bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using SWARA II for Subjective Evaluation of Transport Emissions Reduction Policies
Authors: Keshavarz-Ghorabaee Mehdi 
Published: November 2023

Background:
Transportation is a significant contributor to greenhouse gas emissions, necessitating the implementation of effective policies to mitigate its environmental impact. The use of Multi-Criteria Decision-Making (MCDM) methods is crucial for evaluating policies that aim to reduce transport emissions and for assigning importance or prioritization to various options. These techniques are valuable because they allow for unbiased and thorough evaluations of policies in a systematic way.

Objective:
This study aims to address the evaluation of transport emissions reduction policies, while considering varying levels of budget constraints.

Methods:
An MCDM technique, called SWARA II (Stepwise Weight Assessment Ratio Analysis II), is presented to evaluate the effectiveness of different policies across three budget scenarios. This study provides a framework for addressing the challenges associated with transport emissions reduction policies.

Results:
The evaluation results show that at a low and medium-budget level mode, increasing active and public transport trip share and reducing trip demand could be a feasible policy for implementation. As a result of the analyses, the weight of this criterion is 0.207 at the low-budget level and 0.204 at the medium-budget level. Moreover, switching from fossil-fuelled vehicles to low or zero-emission vehicles is a suitable policy at the high-budget level. This criterion has a weight of 0.247, according to the results.

Conclusion:
This study offers insights into the evaluation of transport emissions reduction policies while considering the impact of varying budget levels. The findings contribute to the development of informed policy strategies that optimize emission reduction efforts within financial constraints.
Diabetes Distress and Associations With Demographic and Clinical Variables: A Nationwide Population-Based Registry Study of 10,186 Adults With Type 1 Diabetes in Norway
Authors: Hernar Ingvild , Cooper John G. , Nilsen Roy M. , Skinner Timothy C. , Strandberg Ragnhild B. , Iversen Marjolein M. , Graue Marit , Ernes Tony , Løvaas Karianne F. , Madsen Tone V. , Lie Silje S. , Richards David A. , Ueland Grethe Å. , Haugstvedt Anne 
Published: November 2023

OBJECTIVE
To estimate diabetes distress prevalence and associations with demographic and clinical variables among adults with type 1 diabetes in Norway.

RESEARCH DESIGN AND METHODS
In this nationwide population-based registry study, the 20-item Problem Areas in Diabetes (PAID-20) questionnaire was sent to 16,255 adults with type 1 diabetes. Linear regression models examined associations of demographic and clinical variables with distress.

RESULTS
In total, 10,186 individuals (62.7%) completed the PAID-20, with a mean score of 25.4 (SD 18.4) and 21.7% reporting high distress. Respondents endorsed worrying about the future and complications as the most problematic item (23.0%). Female sex, younger age, non-European origin, primary education only, unemployment, smoking, continuous glucose monitoring use, more symptomatic hypoglycemia, reduced foot sensitivity, treated retinopathy, and higher HbA1c were associated with higher distress.

CONCLUSIONS
Diabetes distress is common among adults with type 1 diabetes and associated with clinically relevant factors, underlining that regular care should include efforts to identify and address distress.
The Acute Effects of Real-World Physical Activity on Glycemia in Adolescents With Type 1 Diabetes: The Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) Study
Authors: Riddell Michael C. , Gal Robin L. , Bergford Simon , Patton Susana R. , Clements Mark A. , Calhoun Peter , Beaulieu Lindsey C. , Sherr Jennifer L. 
Published: November 2023

OBJECTIVE
Data from the Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) study were evaluated to understand glucose changes during activity and identify factors that may influence changes.

RESEARCH DESIGN AND METHODS
In this real-world observational study, adolescents with type 1 diabetes self-reported physical activity, food intake, and insulin dosing (multiple-daily injection users) using a smartphone application. Heart rate and continuous glucose monitoring data were collected, as well as pump data downloads.

RESULTS
Two hundred fifty-one adolescents (age 14 ± 2 years [mean ± SD]; HbA1c 7.1 ± 1.3% [54 ± 14.2 mmol/mol]; 42% female) logged 3,738 activities over ∼10 days of observation. Preactivity glucose was 163 ± 66 mg/dL (9.1 ± 3.7 mmol/L), dropping to 148 ± 66 mg/dL (8.2 ± 3.7 mmol/L) by end of activity; median duration of activity was 40 min (20, 75 [interquartile range]) with a mean and peak heart rate of 109 ± 16 bpm and 130 ± 21 bpm. Drops in glucose were greater in those with lower baseline HbA1c levels (P = 0.002), shorter disease duration (P = 0.02), less hypoglycemia fear (P = 0.04), and a lower BMI (P = 0.05). Event-level predictors of greater drops in glucose included self-classified “noncompetitive” activities, insulin on board &gt;0.05 units/kg body mass, glucose already dropping prior to the activity, preactivity glucose &gt;150 mg/dL (&gt;8.3 mmol/L) and time 70–180 mg/dL &gt;70% in the 24 h before the activity (all P &lt; 0.001).

CONCLUSIONS
Participant-level and activity event-level factors can help predict the magnitude of drop in glucose during real-world physical activity in youth with type 1 diabetes. A better appreciation of these factors may improve decision support tools and self-management strategies to reduce activity-induced dysglycemia in active adolescents living with the disease.
Fuel Injector Requirements to Achieve Supercritical Flow at the Exit
Authors: Harris Zachary B. , Bittle Joshua A. , Agrawal Ajay K. 
Published: November 2023

Advanced engine designs and alternative fuels introduce the possibility of supercritical fuel injection in aviation gas turbines and diesel engines, as is already the case for many rocket engines. Previous studies have focused mainly on fuel–air mixing in the supercritical regime after injection. However, injector requirements to achieve supercritical flow at the exit have not been investigated systematically. In this study, supercritical flow in an injector is analyzed using computational fluid dynamics with a real gas model and fluid properties derived from Helmholtz equations of state. Three operational challenges are illustrated depending upon the fuel: 1) large decreases in pressure and temperature within the injector, 2) injector choking, and 3) supersonic expansion of the supercritical jet. These challenges are addressed by developing and validating a one-dimensional, nonisentropic model of supercritical flow in the injector. This reduced-order model can guide injector designs for different fuels and applications and help decouple the injector supercritical flow from that in the downstream chamber to significantly reduce the computational effort for fuel–air mixing simulations. Results show that larger-diameter injectors are generally required to achieve supercritical injection with a fuel energy injection rate per unit area matching that of a typical diesel injector.
Numerical Study of Circular-Cylinder Disturbance Generators with Rigid Splitter Plates
Authors: Jenkins Michael , Suresh Babu Arun Vishnu , Bryant Matthew , Gopalarathnam Ashok 
Published: November 2023

This paper describes the numerical study of oscillating circular cylinders with rigid splitter plates of different lengths. These geometries may be used as disturbance generators for the study of unsteady airfoils and wings operating in highly vortical flowfields. It has been shown that cylinders undergoing forced rotational oscillations at their natural shedding frequency can produce wakes with minimal deviation in cycle-to-cycle vortex strength and position. Adding a splitter plate allows these deviations to be reduced even further. We present cases for oscillating cylinders having splitter-plate lengths up to [Formula: see text] at a Reynolds number of 7600. Frequencies are maintained at the natural shedding frequency, and a rotational amplitude of 45 deg is used. Numerical simulations are performed using a two-dimensional unsteady Reynolds-averaged Navier–Stokes (RANS) code. Results are presented in the form of vorticity contours and cycle-averaged velocity profiles, as well as the dominant frequencies of cylinder lift force and downstream velocity angles. The results show that splitter-plate lengths shorter than [Formula: see text] adversely affect the ability to generate a coherent vortex wake due to shear layer roll-up near the trailing edge of the plate. Splitter plates longer than [Formula: see text] produced a reverse von Kármán wake with consistent cycle-to-cycle vortex shedding.
Issues Related to Children-Faced by Armed Forces Families When Caring for Patients in Palliative Care – A Qualitative Study
Authors: Butola Savita , Butola Damini 
Published: November 2023

Objectives:
Access to palliative care is limited, especially in rural India. Children needing care by palliative teams may themselves be patients, or siblings and children of patients. Armed forces families face characteristic lifestyle challenges – frequent transfers, living in difficult and remote areas, serving personnel staying apart from families for long periods – very different from issues faced by civilians. Military service increases the risk of psychosocial burden for serving personnel as well as families. Most depend on private and state medical services for palliative care so it is important for the palliative community to understand their issues. This study aimed to explore the issues related to children – faced by armed forces families when caring for patients in palliative care.

Material and Methods:
Qualitative study based on thematic analysis of semi-structured interviews with caregivers – either serving personnel or their dependents, in three centres.

Results:
Analysis of the 15 interviews showed that armed forces families face complex challenges related to children when caring for the palliative patient due to frequent movement, lack of paediatric palliative services in far-flung areas, disruption of the continuity of care, social isolation, language, and cultural barriers when living in non-native areas, inability to build and access family and community support and financial burden due to restrictive reimbursement policies.

Conclusion:
Although medical and administrative support within the organisation provides a cushion, wives have to manage alone in the father’s prolonged absence, and safety is a concern for children when living outside the campuses and serving personnel report guilt, anger, and helplessness at not being present when needed. Awareness of these issues can enable palliative workers to provide more meaningful support tailored to the needs of service families.
Criteria for the boundedness of a certain class of matrix operators from lpv into lqu
Authors: Temirkhanova A.M. , Beszhanova A.T. 
Published: November 2023

One of the main aims in the theory of matrices is to find necessary and sufficient conditions for the elements of any matrix so that the corresponding matrix operator maps continuously from one normed space into another one. Thus, it is very important to find the norm of the matrix operator, at least, to find upper and lower estimates of it. This problem in Lebesgue spaces of sequences in the general case is still open. This paper deals with the problem of boundedness of matrix operators from lpv into lqu for 1 < q < p < ∞, and we obtain necessary and sufficient conditions of this problem when matrix operators belong to the classes O2+- satisfying weaker conditions than Oinarov’s condition.
The Role of Spiritual Unit (Chaplaincy) in The Development of Islamization of Health Management in Al-Islam Specialist Hospital, Kuala Lumpur
Authors: Mohamad Shafi Surina , Awang Mohd Zulkifli , Mas’ud Ishak , Amir Ramli Nurul Aisyah 
Published: November 2023

This paper discussed the role of the Spiritual Unit (Chaplaincy) of Al-Islam Specialist Hospital to implement the process of Islamization of health management in the administration. The study will unravel the history and the role of Spiritual Unit (Chaplaincy) on the development of hospital staff as well as the contribution to other health sectors. This research is using qualitative research methods where the research is founded on a comprehensive study of current literature on Muslim chaplaincy and Islamization in healthcare management. Important reviews of these literature studies have resulted in the study that found the role of the Spiritual Unit (Chaplaincy), Al-Islam Specialist Hospital has successfully strengthened the hospital management journey in implementing da’wah bil hal through the concept of Ibadah Friendly Hospital (IFH) and successfully left an impact on health management through the Islamization process that has been implemented. Thus, the Spiritual Unit (Chaplaincy) plays a significant role in transforming the paradigm of health management in a complete and holistic way, in addition to its major role in offering spiritual care to patients.
Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment
Authors: Gronemeyer Karen , Fuss Carmina Teresa , Hermes Franca , Plass Armin , Koschker Ann-Cathrin , Hannemann Anke , Völzke Henry , Hahner Stefanie 
Published: November 2023

ContextAlthough renal long-term complications are acknowledged in chronic hypoparathyroidism (HPT), standardized investigations are scarce.ObjectiveTo systematically investigate renal complications and their predictors in hypoparathyroid patients compared to matched individuals.DesignProspective observational study in 161 patients with chronic HPT.MethodsPatients received renal ultrasound, clinical and laboratory assessments. An individual 1:3 matching with participants from the German population-based Study of Health in Pomerania was performed.ResultsOf 161 patients (92% postoperative HPT), prevalence of eGFR &lt;60ml/min/1.73m2 was 21%, hypercalciuria 41%. Compared to healthy individuals, HPT patients had a significantly lower eGFR (74.2 vs. 95.7 ml/min/1.73m², p&lt;0.01). Renal ultrasound revealed calcifications in 10% (nephrocalcinosis in 7% and calculi in 3%). Patients with renal calcifications had higher levels of 24-hour urine calcium excretion (8.34 vs. 5.08 mmol/d, p=0.02), spot urine calcium excretion (4.57 vs. 2.01 mmol/L, p=0.01) and urine calcium-to-creatinine ratio (0.25 vs. 0.16, p&lt;0.01) than patients without calcifications. Albumin-corrected calcium, phosphate, calcium-phosphate product, 25-hydroxyvitamin D in serum, eGFR, daily calcium intake or disease duration were not significantly different between these two groups. Including patients receiving rhPTH therapy, a lower serum phosphate concentration (odds ratio 1.364 [95% confidence interval (CI) 1.049-1.776], p&lt;0.05) and a longer disease duration of HPT (odds ratio 1.063 [95% CI 1.021-1.106], p&lt;0.01) were significant predictors for renal calcifications. Excluding patients receiving rhPTH therapy, a higher 24-hour urine calcium excretion (odds ratio 1.215 [95% CI 1.058-1.396], p&lt;0.01) was a significant predictor for renal calcifications but not serum magnesium or disease duration.ConclusionsPrevalence of impaired renal function among patients with chronic HPT is increased and independent from visible renal calcifications. Depending on exclusion of patients with rhPTH therapy, regression analysis revealed disease duration and serum phosphate or disease duration and 24-hour urinary calcium excretion as predictors for renal calcifications.Clin Trials IdentifierNCT05585593
International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients
Authors: Wong Mabel Ngai-Kiu , Cheung Mike Kwun-Ting , Ng Yuk-Mun , Yuan Huan-Ling , Lam Bess Yin-Hung , Fu Siu Ngor , Chan Chetwyn Che Hin 
Published: November 2023

BackgroundThe International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients’ Activity and Participation (ICF-A&amp;P) level.PurposeThis study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&amp;P of post-stroke patients.MethodsFifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&amp;P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life).ResultsThere were significantly higher levels in the ICF-BF and ICF-A&amp;P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&amp;P) which predicted patients’ satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&amp;P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&amp;P contents throughout the ICF-PSRP contributed to the positive treatment effects.ConclusionThe ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&amp;rank=1, identifier NCT05941078.
Network meta-analysis of first-line thrombectomy strategy for acute posterior circulation strokes: a preliminary evaluation for combined approach
Authors: Ye Gengfan , Cao Ruoyao , Chen Pandi , Wang Hongcai , Wang Dongfeng , Chen Maosong , Li Zhenqiang 
Published: November 2023

ObjectiveThrombectomy may provide superior results compared to best medical care for acute posterior circulation strokes (PCS). Contact aspiration (CA), stent retriever (SR), and combined SR + CA (SRA) are commonly employed as first-line techniques. However, the optimal strategy and the role of SRA remain uncertain.MethodsSystematic searching was conducted in three databases (PubMed, Embase, and Cochrane). Network meta-analyzes were performed using random-effects models. The reperfusion and clinical outcomes were compared. Pooled outcomes were presented as odds ratios (OR) with 95% confidence intervals (CI). Rankograms with surface under the cumulative ranking curve (SUCRA) were calculated.ResultsSeventeen studies were included, involving a total of 645 patients who received first-line CA, 850 patients who received SR, and 166 patients who received SRA. Regarding final recanalization outcomes, both first-line SRA (OR = 3.2, 95%CI 1.4–11.0) and CA (OR = 2.1, 95%CI 1.3–3.7) demonstrated superiority over SR in achieving successful reperfusion [modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3], with values of SUCRA 91.1, 58.5, and 0.4%, respectively. In addition, first-line SRA showed an advantage in achieving final mTICI 2c/3 compared to CA (OR = 3.6, 95%CI 0.99–16.0) and SR (OR = 6.4, 95%CI 1.3–35.0), with SUCRA value of 98.0, 44.7, and 7.2%, respectively. Regarding reperfusion outcome after the first pass, SRA also achieved a higher rate of mTICI 3 than SR (OR = 4.1, 95%CI 1.3–14.0), while CA did not (SUCRA 97.4, 4.6, 48.0%). In terms of safety outcomes, first-line CA was associated with a lower incidence of symptomatic intracranial hemorrhage (sICH) compared to SR (OR = 0.38, 95%CI 0.1–1.0), whereas the SRA technique did not (SUCRA 15.6, 78.6, 55.9%). Regarding clinical prognosis, first-line CA achieved a higher proportion of functional independence (modified Rankin Scale (mRS) 0–2) at 90 days than SR (OR = 1.4, 95%CI 1.1–1.9), whereas SRA did not (SUCRA 90.5, 17.4, 42.1%).ConclusionFor acute PCS, a first-line CA strategy yielded better results in terms of final successful reperfusion and 90-day functional independence compared to SR. As the combined technique, first-line SRA was associated with superior first-pass and final reperfusion outcomes compared to SR. However, no significant difference was observed in functional independence achieved by first-line SRA compared to the other two strategies. Further high-quality studies are warranted.
Associations of phase angle with platelet-activating factor metabolism and related dietary factors in healthy volunteers
Authors: Detopoulou Paraskevi , Fragopoulou Elizabeth , Nomikos Tzortzis , Antonopoulou Smaragdi 
Published: November 2023

IntroductionPhase angle (PA) is derived from bioelectrical impedance analysis (BIA). It reflects cell membrane function and decreases in disease. It is affected by inflammation, oxidative stress, and diet. Platelet-activating factor (PAF) is a potent inflammatory lipid mediator. Its levels, along with the activity of its metabolic enzymes, including CDP-choline:1-alkyl-2-acetyl-sn-glycerol-cholinephosphotransferase, acetyl-CoA:lyso-PAF-acetyltransferases, and PAF-AH/Lp-PLA2 are also related to dietary factors, such as the dietary antioxidant capacity (DAC). The aim of the study was to estimate whether the PAF metabolic circuit and related dietary factors are associated with PA in healthy volunteers.MethodsIn healthy subjects, PAF, its metabolic enzyme activity, and erythrocyte fatty acids were measured, while desaturases were estimated. Food-frequency questionnaires and recalls were used, and food groups, macronutrient intake, MedDietScore, and DAC were assessed. Lifestyle and biochemical variables were collected. DXA and BIA measurements were performed.ResultsLp-PLA2 activity was positively associated with PA (rho = 0.651, p &lt; 0.001, total population; rho = 0.780, p &lt; 0.001, women), while PAF levels were negatively associated with PA only in men (partial rho = −0.627, p = 0.012) and inversely related to DAC. Estimated desaturase 6 was inversely associated with PA (rho = −0.404, p = 0.01, total sample). Moreover, the DAC correlated positively with PA (rho = 0.513, p = 0.03, women). All correlations were adjusted for age, body mass index, and sex (if applicable).ConclusionPA is associated with PAF levels and Lp-PLA2 activity in a gender-dependent fashion, indicating the involvement of PAF in cell membrane impairment. The relationship of PA with DAC suggests a protective effect of antioxidants on cellular health, considering that antioxidants may inhibit PAF generation.