bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design of Stress Constrained SiC/SiC Ceramic Matrix Composite Turbine Blades
Authors: Boyle Robert J. , Gnanaselvam Pritheesh , Parikh Ankur H. , Ameri Ali A. , Bons Jeffrey P. , Nagpal Vinod K. 
Published: January 2021

Abstract
The structural and aerodynamic performance of a low aspect ratio SiC/SiC ceramic matrix composite (CMC) high pressure turbine (HPT) blade was determined. The application was a NASA notional single aisle aircraft engine to be available in the N + 3, beyond 2030, time frame. The notional rpm was maintained, and to satisfy stress constraints, the annulus area was constrained. This led to a low span blade. For a given clearance, low span blade is likely to have improved efficiency when shrouded. The efficiency improvement due to shrouding was found to strongly depend on the axial gap between the shroud and casing. Axial gap, unlike clearance or reaction, is not a common parameter used to correlate the efficiency improvement due to shrouding. The zero clearance stage efficiency of the low aspect ratio turbine was 0.920. Structural analyses showed that the rotor blade could be shrouded without excessive stresses. The goal was to have blade stresses less than 100 MPa (14.5 ksi) for the unshrouded blade. Under some not very restrictive circumstances, such as blade stacking, a one-dimensional radial stress equation accurately predicted area averaged Von Mises stress at the blade hub. With appropriate stacking, radial and Von Mises stresses were similar.
Boundary Layer Flashback Limits of Hydrogen-Methane-Air Flames in a Generic Swirl Burner at Gas Turbine-Relevant Conditions
Authors: Ebi Dominik , Jansohn Peter 
Published: January 2021

AbstractOperating stationary gas turbines on hydrogen-rich fuels offers a pathway to significantly reduce greenhouse gas emissions in the power generation sector. A key challenge in the design of lean-premixed burners, which are flexible in terms of the amount of hydrogen in the fuel across a wide range and still adhere to the required emission levels, is to prevent flame flashback. However, systematic investigations on flashback at gas turbine relevant conditions to support combustor development are sparse. The current work addresses the need for an improved understanding with an experimental study on boundary layer flashback in a generic swirl burner up to 7.5 bar and 300 °C preheat temperature. Methane-hydrogen-air flames with 50 to 85% hydrogen by volume were investigated. High-speed imaging was applied to reveal the flame propagation pathway during flashback events. Flashback limits are reported in terms of the equivalence ratio for a given pressure, preheat temperature, bulk flow velocity, and hydrogen content. The wall temperature of the center body along which the flame propagated during flashback events has been controlled by an oil heating/cooling system. This way, the effect any of the control parameters, e.g., pressure, had on the flashback limit was decoupled from the otherwise inherently associated change in heat load on the wall and thus change in wall temperature. The results show that the preheat temperature has a weaker effect on the flashback propensity than expected. Increasing the pressure from atmospheric conditions to 2.5 bar strongly increases the flashback risk, but hardly affects the flashback limit beyond 2.5 bar.
Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040
Authors: Tönnies Thaddäus , Heidemann Christin , Paprott Rebecca , Seidel-Jacobs Esther , Scheidt-Nave Christa , Brinks Ralph , Hoyer Annika 
Published: January 2021

IntroductionAs a population-wide intervention, it has been proposed to raise taxes on unhealthy products to prevent diseases such as type 2 diabetes. In this study, we aimed to estimate the effect of tax policy interventions in 2020 on the projected prevalence and number of people with type 2 diabetes in the German adult population in 2040.Research design and methodsWe applied an illness-death model and the German Diabetes Risk Score (GDRS) to project the prevalence and number of adults with type 2 diabetes in Germany under a base case scenario and under a tax policy intervention scenario. For the base case scenario, we assumed constant age-specific incidence rates between 2020 and 2040. For the intervention scenario, we assumed a 50% price increase for sugar-sweetened beverages, tobacco and red meat products in the year 2020. Based on price elasticities, we estimated the impact on these risk factors alone and in combination, and calculated subsequent reductions in the age-specific and sex-specific GDRS. These reductions were used to determine reductions in the incidence rate and prevalence using a partial differential equation.ResultsCompared with the base case scenario, combined tax interventions in 2020 resulted in a 0.95 percentage point decrease in the prevalence of type 2 diabetes (16.2% vs 17.1%), which corresponds to 640 000 fewer prevalent cases of type 2 diabetes and a relative reduction by 6%.ConclusionsTaxation of sugar-sweetened beverages, tobacco products and red meat by 50% modestly lowered the projected number and prevalence of adults with type 2 diabetes in Germany in 2040. Raising taxes on unhealthy products as a stand-alone measure may not be enough to attenuate the future rise of type 2 diabetes.
Atherogenic dyslipidaemia and cardiovascular events in patients with diabetes or pre-diabetes and stable coronary artery disease: a prospective, cohort study
Authors: Jin Jing-Lu , Cao Ye-Xuan , Wu Li-Guo , You Xiang-Dong , Guo Na , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Xu Rui-Xia , Liu Hui-Hui , Sun Jing , Dong Qian , Gao Ying , Li Jian-Jun 
Published: January 2021

ObjectiveThe aim of the study was to investigate the impacts of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) dyslipidaemia on prognosis in coronary artery disease (CAD) patients with different glucose metabolism status.DesignAn observational cohort study.Setting/participantsA total of 3057 patients with stable CAD were consecutively enrolled and divided into three groups according to different glucose metabolism status. Atherogenic dyslipidaemia (AD) was defined as TG ≥1.7 mmol/L and HDL-C <1.0 mmol/L for men or <1.3 mmol/L for women. The patients were further classified into six subgroups by status of AD. All subjects were followed up for the cardiovascular events (CVEs).Primary outcome measuresThe primary endpoints were cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke.ResultsDuring a median follow-up of 6.1 years, 308 (10.1%) CVEs occurred. No significant difference in the occurrence of CVEs was observed between normal glucose regulation (NGR) and pre-diabetes (pre-DM) groups (HR: 1.25, 95% CI 0.89 to 1.76) while DM group presented 1.45-fold higher risk of CVEs (HR: 1.45, 95% CI 1.02 to 2.05). When the participants were categorised according to combined status of two parameters, the cardiovascular risk was significantly elevated in pre-DM or DM plus AD group compared with the NGR plus non-AD group (HR: 1.76, 95% CI 1.10 to 2.80 and HR: 1.87, 95% CI 1.17 to 2.98).ConclusionsThe present study suggested that the presence of AD might affect the prognosis in patients with DM or pre-DM and stable CAD.
Prevalence and associated factors of depression among adolescent boys and girls in Bangladesh: findings from a nationwide survey
Authors: Mridha Malay Kanti , Hossain Md Mokbul , Khan Md Showkat Ali , Hanif Abu Abdullah Mohammad , Hasan Mehedi , Mitra Dipak , Hossaine Moyazzam , Ullah Mohammad Aman , Sarker Samir Kanti , Rahman S M Mustafizur , Bulbul Md M Islam , Shamim Abu Ahmed 
Published: January 2021

ObjectiveTo assess the prevalence of and factors associated with depression among adolescent boys and girls.DesignWe conducted a nationwide cross-sectional study.SettingThis study was carried out in 82 randomly selected clusters (57 rural, 15 non-slum urban and 10 slums) from eight divisions of Bangladesh.ParticipantsWe interviewed 4907 adolescent boys and 4949 adolescent girls.Primary and secondary outcome measuresThe primary outcome measure was ‘any depression’ and the secondary outcome measures were types of depression: no or minimal, mild, moderate, moderately severe and severe.ResultsThe overall prevalence of no or minimal, mild, moderate, moderately severe and severe depression was 75.5%, 17.9%, 5,4%, 1.1% and 0.1%, respectively. Across most of the sociodemographic, lifestyle and anthropometric strata, the prevalence of any depression was higher among adolescent girls. In both sexes, depression was associated with higher age, higher maternal education, paternal occupation e.g., business, absence of a 6–9-year-old member in the household, food insecurity, household consumption of unfortified oil, household use of non-iodised salt, insufficient physical activity (adjusted odds ratio, AOR: 1.24 for boys, 1.44 for girls) and increased television viewing time e.g., ≥121 minute/day (AOR: 1.95 for boys, 1.99 for girls). Only among boys, depression was also associated with higher paternal education e.g., complete secondary and above (AOR: 1.42), absence of another adolescent member in the household (AOR: 1.34), household use of solid biomass fuel (AOR: 1.39), use of any tobacco products (AOR: 2.17), and consumption of processed food (AOR: 1.24). Only among girls, non-slum urban residence, Muslim religion, and household size ≤4 were also associated with depression.ConclusionThe prevalence of depression among adolescent boys and girls is high in Bangladesh. In most sociodemographic, lifestyle and anthropometric strata, the prevalence is higher among girls. In this age group, depression is associated with a number of sociodemographic and lyfestyle factors. The government of Bangladesh should consider these findings while integrating adolescent mental health in the existing and future programmes.
Construction of the National Brain Tumor Registry of China for better management and more efficient use of data: a protocol
Authors: Zhang Liwei , Jia Wang , Ji Nan , Li Deling , Xiao Dan , Shan Guang-Liang , Wang Tao , Xiao Xiong 
Published: January 2021

IntroductionBrain tumours encompass a complex group of intracranial tumours that mostly affect young adults and children, with a high incidence rate and poor prognosis. It remains impossible to systematically collect data on patients with brain tumours in China and difficult to perform in-depth analysis on the status of brain tumours, medical outcomes or other important medical issues through a multicentre clinical study. This study describes the first nation-wide data platform including the entire spectrum of brain tumour entities, which will allow better management and more efficient application of patient data in China.Methods and analysisThe National Brain Tumor Registry of China (NBTRC) is a registry of real-word clinical data on brain tumours. It is established and managed by the China National Clinical Research Center for Neurological Diseases and administered by its scientific and executive committees. The 54 participating hospitals of the NBTRC are located in 27 provinces/municipalities, performing more than 40 000 brain tumour surgeries per year. The data consist of in-hospital medical records, images and follow-up information after discharge. Data can be uploaded in three ways: the web portal, remote physical servers and offline software. The data quality control scheme is seven-dimensional. Each participating hospital could focus on a single pathology subtype and public subtypes of brain tumour for which they expect to conduct related multicentre clinical research. The standardised workflow to conduct clinical research is based on the benefit-sharing mechanism. Data collection will be conducted continuously from 1 February 2019 to 31 January 2024.Ethics and disseminationInformed consent will be obtained from all participants. Consent for the adolescents’ participation will be also obtained from their guardians via written consent. The results will be published in professional journals, in both Chinese and English.Trial registration numberChinese Clinical Trial Registry (ChiCTR1900021096).
Development and temporal external validation of a simple risk score tool for prediction of outcomes after severe head injury based on admission characteristics from level-1 trauma centre of India using retrospectively collected data
Authors: Kamal Vineet Kumar , Pandey Ravindra Mohan , Agrawal Deepak 
Published: January 2021

ObjectiveTo develop and validate a simple risk scores chart to estimate the probability of poor outcomes in patients with severe head injury (HI).DesignRetrospective.SettingLevel-1, government-funded trauma centre, India.ParticipantsPatients with severe HI admitted to the neurosurgery intensive care unit during 19 May 2010–31 December 2011 (n=946) for the model development and further, data from same centre with same inclusion criteria from 1 January 2012 to 31 July 2012 (n=284) for the external validation of the model.Outcome(s)In-hospital mortality and unfavourable outcome at 6 months.ResultsA total of 39.5% and 70.7% had in-hospital mortality and unfavourable outcome, respectively, in the development data set. The multivariable logistic regression analysis of routinely collected admission characteristics revealed that for in-hospital mortality, age (51–60, >60 years), motor score (1, 2, 4), pupillary reactivity (none), presence of hypotension, basal cistern effaced, traumatic subarachnoid haemorrhage/intraventricular haematoma and for unfavourable outcome, age (41–50, 51–60, >60 years), motor score (1–4), pupillary reactivity (none, one), unequal limb movement, presence of hypotension were the independent predictors as its 95% confidence interval (CI) of odds ratio (OR)_did not contain one. The discriminative ability (area under the receiver operating characteristic curve (95% CI)) of the score chart for in-hospital mortality and 6 months outcome was excellent in the development data set (0.890 (0.867 to 912) and 0.894 (0.869 to 0.918), respectively), internal validation data set using bootstrap resampling method (0.889 (0.867 to 909) and 0.893 (0.867 to 0.915), respectively) and external validation data set (0.871 (0.825 to 916) and 0.887 (0.842 to 0.932), respectively). Calibration showed good agreement between observed outcome rates and predicted risks in development and external validation data set (p>0.05).ConclusionFor clinical decision making, we can use of these score charts in predicting outcomes in new patients with severe HI in India and similar settings.
Participatory health through behavioural engagement and disruptive digital technology for postoperative rehabilitation: protocol of the PATHway trial
Authors: Wang Xia , Hunter David J , Robbins Sarah , Capistrano Sarah , Duong Vicky , Melo Luciano , Harris Anthony , Ferreira Manuela 
Published: January 2021

IntroductionPostsurgical rehabilitation is critical for optimal recovery in people undergoing orthopaedic surgery. Currently, knee and lumbar spine postsurgical care is not standardised, economically sustainable, nor based on quality evidence, contributing to substantial clinical variation, poor outcomes and increasing healthcare costs. This protocol describes the design of a randomised controlled trial aiming to evaluate the effectiveness and cost-effectiveness of a postsurgical clinical pathway augmented by disruptive technology and compared with standardised rehabilitation alone, in decreasing pain and improving function after total knee replacement (TKR) or lumbar laminectomy (with or without fusion).MethodsAn assessor-blinded, parallel group, randomised controlled trial will be conducted to recruit 204 consenting participants (102 per arm) of whom 50% are undergoing TKR and 50% lumbar surgery. The intervention group will receive a 6-month technology-enabled rehabilitation package in addition to usual postsurgical care. The package includes (1) an exercise program delivered via the Physitrack app on the iPad, (2) a health-coaching program delivered via video calls and motivational messages, (3) use of physical activity tracker with goal setting and motivational reminders (Fitbit). For those undergoing TKR, the intervention will also include knee joint range of motion self-monitoring via the Goniometer app. The control group will receive usual postsurgical care. Participants will be followed up at 3, 6 and 12 months from the enrolment date. The primary outcome is pain measured with the Numerical Rating Scale at 3 months. Secondary outcomes include pain-related disability, quality of life, computer self-efficacy, physical activity participation and sedentary behaviour. Data analysis will be blinded and by intention-to-treat. A trial-based cost-effectiveness analysis will determine the potential incremental cost per quality-adjusted life-year gained.Ethics and disseminationThis protocol is approved by the human research ethics committee of the University of Sydney. Dissemination will occur through lay summary, infographics, conferences and journal publications.Trial registration numberACTRN12618001448235.
Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
Authors: Jeukens Cécile R L P N , Boere Hub , Wagemans Bart A J M , Nelemans Patty J , Nijssen Estelle C , Smith-Bindman Rebecca , Wildberger Joachim E , Sailer Anna M 
Published: January 2021

ObjectiveHigh radiation exposure is a concern because of the association with cancer. The objective was to determine the probability of receiving a high radiation dose from CT (from one or more examinations within a 5-year period) and to assess the clinical context by evaluating clinical indications in the high-dose patient group.DesignObservational cohort study. Effective radiation dose received from one or more CT examinations within a predefined 5-year calendar period was assessed for each patient.SettingHospital setting.ParticipantsAll patients undergoing a diagnostic CT examination between July 2013 and July 2018 at the Maastricht University Medical Center.Primary and secondary outcome measuresThe primary outcome was the probability of receiving a high effective dose, defined as ≥100 mSv, from one or more CT examinations within 5 years as derived from a time-to-event analysis. Secondary outcomes were the clinical indication for the initial scan of patients receiving a high effective dose.Results100 672 CT examinations were performed among 49 978 patients including 482 (1%) who received a high radiation dose. The estimated probability of a high effective dose from a single examination is low (0.002% (95% CI 0.00% to 0.01%)). The 4.5-year probability of receiving a high cumulative effective dose was 1.9% (95% CI 1.6% to 2.2%) for women and 1.5% (95% CI 1.3% to 1.7%) for men. The probability was highest in age categories between 51 and 74 years. A total of 2711 (5.5%) of patients underwent more than six CT examinations, and the probability of receiving a high effective dose was 16%. Among patients who received a high effective dose, most indications (80%) were oncology related.ConclusionsThe probability of receiving a high radiation dose from CT examinations is small but not negligible. In the majority (80%) of high effective dose receiving patients, the indication for the initial CT scan was oncology related.
Acupuncture for biliary colic: a systematic review protocol
Authors: Sun Ning , Zuo Wenwei , Zhou Yuanfang , Cheng Ying , Cheng Shirui , Zhou Jun , Xu Guixing , Huang Liuyang , Liang Fanrong , Sun Ruirui 
Published: January 2021

IntroductionBiliary colic (BC) is a severe pain associated with nausea and vomiting, which is the most common symptom among the gallstone population. This protocol proposes a methodology for conducting a systematic review and meta-analysis that aims to assess the benefits and safety of acupuncture in patients with BC.Methods and analysisClinical trials will be identified through nine databases from inception to December 2020, using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Allied and Complementary Medicine Database (AMED), CINAHL, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database and Wanfang Database. Search words will be used for the BC and acupuncture. The analysis would include randomised, controlled, clinical trials of adults with BC that were published in either Chinese or English. The primary outcome is to measure pain relief. Two or three reviewers should be in charge of study selection, data extraction and evaluating the risk of bias. RevMan software (V.5.4) will be used to perform the assessment of the risk of bias and data synthesis.Ethics and disseminationEthics approval will not be required for this review, as it will only involve the collection of literature previously published. The results of this meta-analysis will be disseminated in a peer-reviewed journal or relevant conference, through publication.Trial registration numberCRD42020167510.
Systematic approach to school-based assessments for autism spectrum disorders to reduce inequalities: a feasibility study in 10 primary schools
Authors: Wright Barry , Konstantopoulou Kalliopi , Sohal Kuldeep , Kelly Brian , Morgan Geoff , Hulin Cathy , Mansoor Sara , Mon-Williams Mark 
Published: January 2021

ObjectivesThis was a pilot study to explore whether the Early Years Foundation Stage Profile (EYFSP) carried out by UK teachers within the ‘reception’ year, combined with the Social Communication Questionnaire (SCQ), can lead to early identification of children with autism spectrum disorders (ASD) and early access to intervention and can reduce inequity in access to assessment and intervention.DesignPragmatic prospective cohort.SettingTen primary schools from the SHINE project in Bradford.Participants587 pupils from 10 schools who transitioned from reception to year 1 in July 2017 and had the EYFSP completed were included in the final study.InterventionsThe assessment involved a multidisciplinary team of three staff who completed Autism Diagnostic Interview–Revised, Autism Diagnostic Observation Schedule Version 2, classroom observations with an ASD checklist, a teacher-based ASD questionnaire and a final consensus meeting.Primary outcome measureNational Institute for Health and Care Excellence guideline-compliant clinical diagnosis of ASD.Secondary outcome measuresAge of diagnosis, demographic data and feasibility parameters.ResultsChildren with low scores on the EYFSP were more likely to score above the SCQ threshold of 12, indicating potential autism (50% compared with 19% of children with high scores on the EYFSP (p<0.001)). All children scoring above the SCQ threshold received a full autism assessment; children who scored low on the EYFSP were more likely to be diagnosed with autism (and other developmental issues) compared with those who did not.ConclusionsWe identified nine new children with a diagnosis of ASD, all from ethnic minorities, suggesting that this process may be addressing the inequalities in early diagnosis found in previous studies. All children who scored above the SCQ threshold required support (ie, had a neurodevelopmental disorder), indicating the EYFSP questionnaire captured ‘at-risk’ children.