bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Mechanical Responses of a Uniaxially Stretched Neural Fiber Bundle: Theoretical Approach for a Traumatic Loading Condition
Authors: Tamura Atsutaka , Hongu Jun-ichi 
Published: November 2022

Abstract
Viscoelasticity of the spinal nerve roots may play a significant role in predicting nerve root damage caused by overall spinal motion. However, only a few studies have investigated the complex mechanical behavior of this tissue. The current study presents a theoretical protocol for predicting mechanical responses of soft biological materials, and this method was used to a uniaxially stretched neural fiber bundle isolated from porcine spinal nerve roots with various loading configurations. Stress relaxation tests were performed to systematically determine a set of parameters dictating the stress decaying process, i.e., a set of relaxation moduli and the corresponding time constants. Based on the obtained experimental and numerical test data, it was confirmed that the proposed method is effective even for the prediction of mechanical response to a cyclic stretch immediately after the ramp-hold test. In addition, an elastic response, i.e., a stress–strain relationship under a high-rate loading regime, was determined analytically. The results demonstrated that instantaneous mechanical responses of neural fiber bundles can be stiffened against very rapid stretch (&gt;10 s−1); however, the fibers are relatively insensitive to moderate loading rates (&lt;1 s−1). The ultimate tensile strength was estimated to be approximately 8 MPa at the structural failure strain (15%). This information will enable the computational assessment of traumatic nerve root injuries sustained during traffic accidents and contact sports.
Numerical Investigation on the Leakage and Rotordynamic Characteristics for a Hole-Pattern Seal in Wet-Gas Conditions
Authors: Fang Zhi , Li Zhigang , Li Jun 
Published: November 2022

Abstract
For turbomachinery working in wet-gas conditions, liquid-phase fluid may worsen the rotordynamic characteristic of an annular seal, which induces a subsynchronous vibration problem and destabilizes the rotor-bearing system. The hole-pattern seal, demonstrated as effective to eliminate synchronous or subsynchronous vibrations for gas turbomachinery, is an ideal seal scheme to increase rotor stability and liquid tolerance capability of wet-gas turbomachinery. In this paper, the leakage and rotordynamic characteristics of a hole-pattern seal are numerically investigated under wet-gas conditions, using a three-dimensional transient CFD-based perturbation method. The accuracy and reliability of the present numerical method are demonstrated based on published experimental data. The rotordynamic force coefficients are presented and compared for the wet-gas hole-pattern seal with various inlet liquid volume fractions (LVF = 0%–20%), rotor speeds (ω = 0–20 krpm), inlet preswirl ratios (Sr = −0.2–0.5), and pressure ratios (Pr = 0.3–0.7). Numerical results show that the hole-pattern seal possesses desired tolerance capability for high inlet liquid volume fraction (LVF) of up to 20%. With inlet LVF increasing from 0 to 20%, the effective damping of the hole-pattern seal increases by about 50%, suggesting an improvement in rotor stability. The leakage flow rate of the oil-air mixture increases by 97.5%, combined with the sharply increasing oil leakage flow rate (by 636%) and decreasing air leakage flow rate (by 40%). The increasing rotor speed and inlet preswirl ratio both result in an obvious increase (by 50%) in the cross-coupled stiffness, yielding a smaller effective damping and worse rotor stability. With the increase in pressure ratio, all the rotordynamic force coefficients show a weaker frequency dependency and smaller magnitudes. The swirl velocity in the seal clearance can cause an accumulation of the liquid component in the hole cavities. With the increase of swirl velocity, more liquid component accumulates in the hole cavities, and the main accumulation position gradually moves upstream.
Numerical and Theoretical Investigation of the Gap Flow in Centrifugal Fans for Design and Off-Design Conditions
Authors: Fritsche Manuel , Epple Philipp , Delgado Antonio 
Published: November 2022

Abstract
Industrial turbomachines, such as fans and blowers for drying, venting, cooling or conveying tasks, are often used in industrial applications and frequently are large energy consumers. Thus, there is a need for further optimization and efficiency increase. For fans and blowers, gaps between moving parts are unavoidable due to manufacturing tolerances and possible thermal expansion. In this work, the radial gap and axial overlap between the inlet nozzle and the impeller and its impact on the performance characteristics have been investigated, because detailed knowledge of the losses due to the gap is important for the design of more efficient fans. The presented analysis was performed with the Navier–Stokes-solver ansyscfx. After a detailed grid study, the quantitative effect of the gaps on the performance of the centrifugal fan has been investigated by a variation of the radial gap and axial overlap. It was found, that at the best efficiency point (BEP) the efficiency drops between 1 and 6% depending on the gap width and at partial load it might drop fast also depending on the gap width, up to 50–60%. At overload the drop in efficiency is smaller than at partial load, dropping between 1 and 10%, depending on the gap width and the flowrate. In addition, a metamodel based on a dimensional and regression analysis was developed for partial and overload to predict the gap flowrate without additional computational fluid dynamics (CFD) simulations. The prediction accuracy between the CFD results and the dimensional analysis based metamodel is about 5–10%.
Costs associated with retinopathy of prematurity: a systematic review and meta-analysis
Authors: Gyllensten Hanna , Humayun Jhangir , Sjöbom Ulrika , Hellström Ann , Löfqvist Chatarina 
Published: November 2022

ObjectivesTo review and analyse evidence regarding costs for retinopathy of prematurity (ROP) screening, lifetime costs and resource use among infants born preterm who develop ROP, and how these costs have developed over time in different regions.DesignSystematic review and meta-analysisData sourcesPubMed and Scopus from inception to 23 June 2021.Eligibility criteria for selecting studiesIncluded studies presented costs for ROP screening and the lifetime costs (including laser treatment and follow-up costs) and resource use among people who develop ROP. Studies not reporting on cost calculation methods or ROP-specific costs were excluded.Data extraction and synthesisTwo independent reviewers screened for inclusion and extracted data, including items from a published checklist for quality assessment used for bias assessment, summary and random-effects meta-analysis for treatment costs. Included studies were further searched to identify eligible references and citations.ResultsIn total, 15 studies reported ROP screening costs, and 13 reported lifetime costs (either treatment and/or follow-up costs) for infants with ROP. The range for screening costs (10 studies) was US$5–US$253 per visit, or US$324–US$1072 per screened child (5 studies). Costs for treatment (11 studies) ranged from US$38 to US$6500 per child. Four studies reported healthcare follow-up costs (lifetime costs ranging from US$64 to US$2420, and 10-year costs of US$1695, respectively), and of these, three also reported lifetime costs for blindness (range US$26 686–US$224 295) using secondary cost data. Included papers largely followed the quality assessment checklist items, thus indicating a low risk of bias.ConclusionThe costs of screening for and treating ROP are small compared with the societal costs of resulting blindness. However, little evidence is available for predicting the effects of changes in patient population, screening schedule or ROP treatments.PROSPERO registration numberCRD42020208213.
Intention to use contraceptives among married and cohabiting women in sub-Saharan Africa: a multilevel analysis of cross-sectional data
Authors: Budu Eugene , Ahinkorah Bright Opoku , Seidu Abdul-Aziz , Armah-Ansah Ebenezer Kwesi , Salihu Tarif , Aboagye Richard Gyan , Yaya Sanni 
Published: November 2022

ObjectiveTo examine the factors associated with intention to use contraceptives among married and cohabiting women in sub-Saharan Africa (SSA).DesignData for the study were extracted from the most recent Demographic and Health Surveys of 29 countries in SSA conducted from 2010 to 2020. We included a total of 180 682 women who were married or cohabiting. Multilevel regression analysis was carried out and the results were presented as adjusted odds ratio (AOR), with 95% confidence interval (CI).Setting29 countries in SSA.ParticipantsWomen aged 15–49 years in sexual unions.Outcome measureIntention to use contraceptives.ResultsThe pooled prevalence of intention to use contraceptives among married and cohabiting women in the 29 countries was 41.46%. The prevalence ranged from 18.28% in Comoros to 71.39% in Rwanda. Intention to use contraceptives was lower among women aged 45–49 (AOR=0.06, 95% CI= 0.05 to 0.07), those with no education (AOR=0.60, 95% CI= 0.58 to 0.61), and primary education (AOR=0.90, 95% CI 0.88 to 0.93), married women (AOR=0.81, 95% CI= 0.79 to 0.84), those of the poorest wealth quintile (AOR=0.78, 95% CI= 0.75 to 0.82), and women who were not exposed to mass media (AOR=0.87, 95% CI= 0.86 to 0.90). Women with four or more births (AOR=2.09, 95% CI= 1.99 to 2.19) had greater likelihood of contraceptive use intention compared to those with no birth. Women in rural settings were found to have greater likelihood of intention to use contraceptives compared to those in urban settings (AOR=1.10, 95% CI= 1.07 to 1.14).ConclusionThere is a low prevalence of contraceptive use intention among married and cohabiting women in SSA with differences between countries. It is imperative for policymakers to consider these factors when developing and executing contraceptive programmes or policies to enhance contraceptive intents and use among married and cohabiting women. To resolve discrepancies and increase contraceptive intention among women, policymakers and other key stakeholders should expand public health education programmes.
Does the healthcare system know what to cut under the pandemic emergency pressure? An observational study on geographic variation of surgical procedures in Italy
Authors: Vainieri Milena , Nuti Sabina , Mantoan Domenico 
Published: November 2022

ObjectivesDuring 2020 many countries reduced the number of elective surgeries to free up beds and cope with the COVID-19 outbreak. This situation led healthcare systems to prioritise elective interventions and reduce the overall volumes of treatments.The aim of this paper is to analyse whether the pandemic and the prioritisation policies on elective surgery were done considering the potential inappropriateness highlighted by the measurement of geographic variation.SettingThe setting of the study is acute care with a focus on elective surgical procedures. Data were analysed at the Italian regional level.ParticipantsThe study is observational and relies on national hospitalisation records from 2019 to 2020. The analyses refer to the 21 Italian regional health systems, using 48 917 records for 2019 and 33 821 for 2020. The surgical procedures analysed are those considered at high risk of unwarranted variation: coronary angioplasty, cholecystectomy, colectomy, knee replacement, hysterectomy, tonsillectomy, hip replacement and vein stripping.Primary and secondary outcome measuresPrimary measures were the hospitalisation rate and its reduction per procedure, to understand the level of potential inappropriateness. Secondary measures were the SD and high/low ratio, to map the level of geographic variation.ResultsFor some procedures, there is a linear negative relationship (eg, tonsillectomy: ρ = −0.92, p<0.01; vein stripping: ρ = −0.93, p<0.01) between the reduction in hospitalisation and its starting point. The only two procedures for which no significant differences were registered are cholecystectomy (ρ = −0.22, p=0.31) and hysterectomy (ρ = −0.22, p=0.33). In particular, in all cases, data show that regions with higher 2019 hospitalisation rates registered a larger reduction.ConclusionsThe Italian data show that the pandemic seems to have led hospital managers and health professionals to cut surgical interventions more likely to be inappropriate. Hence, these findings can inform and guide the healthcare system to manage unwarranted variation when coming back to the new normal. This new starting point (lower volumes in some selected elective surgical procedures) should be used to plan elective surgical treatments that can be cancelled because of their high risk of inappropriateness.
Characteristics of exposure to 10 polycyclic aromatic hydrocarbon metabolites among pregnant women: cohort of pregnant women in Zunyi, southwest China
Authors: Tian Yingkuan , Zhang Renjuan , Liu Xiang , Liu Yijun , Xiong Shimin , Wang Xia , Zhang Haonan , Li Quan , Liao Juan , Fang Derong , Wang Linglu , Zhang Ya , Yuan Hongyu , Zhang Li , He Caidie , An Songlin , Chen Wei , Zhou Yuanzhong , Shen Xubo 
Published: November 2022

ObjectiveOur aim was to elucidate the polycyclic aromatic hydrocarbon (PAH) metabolites exposure levels of pregnant women in the underdeveloped region of Zunyi, southwest China.MethodsSociodemographic information was collected via questionnaires, and urine samples were collected at the same time. A total of 3047 pregnant women participated in the study. Gas chromatography/mass spectrometry was used to detect the urine concentrations of 10 PAH metabolites. A generalised linear model (GLM) was used to identify predictive factors of PAH metabolites.ResultsAll PAH metabolites had a detection rate greater than 60% (67.21%–90.57%) except for 4-OH-PHE at 55.54%. The median concentrations were 0.02–0.11 µg/g Cre except for 1-OH-NAP, 2-OH-NAP, 2-OH-FLU and 9-OH-FLU (0.36–0.50 µg/g Cre). The cluster analysis identified the phenanthrene and fluorene metabolite clusters (containing no other metabolites), while naphthalene metabolites (1-OH-NAP, 2-OH-NAP) could not be clustered without other metabolites. GLM analysis identified that pregnant women with the following characteristics have high urinary concentration of PAH metabolites: overweight, in the last trimester of pregnancy, distance between their house and main traffic lines as <5 m, use fuel for cooking, passive smoking, renovated their residence for less than 3 years, middle family income and office workers.ConclusionThe results clarified pregnant women from the economically underdeveloped area could be the victims of PAHs. In addition, PAHs present a demographic and seasonal differential distribution, which will aid in the development of targeted interventions and reduce exposure to PAHs during pregnancy.
On the Structure and Variability of the Migrating Diurnal Temperature Tide Observed by SABER
Authors: Garcia Rolando R. 
Published: November 2022

Abstract
Temperature observations made by the SABER infrared radiometer from January 2002 through December 2021 are used to study the structure and variability of the migrating diurnal temperature tide in the middle atmosphere (∼17–105 km). In the lower stratosphere, and in the mesosphere and lower thermosphere (MLT), tidal structure is dominated by the gravest latitudinally symmetric mode, with a smaller contribution from the first antisymmetric mode; in the middle and upper stratosphere, vertically nonpropagating modes are prominent. Consistent with previous work, low-frequency variability is mainly semiannual, with maxima at the equinoxes. Quasi-biennial variability is also present and evident in low-passed time series. There are robust relationships between the semiannual and quasi-biennial variability of the tide and the semiannual and quasi-biennial tropical zonal wind oscillations, respectively, which persist throughout the 20-yr dataset. While the physical mechanisms responsible for these relationships cannot be ascertained from the observations, the present results should be useful for hypothesis testing with numerical models. It is also found that the diurnal tide breaks due to convective instability in the MLT. This is reflected in its mean vertical structure, which grows as expected for a nondissipating wave below ∼85 km, but ceases to grow at higher altitudes. Direct confirmation that dissipation is due to breaking is obtained from the potential temperature field, which shows frequent instances of reversed vertical gradient, particularly at the equinoxes. Breaking of the diurnal tide has a major impact on the zonal-mean temperature and zonal wind structure of the MLT at the equinoxes.
Combined use of intranasal Dexmedetomidine and an oral novel formulation of Midazolam for sedation of young children during brain MRI examination: a prospective, single-center, randomized controlled trial
Authors: Gu Hongbin , Miao Liyan , Bai Jie , Lu Guolin , Lei Qian , Yang Lijun , Wang Denggui 
Published: November 2022

Abstract
Background
To evaluate the safety and effectiveness of different dosages of intranasal Dexmedetomidine (DEX) in combination with oral midazolam for sedation of young children during brain MRI examination.

Methods
Included in this prospective single-blind randomized controlled trial were 156 children aged from 3 months to 6 years and weighing from 4 to 20 Kg with ASA I-II who underwent brain MRI examination between March 2021 and February 2022. Using the random number table method, they were divided into group A (using 3 ug/kg intranasal DEX plus 0.2 mg/Kg oral midazolam) and group B (using 2 ug/kg intranasal DEX plus 0.2 mg/Kg oral Midazolam). The one-time success rate of sedation, sedation onset time, recovery time, overall sedation time, and occurrence of adverse reactions during MRI examination were compared between the two groups. The heart rate (HR), mean arterial pressure (MAP), and percutaneous SpO2before and after drug administration were observed in both groups. Differences in sedation scores between the two groups were compared before intranasal drug administration (T0), 10 min after drug administration (T1), at the time of falling asleep (T2), at the end of examination (T3), and at the time of recovery (T4).

Results
The one-time success rate of sedation in group A and B was 88.31% and 79.75% respectively, showing no significant difference between the two groups (P>0.05). The sedation onset time in group A was 24.97±16.94 min versus 27.92±15.83 min in group B, and the recovery time was 61.88±22.18 min versus 61.16±28.16 min, both showing no significance difference between the two groups (P>0.05). Children in both groups exhibited good drug tolerance without presenting nausea and vomiting, hypoxia, or bradycardia and hypotension that needed clinical interventions. There was no significant difference in the occurrence of abnormal HR, MAP or other adverse reactions between the two groups (P>0.05).

Conclusion
3 ug/kg or 2 ug/kg intranasal DEX in combination with 0.2 mg/kg oral Midazolam both are safe and effective for sedation of children undergoing MRI examination with the advantages of fast-acting and easy application.

Trial registration
It was registered at the Chinese Clinical Trial Registry (ChiCTR1800015038) on 02/03/2018.
HIV retention in care: results and lessons learned from the Positive Pathways Implementation Trial
Authors: Wohlfeiler Michael B. , Weber Rachel Palmieri , Brunet Laurence , Fusco Jennifer S. , Uranaka Christine , Cochran Quateka , Palma Monica , Evans Tammeka , Millner Carl , Fusco Gregory P. 
Published: November 2022

Abstract
Background
Sustained, routine care is vital to the health of people with HIV (PWH) and decreasing transmission of HIV. We evaluated whether the identification of PWH at-risk of falling out of care and prompts for outreach were effective in retaining PWH in care in the United States.

Methods
In this cluster randomized controlled trial, 20 AIDS Healthcare Foundation Healthcare Centers (HCCs) were randomized to the intervention (n = 10) or control (n = 10) arm; all maintained existing retention efforts. The intervention included daily automated flags in CHORUS™, a mobile app and web-based reporting solution utilizing electronic health record data, that identified PWH at-risk of falling out of care to clinic staff. Among flagged PWH, the association between the intervention and visits after a flag was assessed using logistic regression models fit with generalized estimating equations (independent correlation structure) to account for clustering. To adjust for differences between HCCs, models included geographic region, number of PWH at HCC, and proportions of PWH who self-identified as Hispanic or had the Ryan White Program as a payer.

Results
Of 15,875 PWH in care, 56% were flagged; 76% (intervention) and 75% (control) resulted in a visit, of which 76% were within 2 months of the flag. In adjusted analyses, flags had higher odds of being followed by a visit (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 0.97, 1.21) or a visit within 2 months (OR: 1.07, 95% CI: 0.97, 1.17) at intervention than control HCCs. Among at-risk PWH with viral loads at baseline and study end, the proportion with < 50 copies/mL increased in both study arms, but more so at intervention (65% to 74%) than control (62% to 67%) HCCs.

Conclusion
Despite challenges of the COVID-19 pandemic, adding an intervention to existing retention efforts, and the reality that behavior change takes time, PWH flagged as at-risk of falling out of care were marginally more likely to return for care at intervention than control HCCs and a greater proportion achieved undetectability. Sustained use of the retention module in CHORUS™ has the potential to streamline retention efforts, retain more PWH in care, and ultimately decrease transmission of HIV.

Trial Registration
The study was first registered at Clinical Trials.gov (NCT04147832, https://clinicaltrials.gov/show/NCT04147832) on 01/11/2019.
Quantitative assessment of the microstructure of the mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighed magnetic resonance imaging
Authors: Lu Bao-Lan , Chen Yan , Wen Zi-Qiang , Liu Yi-Yan , Ma Yu-Ru , Que Yu-Tao , Zhang Zhi-Wen , Wu Xue-Han , Yu Shen-Ping 
Published: November 2022

Abstract
Background
The mesorectum surrounding the rectum provides an ideal substrate for tumour spread. However, preoperative risk assessment is still an issue. This study aimed to investigate the microstructural features of mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI).

Methods
Patients with pathologically proven rectal adenocarcinoma underwent routine high-resolution rectal magnetic resonance imaging (MRI) and IVIM DWI sequences were acquired. The MRI-detected circumferential resection margin (mrCRM) and extramural vascular invasion (mrEMVI) were evaluated. IVIM parameters of the mesorectum adjacent to (MAT) and distant from (MDT) the tumour were measured and compared between and within the prognostic factor groups.

Results
The positive mrCRM (pMAT < 0.001; pMDT = 0.013) and mrEMVI (pMAT = 0.001; pMDT < 0.001) groups demonstrated higher D values in the MAT and MDT than the corresponding negative groups. Conversely, the positive mrCRM (p = 0.001) and mrEMVI (p < 0.001) groups both demonstrated lower f values in the MAT. Similarly, in the self-comparison between the MAT and MDT in the above subgroups, D showed a significant difference in all subgroups (p < 0.001 for all), and f showed a significant difference in the positive mrCRM (p = 0.001) and mrEMVI (p = 0.002) groups. Moreover, the MAT displayed a higher D* in the positive mrCRM (p = 0.014), negative mrCRM (p = 0.009) and negative mrEMVI groups (p < 0.001).

Conclusion
The microstructure of the mesorectum in patients with rectal cancer with poor prognostic status shows changes based on IVIM parameters. IVIM parameters might be promising imaging biomarkers for risk assessment of tumour spread in mesorectum preoperatively.