bluuebunny/crossref_metadata_2025_split huggingface dataset:
Divinity in nursing: The complexities of adopting a spiritual basis for care
Authors: Garrett Bernie 
Published: May 2021

AbstractIn this paper, the historical alignment of nursing with divinity‐based perspectives and modern New Age nursing theories are explored. The nature of divinity in nursing is examined, together with the complexities and issues that arise in adopting a spiritual basis for care. The work of the key theorists in this area (Rogers, Newman, Parse, Watson, Dossey) is reconsidered and fundamental epistemological problems inherent in this approach reviewed. Specific concerns with the interpretation of holistic care, adoption of doxastic logic, faith‐based rationales, influence of Caucasian Judeo‐Christian and New Age values, misappropriation of science, use of pseudoscience and development of divinity as social consumer product are discussed. Practical problems with using a spiritual basis in contemporary nursing practice are also explored and the alignment of divinity‐based nursing theories with the modern antiscience movement is examined. Overall, the re‐emergence of divinity‐based nursing and spiritual basis for care may be problematic, and would seem to counter the development of an inclusive profession. Additionally, the alignment of nursing with antiscience movements rejecting biomedicine has significant public health implications. This is argued as a regressive step for the advancement of the profession.
Covid‐19 Control and the Economy: Test, Test, Test*
Authors: Taamouti Abderrahim 
Published: May 2021

AbstractHard lockdowns have left policymakers to face the ethical dilemma of choosing between saving lives and saving the economy. However, massive testing could have helped to respond more effectively to Covid‐19 crisis. In this paper, we study the trade‐off between infection control, lockdown and testing. The aim is to understand how these policies can be effectively combined to contain Covid‐19 without damaging the economy. An extended SIR epidemic model is developed to identify the set of testing and lockdown levels that lead to a reproduction number below one, thus to infection control and saving lives. Depending on whether the testing policy is static or dynamic, the model suggests that testing 4% to 7% of the population is the way to safely reopen the economy and the society.
Preventing weight gain in adults: A systematic review and meta‐analysis of randomized controlled trials
Authors: Martin Julie C. , Awoke Mamaru Ayenew , Misso Marie L. , Moran Lisa J. , Harrison Cheryce L. 
Published: May 2021

SummaryWeight gain prevention is a global public health priority to address escalating adiposity in adults. This review evaluates the efficacy of weight gain prevention trials targeting adults aged 18–50 years and adheres to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) protocol. Trials of any duration from inception to May 2020 that evaluated a weight gain prevention intervention (using either prescriptive diet, prescriptive physical activity, prescriptive diet, and/or physical activity or non‐prescriptive lifestyle) and included weight or body mass index (weight [kg]/height [m2]) were eligible. Twenty‐nine trials across 34 publications (participants n = 37,407) were included. Intervention resulted in less weight gain compared with controls (−1.15 kg [95% CI −1.50, −0.80 kg] p < 0.001). Subgroup analysis demonstrated greater effectiveness with prescriptive (−1.60 kg [95% CI −2.00, −1.19] p < 0.001) compared with non‐prescriptive (−0.81 kg [95% CI 1.10, −0.53] p < 0.001) intervention types. Interventions had greatest impact in healthy weight (18.5–24.9 kg/m2) (−0.82 kg [95% CI −1.5, −0.50] p < 0.001) or overweight (25.0–29.9 kg/m2) (−1.48 kg [95% CI −1.85, −1.12] p < 0.001) compared with obese populations (≥30.0 kg/m2) (−0.56 kg [95% CI −1.40, 0.27] p = 0.19). These findings demonstrate that lifestyle intervention prevents cumulative weight gain in non‐obese adults, with future research required to inform cost‐effectiveness and implementation feasibility.
Person‐centred communication with cancer survivors: Exploring the meaning of follow‐up coaching conversations
Authors: Timmermann Connie , Ammentorp Jette , Birkelund Regner 
Published: May 2021

AbstractAimThe aim of this study was to explore the meaning of a coaching intervention for cancer survivors.BackgroundCancer survivors often experience existential concerns and worries after adjuvant treatment. A number of “care transition interventions” have been developed to improve person‐centred care by empowering patients. Several of these interventions include a “care transition coach”. A coaching approach to communication used in health care communication have among others shown to assists in establishing confidential relationships between health professionals, increase the patient's well‐being and support the patient's experience of being met and viewed as a whole person.DesignThis is a qualitative study using semi‐structured interviews to explore the meaning of a coaching intervention. In analyzing and interpreting the qualitative interviews Ricoeur's theory of interpretation was applied.MethodThe intervention consisted of two parts: (1) a two‐day training program in coaching for nurses and (2) a specially developed communication intervention for cancer survivors.Results and discussionThe analysis of the transcribed interview material led to the development of two themes: (1) Support in moving forward in life, and (2) An opportunity to talk about existential thoughts and worries. Our results show how the experience of cancer, even when cured, leaves the survivors with profound existential worries. The cancer survivors described how coaching conversations allowed them to express their current concerns and provided them with an opportunity to discuss wider issues than treatment, symptoms, and after‐effects, which had been the main focus during treatment.ConclusionThe time immediately after the end of adjuvant treatment can be challenging, with many existential concerns and opposing emotions. We found that the follow‐up coaching conversations performed helped the cancer survivors to process many of these difficult thoughts and feelings.
Modeling the Response of Structure–Tuned Liquid Damper Systems Under Large Amplitude Excitation Using Smoothed Particle Hydrodynamics
Authors: McNamara K. P. , Tait M. J. 
Published: May 2021

Abstract
The tuned liquid damper (TLD) is a system used to reduce the response of tall structures. Numerical modeling is a very important tool when designing TLDs. Many existing numerical models are capable of accurately capturing the structure–TLD system response at serviceability levels, covering the range where TLDs are primarily intended to perform. However, these models often have convergence issues when considering more extreme structural excitations. The goal of this study is to develop a structure–TLD model without convergence limitations at large amplitude excitations. A structure–TLD numerical model where the TLD is represented by a two-dimensional incompressible smoothed particle hydrodynamics (ISPH) scheme is presented. The TLD contains damping screens which are represented by a force term based on the Morison equation. The performance of the model is assessed by comparing to experimental data for a structure–TLD system undergoing large amplitude excitations consisting of 4-h random signals and shorter transient signals. The model shows very good agreement with the experimental data for the structural response. The free surface response of the TLD is captured accurately by the model for the lower excitation forces considered, however as the excitation force is increased there are some discrepancies. The large amplitude excitations also result in smoothed particle hydrodynamics (SPH) fluid particles penetrating the boundaries, resulting in degradation of the model performance over the 4-h simulations. Overall, the model is shown to capture the response of a structure–TLD system undergoing large amplitude excitations well.
Aerothermal Effect of Cavity Welding Beads on a Transonic Squealer Tip
Authors: Vieira Joao , Coull John , Ireland Peter , Romero Eduardo 
Published: May 2021

Abstract
High-pressure turbine blade tips are critical for gas turbine performance and are sensitive to small geometric variations. For this reason, it is increasingly important for experiments and simulations to consider real geometry features. One commonly absent detail is the presence of welding beads on the cavity of the blade tip, which are an inherent by-product of the blade manufacturing process. This paper therefore investigates how such welds affect the Nusselt number, film cooling effectiveness and aerodynamic performance.
Measurements are performed on a linear cascade of high-pressure turbine blades at engine realistic Mach and Reynolds numbers. Two cooled blade tip geometries were tested: a baseline squealer geometry without welding beads, and a case with representative welding beads added to the tip cavity. Combinations of two tip gaps and several coolant mass flow rates were analyzed. Pressure sensitive paint was used to measure the adiabatic film cooling effectiveness on the tip, which is supplemented by heat transfer coefficient measurements obtained via infrared thermography. Drawing from all of this data, it is shown that the weld beads have a generally detrimental impact on thermal performance, but with local variations. Aerodynamic loss measured downstream of the cascade is shown to be largely insensitive to the weld beads.
Aerothermal Optimization of Turbine Squealer Tip Geometries With Arbitrary Cooling Injection
Authors: De Maesschalck C. , Andreoli V. , Paniagua G. , Gillen T. , Barker B. 
Published: May 2021

Abstract
The optimization of the turbine rotor tip geometry remains a vital opportunity to create more efficient and durable engines. Balancing the aerodynamic and thermal aspects, while maintaining the mechanical integrity, is key to reshape one of the most vulnerable and life-determining parts of the entire turbine. The ever-increasing turbine gas temperatures, combined with the difficulty of cooling the tip and the aerodynamically penalizing nature of the overtip leakage vortex, make the design of the tip a truly multidisciplinary challenge.
While many earlier efforts focused on uncooled geometries or studied the aerothermal impact with a fixed cooling configuration, the current paper presents the outcome of a multi-objective optimization where both the squealer rim geometry and the cooling injection pattern were allowed to vary simultaneously. This study explores a significantly wider design space, seeking a further synergistic aerothermal benefit through the combination of a quasi-fully arbitrary cooling arrangement, with mutating squealer rim structures. Specifically, the current manuscript presents the results of over 330 cooled and uncooled squealer tip geometries. The high-pressure turbine tip was automatically altered using a novel parametrization strategy adopting a maximum of 40 design variables to vary the squealer rim structures, as well as the size and location of the various cooling holes. The aerodynamic and thermal characteristics of every design were evaluated through Reynolds-averaged Navier–Stokes computational fluid dynamics (CFD) simulations with the k–ω shear-stress transport (SST) model for the turbulence closure, adopting an unstructured hexahedral grid typically containing more than 8 × 106 cells. A multi-objective differential evolution algorithm was used to obtain a Pareto front of designs which maximize the aerodynamic efficiency, while minimizing the overtip thermal loads. Eventually, a detailed investigation and robustness study was performed on a set of prime squealer geometries, to further investigate the aerodynamic flow topology and the effect of various cooling injection schemes on the heat transfer patterns.
Physical Activity, Screen Time, and Sleep Trajectories From Childhood to Adolescence: The Influence of Sex and Body Weight Status
Authors: Guimarães Roseane de Fátima , Mathieu Marie-Eve , Reid Ryan E.R. , Henderson Mélanie , Barnett Tracie Ann 
Published: May 2021

Background: Behavioral trajectories from childhood to adolescence may differ and are poorly understood. The authors estimated the trajectories of moderate to vigorous physical activity (MVPA), screen time, and sleep duration during this period, by sex and initial weight status. Methods: Data from Quebec Adiposity and Lifestyle Investigation in Youth, an ongoing cohort study in Canada on the natural history of obesity, were used. Participants predisposed to obesity attended baseline (8–10 y old, n = 630) and follow-up visits 2 years (n = 564) and 7 years (n = 359) after baseline. Participants with completed self-reported and accelerometer-based data were included in the analyses (n = 191, 353, and 240 for MVPA, screen time, and sleep, respectively). The authors performed group-based trajectory analyses and multinomial logistic regression models. Results: Two MVPA, 3 screen time, and 2 sleep trajectories were identified. Girls were more likely than boys to belong to trajectory with lower MVPA means (odds ratio [OR] = 6.45; 95% confidence interval [CI], 3.08 to 13.49), yet less likely to belong to the trajectory with higher screen time (OR = 0.47; 95% CI, 0.23 to 0.97) and lower sleep duration (OR = 0.46; 95% CI, 0.27 to 0.78). Overweight or obesity at baseline was associated with a greater likelihood of belonging to the trajectory with lower MVPA (OR = 10.99; 95% CI, 1.31 to 91.14) and higher screen time (OR = 2.01; 95% CI, 1.04 to 4.06), respectively. Conclusions: It appears to be gender- and weight-based determinants of behavioral trajectories in this sample. These results may provide guidance for interventions in similar populations.
Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer
Authors: Oliveira Gabriel dos Santos , Ribeiro-Alvares João Breno de Araujo , de Lima-e-Silva Felipe Xavier , Rodrigues Rodrigo , Vaz Marco Aurélio , Baroni Bruno Manfredini 
Published: May 2021

Context: Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries. Objective: To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer. Design: Reliability study. Setting: Physical Therapy Laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). Participants: Fifty male amateur athletes (soccer or rugby players; 24 [3] y). Main Outcome Measures: Eccentric knee flexor strength. Results: When compared with a load cell–based device, the clinical test using a handheld dynamometer provided smaller force values (P < .05) with large effect sizes (.92–1.21), moderate intraclass correlation (.60–.62), typical error of 30 to 31 N, and coefficient of variation of 10% to 11%. Regarding the test–retest reproducibility (2 sessions separated by 1 week), the clinical test provided similar force values (P > .05) with only small effect sizes (.20–.27), moderate to good correlation (.67–.76), typical error of 23 to 24 N, and coefficient of variation of 9% to 10%. Conclusion: The clinical test with handheld dynamometer proposed by this study can be considered an affordable and relatively reliable tool for eccentric knee flexor strength assessment in the clinical setting, but results should not be directly compared with those provided by load cell–based devices.
Adipose-specific C-C motif chemokine ligand (CCL) 19 overexpression drives the mice to both insulin resistance and weight gain
Authors: Hayashi Masato , Iwashita Misaki , Nishimura Yuki , Shinjo Takanori , Sano Tomomi , Yamashita Akiko , Fukuda Takao , Sanui Terukazu , Asano Tomoichiro , Nishimura Fusanori 
Published: May 2021

IntroductionEnlarged adipose tissue is characterized by infiltration of activated immune cells and increased expression of chemokines recruiting these cells including C-C motif ligand 19 (CCL19), although the role of adipose CCL19 is still inconclusive.Research design and methodsAdipocyte-specificCcl19knock-in (KI) mice were generated, and the mice were fed either a normal diet or 40% or 60% fat diet (FD) to investigate the effects of CCL19 on the induction of inflammation and lipid metabolism.ResultsCcl19KI mice exhibited increased inflammatory signs in adipose tissue and enlarged subcutaneous white and brown adipose tissue than those of wild-type (WT) mice. The adipose tissue ofCcl19KI mice was characterized by increased extracellular signal-regulated kinase 1/2 and decreased AMP-activated protein kinase α phosphorylation. The protein expression of peroxisome proliferator-activated receptor γ coactivator 1α and uncoupling protein 1 was significantly reduced in brown adipose tissue ofCcl19KI mice compared with that in WT mice. The most remarkable changes between genotypes were observed in mice fed a 40% FD.ConclusionA 40% FD enhanced the effects of CCL19 overexpression, and these mice could be a suitable model to study metabolic disorders in overweight Asians.
Histological and transcriptional characterization of the pancreatic acinar tissue in type 1 diabetes
Authors: Granlund Louise , Hedin Anders , Wahlhütter Miriam , Seiron Peter , Korsgren Olle , Skog Oskar , Lundberg Marcus 
Published: May 2021

IntroductionDespite a reduced function and volume of the exocrine pancreas in type 1 diabetes, the acinar cells remain understudied in type 1 diabetes research. The hypothesis of this study is that the acinar tissue is altered in subjects with type 1 diabetes compared with subjects without diabetes.Research design and methodsThe cell density, expression of digestive enzymes, and transcriptome of acinar tissue at varying distances from islets were analyzed using histology, immunostaining, and AmpliSeq RNA sequencing of laser capture microdissected tissue. Pancreases examined were from organ donors with or without type 1 diabetes.ResultsWe demonstrate preserved acinar nuclei density and find no support of acinar atrophy in type 1 diabetes. Staining for digestive enzymes (amylase, lipase, and trypsin) demonstrated an evenly distributed expression in the exocrine parenchyma; although occasional amylase-negative regions appeared in tissue that had been formalin-fixed and paraffin-embedded, this phenomenon was not evident in frozen tissue. Gene set enrichment analysis of whole transcriptome data identified transcriptional alterations in type 1 diabetes that were present in the acinar tissue independent of the distance from islets. Among these, the two most enriched gene sets wereMyc Targets V2andEstrogen Response Early.ConclusionTaken together, these new data emphasize the involvement of the entire pancreas in type 1 diabetes pathology. The alteration of the gene setsMyc Targets V2andEstrogen Response Earlyis a possible link to the increased incidence of pancreatic cancer in type 1 diabetes.
Correct diagnosis of childhood pneumonia in public facilities in Tanzania: a randomised comparison of diagnostic methods
Authors: Salisbury Taylor , Redfern Alice , Fletcher Erin K , Arkedis Jean , Bundala Felix , Connor Alison , Kapologwe Ntuli A , Massaga Julius , Mkongwa Naibu , Musa Balowa , Lee Cammie 
Published: May 2021

ObjectiveThis study compares two methods for clinical diagnosis of childhood pneumonia that aim to estimate rates of underdiagnosis and overdiagnosis of childhood pneumonia by examining the sensitivity of Integrated Management of Childhood Diseases implementation in routine care against lung ultrasound (LUS) diagnosis.SettingWe conducted observations in 83 public health facilities (dispensaries, health centres and district hospitals) in Pwani, Dodoma and Tabora, Tanzania between October and December 2017.MethodsWe used a novel method to estimate rates of underdiagnosis and overdiagnosis of childhood pneumonia by comparing directly observed public provider diagnoses to the results of diagnoses made by trained clinicians using Mindray DP-10 ultrasound machines. We perform multivariate analysis to identify confounding effects and robustness checks to bound the result. We also explore a number of observable characteristics correlated with higher rates of agreement between provider diagnoses and ultrasound diagnoses.ResultsWe observed 93 providers conducting exams on patients aged 2 months–5 years who presented respiratory symptoms or were given a respiratory diagnosis by the provider. Of these 957 patients, 110 were excluded from analysis resulting in a final sample of 847.17.6% of cases identified as pneumonia via LUS examinations in our sample were diagnosed as pneumonia by providers, suggesting that a significant number of pneumonia cases for which care is sought in the public sector go undiagnosed. Provider knowledge of breath counting and years of experience are positively correlated with higher agreement. While clinical examination rates are not statistically correlated with agreement, it is notable that providers conducted a clinical examination on only about one-third of patients in the sample.ConclusionOur results suggest that provider training and knowledge of clinical examination protocols for pneumonia diagnosis are predictive of correct diagnosis of pneumonia and should be further explored in future research as a tool for improving quality of care.
‘Relieved to be seen’—patient and carer experiences of psychosocial assessment in the emergency department following self-harm: qualitative analysis of 102 free-text survey responses
Authors: Quinlivan Leah M , Gorman Louise , Littlewood Donna L , Monaghan Elizabeth , Barlow Steven J , Campbell Stephen M , Webb Roger T , Kapur Navneet 
Published: May 2021

ObjectivesWe sought to explore patient and carer experiences of psychosocial assessments following presentations to hospital after self-harm.DesignThematic analysis of free-text responses to an open-ended online survey.SettingBetween March and November 2019, we recruited 88 patients (82% women) and 14 carers aged ≥18 years from 16 English mental health trusts, community organisations, and via social media.ResultsPsychosocial assessments were experienced as helpful on some occasions but harmful on others. Participants felt better, less suicidal and less likely to repeat self-harm after good-quality compassionate and supportive assessments. However, negative experiences during the assessment pathway were common and, in some cases, contributed to greater distress, less engagement and further self-harm. Participants reported receiving negative and stigmatising comments about their injuries. Others reported that they were refused medical care or an anaesthetic. Stigmatising attitudes among some mental health staff centred on preconceived ideas over self-harm as a ‘behavioural issue’, inappropriate use of services and psychiatric diagnosis.ConclusionOur findings highlight important patient experiences that can inform service provision and they demonstrate the value of involving patients/carers throughout the research process. Psychosocial assessments can be beneficial when empathetic and collaborative but less helpful when overly standardised, lacking in compassion and waiting times are unduly long. Patient views are essential to inform practice, particularly given the rapidly changing service context during and after the COVID-19 emergency.