bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and Validation of a Pre-Swirl System in the Newly Developing Gas Turbine for Power Generation
Authors: Kim Donghwa , Lee Hyungyu , Lee Jungsoo , Cho Jinsoo 
Published: September 2018

To supply cooling air which delivered from turbine stationary parts to the rotational parts, pre-swirl system have been widely used in gas turbines with various shapes and types. The key functions of pre-swirl system is to provide turbine cooling temperature lower than pre-swirl system inlet within required pressure drop target. In modern gas turbine system, pre-swirl system is a key component in the turbine cooling system because first rotor entering flow qualities were defined by pre-swirl system. Especially most of modern blade cooling system were required adequate coolant pressure level to meet film cooling conditions and also need to keep lower level of temperature condition to improve cooling effectiveness in their cooling circuit.
To meet the design target, cooling system designer should built effective pre-swirl system by increase swirl ratio within required pressure margin. When the design results of pre-swirler system was satisfied initial design requirements, designer should select best pre-swirler system based on its discharge coefficient characteristics. To verify analytic methodologies, to compare main design parameters of this research and former studies which reference data already validated analytically and experimentally.
To find best pre-swirl nozzles shape, total 15 kinds of airfoil was selected for detail investigation. Best available was selected by pre-swirl performance comparing. Also shape optimization was applied to improve pre-swirl performance within minor geometrical changes within mechanical integration limit.
To verify inlet duct system effects, the effect of the inlet duct shape was added on to verify desired pre-swirl system. To find the best model, case study was conducted by CFD approaches to increase the discharge coefficient and the adiabatic effectiveness of the pre-swirl system.
New pre-swirl test rig was construct to verify pre-swirl characteristics and to find best pre-swirl nozzles shape. Discharge coefficients of the tested data was relatively higher than 3-D CFD results due to the pre-swirl inlet conditions was relatively fair in test rig compared with real gas turbine conditions.
A molecular phylogenetic hypothesis for the Asian agamid lizard genus Phrynocephalus reveals discrete biogeographic clades implicated by plate tectonics
Authors: MACEY J. ROBERT , SCHULTE JAMES A. II , ANANJEVA NATALIA B. , DYKE ERIK T. VAN , WANG YUEZHAO , ORLOV NIKOLAI , SHAFIEI SOHEILA , ROBINSON MICHAEL D. , DUJSEBAYEVA TATJANA , FREUND GABRIEL S. , FISCHER CLAYTON M. , LIU DAVID , PAPENFUSS THEODORE J. 
Published: September 2018

Phylogenetic relationships of the agamid lizard genus Phrynocephalus are described in the context of plate tectonics. A near comprehensive taxon sampling reports three data sets: (1) mitochondrial DNA from ND1 to COI (3’ end of ND1, tRNAGln, tRNAIle, tRNAMet, ND2, tRNATrp, tRNAAla, tRNAAsn, tRNACys, tRNATyr, and the 5’ end of COI) with 1761 aligned positional sites (1595 included, 839 informative), (2) nuclear RAG-1 DNA with 2760 aligned positional sites (342 informative), and (3) 25 informative allozyme loci with 213 alleles (107 informative when coded as presence/absence). It is hypothesized that Phrynocephalus phyletic patterns and speciation reflect fault lines of ancient plates now in Asia rejuvenated by the more recent Indian and Arabian plate collisions. Molecular estimates of lineage splits are highly congruent with geologic dates from the literature. A southern origin for the genus in Southwest Asia is resolved in phylogenetic estimates and a northern origin is statistically rejected. On the basis of monophyly and molecular evidence several taxa previously recognized as subspecies are recognized as species: P. hongyuanensis, P. sogdianus, and P. strauchi as “Current Status”; Phrynocephalus bannikovi, Phrynocephalus longicaudatus, Phrynocephalus turcomanus, and Phrynocephalus vindumi are formally “New Status”. Phylogenetic evaluation indicates a soft substrate habitat of sand for the shared ancestor of modern Phrynocephalus. Size diversity maximally overlaps in the Caspian Basin and northwestern Iranian Plateau. The greatest species numbers of six in sympatry and regional allopatry are found in the southern Caspian Basin and southern Helmand Basin, both from numerous phylogenetic lineages in close proximity attributed to tectonic induced events.
A mixed-methods study to identify factors associated with MenACWY vaccine uptake, barriers and motivations towards vaccination among undergraduate students
Authors: Trayner Kirsten MA , Anderson Niall , Cameron J Claire 
Published: September 2018

Background: In response to an outbreak of severe meningococcal disease caused by serogroup W, the UK introduced the meningococcal ACWY (MenACWY) for adolescents and new university students as a control measure. Objective: To estimate MenACWY vaccine uptake and identify factors associated with uptake, barriers and motivations towards vaccination among university students. Design: Mixed methods including a cross-sectional survey, 7 interviews and 1 focus group. Setting: A Scottish university between April and May 2016. Methods: Inclusion criteria were <25 years and attending university for the first time (MenACWY eligible). All first-year undergraduates ( n = 5,808) were invited to take part in the survey via email, and qualitative participants were recruited through the survey. The final sample consisted of 768 students, representing 13% (768/5,808) of the target population. Results: MenACWY uptake among the sample was 71.5% (549/768). Older students (22–24 years) were less likely than younger students (18 years) to have been vaccinated [adjusted odds ratio (aOR) = 0.21; 95% confidence interval (CI) = 0.06–0.77], and male students were less likely to be vaccinated than female students (aOR = 0.667; 95% CI = 0.45–0.96). In comparison to international students, domestic students had a significantly higher odds of vaccination (aOR = 3.89; 95% CI = 2.64–5.72). Communication barriers were most frequently identified as reasons for non-vaccination. Most vaccination occurred before starting university (76.7%, 421/549), highlighting access barriers. Meningococcal disease knowledge was low; a significant association ( p < 0.001) was found between knowledge and vaccination uptake. Some participants were unaware of their vaccination history. They perceived meningococcal disease as severe, but disease risk as low. Key motivations were knowledge of the benefits of vaccines, influence of others and social responsibility. Conclusion: Students outside main UK-based, core age cohorts were under-immunised and focused efforts are needed to improve vaccination rates. Future student vaccination programmes could focus on raising awareness of the serious implications of meningococcal disease. Additional benefit may be gained from emphasising the benefits of vaccinations for society as a whole.
High-intensity interval walking in combination with acute green tea extract supplementation reduces postprandial blood glucose concentrations in physically inactive participants
Authors: Bulmer Joseph M , McBain Thomas R , Peart Daniel J 
Published: September 2018

Background: Exercise and green tea supplementation have been shown to have the potential to improve postprandial blood glucose concentrations, but past interventions have not often investigated attainable and time effective exercise protocols. Aim: The purpose of this study was to investigate the effects of interval walking exercise and acute green tea extract supplementation on the glycaemic response to an oral glucose tolerance test (OGTT). Method: Twelve physically inactive participants (nine male, three female, age: 22 ± 1 years; body mass: 81.2 ± 16.3 kg; stature: 175.7 ± 9.6 cm; body mass index (in kg/m2): 26.2 ± 4.3) underwent a 2-h OGTT immediately following i) no intervention (REST), ii) placebo and exercise (EX-PLAC), iii) green tea extract supplementation and exercise (EX-GTE), in a random order. The walking exercise consisted of 6 × 1 min of brisk walking (7.92 ± 0.56 km/h) separated by 1 min of slower walking (4.8 km/h). Differences between groups were identified using magnitude-based inferences. Results: The EX-GTE intervention resulted in a ∼9% most likely beneficial effect on blood glucose area under the curve response to the OGTT (702.18 ± 76.90 mmol/L–1·120 min–1) compared with REST (775.30 ± 86.76 mmol/L–1·120 min–1), and a very likely beneficial effect compared with the EX-PLAC (772.04 ± 81.53 mmol/L–1·120 min–1). Conclusion: These data suggest that an EX-GTE intervention can reduce postprandial glucose concentrations in physically inactive individuals.
Use of veno-venous extracorporeal membrane oxygenation to treat severe combined calcium channel blocker and angiotensin converting enzyme inhibitor overdose
Authors: Haughey Ryan , Vernick William , Gutsche Jacob , Laudanski Krzysztof 
Published: September 2018

Introduction: Calcium channel blockers (CCBs) are a commonly prescribed medication that, at toxic levels, are capable of causing severe refractory hypotension, hypoxic respiratory failure and cardiotoxicity. There is little evidence currently guiding the approach to managing CCB overdose, particularly when combined with other antihypertensive agents. Case report: We describe the use of veno-venous extracorporeal membrane oxygenation (VV ECMO) in a previously healthy man following combined overdose with amlodipine and lisinopril in a suicide attempt. ECMO was used to provide oxygenation support, allowing for the amlodipine and lisinopril to be metabolized and cleared while also reducing ventilator-induced lung injury (VILI) and avoiding the complications associated with venous-arterial (VA) ECMO, such as differential hypoxemia. Conclusion: Limited case reports suggesting the use of ECMO in CCB overdose have employed VA ECMO due to CCB-induced cardiotoxicity. We believe that, if cardiac function has been preserved, VV ECMO should be considered a viable treatment strategy for CCB and ACE-I overdose resulting in refractory hypoxemic respiratory failure.
Increased Early Revision Rate With the INFINITY Total Ankle Prosthesis
Authors: Cody Elizabeth A. , Taylor Michel A. , Nunley James A. , Parekh Selene G. , DeOrio James K. 
Published: September 2018

Background: A number of new 2-component total ankle arthroplasty systems that emphasize minimal bone resection have been introduced for which few clinical outcomes reports are available. Our aim was to identify the rate of early revision among patients receiving the 2-component INFINITY prosthesis. Methods: Patients from 2 prospectively collected databases at the authors’ institution were screened for inclusion in the present study. All patients who underwent a primary total ankle arthroplasty (TAA) with the INFINITY prosthesis and who were at least 1 year postoperative were included. A total of 159 ankles with a mean 20 months of follow up (range, 12-37) met these criteria. All surgeries were performed by 1 of 2 orthopedic foot and ankle surgeons with extensive experience in TAA. The primary outcome was the need for revision surgery, defined as removal of 1 or both metal components. Peri-implant lucency at most recent follow-up was a secondary outcome. Weightbearing radiographs at most recent follow-up were graded for lucency independently by 2 reviewers. Results: Sixteen ankles (10%) underwent revision at a mean 13 months postoperatively. The most common reasons for revision were symptomatic tibial component loosening and deep infection (6 patients each, 3.8%). Of the 108 ankles with retained components and at least 1 year of radiographic follow-up, 8 (7.4%) had global lucency around the tibial component suggestive of loosening at most recent follow-up. Conclusions: Our initial review of patients undergoing TAA with this new 2-component prosthesis demonstrates an elevated early revision rate due to tibial component loosening compared to other implant systems. Level of Evidence: Level IV, case series.
A randomized trial of the efficacy and safety of azilsartan medoxomil combined with chlorthalidone
Authors: Weber Michael A , Sever Peter , Juhasz Attila , Roberts Andrew , Cao Charlie 
Published: September 2018

Introduction: We measured the effects of azilsartan medoxomil co-administered with chlorthalidone 25 mg in stage 2 hypertension. Methods: Azilsartan medoxomil 40 or 80 mg plus chlorthalidone were compared with placebo plus chlorthalidone once daily in a randomized, double-blind, 6-week trial. The primary endpoint was change from baseline in 24-hour mean systolic blood pressure by ambulatory blood pressure monitoring. Results: Patients ( N=551; mean age 59 years; 51.7% men) were randomly assigned to placebo plus chlorthalidone ( n=184), azilsartan medoxomil 40 mg plus chlorthalidone ( n=185), or azilsartan medoxomil 80 mg plus chlorthalidone ( n=182). Baseline systolic blood pressures were similar among groups. After 6 weeks, least squares mean (standard error) reductions with azilsartan medoxomil 40 mg and 80 mg plus chlorthalidone were similar in magnitude (−31.7 (1.0) and −31.3 (1.0) mmHg, respectively), but greater than chlorthalidone alone (−15.9 (1.0) mmHg). Hypotension and serum creatinine elevations were more frequent with azilsartan medoxomil plus chlorthalidone than chlorthalidone alone (reversed with drug discontinuation). Notably, plasma potassium reduction of 0.43 meq/L with chlorthalidone was attenuated to 0.13 and 0.05 meq/L by azilsartan medoxomil 40 mg and 80 mg, respectively. Conclusion: Azilsartan medoxomil 40 mg or 80 mg plus chlorthalidone 25 mg was significantly more efficacious than chlorthalidone alone in reducing blood pressure and was well tolerated. Clinicaltrial.gov , https://clinicaltrials.gov/ct2/show/NCT00591773 , NCT00591773
Updates on managing advanced breast cancer with palbociclib combination therapy
Authors: McShane Teresa M. , Wolfe Thomas A. , Ryan Joanne C. 
Published: September 2018

Background: The objective of this study was to review the pharmacology, efficacy, and safety of palbociclib, a first-in-class cyclin-dependent kinase 4/6 inhibitor, for the management of advanced breast cancer (ABC). Methods: Pharmacokinetics and drug interactions associated with palbociclib are described. Recent clinical trial data are reviewed, including patient-reported outcomes and subgroup analyses. Results: Palbociclib is indicated in combination with an aromatase inhibitor as initial endocrine therapy (ET) or with fulvestrant for patients with disease progression following ET for hormone receptor positive, human epidermal growth factor receptor 2 negative ABC or metastatic breast cancer. Palbociclib inhibits cyclin-dependent kinases 4/6, resulting in a blockade of phosphorylation of the retinoblastoma protein, which hinders the activation of transcription factors involved in S-phase entry, thereby arresting cell cycle progression at G1 phase. The efficacy and safety of palbociclib in combination with ET was established in three randomized trials (PALOMA-1, -2, and -3); all studies met their primary endpoint of significantly prolonging investigator-assessed progression-free survival versus ET alone. Findings were similar in subgroup analyses of the three PALOMA studies. Palbociclib plus ET also maintained health-related quality of life (QoL) compared with ET alone in PALOMA-2 and -3. A long-term safety profile for palbociclib, up to 3 years, has been established. Neutropenia, the most common any-grade and grade 3 or higher adverse event associated with palbociclib, is consistent with the drug’s mechanism of action and can be effectively managed with dose interruption, dose reduction, or delay in starting treatment cycles. Conclusions: Palbociclib in combination with ET improved progression-free survival and QoL in patients with ABC, including in several patient subgroups.
Key factors to consider when measuring multimorbidity
Authors: Griffith Lauren E , Gruneir Andrea , Fisher Kathryn A , Nicholson Kathryn , Panjwani Dilzayn , Patterson Christopher , Markle-Reid Maureen , Ploeg Jenny , Bierman Arlene S , Hogan David B , Upshur Ross 
Published: September 2018

Background: There are multiple multimorbidity measures but little consensus on which measures are most appropriate for different circumstances. Objective: To share insights gained from discussions with experts in the fields of ageing research and multimorbidity on key factors to consider when measuring multimorbidity. Design: Descriptive study of expert opinions on multimorbidity measures, informed by literature to identify available measures followed by a face-to-face meeting and an online survey. Results: The expert group included clinicians, researchers and policymakers in Canada with expertise in the fields of multimorbidity and ageing. Of the 30 experts invited, 15 (50%) attended the in-person meeting and 14 (47%) responded to the subsequent online survey. Experts agreed that there is no single multimorbidity measure that is suitable for all research studies. They cited a number of factors that need to be considered in selecting a measure for use in a research study including: (1) fit with the study purpose; (2) the conditions included in multimorbidity measures; (3) the role of episodic conditions or diseases; and (4) the role of social factors and other concepts missing in existing approaches. Conclusions: The suitability of existing multimorbidity measures for use in a specific research study depends on factors such as the purpose of the study, outcomes examined and preferences of the involved stakeholders. The results of this study suggest that there are areas that require further building out in both the conceptualization and measurement of multimorbidity for the benefit of future clinical, research and policy decisions.
New drugs in thoracic oncology: needs and knowledge – an online ERS Lung Cancer Assembly survey
Authors: Berghmans Thierry , Evison Matthew , Blum Torsten Gerriet , Peled Nir , Cadranel Jacques 
Published: September 2018

In the last decade, systemic therapy for advanced lung cancer has become diverse, complex and personalised. These new therapies (monoclonal antibodies, tyrosine kinase inhibitors (TKIs) and immunotherapy) have a far different toxicity profile compared to chemotherapy. Furthermore, clinical indications and reimbursement criteria can vary across Europe. The aim of the present online survey was to assess the knowledge, views and challenges facing the European respiratory community in this rapidly changing field.A 15-question web survey was sent to all European Respiratory Society members through the Society's monthly electronic communication.A total of 315 questionnaires were completed. Most of the respondents were male (59.1%), were above 40 years of age (52.9%) and were working in university/academic hospitals (74.8%), the majority as pulmonologists (90%). Only 55% of the participants were aware of the legal processes for drug recognition. Except for epidermal growth factor receptor TKI, up to 38% did not know about the specific toxicities of anaplastic lymphoma kinase/ROS proto-oncogene 1 TKIs, monoclonal antibodies and immune checkpoint inhibitors. Of the respondents, 92% showed an interest in an online platform reporting new drugs' toxicities.Despite a large amount of publicity and integration of new drugs into therapeutic algorithms and clinical guidelines, physicians taking care of lung cancer patients have a need for up-to-date information on systemic therapy toxicity management and legal constraints.
The Reading the Mind in the Eyes Test: A Portuguese version of the adults’ test
Authors: Pestana José , Menéres Sofia , Gouveia Maria João , Oliveira Rui Filipe 
Published: September 2018

O Reading the Mind in the Eyes Test (RMET) é uma tarefa de Teoria da Mente utilizada para avaliar a capacidade de compreender estados mentais de terceiros, tanto em populações normativas como clínicas. O presente estudo teve como objectivo traduzir para Português (Europeu) a versão adulta revista do RMET, investigar a validade dos itens desta versão e diferenças associadas ao género. A versão revista Inglesa foi traduzida para Português e foram realizados 5 estudos piloto de forma a chegar a uma versão final Portuguesa do teste. Após estes procedimentos, 130 participantes adultos (71 mulheres) responderam a uma versão computorizada do RMET. Trinta itens mostraram uma distribuição de respostas adequada, enquanto os restantes seis itens não foram de encontro aos critérios de validação interna considerados. As médias das pontuações obtidas nesta versão do RMET foram semelhantes às conseguidas tanto na versão original revista do teste como noutras traduções. Não foram observadas nesta amostra diferenças significativas entre géneros. Investigações futuras deverão explorar indicadores adicionais de validade e fiabilidade deste instrumento.
Sepsis in a Child with Foreign Magnetic Bodies: Clinical Case
Authors: Bocharov R. V. 
Published: September 2018

The purpose of the study. To describe a clinical case of sepsis in a child due to accidental ingestion of magnetic objects.Materials and methods. Medical records of a 3-year-old patient were analyzed. Clinical presentation of diffuse purulent peritonitis was found at admission. Sepsis was diagnosed according to age-specific criteria, laboratory test findings, evidence of infection and organ dysfunction.Results. During the surgery, diffuse fecal peritonitis was found, which had been caused by 9 unidentified magnetic foreign objects found in the intestinal lumen. The postoperative period had a severe course accompanied by developing cardiovascular, respiratory, and intestinal multiple organ failure..Conclusion. In young children, foreign magnetic bodies can damage the gastrointestinal tract.
Timing and Duration of Pre- and Postnatal Homelessness and the Health of Young Children
Authors: Sandel Megan , Sheward Richard , Ettinger de Cuba Stephanie , Coleman Sharon , Heeren Timothy , Black Maureen M. , Casey Patrick H. , Chilton Mariana , Cook John , Cutts Diana Becker , Rose-Jacobs Ruth , Frank Deborah A. 
Published: September 2018

OBJECTIVES:
Prenatal homelessness is associated with elevated risks of adverse neonatal outcomes. How the timing and duration of homelessness during pregnancy and/or a child’s early life relate to postnatal child health is unclear.

METHODS:
We interviewed 20 571 low-income caregivers of children &lt;4 years old in urban pediatric clinics and/or emergency departments in 5 US cities. Categories of homelessness timing were prenatal, postnatal, both, or never; postnatal duration was &gt;6 months or &lt;6 months.

RESULTS:
After controlling for birth outcomes and other potential confounders, compared with never-homeless children, children who were homeless both pre- and postnatally were at the highest risk of the following: postneonatal hospitalizations (adjusted odds ratio [aOR] 1.41; confidence interval [CI] 1.18–1.69), fair or poor child health (aOR 1.97; CI 1.58–2.47), and developmental delays (aOR 1.48; CI 1.16–1.89). There was no significant association with risk of underweight (aOR 0.95; CI 0.76–1.18) or overweight status (aOR 1.07; CI 0.84–1.37). Children &lt;1 year old with &gt;6 months of homelessness versus those who were never homeless had high risks of fair or poor health (aOR 3.13; CI 2.05–4.79); children 1 to 4 years old who were homeless for &gt;6 months were at risk for fair or poor health (aOR 1.89; CI 1.38–2.58).

CONCLUSIONS:
After controlling for birth outcomes, the stress of prenatal and postnatal homelessness was found to be associated with an increased risk of adverse pediatric health outcomes relative to those who were never homeless. Interventions to stabilize young families as quickly as possible in adequate and affordable housing may result in improved pediatric health outcomes.