period.ResultsAt baseline, a median number of 11 (range: 7–16) persistent PIVs per day was observed. After the intervention, the number reduced to 3 (range: 1–7) per day. The advanced IVOS clinical rules showed an immediate relative reduction of 79% (incidence rate ratio=0.21, 95% CI 0.13 to 0.32; p<0.01) in the proportion of persistent PIVs. No significant underlying time trends were observed during the study. Postintervention, 1091 recommendations were provided, of which 74.1% were accepted, resulting in a total 1-day cost saving of €4648.35.ConclusionsWe showed the efficacy of advanced clinical rules combined with a pharmacist-led medication review for IVOS of bioequivalent drugs.
Development of a decision analytical framework to prioritise operating room capacity: lessons learnt from an empirical example on delayed elective surgeries during the COVID-19 pandemic in a hospital in the Netherlands
Authors: Rovers Maroeska M , Wijn Stan RW , Grutters Janneke PC , Metsemakers Sanne JJPM , Vermeulen Robin J , van der Pennen Ron , Berden Bart JJM , Gooszen Hein G , Scholte Mirre , Govers Tim M 
Published: April 2022

ObjectiveTo develop a prioritisation framework to support priority setting for elective surgeries after COVID-19 based on the impact on patient well-being and cost.DesignWe developed decision analytical models to estimate the consequences of delayed elective surgical procedures (eg, total hip replacement, bariatric surgery or septoplasty).SettingThe framework was applied to a large hospital in the Netherlands.Outcome measuresQuality measures impacts on quality of life and costs were taken into account and combined to calculate net monetary losses per week delay, which quantifies the total loss for society expressed in monetary terms. Net monetary losses were weighted by operating times.ResultsWe studied 13 common elective procedures from four specialties. Highest loss in quality of life due to delayed surgery was found for total hip replacement (utility loss of 0.27, ie, 99 days lost in perfect health); the lowest for arthroscopic partial meniscectomy (utility loss of 0.05, ie, 18 days lost in perfect health). Costs of surgical delay per patient were highest for bariatric surgery (€31/pp per week) and lowest for arthroscopic partial meniscectomy (−€2/pp per week). Weighted by operating room (OR) time bariatric surgery provides most value (€1.19/pp per OR minute) and arthroscopic partial meniscectomy provides the least value (€0.34/pp per OR minute). In a large hospital the net monetary loss due to prolonged waiting times was €700 840 after the first COVID-19 wave, an increase of 506% compared with the year before.ConclusionsThis surgical prioritisation framework can be tailored to specific centres and countries to support priority setting for delayed elective operations during and after the COVID-19 pandemic, both in and between surgical disciplines. In the long-term, the framework can contribute to the efficient distribution of OR time and will therefore add to the discussion on appropriate use of healthcare budgets. The online framework can be accessed via:https://stanwijn.shinyapps.io/priORitize/.