bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-objective crashworthiness optimization of CFRP/Al hybrid tube under transverse loading
Authors: Bai Cuiping , Zhou Tianjun , Ma Qihua , Gan Xuehui 
Published: March 2022

This paper aimed to investigate the bending collapse and optimization of carbon fiber reinforced plastics/aluminum (CFRP/Al) hybrid tubes with different parameters through the three-point bending test. Based on the experimental tests, the transverse energy absorption of upon hybrid tubes was found to be higher than net aluminum tube, and the overall strain and internal failure mode of the CFRP/Al hybrid tube were observed by digital image correlation technology and X-ray computed tomography scan. The failure of outer CFRP and interaction between aluminum and CFRP was the main factor to improve loading capacity and energy absorption, and various parameters configuration of CFRP and aluminum are of their own benefits. Afterward, the validated numerical simulation model was carried out by correlating with the test results. Based upon the numerical simulation model, the parametric study and design optimization on the CFRP/Al hybrid tube (concerning the thickness of aluminum, ply angle, and layer number of CFRP) were further conducted systemically. It was found that the optimization results were θ = 15°, t = 1.65 mm, n = 3, which decreased the peak force ( F max) by 10.82%, mass is reduced by 13.0%, and specific energy absorption ( SEA) shows almost no change.
Multimorbidity Patterns in US Adults with Subjective Cognitive Decline and Their Relationship with Functional Difficulties
Authors: Liu Yixiu , Jiang Depeng 
Published: March 2022

Objectives This study identified different multimorbidity patterns among adults with subjective cognitive decline (SCD) and examined their association with SCD-related functional difficulties. Methods Data were obtained from the 2019 Behavioral Risk Factor Surveillance System. Latent class analysis was applied to identify different patterns of chronic conditions. Logistic regression was implemented to examine relationships between multimorbidity patterns and risk of SCD-related functional difficulties. Results Five multimorbidity patterns were identified: severely impaired (14.6%), respiratory/depression (18.2%), obesity/diabetes (18.6%), age-associated (22.3%), and minimal chronic conditions group (26.3%). Compared with minimal chronic conditions group, severely impaired group was most likely to report SCD-related functional difficulties, followed by respiratory/depression and obesity/diabetes group. Discussions Individuals in the three multimorbidity groups had elevated risk of SCD-related functional difficulties compared with minimal chronic conditions group. Characteristics of the high-risk groups identified in this study may help in development and implementation of interventions to prevent serious consequences of having multiple chronic conditions.
The seroprevalence of COVID-19 in patients living with HIV in metropolitan Detroit
Authors: Gudipati Smitha , Lee Monica , Scott Megan , Yaphe Sean , Huisting Joanne , Yared Nicholas , Brar Indira , Markowitz Norman 
Published: March 2022

Background COVID-19, a novel respiratory illness caused by SARS-CoV-2, has become a global pandemic. As of December 2020, 4.8% of the 941 people living with HIV in our Ryan White clinic have tested polymerase chain reaction positive for SARS-CoV-2. The aim of our study was to estimate the seroprevalence of COVID-19 in our Ryan White people living with HIV, irrespective of known past infection. Methods We conducted a cross-sectional study that recruited people living with HIV in the Ryan White program at Henry Ford Hospital in Detroit, Michigan, from September 2020 through May 2021. All Ryan White patients were offered participation during clinic visits. After informed consent, patients completed a survey, and had blood sampled for SARS-CoV-2 antibody testing. Results Of the 529 individuals who completed the written survey, 504 participants were tested for SARS-CoV-2 antibody and 52 people living with HIV were COVID-19 immunoglobulin (Ig) G positive resulting in a seroprevalence of 10.3%. Among 36 persons with PCR-confirmed COVID-19, 52.8% were IgG negative. Inclusion of PCR positive but IgG-negative people living with HIV yields a COVID-19 infection prevalence of 14.1%. Conclusions These findings suggest that passive public health-based antibody surveillance in people living with HIV significantly underestimates past infection.
Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
Authors: Huang Lin , Wei Guixia , Chen Nan , Liu Jiewei , Wang Ziqiang , Yu Yongyang , Qiu Meng 
Published: March 2022

Background: It is controversial whether primary tumour resection (PTR) and the sequencing of chemotherapy and PTR are associated with the survival of patients with incurable stage IV colorectal cancer. This study aimed to explore the effects of PTR and the sequencing of chemotherapy and PTR on asymptomatic colorectal cancer with synchronous unresectable metastases (asmCRC). Patients and Methods: Patients with asmCRC were retrospectively identified from a single centre and categorised into 3 groups: PTR followed by chemotherapy (POC), upfront chemotherapy followed by PTR (UFC), and palliative chemotherapy (PC). The primary end points included median overall survival (OS) and progression-free survival (PFS). Clinical features were analysed using χ2 test, while survival curves were generated using the Kaplan-Meier test. Propensity-score matching (PSM) was performed when comparing survival between POC and UFC groups. Results: From 2008 to 2014, 255 patients were identified and included into the POC (n = 101), UFC (n = 40), and PC (n = 114) groups. The UFC and POC groups had significantly better median OS compared with the PC group (40.7 vs 16.3 months, P < .0001; 39.7 vs 16.3 months, P < .0001). Before PSM, the UFC group had better median PFS than the POC and PC groups (18.5 vs 9.7 months, P = .038; 18.5 vs 6.1 months, P < .0001). After PSM, UFC has better PFS than POC ( P = .038). And the UFC group did not have higher postoperative or preoperative morbidity compared with the POC group ( P = .235). Conclusions: Primary tumour resection could improve the survival of patients with asmCRC. Compared with POC or PC, UFC was associated with a better median PFS without significantly increasing preoperative or postoperative morbidity.
Minimally Invasive Resection of the Uncinate Process of the Pancreas: Anatomical Considerations and Surgical Technique
Authors: Machado Marcel A. , Ardengh José C. , Makdissi Fábio F. , Machado Marcel C. 
Published: March 2022

Background Low-grade lesions may benefit from pancreatic-sparing techniques. Resection of the uncinate process is rarely performed and reported due to its complexity that requires careful patient selection and accurate knowledge of the pancreatic anatomy. This study describes relevant anatomical elements to safely perform this complex operation in the minimally invasive setting. Methods In this study, consecutive patients undergoing resection of the uncinate process of the pancreas were studied. Patients undergoing open approach were used for comparison. Preoperative and intraoperative variables were recorded, and the diagnosis and tumor size were determined from the pathology reports. Immediate postoperative results and hospital stay were analyzed. Follow-up was used to assess long-term complications and endocrine and exocrine functions. Results Twenty-nine patients underwent resection of the uncinate process. The median age was 57 years. There were 21 males and eight females. Twenty patients underwent minimally invasive resection (14 laparoscopic and six by robotic approach) and nine were operated by open approach. A clinically relevant postoperative pancreatic fistula was observed in one patient (3.4%). Biochemical leakage was present in 44.8% of our patients. Mean follow-up was 62 months (3–147). Two patients needed reoperation during follow-up. No patient presented exocrine or endocrine insufficiency during late follow-up. Conclusion Minimally invasive resection of the uncinate process of the pancreas is a complex but a feasible procedure that preserves the pancreatic endocrine and exocrine functions. This pancreas-sparing procedure is an interesting alternative to pancreaticoduodenectomy in selected patients.
Mood Disorders Are Associated with Increased Perioperative Opioid Usage and Health Care Costs in Patients Undergoing Knee Cartilage Restoration Procedure
Authors: Stone Austin V. , Murphy Meredith L. , Jacobs Cale A. , Lattermann Christian , Hawk Gregory S. , Thompson Katherine L. , Conley Caitlin E. W. 
Published: March 2022

Objective To identify the prevalence of mood disorder diagnoses in patients undergoing cartilage transplantation procedures and determine the relationship between mood disorders, opioid usage, and postoperative health care costs. Design Patients with current procedural terminology (CPT) codes for osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI) were identified in the Truven Health Marketscan database (January 2009-September 2014). Patients were grouped based on having a preoperative mood disorder diagnosis (preMDD). Preoperative opioids, postoperative opioids ≥90 days, and health care costs within the year postoperative were compared for those with and without mood disorders. Costs were analyzed, adjusting for preoperative cost, sex, age, and opioid usage, for those with and without mood disorders. Results A total of 3,682 patients were analyzed (ACI: 690, OAT: 1,294, OCA: 1,698). A quarter of patients had preMDD (ACI: 25.4%, OAT: 20.6%, OCA: 22.7%). Postoperative opioid use was more prevalent in preMDD patients (OAT: 37.1% vs. 24.1%, P < 0.001; OCA: 30.4% vs. 24.8%, P = 0.032; ACI: 33.7% vs. 26.2%, P = 0.070) (odds ratio [OR] ranged from 1.29 to 1.86). First-year postoperative log-transformed costs were significantly greater for preMDD patients (ACI: $7,733 vs. $5,689*, P = 0.012; OAT: $5,221 vs. $3,823*, P < 0.001; OCA: $6,973 vs. $3,992*, P < 0.001; *medians reported). The estimated adjusted first postoperative year cost increase for preMDD OCA patients was 41.7% ( P < 0.001) and 28.0% for OAT patients ( P = 0.034). There was no statistical difference for ACI patients ( P = 0.654). Conclusion Cartilage transplantation patients have a high prevalence of preoperative mood disorders. Opioid use and health care costs were significantly greater for patients with preoperative mood disorder diagnoses. Level of Evidence: Level III, retrospective therapeutic study.
Associations among eHealth literacy, social support, individual resilience, and emotional status in primary care providers during the outbreak of the SARS-CoV-2 Delta variant
Authors: Xu Richard Huan , Shi Lu-shao-bo , Xia Yi , Wang Dong 
Published: March 2022

Objective This study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China. Methods A cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts. Results Participants showed a moderate self-perceived level of eHealth literacy ( M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy. Conclusions This study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.
The conservative management of self-inflicted chemical burns: Case report and literature review
Authors: Galo Amenah , Farid Mohammed , Almasharqah Riyadh 
Published: March 2022

Introduction Chemical burns, particularly injuries related to psychiatric illnesses, are underreported in the literature. We present two cases of self-inflicted alkali chemical burns managed conservatively. Frequent clinical review of the burn was aimed to ensure appropriate healing and compliance with the treatment plan based on regular dressing changes. Case 1 A 24-year-old woman presented during the first day of the initial injury with a minor self-inflicted chemical burn to the right forearm. The causative agent was an oven cleaner containing sodium hydroxide triggering an alkali-based burn. The surface area of the injury was 0.5% total body surface area (TBSA) full-thickness burn. The patient had a complex psychiatric history diagnosed with personality disorder, anxiety and depression. Case 2 A 55-year-old woman presented with a self-inflicted left forearm full-thickness burn (0.5% TBSA). This was five days after the initial injury from an oven cleaner containing sodium hydroxide. The patient had a psychiatric history of anxiety and depressive disorder. The mainstay of burn management was conservative with regular dressing changes and a topical agent. Telemedicine via a designated email address was given to the patient for virtual clinical burn review and any urgent issues. Photograph of the initial burn was taken, and clinic visits were scheduled to determine healing progress. Conclusion Self-inflicted chemical burns are to be managed within a multidisciplinary setting including early psychiatric involvement. We advocate a holistic approach to determine conservative or operative management, taking into account patient factors, burn complexity and clinician's judgement to streamline the treatment plan. Lay Summary Chemical burns due to self-harm are rare to see in clinical practice. A review of two cases secondary to intentional burns sustained using an oven cleaning material. Patients had psychiatric issues and were on medications to control symptoms. Close observation with regular dressings and topical cream would allow burns to heal without the need for an operation. Our recommendation would be to treat these burns with dressings and regular follow up in the clinic or virtually till healed.
Evaluating Family Medicine Resident Narrative Comments Using the RIME Scheme
Authors: Folk Destiny , Ryckeley Christian , Nguyen Michelle , Essig Jeremiah J. , Beck Dallaghan Gary L. , Coe Catherine 
Published: March 2022

Background In 2013, the Accreditation Council on Graduate Medical Education (ACGME) launched the Next Accreditation System, which required explicit documentation of trainee competence in six domains. To document narrative comments, the University of North Carolina Family Medicine Residency Program developed a mobile application to document real time observations. Objective The objective of this work was to assess if the Reporter, Interpreter, Manager, Expert (RIME) framework could be applied to the narrative comments in order to convey a degree of competency. Methods From August to December 2020, 7 individuals analyzed narrative comments of four family medicine residents. The narrative comments were collected from July to December 2019. Each individual applied the RIME framework to the comments and the team met to discuss. Comments where 5/7 individuals agreed were not further discussed. All other comments were discussed until consensus was achieved. Results 102 unique comments were assessed. Of those comments, 25 (25.5%) met threshold for assessor agreement after independent review. Group discussion about discrepancies led to consensus about the appropriate classification for 92 (90.2%). General comments on performance were difficult to fit into the RIME framework. Conclusions Application of the RIME framework to narrative comments may add insight into trainee progress. Further faculty development is needed to ensure comments have discrete elements needed to apply the RIME framework and contribute to overall evaluation of competence.
Assessing trace-element mobility during alteration of rhyolite tephra from the Dinaride Lake System using glass-phase and clay-separate laser ablation inductively coupled plasma mass spectrometry
Authors: Badurina Luka , Šegvić Branimir 
Published: March 2022

AbstractThis paper reports a novel approach in the study of trace-element mobility during the argillization of volcanic glass that is based onin situlaser ablation inductively coupled plasma mass spectrometry glass analyses and that of spatially related illite-smectite collected in the form of fraction separates. The material studied originates from lacustrine sediments of the Dinaride Lake System that bear evidence of intensive weathering of distal tephra during the Miocene climatic optimum. Yttrium andHREEwere probably mobilized from decomposing glass in the form of carbonate complexes and were consequently depleted significantly in the clays studied. On the other hand, the Mg-rich illite-smectite demonstrates an elevated adsorption potential of solvatedLREEcomplexes. This may be explained through clay surface geochemistry controlled largely by Mg for Al octahedral substitution. This paper highlights the role of eogenetic 2:1 clay aluminosilicates that, under favourable geological conditions, may be conducive to secondaryREEenrichment and the formation of potential ion adsorption-type deposits.
High diversity in the regulatory region of Shiga toxin encoding bacteriophages
Authors: Fagerlund Annette , Aspholm Marina , Węgrzyn Grzegorz , Lindbäck Toril 
Published: March 2022

Abstract
Background
Enterohemorrhagic Escherichia coli (EHEC) is an emerging health challenge worldwide and outbreaks caused by this pathogen poses a serious public health concern. Shiga toxin (Stx) is the major virulence factor of EHEC, and the stx genes are carried by temperate bacteriophages (Stx phages). The switch between lysogenic and lytic life cycle of the phage, which is crucial for Stx production and for severity of the disease, is regulated by the CI repressor which maintain latency by preventing transcription of the replication proteins. Three EHEC phage replication units (Eru1-3) in addition to the classical lambdoid replication region have been described previously, and Stx phages carrying the Eru1 replication region were associated with highly virulent EHEC strains.

Results
In this study, we have classified the Eru replication region of 419 Stx phages. In addition to the lambdoid replication region and three already described Erus, ten novel Erus (Eru4 to Eru13) were detected. The lambdoid type, Eru1, Eru4 and Eru7 are widely distributed in Western Europe. Notably, EHEC strains involved in severe outbreaks in England and Norway carry Stx phages with Eru1, Eru2, Eru5 and Eru7 replication regions. Phylogenetic analysis of CI repressors from Stx phages revealed eight major clades that largely separate according to Eru type.

Conclusion
The classification of replication regions and CI proteins of Stx phages provides an important platform for further studies aimed to assess how characteristics of the replication region influence the regulation of phage life cycle and, consequently, the virulence potential of the host EHEC strain.
Effects of different cultivation conditions on the production of β-cyclocitral and β-ionone in Microcystis aeruginosa
Authors: Moretto Jéssica Aparecida Silva , de Freitas Paloma Nathane Nunes , de Almeida Éryka Costa , Altarugio Lucas Miguel , da Silva Simone Vieira , de Fátima Fiore Marli , Pinto Ernani 
Published: March 2022

Abstract
Background
Cyanobacteria blooms have become a major environmental problem and concern because of secondary metabolites produced by cyanobacteria released into the water. Cyanobacteria produce volatile organic compounds (VOCs), such as the compounds β-cyclocitral and β-ionone, which comprise odors, off-flavors, defense compounds, as well as growth regulators. Therefore, the general objective of this work was to evaluate the VOCs produced by two strains of Microcystis aeruginosa, differing in their ability to produce microcystins (LTPNA 01—non-producing and LTPNA 08—toxin-producing). The analysis of VOC production was carried out in (1) normal culture conditions, (2) under different light intensities (LI), and (3) after the external application of β-ionone in both cultures.

Results
The results showed that β-cyclocitral and β-ionone are produced in all growth phases of LTPNA 01 and LTPNA 08. Both strains were producers of β-cyclocitral and β-ionone in normal culture conditions. It was observed that the β-cyclocitral concentration was higher than β-ionone in all light intensities investigated in this study. Additionally, the strain LTPNA 01 produced more β-cyclocitral than LTPNA 08 at almost all times and LIs analyzed. However, the strain LTPNA 08 produced more β-ionone, mainly at the initial times. In addition, the experiment results with the external addition of β-ionone in the cultures showed that the strain LTPNA 01 produced more β-cyclocitral in control conditions than in treatment. Nonetheless, β-ionone production was higher in treatment conditions in LTPNA 08, indicating that the addition of β-ionone may favor the production of these compounds and inhibit the production of β-cyclocitral.

Conclusion
Our results showed that some abiotic factors, such as different light intensities and external application of β-ionone, can be triggers that lead to the production of VOCs.
Performance of the new SmartCardia wireless, wearable oximeter: a comparison with arterial SaO2 in healthy volunteers
Authors: Rincon Francisco , Pidoux Julien , Murali Srini , Goy Jean-Jacques 
Published: March 2022

Abstract
Background
Our goal was to evaluate the performance of a new wearable arm located pulse oximeter.

Methods
Twelve volunteers were monitored with three pulse oximeters and underwent desaturation to 70% SaO2.
We compared the accuracy of SpO2 reading from the SmartCardia system with SpO2 using two well established devices (Masimo and Nellcor) as reference.
Oximetry was performed at different level of oxygen saturation varying from 70 to 100%. Bias, ARMS and precision were evaluated using Bland-Altman plots.

Results
The mean (SD) differences between SaO2 compared to SpO2 and the devices were as follows: SaO2 versus Masimo 2,12 ± 1,01% (95% CI 1,45 to 2,79), SaO2 versus Nellcor 0,78 ± 0,58% (95% CI − 0,29 to 1,65) and SaO2 versus SmartCardia 0,42 ± 0,24% (95% CI − 0,64 to 1,46). The bias between SmartCardia, Masimo, Nellcor devices and SaO2 was 0.16 (95% CI 0.05 to 0.33) and LoA (level of agreements) 2.96 (95% CI − 2,68 to 2,89) for SmartCardia, 2,02 (95% CI 1,49 to 2,54) and LoA − 6 to 11 for Masimo, and 0,76 (95% CI 0,5 to − 1) and LoA − 3,5 to 5,0 for Nellcor. ARMS for the 70–100% SaO2 range was 1,4 for SmartCardia, 5,0 for Masimo and 2,31 for Nellcor.

Conclusions
The new wireless SmartCardia SpO2 measurement system demonstrated in-line results, bias, ARMS and precision in healthy volunteers, when compared with the gold standard SaO2 and with two well established systems, Masimo and Nellcor.

Trial registration
The present trial was prospectively registered at UCSF record (registration number:10–00437), on March 8, 2021.