bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Formation Mechanism of Static Pressure Circumferential Distribution of Centrifugal Compressor Under Different Operating Conditions
Authors: Su Botai , Yang Ce , Zhang Hanzhi , Shi Xin , Fu Li 
Published: August 2021

Abstract
The casing-wall static pressure of the centrifugal compressor behaves the double-peak distribution in the circumference at small flow rates (SM) but the single-peak distribution at large flow rates (LM). A previous study shows that the double-peak distribution is induced by the redistribution of impeller outlet flow rates. In this paper, by using the similar simplified method of directly imposing pressure boundary to the diffuser outlet, the original reason for the formation process difference of pressure distribution in the circumference at different operating conditions is further investigated. The results show that at LM, under the combined action of the specific downstream pressure distribution and the flow performance of the compressor itself, alternating low/high velocity airflow zones similar to those at SM cannot be established in the diffuser when the impeller outlet flow rates are redistributed. Therefore, the static pressure can only express the single-peak distribution in the circumference. In fact, whether the static pressure exhibits the double-peak or single-peak distribution in the circumference depends on whether the impeller outlet flow mutation can destroy the original flow balance. When the flow mutation is dominant, the double-peak distribution is created, whereas when the original flow balance is prevailing, the single-peak distribution is formed.
Physical Activity Among People With Lower Limb Amputation in Brazil
Authors: Luza Lisiane Piazza , da Silva Diego Rodrigues Pimentel , Ferreira Elizandra Gonçalves , Pires Greicy Kelly Wosniak , Filho Paulo José Barbosa Gutierres , da Silva Rudney 
Published: August 2021

Background: Limb loss affects quality of life, well-being, and autonomy. The World Health Organization has launched a global action plan to reduce physical inactivity and presented recommendations of physical activity for people living with disability. Knowledge of the characteristics of people with lower limb amputation regarding physical activity is important. Thus, the aim of this study was to identify the quantity and type of physical activity done by people with lower limb amputation. Methods: The sample (N = 149) included adults aged 53.08 (17.24) years old with lower limb loss. Data collection was performed through the application of a sociodemographic, behavioral, and clinical data sheet and the Brazilian version of the Physical Activity Scale for Individuals with Physical Disabilities. Results: The total Physical Activity Scale for Individuals with Physical Disabilities score was between 0 and 65.79 metabolic equivalents of task per hour per day, which suggests low practice of physical activities. The most frequently practiced activities (79.9%) were those that involved stationary behavior. Women carried out more domestic activities, and subjects who used lower limb prosthesis and those with traumatic amputation reported higher practice of physical activity. Conclusions: People living with lower limb amputation, from different regions of Brazil, have low levels of physical activity and mainly carry out activities of stationary behavior.
Developing Principles of Practice for Implementing Models-Based Practice: A Self-Study of Physical Education Teacher Education Practice
Authors: Baker Kellie 
Published: August 2021

Purpose: Models-Based Practice (MBP) has been suggested as one possible physical education future. However, there are few examples that consider the challenges faced implementing MBP. The purpose of this research is to develop and articulate principles of practice for implementing MBP in physical education teacher education. Method: Self-Study of Teacher Education Practice methodology guided collection of teacher educator and preservice teacher (n = 9) data. Results: Principles of practice are identified: (a) providing opportunities for beginning teachers to analyze their learning about and through MBP provides unique insights into using MBP, (b) experiencing and examining alternatives to MBP provides preservice teachers with opportunities to practice pedagogical decision making, and (c) individual and group meetings support teacher educators and preservice teachers in crystallizing understandings of MBP implementation. Conclusion: The articulation of principles of practice offers insights into how teacher educator practice might be examined, developed, and shared for use by others.
Necrotising enterocolitis, late-onset sepsis and mortality after routine probiotic introduction in the UK
Authors: Granger Claire , Dermyshi Elda , Roberts Eve , Beck Lauren C , Embleton Nicholas , Berrington Janet 
Published: August 2021

ObjectiveTo compare necrotising enterocolitis (NEC), late-onset sepsis (LOS), focal intestinal perforation (FIP) and mortality in infants from a single neonatal unit before and after probiotic introduction.DesignRetrospective review of infants <32 weeks admitted January 2009–December 2012 (no probiotic) and January 2013–December 2017 (routine probiotics). Infants included were admitted before day 3, and not transferred out before day 3. NEC, LOS and FIP were defined with standard definitions.Patients1061 infants were included, 509 preprobiotic and 552 postprobiotic. Median gestation, birth weight and antenatal steroid use did not differ, and proportions of extremely low birthweight infants were similar (37% and 41%).ResultsOverall unadjusted risk of NEC (9.2% (95% CI 7.1 to 12.1) vs 10.6% (95% CI 8.2 to 13.4), p=0.48), LOS (16.3% (95% CI 13.2 to 19.6) vs 14.1% (95% CI 11.5 to 17.4), p=0.37) and mortality (9.2% (95% CI 7.1 to 12.1) vs 9.7% (95% CI 7.6 to 12.6), p=0.76) did not differ, nor proportion of surgical NEC. In multiple logistic regression, accounting for gestation, birth weight, antenatal steroid, maternal milk, chorioamnionitis and sex, probiotic receipt was not significantly associated with NEC (adjusted OR (aOR) 1.08 (95% CI 0.71 to 1.68), p=0.73), LOS or mortality. In subgroup (645 infants) >28 weeks, aOR for NEC in the probiotic cohort was 0.42 (95% CI 0.2 to 0.99, p=0.047). FIP was more common in the probiotic cohort (OR 2.3 (95% CI 1.0 to 5.4), p=0.04), not significant in regression analysis (2.11 (95% CI 0.97 to 4.95), p=0.05).ConclusionsProbiotic use in this centre did not reduce overall mortality or rates of NEC, LOS or FIP but subgroup analysis identified NEC risk reduction in infants >28 weeks, and LOS reduction <28 weeks.
Direct selective laser trabeculoplasty in open angle glaucoma study design: a multicentre, randomised, controlled, investigator-masked trial (GLAUrious)
Authors: Congdon Nathan , Azuara-Blanco Augusto , Solberg Yoram , Traverso Carlo E , Iester Michele , Cutolo Carlo Alberto , Bagnis Alessandro , Aung Tin , Fudemberg Scott J , Lindstrom Richard , Samuelson Thomas , Singh Kuldev , Blumenthal Eytan Z , Gazzard Gus 
Published: August 2021

IntroductionLaser trabeculoplasty is an effective and widely used treatment for glaucoma. A new laser technology, the Eagle direct selective laser trabeculoplasty (DSLT) device, may provide automated, fast, simple, safe and effective laser treatment for glaucoma in a broader range of clinical settings. This trial aims to test the hypothesis that translimbal DSLT is effective and not inferior to selective laser trabeculoplasty (SLT) in reducing intraocular pressure (IOP) in open angle glaucoma (OAG).Methods and analysisThis is a multicentre, randomised, controlled, investigator-masked study. The primary efficacy outcome is intergroup difference in mean change from baseline IOP measured at 6 months. Secondary outcomes include mean percentage reduction in IOP at 3, 6 and 12 months; proportion of participants with at least 20% reduction in IOP from baseline at 6 months; change in ocular hypotensive medications at 12 months and evaluation of safety. Participants were aged >= 40 years with OAG, including exfoliative or pigmentary glaucoma, or ocular hypertension with untreated or washed out IOP 22–35 mm Hg. Treatments: DSLT: 120 shots, 3 ns, 400 µm spot size, energy 1.4–1.8 mJ delivered at the limbus over 2 s. SLT: approximately 100 shots, 3 ns, 400 µm spot size administered 360 degrees at the limbus using any gonioscopy lens, energy 0.3–2.6 mJ. A sample size of 164 is sufficient to detect a non-inferiority margin of 1.95 mm Hg for change from baseline IOP.Clinical trial registration numberNCT03750201,ISRCTN14033075.
Joint associations of metabolically healthy abdominal obesity and non-alcoholic fatty liver disease with prediabetes and diabetes in Chinese adults
Authors: Zhang Junfeng , Xu Qiaoyan , Lai Fangfang , Chen Ning , Lin Mingzhu , Liu Yongwen , Zhang Wei , Liu Changqin , Wang Shunqin , Li Zhibin 
Published: August 2021

IntroductionWe aimed to evaluate the joint associations of metabolically healthy abdominal obesity (MHAO) with non-alcoholic fatty liver disease (NAFLD) on risks of diabetes and prediabetes.Research design and methodsBaseline information of 1318 adults with abdominal obesity (waist circumference ≥90 cm for men and 80 cm for women) from an ongoing cohort study in Xiamen, China were analyzed. Metabolic health was identified as none of the criteria of metabolism syndrome, except for obesity, was met.ResultsMHAO and metabolically unhealthy abdominal obesity (MUAO) were identified on 173 (13.1%) and 1145 (86.9%) subjects. NAFLD was further diagnosed on 60 (34.7%) in MHAO and 721 (63.0%) in MUAO groups (p<0.001). Both MUAO (vs MHAO) and NAFLD (vs non-NAFLD) were independently associated with increased risks of diabetes as well as prediabetes plus diabetes, with the adjusted ORs (95% CIs) of 9.40 (3.38 to 26.14) and 2.02 (1.47 to 2.77), respectively. Compared with MHAO and non-NAFLD, MHAO and NAFLD showed significantly increased risks of prediabetes plus diabetes with the adjusted ORs (95% CIs) of 2.87 (1.32 to 6.27, p=0.008). And there were significantly positive trends between increasing categories jointly by MHAO and NAFLD (from MHAO and non-NAFLD, MHAO and NAFLD, MUAO and non-NAFLD to MUAO and NAFLD) with risks of diabetes and prediabetes plus diabetes (both trend tests: p<0.001).ConclusionsAbout 35% of subjects with MHAO accompanied by NAFLD showed excessive risk of prediabetes plus diabetes compared with MHAO and non-NAFLD. Thus, NAFLD should be screened and intervened even for those subjects with metabolically healthy obesity (MHO) and should be considered as one additional criterion when defining and diagnosing MHO.
CPD in the remote environment: a role for practice-based small group learning?
Authors: Eager Michael Mathew , Capella S C , Willman A , Taylor N 
Published: August 2021

BackgroundContinuous professional development (CPD) is recognised as essential and mandated by the Royal College of General Practitioners and other medical professional colleges. However, it can be difficult to maintain when deployed and remote from normal training and support structures. There is no literature directly discussing how military doctors in the deployed and remote environment maintain CPD and if practice-based small group learning (PBSGL) could be an appropriate tool to facilitate this in future.AimTo describe the CPD experience of medical officers (MOs) working for the Defence Medical Services (DMS) and assess if offering PBSGL would be welcomed and likely beneficial.Design and settingThis is a quantitative survey of doctors working in primary care within the DMS.MethodA questionnaire was designed to elicit opinions, current practice and previous experience of CPD within the deployed and firm base environments. It also aimed to elicit prior experience of and appetite for PBSGL as a solution. This was then distributed via email to MOs working for the DMS.Results130 responses (25%) were received. 122 (96%) had heard of PBSGL, 56% had participated in PBSGL in the firm base. 60% agreed or strongly agreed PBSGL was an effective way to maintain CPD. 73% reported eLearning as a mode of maintaining CPD while deployed or working in a remote environment.ConclusionThis study demonstrated that many general practitioners deployed to remote locations feel that CPD provision could be improved and that PBSGL is a potential solution.
Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study
Authors: You Xinyi , Gu Jing , Xu Dong Roman , Huang Shanshan , Xue Hao , Hao Chun , Ruan Yunzhou , Sylvia Sean , Liao Jing , Cai Yiyuan , Peng Liping , Wang Xiaohui , Li Renzhong , Li Jinghua , Hao Yuantao 
Published: August 2021

IntroductionIn the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas. The Healthy China 2030 highlights the gate-keeping role of primary healthcare (PHC). However, the impact of PHC reforms on the future TB burden is unclear. We propose to use mathematical models to project and evaluate the impacts of different gate-keeping policies.Methods and analysisWe will develop a deterministic, population-level, compartmental model to capture the dynamics of TB transmission within adult rural population. The model will incorporate seven main TB statuses, and each compartment will be subdivided by service providers. The parameters involving preference for healthcare seeking will be collected using discrete choice experiment (DCE) method. We will solve the deterministic model numerically over a 20-year (2021–2040) timeframe and predict the TB prevalence, incidence and cumulative new infections under the status quo or various policy scenarios. We will also conduct an analysis following standard protocols to calculate the average cost-effectiveness for each policy scenario relative to the status quo. A numerical calibration analysis against the available published TB prevalence data will be performed using a Bayesian approach.Ethics and disseminationMost of the data or parameters in the model will be obtained based on secondary data (eg, published literature and an open-access data set). The DCE survey has been reviewed and approved by the Ethics Committee of the School of Public Health, Sun Yat-sen University. The approval number is SYSU [2019]140. Results of the study will be disseminated through peer-reviewed journals, media and conference presentations.
Co-designing a dashboard of predictive analytics and decision support to drive care quality and client outcomes in aged care: a mixed-method study protocol
Authors: Ludlow Kristiana , Westbrook Johanna , Jorgensen Mikaela , Lind Kimberly E , Baysari Melissa T , Gray Leonard C , Day Richard O , Ratcliffe Julie , Lord Stephen R , Georgiou Andrew , Braithwaite Jeffrey , Raban Magdalena Z , Close Jacqueline , Beattie Elizabeth , Zheng Wu Yi , Debono Deborah , Nguyen Amy , Siette Joyce , Seaman Karla , Miao Melissa , Root Jo , Roffe David , O’Toole Libby , Carrasco Marcela , Thompson Alex , Shaikh Javed , Wong Jeffrey , Stanton Cynthia , Haddock Rebecca 
Published: August 2021

IntroductionThere is a clear need for improved care quality and quality monitoring in aged care. Aged care providers collect an abundance of data, yet rarely are these data integrated and transformed in real-time into actionable information to support evidence-based care, nor are they shared with older people and informal caregivers. This protocol describes the co-design and testing of a dashboard in residential aged care facilities (nursing or care homes) and community-based aged care settings (formal care provided at home or in the community). The dashboard will comprise integrated data to provide an ‘at-a-glance’ overview of aged care clients, indicators to identify clients at risk of fall-related hospitalisations and poor quality of life, and evidence-based decision support to minimise these risks. Longer term plans for dashboard implementation and evaluation are also outlined.MethodsThis mixed-method study will involve (1) co-designing dashboard features with aged care staff, clients, informal caregivers and general practitioners (GPs), (2) integrating aged care data silos and developing risk models, and (3) testing dashboard prototypes with users. The dashboard features will be informed by direct observations of routine work, interviews, focus groups and co-design groups with users, and a community forum. Multivariable discrete time survival models will be used to develop risk indicators, using predictors from linked historical aged care and hospital data. Dashboard prototype testing will comprise interviews, focus groups and walk-through scenarios using a think-aloud approach with staff members, clients and informal caregivers, and a GP workshop.Ethics and disseminationThis study has received ethical approval from the New South Wales (NSW) Population & Health Services Research Ethics Committee and Macquarie University’s Human Research Ethics Committee. The research findings will be presented to the aged care provider who will share results with staff members, clients, residents and informal caregivers. Findings will be disseminated as peer-reviewed journal articles, policy briefs and conference presentations.
What work-related exposures are associated with post-traumatic stress disorder? A systematic review with meta-analysis
Authors: Coenen Pieter , van der Molen Henk F 
Published: August 2021

ObjectivesAlthough there is evidence that work-related exposures cause post-traumatic stress disorder (PTSD), there are few quantitative studies assessing the degree to which these factors contribute to PTSD. This systematic review with meta-analysis identified work-related exposures associated with PTSD, and quantified their contribution to this disorder.MethodsWe searched Medline, PsycINFO, Embase, PILOTS and Web of Science (2005–10 September 2019) for longitudinal studies on work-related exposures and PTSD. We described included articles, and conducted meta-analyses for exposures with sufficient homogeneous information. We performed subgroup analyses for risk of bias, study design and PTSD ascertainment. We assessed evidence quality using Grades of Recommendations, Assessment, Development and Evaluation, and estimated population attributable fractions.ResultsAfter screening 8590 records, we selected 33 studies (n=5 719 236). From what was moderate quality evidence at best, we identified various work-related exposures that were associated with PTSD, mainly involving individuals in the military and first responder (eg, police or fire brigade) occupations. These exposures included the number of army deployments (OR: 1.15 (95% CI 1.14 to 1.16)), combat exposure (OR 1.89 (95% CI 1.46 to 2.45)), army deployment (OR 1.79 (95% CI 1.45 to 2.21)) and confrontation with death (OR 1.63 (95% CI 1.41 to 1.90)). Effects were robust across subgroups and exposures attributed modestly (7%–34%) to PTSD. We identified additional exposures in other occupations, including life threats, being present during an attack, and hearing about a colleague’s trauma.ConclusionsWe identified various work-related exposures associated with PTSD and quantified their contribution. While exposure assessment, PTSD ascertainment and inconsistency may have biased our findings, our data are of importance for development of preventive interventions and occupational health guidelines.
Impact of social restrictions during the COVID-19 pandemic on the physical activity levels of adults aged 50–92 years: a baseline survey of the CHARIOT COVID-19 Rapid Response prospective cohort study
Authors: Salman David , Beaney Thomas , E Robb Catherine , de Jager Loots Celeste A , Giannakopoulou Parthenia , Udeh-Momoh Chinedu T , Ahmadi-Abhari Sara , Majeed Azeem , Middleton Lefkos T , McGregor Alison H 
Published: August 2021

ObjectivesPhysical inactivity is more common in older adults, is associated with social isolation and loneliness and contributes to increased morbidity and mortality. We examined the effect of social restrictions to reduce COVID-19 transmission in the UK (lockdown), on physical activity (PA) levels of older adults and the social predictors of any change.DesignBaseline analysis of a survey-based prospective cohort study.SettingAdults enrolled in the Cognitive Health in Ageing Register for Investigational and Observational Trials cohort from general practitioner practices in North West London were invited to participate from April to July 2020.Participants6219 cognitively healthy adults aged 50–92 years completed the survey.Main outcome measuresSelf-reported PA before and after the introduction of lockdown, as measured by metabolic equivalent of task (MET) minutes. Associations of PA with demographic, lifestyle and social factors, mood and frailty.ResultsMean PA was significantly lower following the introduction of lockdown from 3519 to 3185 MET min/week (p<0.001). After adjustment for confounders and prelockdown PA, lower levels of PA after the introduction of lockdown were found in those who were over 85 years old (640 (95% CI 246 to 1034) MET min/week less); were divorced or single (240 (95% CI 120 to 360) MET min/week less); living alone (277 (95% CI 152 to 402) MET min/week less); reported feeling lonely often (306 (95% CI 60 to 552) MET min/week less); and showed symptoms of depression (1007 (95% CI 612 to 1401) MET min/week less) compared with those aged 50–64 years, married, cohabiting and not reporting loneliness or depression, respectively.Conclusions and implicationsMarkers of social isolation, loneliness and depression were associated with lower PA following the introduction of lockdown in the UK. Targeted interventions to increase PA in these groups should be considered.
Home spirometry utilisation in telemedicine clinic for cystic fibrosis care during COVID-19 pandemic: a quality improvement process
Authors: Compton Martina , List Rhonda , Starheim Elissa , Somerville Lindsay , Williamson Lauren , Murray Rachel , Jennings Deirdre , Bruschwein Heather , Albon Dana 
Published: August 2021

IntroductionThe Cystic Fibrosis (CF) Foundation chronic care guidelines recommend monitoring spirometry during quarterly multidisciplinary visits to identify early lung function decline. During the COVID-19 pandemic, the CF adult clinic at University of Virginia (UVA) transitioned from the classic CF care model to a model that included quarterly multidisciplinary telemedicine visits. While using telemedicine, CF care needed to include spirometry monitoring. Only a fraction of adult CF patients at UVA owned and used home spirometers (HS) in March 2020.AimThe specific aims of this quality improvement (QI) project were to increase the percentage of eligible adult CF patients who owned an HSs from 37% to 85% and to increase the percentage of adult CF patients seen at UVA with available spirometry in telemedicine from 50% to 95% by 31 December 2020.MethodsFollowing the Model for Improvement QI methodology, a standardised process was developed for monitoring forced expiratory volume in 1 s with HS during multidisciplinary telemedicine visits during the COVID-19 pandemic.Intervention(1) HSs were distributed to eligible patients and (2) Home spirometry was monitored in eligible patients with each telemedicine visit and results were used for clinical care decisions.ResultsBoth specific aims were achieved ahead of expected date. In March 2020, the beginning of the pandemic, 37% (49/131) of patients owned an HS and 50% (9/18) of patients seen via telemedicine performed spirometry at home. By September 2020, 97% (127/131) of adult patients at UVA owned an HS and by October 2020, 96% (24/25) of patients provided spirometry results during their telemedicine encounters.ConclusionEmploying QI tools to standardise the process of monitoring spirometry data with home devices via telemedicine is reliable and sustainable and can be replicated across centres that provide care for patients with CF.