bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suppression of Combustion Oscillations in Hydrogen-Enriched Can-Type Combustors Through Fuel Staging
Authors: Jung Junwoo , Kim Daesik , Wang Yuangang , Park Soonbeen , Sohn Chae Hoon , Kim Minkuk , Hwang Jeongjae , Kang Dowon , Lee Wonjune , Kim Hanseok 
Published: August 2024

Abstract
To achieve decarbonization in power-generating gas turbines, the technology of mixing hydrogen with natural gas is garnering significant attention. However, when blending natural gas with hydrogen, the altered combustion characteristics can lead to combustion instability in gas turbine combustors. Although fuel staging can effectively suppress combustion instability for can-type combustors, further research on mitigation strategies for hydrogen cofiring and their predictive methods is required. This study involves hydrogen cofiring experiments using a full-scale can-type combustor. Moreover, the resulting suppression of combustion instability is analyzed through fuel staging by utilizing three-dimensional (3D) computational fluid dynamics (CFD) and one-dimensional (1D) thermo-acoustic analysis. The experiments used a full-scale industrial can-type combustor with a five-around-one nozzle configuration. Hydrogen was blended with natural gas up to a volume fraction of 30%, maintaining a constant thermal power. Fuel staging was applied by controlling two out of five outer nozzles (ONs) along with the remaining three. Before the 1D thermo-acoustic analysis, the internal flame structure of the combustor was examined through 3D CFD analysis. Based on the results, a multi-input multi-output (MIMO) system was constructed for 1D thermo-acoustic analysis of the can-type combustor. The application of time delays derived from 3D CFD analysis to the 1D model revealed that differences in flame time delays across the nozzles cause combustion instability suppression observed in fuel staging.
Cryolite as a Reference Mineral of Rare Metal Mineralization: An Experimental Study
Authors: Rusak A. A. , Shchekina T. I. , Zinovieva N. G. , Bychkov A. Y. , Lukanin O. A. 
Published: August 2024

Abstract
Phase relations and the distributions of rare earth elements (REE), Sc, Y, and Li between aluminofluoride and aluminosilicate melts in the model granite system Si–Al–Na–K–Li–F–O–H were experimentally studied at 700°C, 1 and 2 kbar, and water contents of 3 to 50 wt %. Our original and available literature experimental data on phase relations in the granite system saturated with water and fluorine and containing trace elements are compared with the mineral assemblages of rare-metal cryolite-bearing granites from the Zashikhinsky, Katugin, and Ulug-Tanzek deposits in eastern Siberia. Liquid immiscibility between granite and salt aluminofluoride melts, which occurs at high contents of fluorine and lithium in the system, is proved to facilitate the accumulation of rare elements in salt cryolite-like melts. At a temperature of 700°C and pressures of 1 and 2 kbar, aluminofluoride melt in the granite system crystallizes and forms cryolite. Fluorine-bearing minerals of trace and rare earth elements, such as pyrochlore and gagarinite, occur at these deposits in association with cryolite and lithium micas. Comparison of experimental data and natural observations provides arguments in support of the hypothesis that liquid immiscibility should play an important role in the formation of cryolite. Cryolite is thought to be able to serve as a reference mineral for rare metal-rare earth mineralization in granites with high lithium and fluorine content.
Voices of experience: what Dutch parents teach us about values and intuition in periviable decisions
Authors: de Boer Angret , De Proost Lien , de Vries Marieke , Hogeveen Marije , de Vries Martine C , Verweij E J T (Joanne) , Geurtzen Rosa 
Published: August 2024

Objective
When extremely premature birth at the limits of viability is imminent, shared decision-making with parents regarding the infant’s treatment is widely recommended. Aligning decisions with parental values can be challenging. So, this study aims to get insight into (1) what values parents considered important in their decision, (2) whether their decision was based on intuition and/or rational analysis and (3) parental suggestions on how to help explore and articulate values during prenatal counselling.

Design
A qualitative study was performed among Dutch parents who experienced (imminent) extremely premature birth. Diversity was aimed for through purposive sampling. Semistructured interviews were conducted until saturation was achieved. Transcripts were coded and themes were derived from the data.

Results
Nineteen interviews were performed. Results show what parents considered important in their decision, such as the infants’ future, family life and ‘giving a chance’. Most parents made their decision more intuitively rather than rationally, for others both coexisted. Particularly fathers and parents who opted for palliative comfort care experienced the decision as rational. Parents would have liked to explore values, but found it challenging. They suggested strategies and conditions to help explore and articulate their values during counselling, such as a multidisciplinary approach.

Conclusions
Various considerations and underlying values were found to be important. Parents recognise the influence of emotions and intuition in decision-making and struggle to articulate their values, emphasising the need for guidance. Healthcare providers should engage in open, personalised discussions to facilitate value exploration, enabling informed decisions aligned with parental values.
Task-sharing spinal anaesthesia care in three rural Indian hospitals: a non-inferiority randomised controlled clinical trial
Authors: Menon Nandakumar , George Regi , Kataria Raman , Manoharan Ravi , Brooks Meredith B. , Pendleton Alaska , Sheshadri Veena , Chatterjee Sudarshana , Rajaleelan Wesley , Krishnan Jithen , Sandler Simone , Saluja Saurabh , Ljungman David , Raykar Nakul , Svensson Emma , Wasserman Isaac , Zorigtbaatar Anudari , Jesudian Gnanaraj , Afshar Salim , Meara John G , Peters Alexander W , McClain Craig D 
Published: August 2024

BackgroundTask-sharing of spinal anaesthesia care by non-specialist graduate physicians, termed medical officers (MOs), is commonly practised in rural Indian healthcare facilities to mitigate workforce constraints. We sought to assess whether spinal anaesthesia failure rates of MOs were non-inferior to those of consultant anaesthesiologists (CA) following a standardised educational curriculum.MethodsWe performed a randomised, non-inferiority trial in three rural hospitals in Tamil Nadu and Chhattisgarh, India. Patients aged over 18 years with low perioperative risk (ASA I & II) were randomised to receive MO or CA care. Prior to the trial, MOs underwent task-based anaesthesia training, inclusive of remotely accessed lectures, simulation-based training and directly observed anaesthetic procedures and intraoperative care. The primary outcome measure was spinal anaesthesia failure with a non-inferiority margin of 5%. Secondary outcome measures consisted of incidence of perioperative and postoperative complications.FindingsBetween 12 July 2019 and 8 June 2020, a total of 422 patients undergoing surgical procedures amenable to spinal anaesthesia care were randomised to receive either MO (231, 54.7%) or CA care (191, 45.2%). Spinal anaesthesia failure rate for MOs (7, 3.0%) was non-inferior to those of CA (5, 2.6%); difference in success rate of 0.4% (95% CI=0.36–0.43%; p=0.80). Additionally, there were no statistically significant differences observed between the two groups for intraoperative or postoperative complications, or patients’ experience of pain during the procedure.InterpretationThis study demonstrates that failure rates of spinal anaesthesia care provided by trained MOs are non-inferior to care provided by CAs in low-risk surgical patients. This may support policy measures that use task-sharing as a means of expanding anaesthesia care capacity in rural Indian hospitals.Trial registration numberNCT04438811.
Multimorbidity and adverse outcomes following emergency department attendance: population based cohort study
Authors: Blayney Michael C , Reed Matthew J , Masterson John A , Anand Atul , Bouamrane Matt M , Fleuriot Jacques , Luz Saturnino , Lyall Marcus J , Mercer Stewart , Mills Nicholas L , Shenkin Susan D , Walsh Timothy S , Wild Sarah H , Wu Honghan , McLachlan Stela , Guthrie Bruce , Lone Nazir I 
Published: August 2024

ObjectivesTo describe the effect of multimorbidity on adverse patient centred outcomes in people attending emergency department.DesignPopulation based cohort study.SettingEmergency departments in NHS Lothian in Scotland, from 1 January 2012 to 31 December 2019.ParticipantsAdults (≥18 years) attending emergency departments.Data sourcesLinked data from emergency departments, hospital discharges, and cancer registries, and national mortality data.Main outcome measuresMultimorbidity was defined as at least two conditions from the Elixhauser comorbidity index. Multivariable logistic or linear regression was used to assess associations of multimorbidity with 30 day mortality (primary outcome), hospital admission, reattendance at the emergency department within seven days, and time spent in emergency department (secondary outcomes). Primary analysis was stratified by age (<65 v≥65 years).Results451 291 people had 1 273 937 attendances to emergency departments during the study period. 43 504 (9.6%) had multimorbidity, and people with multimorbidity were older (median 73v43 years), more likely to arrive by emergency ambulance (57.8%v23.7%), and more likely to be triaged as very urgent (23.5%v9.2%) than people who do not have multimorbidity. After adjusting for other prognostic covariates, multimorbidity, compared with no multimorbidity, was associated with higher 30 day mortality (8.2%v1.2%, adjusted odds ratio 1.81 (95% confidence interval (CI) 1.72 to 1.91)), higher rate of hospital admission (60.1%v20.5%, 1.81 (1.76 to 1.86)), higher reattendance to an emergency department within seven days (7.8%v3.5%, 1.41 (1.32 to 1.50)), and longer time spent in the department (adjusted coefficient 0.27 h (95% CI 0.26 to 0.27)). The size of associations between multimorbidity and all outcomes were larger in younger patients: for example, the adjusted odds ratio of 30 day mortality was 3.03 (95% CI 2.68 to 3.42) in people younger than 65 years versus 1.61 (95% CI 1.53 to 1.71) in those 65 years or older.ConclusionsAlmost one in ten patients presenting to emergency department had multimorbidity using Elixhauser index conditions. Multimorbidity was strongly associated with adverse outcomes and these associations were stronger in younger people. The increasing prevalence of multimorbidity in the population is likely to exacerbate strain on emergency departments unless practice and policy evolve to meet the growing demand.
Evidence on psychometric properties of self-report questionnaires in evaluating blended learning in health sciences university students: research protocol for systematic review and meta-analysis
Authors: Dones Valentin C , Dalusong Ma Teresita B , Manlapaz Donald , Rojas Juan Alfonso , Ho Kaela Celine , Reyes Jose Joaquin , Sangatanan Lianna Bartolo , Narcelles Audrey Marie , Ballesteros Ma Bianca Beatriz P , Flores Ron Kevin Santos , Monreal Jose Angelo 
Published: August 2024

IntroductionDue to the COVID-19 outbreak, schools had to switch online. As universities ease face-to-face (F2F) schooling, blended teaching and learning (BTL) enables the continuous delivery of education. However, the sudden transition to BTL poses challenges for students and teachers, especially for health sciences programmes that require hands-on practical experience. Several studies have evaluated F2F teaching and learning contexts through student feedback and evaluations. However, there needs to be more reliable and valid self-report questionnaires that focus on the perceptions and experiences of students experiencing BTL. This study will critically appraise, compare and summarise the quality of self-report questionnaires evaluating BTL among health science university students based on their psychometric properties.Methods and analysisA systematic review and meta-analysis design will be used. This review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and follow the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) standardised guidelines. 13 databases will be searched for studies reporting BTL self-report questionnaires as evaluation tools with their respective psychometric properties. Two independent reviewers will appraise the paper using the COSMIN risk of bias checklist and the quality of evidence of the psychometric properties of the relevant questionnaires will be assessed using the modified Grading of Recommendations Assessment, Development and Evaluation approach. Based on their psychometric properties, these assessments will comprehensively summarise and present the best recommendations for the most appropriate self-report questionnaires for BTL evaluation.Ethics and disseminationThe University of the Philippines’ Research Grants Administration Office exempted this research protocol from ethics review evaluation (protocol number UPMREB 2022–0259-EX) since this study will not collect individual data. The research protocol was registered with PROSPERO. The results will be disseminated through peer-reviewed journals and conferences to aid researchers and professionals in the field of health education to prudently choose effective self-report questionnaires evaluating blended learning.CRD42022372362.
Nutritional support in hospitalised patients with diabetes and risk for malnutrition: a secondary analysis of an investigator-initiated, Swiss, randomised controlled multicentre trial
Authors: Keller Bettina , Wunderle Carla , Tribolet Pascal , Stanga Zeno , Kaegi-Braun Nina , Mueller Beat , Schuetz Philipp 
Published: August 2024

ObjectivesThe main objective of this study was to investigate the effects of nutritional support on mortality in hospitalised patients with diabetes and nutritional risk participating in theEffect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial(EFFORT) trial.DesignSecondary analysis of a Swiss-wide multicentre, randomised controlled trial.ParticipantsPatients with diabetes and risk for malnutrition.InterventionsIndividualised nutritional support versus usual care.Primary outcome measure30-day all-cause mortality.ResultsOf the 2028 patients included in the original trial, 445 patients were diagnosed with diabetes and included in this analysis. In terms of efficacy of nutritional therapy, there was a 25% lower risk for mortality in patients with diabetes receiving nutritional support compared with controls (7% vs 10%, adjusted HR 0.75 (95% CI 0.39 to 1.43)), a finding that was not statistically significant but similar to the overall trial effects with no evidence of interaction (p=0.92). Regarding safety of nutritional therapy, there was no increase in diabetes-specific complications associated with nutritional support, particularly there was no increase in risk for hyperglycaemia (adjusted OR 0.97, 95% CI 0.56 to 1.67 p=0.90).ConclusionPatients with diabetes and malnutrition in the hospital setting have a particularly high risk for adverse outcomes and mortality. Individualised nutritional support reduced mortality in this secondary analysis of a randomized trial, but this effect was not significant calling for further large-scale trials in this vhighly ulnerable patient population.Trial registration numberNCT02517476.
Evaluation of the effectiveness of three different interventions on older driver safety over a 12-month period: study protocol for a randomised controlled trial
Authors: Hansen Abigail , Eramudugolla Ranmalee , Kiely Kim M , Delbaere Kim , Bédard Michel , Brown Julie , Clare Linda , Lung Thomas , Wood Joanne M , Anstey Kaarin J 
Published: August 2024

IntroductionThe growing population of older drivers presents challenges for road safety attributed to age-related declines and increased crash fatality rates. However, enabling older people to maintain their health and independence through continued safe driving is important. This study focuses on the urgent need for cost-effective interventions that reduce crash risk while supporting older drivers to remain driving safely for longer. Our study aims to evaluate the effectiveness of three behavioural interventions for older driver safety. These include an online road-rules refresher workshop, tailored feedback on driving performance and two tailored driving lessons.Methods and analysisA single-blind three-parallel group superiority randomised controlled trial will be conducted with 198 urban licensed drivers aged 65 years and older, allowing for 4% attrition. This sample size provides 80% power to detect a difference with an alpha of 0.05. Participants will be selected based on a standardised on-road test that identifies them as moderately unsafe drivers. Interventions, spanning a 3-month period, aim to improve driving safety. Their effectiveness will be assessed through a standardised on-road assessment of driving safety at 3 months (T1) and 12 months postintervention (T2). Additionally, monthly self-reported driving diaries will provide data on crashes and incidents.This trial has the potential to identify cost-effective approaches for improving safety for older drivers and contribute to evidence-based health policy, clinical practice and guidelines.Ethics and disseminationEthical approval was obtained by the University of New South Wales Human Research Ethics Committee (HC190439, 22 August 2019). The results of the study will be disseminated in peer-reviewed journals and research conferences.Trial registration numberACTRN12622001515785.
Aortic root enlargement versus stentless valve implantation for avoidance of patient-prosthesis mismatch in patients with small aortic root: protocol for a systematic review
Authors: Meneas Christophe , Voisine Pierre , Mestres Carlos , Sall Fatouma , Kabore Remi , N'guessan Anon , Yangni-Angate Herve , Mohammadi Siamak , Dagenais François 
Published: August 2024

IntroductionAvoiding patient-prosthesis mismatch (PPM) in patients with small aortic annulus (SAA) during aortic valve replacement (AVR) is still a challenging surgical problem. Among surgical options available, aortic root enlargement (ARE) and stentless valve implantation (SVI) are the two most commonly used strategies. This systematic review will be conducted searching for superiority evidence based on comparative studies between these two options.Methods and analysisThis systematic review will include all relevant articles published from 1 January 1946 to 31 March 2024, with available full texts from Medline (Ovid), Embase, Cochrane Library and Web of Science databases, without any language restriction. Observational studies and randomised controlled trials comparing surgical results of ARE versus SVI for AVR in patients with small aortic root will be screened. Studies will be classified into three groups: group 1 for studies that reported SVI or other tissue valve outcomes without comparing them with ARE outcomes; group 2 for studies that reported ARE outcomes without comparing them with SVI outcomes; and group 3 for studies that compared ARE outcomes with SVI outcomes. The quality of the evidence of each study will be evaluated according to Oxford Centre for Evidence-Based Medicine criteria.Ethics and disseminationEthical approval is not required because no primary data are collected. The findings will be presented at scientific conferences and/or reported in a peer-reviewed scientific journal.Trial registration numberPROSPERO, CRD42023383793.
Clinical manifestations and treatment outcomes among hospitalised COVID-19 patients in tertiary hospitals in Tanzania, 2021–2022: a retrospective cohort study
Authors: Osati Elisha Fred Otieno , Shayo Grace Ambrose , Sangeda Raphael Z , Nagu Tumaini Joseph , Moshiro Candida , Adams Naveeda , Ramadhani Athumani , Wajanga Bahati , Muniko Albert , Seni Jeremiah , Nicholaus Mary A , Nyaisonga Gervas , Mbije Christian , Meda John Robson , Rainer Denis , Nkya Martha Elisande , Mhame Paulo , Samwel Lucy , Vumilia Liggyle , Shekalaghe Seif , Kilonzo Kajiru G , Makubi Abel 
Published: August 2024

BackgroundThere have been differential mortality rates from COVID-19 in different parts of the world. It is not clear whether the clinical presentation does also differ, thus the need for this study in a sub-Saharan African setting. The aim of this study was to describe the clinical manifestations and outcomes of patients diagnosed with COVID-19 in selected tertiary hospitals in Tanzania.MethodsThis was a retrospective analysis of hospitalised adults confirmed SAR-COV-2 infection in five tertiary-level hospitals in Tanzania. Data collected and analysed included sociodemographic, radiological and clinical characteristics of the patients as well as the outcome of the admission (discharge vs death).ResultsOut of 1387 COVID-19 patients, 52% were males. The median age was 60 years ((IQR)=(19–102)). The most common symptoms were dyspnoea (943,68%), cough (889, 64%), fever (597,43%) and fatigue (570, 41%). In-hospital mortality was (476, 34%). Mortality significantly increased with increasing age, being the most in age >90 years (aHR (95% CI)=4.4 (2.52 to 28.82), p=0.02). Other predictors of mortality were not possessing a health insurance, (aHR (95% CI)=3.7 (1.09 to 14.25), p=0.04); chest pain, (aHR (95% CI)=2.27 (1.36 to 4.13), p=0.03); HIV positivity, (aHR (95% CI)=3.9 (1.46 to 8.15), p=0.03); neutrophilia, (aHR (95% CI)=1.12 (1.01 to 2.65), p=0.03); no use of ivermectin, (aHR (95% CI)=1.21 (1.04 to 1.57), p=0.04) and non-use of steroids, (aHR (95% CI)=1.36 (1.18 to 2.78), p=0.04). The retrospective nature of this study which based on documented patients’ records, with a large number of patients left out of the analysis due to missed data, this might in a way affect the results of the present study.ConclusionIn-hospital mortality was 34%. The independent predictors of mortality were advanced age, HIV infection, no possession of a health insurance, chest pain, neutrophilia and no use of steroids or ivermectin.