bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of a New Orbital Steering Concept With Focus on the Control Loop Performance
Authors: Olesen Emil Nørregård , Andersen Torben Ole 
Published: November 2022

Abstract
This paper investigates a new asymmetric steering concept within orbital steering units called OSPS, which asymmetry enables new steering features for the operator of the vehicle compared to traditional OSP variants. A traditional orbital steering unit functions as a proportional valve system with a certain overlap, where the operator input to the steering wheel will initiate the rotation of the wheels with a small dead-band of 2–3 degrees. The new asymmetric unit functions instead as a proportional valve system with a certain under-lap, where the operator will initiate the rotation of the wheels directly related to the steering wheel rotation instead. The objective with this paper is to evaluate the closed loop performance for the new asymmetric concept, because the right and left control loop is changed compared to a tradional OSP unit.
Passive Heating Increases Bench-Pull Power Output in Highly Trained Swimmers
Authors: McKenzie Max R. , Hogarth Luke W. , McKean Mark R. , Doyle Danielle P. , Burkett Brendan J. 
Published: November 2022

Purpose: Determine the effects of skin temperature change on bench-pull power following a passive warm-up intervention with highly trained swimmers using multiple heated clothing garments. Methods: Using a crossover design, 8 high-performance swimmers (mean [SD]; age, 22.4 [4.4] y; body mass, 74.9 [8.1] kg; height, 1.79 [0.09] m; world record ratio, 107.3% [5.1%]) completed a pool-based warm-up followed by a 35-minute transition phase before completing 3 repetitions at 50% of 1-repetition maximum of the bench-pull exercise. During transition, swimmers wore either a warm (control) or a heated (heat) clothing condition. Results: Following heating, mean skin temperature was 0.7 °C higher in heat (P = .011), though no change was seen in tympanic temperature. Bench-pull mean and peak power improved by 4.5% and 4.7% following heating, respectively. A large repeated-measures correlation was observed between skin temperature and mean (r [90% CI] = .94 [.65 to .99], P < .01) and peak (r [90% CI] = .89 [.45 to .98], P < .01) power output. Thermal sensation and comfort at all regions were higher with heating (P ≤ .02). Conclusion: Combined upper- and lower-limb passive heating can increase whole-body skin temperature and improve short-duration upper-limb power output during the bench-pull exercise. Improvements in power output were directly related to the skin temperature increase facilitated by the heated clothing.
Safe prevention ofClostridium difficileusing infectious disease guidelines at an urban hospital in North Carolina
Authors: Davies Eileen , Jolles Diana 
Published: November 2022

Clostridium difficilecauses nearly 500 000 annual infections in the USA. A total of 15 000–30 000 US deaths annually and greater than US$4.8 billion dollars are related toClostridium difficileinfection (CDI). Length of hospital stay is 2.8 –5.5 additional days and inpatient costs are estimated at US$3000–US$15 400 per episode. One major cause of CDI is misuse and overuse of antibiotics. The Centers for Disease Control and Prevention reports that 30%–50% of antibiotics prescribed in hospitals are unnecessary or inappropriate. Patients with unexplained or three or greater unformed stools in 24 hours are candidates for testing of CDI.Prior to implementation, an analysis at the local level was conducted to determine possible causes of CDI influence. Chart auditing at this urban hospital revealed that 1 out of 23 (4%) providers were treating UTIs according to hospital protocol (A. Richmond, personal communication, 6 March 2018). The standardized infection ratio in 2017, which compares the predicted to the actual infection rate, at this hospital was 1.266 for CDI. Having a solid antibiotic stewardship in place is imperative to limit antibiotic related and resistant infections. During an observational study, only one out of nine (11%) staff followed contact precaution policies at this hospital.
Protocol for CLASSIC PBB: comparison of lower airway sampling strategies in children with protracted bacterial bronchitis
Authors: Gilchrist Francis J , Aspey Mathew , Bowler Robert , Brodlie Malcolm , Desai Seema , Harris Caroline , Hinton Emily , Kulkarni Hemant , Ogbolosingha Aviva , Sinha Ian , Solis-Trapala Ivonne , Stock Joanne , Carroll William D 
Published: November 2022

BackgroundProtracted bacterial bronchitis (PBB) is an endobronchial infection and a the most common cause of chronic wet cough in young children. It is treated with antibiotics, which can only be targeted if the causative organism is known. As most affected children do not expectorate sputum, lower airway samples can only be obtained by bronchoalveolar lavage (BAL) samples taken during flexible bronchoscopy (FB-BAL). This is invasive and is therefore reserved for children with severe or relapsing cases. Most children with PBB are treated empirically with broad spectrum antibiotics. CLASSIC PBB will compare the pathogen yield from two less invasive strategies with that from FB-BAL to see if they are comparable.Methods131 children with PBB from four UK centres referred FB-BAL will be recruited. When attending for FB-BAL, they will have a cough swab and an induced sputum sample obtained. The primary outcome will be the discordance of the pathogen yield from the cough swab and the induced sputum when compared with FB-BAL. Secondary outcomes will be the sensitivity of each sampling strategy, the success rate of the induced sputum in producing a usable sample and the tolerability of each of the three sampling strategies.DiscussionIf either or both of the two less invasive airway sampling strategies are shown to be a useful alternative to FB-BAL, this will lead to more children with PBB having lower airway samples enabling targeted antibiotic prescribing. It would also reduce the need for FB, which is known to be burdensome for children and their families.Trial registration numberISRCTN79883982.
Prognostic value ofKRASmutations,TP53mutations and PD-L1 expression among lung adenocarcinomas treated with immunotherapy
Authors: Tønnesen Ea Maria Tønning , Stougaard Magnus , Meldgaard Peter , Lade-Keller Johanne 
Published: November 2022

AimsThe aim of this study was to investigate the association between oncogenic alterations and programmed cell death ligand 1 (PD-L1) expression in lung adenocarcinomas, as well as the prognostic value ofKRASand/orTP53mutations in patients treated with immunotherapy.MethodsThis study is a retrospective cohort study of 519 patients with lung adenocarcinomas analysed for mutations and PD-L1 expression. Data were collected from electronic pathology record system, next-generation sequencing system, and clinical databases. Association between mutations and PD-L1 expression was investigated, as well as survival statistics of the 65 patients treated with immunotherapy.Results41% of the samples contained aKRASmutation, predominantly together with mutations inTP53(41%) orSTK11(10%). Higher expression of PD-L1 was seen among patients withKRASmutations (p=0.002) andEGFRwild type (p=0.006). For patients treated with immunotherapy, there was no statistically significant difference for overall survival (OS) and progression-free survival (PFS) according toKRASmutation status,TP53mutation status or PD-L1 expression. The HR for concomitant mutations inTP53andKRASwas 0.78 (95% CI 0.62 to 0.99) for OS and 0.43 (0.21 to 0.88) for PFS. Furthermore, concomitantTP53andKRASmutations predicted a better PFS (p=0.015) and OS (p=0.029) compared with no mutations or a single mutation in eitherTP53orKRAS.ConclusionMutations inTP53together withKRASmay serve as a potential biomarker for survival benefits with immunotherapy.
High yield of surveillance in patients diagnosed with constitutional mismatch repair deficiency
Authors: Ghorbanoghli Zeinab , van Kouwen Mariëtte , Versluys Birgitta , Bonnet Delphine , Devalck Christine , Tinat Julie , Januszkiewicz-Lewandowska Danuta , Costas Consuelo Calvino , Cottereau Edouard , Hardwick James C H , Wimmer Katharina , Brugieres Laurence , Colas Chrystelle , Vasen Hans F A 
Published: November 2022

BackgroundConstitutional mismatch repair deficiency (CMMRD) is a rare autosomal recessively inherited syndrome that is caused by biallelic pathogenic variants of the mismatch repair genes. It is characterised by the development of multiple tumours in the first and second decade of life including brain, gastrointestinal and haematological tumours often resulting in early death. In order to improve the prognosis of these patients, the European collaborative group ‘care for CMMRD’ developed a surveillance programme in 2014 and established a registry of patients with CMMRD in Paris. The aim of the study was to evaluate the outcome of this programme.MethodsTwenty-two patients with a definitive diagnosis of CMMRD and with at least one follow-up study were selected from the registry. Medical data on the outcome of surveillance were collected from these patients.ResultsDuring a mean follow-up of 4 years, the programme detected eight malignant tumours including three brain tumours, three upper gastrointestinal cancers and two colorectal cancers. Most tumours could successfully be treated. In addition, many adenomas were detected in the duodenum, and colorectum and subsequently removed. Seven patients developed a symptomatic malignancy, including two brain tumours, one small bowel cancer and four haematological malignancies. At the end of the follow-up, 16 out of 22 patients (73%) who participated in the surveillance programme were still alive.ConclusionThe study suggests a beneficial effect of surveillance of the digestive tract and brains.
Detection of COVID-19 Cases from Chest X-Rays using Deep Learning Feature Extractor and Multilevel Voting Classifier
Authors: Suganya G. , Premalatha M. , Geetha S. , Chowdary G. Jignesh , Kadry Seifedine 
Published: November 2022

Purpose: During the current pandemic scientists, researchers, and health professionals across the globe are in search of new technological methods for tackling COVID-19. The magnificent performance reported by machine learning and deep learning methods in the previous epidemic has encouraged researchers to develop systems with these methods to diagnose COVID-19. Methods: In this paper, an ensemble-based multi-level voting model is proposed to diagnose COVID-19 from chest x-rays. The multi-level voting model proposed in this paper is built using four machine learning algorithms namely Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM) with a linear kernel, and K-Nearest Neighbor (KNN). These algorithms are trained with features extracted using the ResNet50 deep learning model before merging them to form the voting model. In this work, voting is performed at two levels, at level 1 these four algorithms are grouped into 2 sets consisting of two algorithms each (set 1 — SVM with linear kernel and LR and set 2 — RF and KNN) and intra set hard voting is performed. At level 2 these two sets are merged using hard voting to form the proposed model. Results: The proposed multilevel voting model outperformed all the machine learning algorithms, pre-trained models, and other proposed works with an accuracy of 100% and specificity of 100%. Conclusion: The proposed model helps for the faster diagnosis of COVID-19 across the globe.
Proteomic analysis reveals that aging rabbit vocal folds are more vulnerable to changes caused by systemic dehydration
Authors: do Nascimento Naila C. , Bailey Taylor W. , Santos Andrea P. , Duan Chenwei , Mohallem Rodrigo , Franco Jackeline , Aryal Uma K. , Xie Jun , Cox Abigail , Sivasankar M. Preeti 
Published: November 2022

Abstract
Background
Older adults are more prone to develop systemic dehydration. Systemic dehydration has implications for vocal fold biology by affecting gene and protein expression. The objective of this study was to quantify vocal fold protein changes between two age groups and hydration status, and to investigate the interaction of age and hydration status on protein expression, which has not been investigated in the context of vocal folds before. Comparative proteomics was used to analyze the vocal fold proteome of 6.5-month-old and > 3-year-old rabbits subjected to water ad libitum or water volume restriction protocol.

Results
Young and older adult rabbits (n = 22) were either euhydrated (water ad libitum) or dehydrated by water volume restriction. Dehydration was confirmed by body weight loss of − 5.4% and − 4.6% in young and older groups, respectively, and a 1.7-fold increase of kidney renin gene expression in the young rabbits. LC-MS/MS identified 2286 proteins in the rabbit vocal folds of young and older adult rabbits combined. Of these, 177, 169, and 81 proteins were significantly (p ≤ 0.05) affected by age, hydration status, or the interaction of both factors, respectively. Analysis of the interaction effect revealed 32 proteins with opposite change patterns after dehydration between older and young rabbit vocal folds, while 31 proteins were differentially regulated only in the older adult rabbits and ten only in the young rabbits in response to systemic dehydration. The magnitude of changes for either up or downregulated proteins was higher in the older rabbits. These proteins are predominantly related to structural components of the extracellular matrix and muscle layer, suggesting a disturbance in the viscoelastic properties of aging vocal fold tissue, especially when subjected to systemic dehydration.

Conclusions
Water restriction is a laboratory protocol to assess systemic dehydration-related changes in the vocal fold tissue that is translatable to human subjects. Our findings showed a higher number of proteins differentially regulated with a greater magnitude of change in the vocal folds of older adult rabbits in the presence of systemic dehydration compared to younger rabbits. The association of these proteins with vocal fold structure and biomechanical properties suggests that older human subjects may be more vulnerable to the effects of systemic dehydration on vocal function. The clinical implications of these protein changes warrant more investigation, but age should be taken into consideration when evaluating vocal treatment recommendations that interfere with body fluid balance.
Changes in hyperglycaemia-related testing for prediabetes and type 2 diabetes mellitus management: a prospective, cross-sectional survey of 16 years of general practice data from Australia
Authors: Leigh Andrew , Hunter Jennifer , Harrison Christopher , Britt Helena , Molodysky Eugen 
Published: November 2022

Abstract
Background
The rising prevalence of prediabetes increases the population risk of type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular disease. Early identification by General Practitioners (GPs) provides opportunities for lifestyle modifications that can lower these risks.

Methods
This study examined 16 years of hyperglycaemia-related testing for patients in Australia aged 13 years or older with, or at risk of a diagnosis of T2DM. The Bettering the Evaluation and Care of Health (BEACH) study is a national cross-sectional survey, with a single-stage, cluster sampling design. Approximately 1,000 GPs were randomly selected annually (2000/01–20,015/16) from across Australia, who each recorded details of 100 consecutive clinical encounters with consenting patients. Point estimates were adjusted for intracluster correlation and GP characteristics.

Results
Fifteen thousand six hundred seventy nine GPs recorded details of 1,387,190 clinical encounters with patients aged 13 + years. Prediabetes and T2DM were managed at 0.25% (95% CI: 0.24–0.27%) and 3.68% (95% CI: 3.62–3.73%) of encounters respectively. By the end of the study, the proportion of encounters where prediabetes was managed was 2.3 times higher and for T2DM, 1.5 times higher. The proportion of prediabetes (55.9%, 95% CI: 53.9–57.8%) and T2DM (27.3%, 95% CI: 26.7–27.9%) management occasions where one or more hyperglycaemia-related tests were requested were relatively stable. However, differences in the types of tests were observed. For prediabetes, glucose tolerance tests were most common but from 2014/15, requests for HbA1c tests began to increase. For T2DM, HbA1c tests were most common, and requests for one or more glucose tests gradually declined.

Conclusion
The observed 16-year annual trends align with the rising incidence of prediabetes and T2DM. GPs appeared to be strongly influenced by changes to the national insurance scheme and clinical guidelines for hyperglycaemia-related pathology testing. However, some GPs may have been pre-empting policy changes as there was also evidence of ‘unendorsed’ testing, notably for prediabetes, that warrants further investigation. The increasing proportion of encounters for prediabetes, coupled with a high proportion of management occasions where pathology was requested have substantial resource implications. Calls to lower the risk threshold for prediabetes screening therefore warrant an economic analysis. Ongoing, reliable, up-to-date data is needed to inform clinical practice guidelines and policy in Australia.
Frontal lobe development in fetuses with growth restriction by using ultrasound: a case–control study
Authors: Peng Ruan , Zheng Qiao , Wu Li-Hong , Yin Xia , Zheng Ju , Xie Hong-Ning 
Published: November 2022

AbstractBackgroundFetal growth restriction (FGR) occurs in up to 10% of pregnancies and is a leading cause of perinatal mortality and neonatal morbidity. Three-dimensional ultrasonography of intracranial structure volume revealed significant differences between fetuses with FGR and appropriate for gestational age (AGA) fetuses. We aimed to compare the frontal lobe development between fetuses with FGR and appropriately grown fetuses and evaluate the impact of fetal circulatory redistribution (FCR) on frontal lobe development in fetuses with FGR.MethodsWe performed a case–control study at our institution from August 2020 to April 2021. The frontal antero-posterior diameter (FAPD) and occipito-frontal diameter (OFD) were measured on the trans-ventricle view and we calculated the Z-scores for FAPD and OFD standardized for gestational age (GA) and transverse cerebellar diameter (TCD) by performing a standard regression analysis followed by weighted regression of absolute residual values in appropriately grown fetuses. We calculated the FAPD/OFD ratio as 100 × FAPD/OFD and FAPD/HC (head circumference) as 100 × FAPD/HC. To compare intracranial parameters, we randomly selected a control group of appropriately grown fetuses matched with the FGR group at the time of ultrasonography. We performed between-group comparisons of the FAPD Z-score, OFD Z-score, FAPD/OFD ratio and FAPD/HC. Similarly, we compared intracranial parameters between fetuses with FGR with and without FCR.ResultsFAPD/OFD ratio was curvilinear related to all the independent variables (GA, BPD, FL, and TCD). Compared with appropriately grown fetuses, fetuses with FGR showed a significantly lower FAPD/OFD ratio, FAPD Z-score, and FAPD/HC. There was no significant difference in the FAPD Z-score, FAPD/OFD ratio, and FAPD/HC between FGR fetuses with and without FCR.ConclusionsThe FAPD/OFD ratio varied during pregnancy, with a mild reduction before and a mild increase after about 33 gestational weeks. Fetuses with FGR showed reduced frontal lobe growth; moreover, fetal frontal lobe development disorders were not significantly different in fetuses with FCR.Trial registrationDate: 09–27-2017; Number: [2017]239.
A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy
Authors: Aldridge Emily , Schubert K. Oliver , Pathirana Maleesa , Sierp Susan , Leemaqz Shalem Y. , Roberts Claire T. , Dekker Gustaaf A. , Arstall Margaret A. 
Published: November 2022

Abstract
Purpose
Pregnancy complications affect over one quarter of Australian pregnancies, and this group of mothers is vulnerable and more likely to experience adverse cardiometabolic health outcomes in the postpartum period. Metabolic syndrome is common in this population and may be associated with postpartum mental health issues. However, this relationship remains poorly understood. To compare the differences in psychosocial parameters and mental health outcomes between women with metabolic syndrome and women without metabolic syndrome 6 months after a complicated pregnancy.

Methods
This study is prospective registry analysis of women attending a postpartum healthy lifestyle clinic 6 months following a complicated pregnancy. Mental health measures included 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalised Anxiety Disorder questionnaire (GAD-7), self-reported diagnosed history of depression, anxiety and/or other psychiatric condition, and current psychotropic medication use.

Results
Women with metabolic syndrome reported significantly more subjective mental health concerns, were more likely to have a history of depression and other psychiatric diagnoses and were more likely prescribed psychotropic medications. However, there were no significant differences in PHQ-9 and GAD-7 scores.

Conclusion
Amongst new mothers who experienced complications of pregnancy, those with metabolic syndrome represent a particularly vulnerable group with regards to psychosocial disadvantage and mental health outcomes. These vulnerabilities may not be apparent when using common standardised cross-sectional mental health screening tools such as PHQ-9 and GAD-7.
Community-based intervention improves abortion knowledge and reduces abortion stigma among women in Oromia, Ethiopia: a quasi-experimental mixed methods evaluation
Authors: Chekol Bekalu Mossie , Dijkerman Sally , Muluye Samuel , Wondimu Dereje 
Published: November 2022

Abstract
Background
Since liberalization of the Ethiopian abortion law, there have been significant improvements in the availability and utilization of facility-based abortion services in the country. However, nearly half of abortions still take place outside of health facilities, where the quality of procedures remains unknown. Abortion stigma is one reason that unsafe abortion persists. This study aims to evaluate the effect of community interventions conducted from 2016 to 2019 on the level and manifestation of abortion stigma and knowledge in a community in Oromia region, Ethiopia.

Methods
The study is a quasi-experimental mixed methods evaluation including intervention and comparison communities. Two cross-sectional structured household surveys with independent samples, participatory evaluation wheels, and participatory impact diagrams were conducted with women of reproductive age (15–49) living in the communities. The baseline was conducted in 2016 and the endline in 2019. Difference-in-differences analysis was used to estimate the effect of the intervention on abortion knowledge and Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS) scores in the intervention community.

Results
One thousand five hundred fifty-five women participated in the household survey and 28 women participated in participatory evaluation meetings. Over one-third (37%) of women surveyed in the intervention community were exposed to the intervention activities. Knowledge of one or more indications of legal abortion increased from 21 to 85% in the intervention community, compared to an increase from 30 to 57% in the comparison. Mean SABAS scores decreased by 9.3 points in the intervention community and increased by 5.3 points in the comparison community. Differences-in-differences models indicate that exposure to the intervention resulted in decreased stigma scores (coefficient = − 9.33, p < 0.001) and increased knowledge (coefficient = 0.26, p < 0.001).

Conclusions
This is one of the first studies to measure changes in community-level abortion stigma and knowledge over time in Ethiopia using a mixed method, quasi-experimental design. The results indicate that the community-based intervention improved abortion knowledge and reduced abortion stigma.