bluuebunny/crossref_metadata_2025_split huggingface dataset:
The health literacy disparity in adolescents with sickle cell disease
Authors: Perry Caldwell Elizabeth , Killingsworth Erin 
Published: July 2021

AbstractPurposeThere are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.Design and MethodsThis is a cross‐sectional, descriptive, exploratory study. One hundred and thirty‐four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples t tests.ResultsThere was a significant relationship between health literacy, age (r = .286, p < .01) and grade level (r = .317, p = .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (r = .235; p < .05) and parental education (r = .263; p < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (t = 4.772; p < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD.Practice ImplicationsThere are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is needed to gain more insight into this phenomenon.
How sleepy patients differ from non‐sleepy patients in mild obstructive sleep apnea?
Authors: Oksenberg Arie , Goizman Vlada , Eitan Edith , Nasser Kitham , Gadoth Natan , Leppänen Timo 
Published: July 2021

SummaryTo aim is investigate whether demographic, polysomnographic or sleep behaviour data differ between non‐sleepy, sleepy and very sleepy patients with mild obstructive sleep apnea. The study population consisted of 439 consecutive adult patients diagnosed with mild obstructive sleep apnea (5 ≤ apnea–hypopnea index < 15) after a complete polysomnographic evaluation. The patients were divided into three groups based on subjective sleepiness: very sleepy (Epworth Sleepiness Scale ≥ 16, n = 59); sleepy (10 < Epworth Sleepiness Scale < 16, n = 102); and non‐sleepy (Epworth Sleepiness Scale ≤ 10, n = 278). Demographic, polysomnographic and sleep behaviour data were compared between the groups. There were no statistically significant differences in breathing abnormality indices and most of the demographic features between the groups. The number of arousals was significantly higher in the very sleepy group compared with the non‐sleepy group (140.8 ± 105.2 versus 107.6 ± 72.2). Very sleepy patients reported feeling sleepy during the daytime more often (42.4% versus 31.7%) and sleeping significantly less during the week compared with non‐sleepy patients. Also, a significantly higher proportion of sleepy (47.1%) and very sleepy patients (44.1%) reported taking naps during weekends compared with non‐sleepy patients (35.6%). In a regression analysis, also total sleep time (β = 0.045), sleep efficiency (β = −0.160), apnea index (β = −0.397), apnea–hypopnea index in supine position (β = 0.044), periodic limb movement index (β = 0.196) and periodic limb movement‐related arousal index (β = −0.210) affected subjective daytime sleepiness. The results suggest that excessive daytime sleepiness in patients with mild obstructive sleep apnea appears to be related to inadequate sleeping habits (i.e. insufficient sleep during working days) and decreased sleep quality rather than differences in breathing abnormalities.
Diet and exercise in NAFLD/NASH: Beyond the obvious
Authors: Semmler Georg , Datz Christian , Reiberger Thomas , Trauner Michael 
Published: July 2021

AbstractLifestyle represents the most relevant factor for non‐alcoholic fatty liver disease (NAFLD) as the hepatic manifestation of the metabolic syndrome. Although a tremendous body of clinical and preclinical data on the effectiveness of dietary and lifestyle interventions exist, the complexity of this topic makes firm and evidence‐based clinical recommendations for nutrition and exercise in NAFLD difficult. The aim of this review is to guide readers through the labyrinth of recent scientific findings on diet and exercise in NAFLD and non‐alcoholic steatohepatitis (NASH), summarizing “obvious” findings in a holistic manner and simultaneously highlighting stimulating aspects of clinical and translational research “beyond the obvious”. Specifically, the importance of calorie restriction regardless of dietary composition and evidence from low‐carbohydrate diets to target the incidence and severity of NAFLD are discussed. The aspect of ketogenesis—potentially achieved via intermittent calorie restriction—seems to be a central aspect of these diets warranting further investigation. Interactions of diet and exercise with the gut microbiota and the individual genetic background need to be comprehensively understood in order to develop personalized dietary concepts and exercise strategies for patients with NAFLD/NASH.
Reversibility of total airway closure and alveolar consolidation in a COVID‐19 patient: A case study
Authors: Voicu Sebastian , Brudon Alexandre , Modestin Louis , Nitenberg Kiyoko , Gonde Antoine , Malissin Isabelle , Mégarbane Bruno 
Published: July 2021

AbstractCoronavirus disease 2019 (COVID‐19) may be complicated by life‐threatening pneumonia requiring tracheal intubation, mechanical ventilation and veno‐venous extracorporeal membrane oxygenation (vvECMO). It is not yet clear to what extent and after which delay the most severe cases of COVID‐19 pneumonia are reversible. Here, we present a 39‐year‐old patient who developed a severe COVID‐19‐attributed acute respiratory distress syndrome (ARDS) resulting in complete alveolar consolidation and airway closure for several weeks. His remarkable ventilatory pattern was established using ventilator airway pressure curve analysis and computed tomography imaging. The patient was managed with supportive care, mechanical ventilation and vvECMO. He received dexamethasone and tocilizumab as immunomodulatory drugs. Despite multiple complications, he recovered and was weaned from vvECMO, ventilator and oxygen on days 75, 95 and 99 post‐intubation, respectively. He was discharged from hospital on day 113. This case study strongly supports the remarkable potential for reversibility of ARDS in COVID‐19 patients and discusses the implications for critical care nursing regarding mechanical ventilation and ECMO device management in patients who may become entirely dependent on vvECMO for oxygenation and carbon dioxide elimination.
Anesthesiologist‐related factors associated with risk‐adjusted pediatric anesthesia‐related cardiopulmonary arrest: a retrospective two level analysis
Authors: Christensen Robert , Haydar Bishr , Leis Aleda , Mentz Graciela , Reynolds Paul 
Published: July 2021

AbstractBackgroundPediatric anesthesia‐related cardiac arrest is an uncommon but catastrophic adverse event which has been, in a previous study, associated with anesthesiologist‐related factors such as number of days per year providing pediatric anesthesia. We aimed to replicate this and assess other anesthesiologist‐related risk factors for anesthesia‐related cardiac arrest after adjusting for known underlying risk factors present in the case mix.MethodsWe analyzed a large retrospectively collected patient cohort of anesthetics administered from 2006 to 2016 to children at a tertiary pediatric hospital. Three reviewers independently reviewed cardiac arrests and categorized whether they appeared to be related to anesthesia care. Anesthesiologist‐related factors including academic rank, experience, recent case mix, and days per year delivering pediatric anesthesia were assessed for association with anesthesia‐related cardiac arrest after adjustment for underlying case mix.ResultsCardiac arrest occurred in 240 of 109 775 anesthetics (incidence 22/10 000 anesthetics); 82 (7/10 000 anesthetics) were classified as anesthesia‐related. In univariable analyses, anesthesia‐related cardiac arrest was associated with age, (infants ≤180 days, p < .001) American Society of Anesthesiologists Physical Status, (>2, p < .001) American Society of Anesthesiologists Physical Status Emergency, (p = .0035) cardiac surgery, (p < .001) operating room location, (p = .0066) and resident/fellow supervision, (p = .009) but none of the anesthesiologist factors. Even after adjusting for age and American Society of Anesthesiologist Status, none of the anesthesiologist factors were associated with anesthesia‐related cardiac arrest.ConclusionsCase mix explained all associations between higher risk of pediatric anesthesia‐related cardiac arrest and anesthesiologist‐related variables at our institution.
Integrating mental health connections in community academic partnerships
Authors: Gotwals Beth , Adamshick Pamela 
Published: July 2021

AbstractBackgroundCommunity academic partnerships (CAPs) connect students to interprofessional collaborations and expand clinical experiences beyond traditional settings. Serious and persistent mental health problems represent an important action area within population health. Mental health disorders across the lifespan are often co‐morbid with substance use, poverty, and community violence.AimsThis article describes CAPs in a community course where students impact vulnerable populations while learning new roles and responsibilities. The process explains student engagement with the community, and using best practices for care of community, population health concerns, and mental health and well‐being.MethodsWe initiate and maintain collaborative relationships that guide culturally sensitive responses to health and illness. Four well‐established CAPs’ exemplars describe the interventions and outcomes.ResultsStudents successfully integrated a variety of health promotion and mental health interventions within the CAPS clinical environments. The Socio‐Ecological framework is used to articulate student outcomes.ConclusionThe CAPs are a dynamic system requiring ongoing maintenance and response to evolving epidemiological issues, such as increased incidence of alterations in mental health. The educational innovation provides an opportunity for students to understand aspects of holistic health in a community environment as they intervene at individual, relationship, community, and societal levels.
Changes in EMG and movement velocity during a set to failure against different loads in the bench press exercise
Authors: Tsoukos Athanasios , Brown Lee E. , Terzis Gerasimos , Wilk Michal , Zajac Adam , Bogdanis Gregory C. 
Published: July 2021

This study examined changes in movement velocity and surface electromyographic (sEMG) activity of the pectoralis major (PM) and triceps brachii (TB) muscles during the bench press exercise to failure against different loads. Fourteen men performed a set to failure with maximum intended velocity, against low (40%‐1 repetition maximum‐RM), moderate (60%‐1RM), and heavy loads (80%‐1RM). Number of repetitions, volume load, mean and peak velocity, and total time increased with decreasing load (40% > 60% > 80%, p < 0.01). sEMG comparisons between different loads were performed by matching time under tension at the initial, middle, and last part of the set. sEMG was higher in the middle and last repetitions, compared with the initial, for all loads in both muscles (p < 0.001). sEMG activity of both muscles was higher in the 60% and 80%‐1RM conditions compared with the 40%1‐RM (p < 0.007). Also, sEMG of both muscles was similar for the 60%‐1RM and 80%‐1RM loads at the initial, middle, and last repetitions, with the exception of the last repetitions for the TB muscle. In contrast, sEMG integrated activity was higher for the 40% 1‐RM and 60% 1‐RM (p < 0.01) compared with the 80% 1‐RM load. Mean velocity loss at exhaustion and drop in sEMG median frequency were greater in the 40% and 60%‐1RM compared with the 80%‐1RM condition (p < 0.05). It was concluded that performing a set to exhaustion with maximum intended velocity using a load of 60% 1‐RM combines the characteristics of the high average sEMG activity of heavier loads, and the high total integrated sEMG observed at lighter loads.
Integrating GIS and location modeling: A relational approach
Authors: Lei Ting L. 
Published: July 2021

AbstractPlanners and geospatial analysts have long been using GIS and optimization methods to solve a wide range of spatial decision problems from routing and facility location to political redistricting. However, there has been a notable disconnection between the tools of GIS and optimization, constraining the capability of spatial decision‐making in GIS. This article presents relational linear programming (RELP), a new framework and tool for bridging the gap between the two fields by integrating a generic optimization solver into GIS: a solver for integer linear programming (ILP). In particular, we choose relational/spatial databases as the GIS platform. We demonstrate that not only data, but also programs for spatial problems (in the form of ILP) can be managed and executed in SQL inside spatial databases. The main focus of this article is on location modeling, and we show how classic models can be formulated succinctly in a declarative way using SQL. The declarative approach of RELP allows researchers to focus onformulatingnew spatial decision problems without being bogged down in sophisticated programming. The integrated approach allows data processing and decision‐making in one language. Therefore, it brings the power of location modeling to non‐specialist GIS practitioners.
Liquid biopsy can detect BRCA2 gene variants in female dogs with mammary neoplasia
Authors: de Oliveira Jéssica Rodrigues , Colombo Jucimara , Gonçalves Francine Moraes , de Carvalho Lucas Amoroso Lopes , Costa Douglas Santos , Henrique Tiago , Novais Adriana Alonso , Moschetta‐Pinheiro Marina Gobbe , Chuffa Luiz Gustavo de Almeida , Coutinho Luiz Lehmann , Santana Áureo Evangelista , Zuccari Debora Aparecida Pires de Campos 
Published: July 2021

AbstractMammary tumours (MT) are one of the most prevalent malignancies in female dogs and women. Currently, molecular analyzes have shown that each tumour type presents its own genetic signature. In this context, liquid biopsy allows a comprehensive genetic characterisation of the tumour, enabling early diagnosis and personalised treatment of patients. In women, deleterious mutations inherited in BRCA2 gene are associated with an increased risk of breast cancer, resistance to therapies and worse prognosis. In female dogs, there are many divergent data on the involvement of BRCA2 gene with mammary carcinogenesis and what its pathogenic potential is. Therefore, the objective was to identify BRCA2 gene variants in 20 plasma DNA samples, from 10 newly diagnosed dogs with mammary cancer (RD), five control (CTR) and five mastectomized patients. Eleven single nucleotide polymorphisms (SNPs) were detected, most of them in the exon 11 and two indels (deletion/insertion) in the BRCA2 gene. However, there was no statistically significant difference in the SNPs/indels detected between the groups. In addition, only one SNP (p.T1425P) and one deletion (p.L2307del) were considered deleterious using in silico computational models. Interestingly, most common variants were present in the plasma of all groups, except for the Ile2614Thr, Ile2614Val, Thr1425Pro and p.L2307del variants. Thus, we observed that SNPs are common in the BRCA2 gene of female dogs with MT, with a similar condition identified in women with breast cancer. Liquid biopsy approach in dogs with MT is useful for genetic and therapeutic proposals.
Making Better Swirl Brakes Using Computational Fluid Dynamics: Performance Enhancement From Geometry Variation
Authors: Yang Jing , San Andrés Luis 
Published: July 2021

Abstract
A fluid with a large swirl (circumferential) velocity entering an annular pressure seal influences the seal cross-coupled dynamic stiffness coefficients, and hence it affects system stability. Typically comprising a large number of angled vanes around the seal circumference, a swirl brake (SB) is a mechanical element installed to reduce (even reverse) the swirl velocity entering an annular seal. SB design guidelines are not readily available, and existing configurations appear to reproduce a single source. By using a computational fluid dynamics (CFD) model, the paper details a process to engineer a SB upstream of a 16-tooth labyrinth seal (LS) with tip clearance Cr = 0.203 mm. The process begins with a known nominal SB* geometry and considers variations in vane length (LV* = 3.25 mm) and width (WV* = 1.02 mm), and stagger angle (θ* = 0 deg). The vane number NV* = 72 and vane height HV* = 2.01 mm remain unchanged. The SB–LS operates with air supplied at pressure PS = 70 bar, a pressure ratio PR = exit pressure Pa/PS = 0.5, and rotor speed Ω = 10.2 krpm (surface speed ΩR = 61 m/s). Just before the SB, the preswirl velocity ratio = average circumferential velocity U/shaft surface speed (ΩR) equals α = 0.5. For the given conditions, an increase in LV allows more space for the development of vortexes between two adjacent vanes. These are significant to the dissipation of fluid kinetic energy and thus control the reduction of α. A 42% increase in vane length (LV = 4.6 mm) produces a ∼43% drop in swirl ratio at the entrance of the LS (exit of the SB), from αE = 0.23 to 0.13. Based on the SB with LV = 4.6 mm, the stagger angle θ varies from 0 deg to 50 deg. The growth in angle amplifies a vortex at ∼70% of the vane height, while it weakens a vortex at 30% of HV. For θ = 40 deg, the influence of the two vortexes on the flow produces the smallest swirl ratio at the LS entrance, αE = −0.03. For a SB with LV = 4.6 mm and θ = 40 deg, the vane width WV varies from 0.51 mm to 1.52 mm (±50% of WV*). A reduction in WV provides more space for the strengthening of the vortex between adjacent vanes. Therefore, a SB with greater spacing of vanes also reduces the inlet circumferential velocity. For WV = 0.51 mm, αE further decreases to −0.07. Besides the design condition (α = 0.5), the engineered SB having LV = 4.6 mm, θ = 40 deg, and WV = 0.51 mm effectively reduces the circumferential velocity at the LS entrance for other inlet preswirl ratios equaling α = 0 and 1.3. Rather than relying on extensive experiments, the CFD analysis proves effective to quickly engineer a best SB configuration from the quantification of performance while varying the SB geometry and inlet swirl condition.
On the Experimental Dynamic Force Performance of a Squeeze Film Damper Supplied Through a Check Valve and Sealed With O-Rings
Authors: Andrés Luis San , Rodríguez Bryan 
Published: July 2021

Abstract
In rotor-bearing systems, squeeze film dampers (SFDs) assist to reduce vibration amplitudes while traversing a critical speed and also offer a means to suppress rotor instabilities. Along with an elastic support element, SFDs are effective means to isolate a rotor from its casing. O-rings (ORs), piston rings (PRs), and side plates as end seals reduce leakage and air ingestion while amplifying the viscous damping in configurations with limited physical space. ORs also add a centering stiffness and damping to a SFD. The paper presents experiments to quantify the dynamic forced response of an O-rings sealed ends SFD (OR-SFD) lubricated with ISO VG2 oil supplied at a low pressure (0.7 bar(g)). The damper is 127 mm in diameter (D), short in axial length L = 0.2D, and the film clearance c = 0.279 mm. The lubricant flows into the film land through a mechanical check valve and exits through a single port. Upstream of the check valve, a large plenum filled with oil serves to attenuate dynamic pressure disturbances. Multiple sets of single-frequency dynamic loads, 10 Hz to 120 Hz, produce circular centered orbits with amplitudes r =0.1c, 0.15c, and 0.2c. The experimental results identify the test rig structure, ORs, and SFD force coefficients, namely, stiffness (K), mass (M), and viscous damping (C). The ORs' coefficients are frequency independent and show a sizeable direct stiffness, KOR ∼ 50% of the test rig structure stiffness, along with a quadrature stiffness, K0 ∼ 0.26KOR, demonstrative of material damping. The lubricated system damping coefficient equals CL = (CSFD + COR); the ORs contributing 10% to the total. The experimental SFD damping and inertia coefficients are large in physical magnitude; CSFD slightly grows with orbit size, whereas MSFD is relatively constant. The added mass (MSFD) is approximately fourfold the bearing cartridge (BC) mass; hence, the test rig natural frequency drops by ∼50% once lubricated. A computational physics model predicts force coefficients that are just 10% lower than those estimated from experiments. The amplitude of measured dynamic pressures upstream of the plenum increases with excitation frequency. Unsuspectedly, during dynamic load operation, the check valve did allow for lubricant backflow into the plenum. Post-tests verification demonstrates that, under static pressure conditions, the check valve does work since it allows fluid flow in just one direction.
Current and sea level control the demise of shallow carbonate production on a tropical bank (Saya de Malha Bank, Indian Ocean)
Authors: Betzler Christian , Lindhorst Sebastian , Lüdmann Thomas , Reijmer John J. , Braga Juan-Carlos , Bialik Or M. , Reolid Jesus , Eisermann Jan Oliver , Emeis Kay , Rixen Tim , Bissessur Dass 
Published: July 2021

AbstractCarbonate platforms are built mainly by corals living in shallow light-saturated tropical waters. The Saya de Malha Bank (Indian Ocean), one of the world's largest carbonate platforms, lies in the path of the South Equatorial Current. Its reefs do not reach sea level, and all carbonate production is mesophotic to oligophotic. New geological and oceanographic data unravel the evolution and environment of the bank, elucidating the factors determining this exceptional state. There are no nutrient-related limitations for coral growth. A switch from a rimmed atoll to a current-exposed system with only mesophotic coral growth is proposed to have followed the South Equatorial Current development during the late Neogene. Combined current activity and sea-level fluctuations are likely controlling factors of modern platform configuration.