bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation of the Thermoacoustic Response of an Aero-Engine Gas Turbine Fuel Injector Using a Hybrid CFD-CAA Method
Authors: Reinhardt Hanna , Alanyalıoğlu Çetin Ozan , Fischer André , Lahiri Claus , Nicolai Hendrik , Hasse Christian 
Published: September 2023

Abstract
Given the stringent emission regulations of aircraft engines, the trend in the aero industry is toward developing leaner combustion systems, which are prone to produce combustion instabilities. Hybrid methods of simultaneous acoustics and fluid dynamics simulations offer an elegant solution for the numerical prediction of these instabilities, taking advantage of the appropriate discretization of relevant scales. The presented work employed a hybrid simulation framework to identify the thermoacoustic response of a practically relevant configuration. The fluid dynamics were described using a computational fluid dynamics solver employing the low Mach formulation of the Navier–Stokes equations, while the acoustics were simulated using a computational aeroacoustics solver employing the acoustic perturbation equations. The coupling was implemented to exchange information between both solvers during runtime. The considered real-life configuration was designed to investigate the thermoacoustic behavior of realistic gas turbine injectors. It is acoustically excited to characterize the given injector via the flame transfer function approach under controlled operating conditions. The computational fluid dynamics simulation results were postprocessed to obtain the acoustic behavior of the combustor. The reacting scattering matrix was constructed and then compared to the experimental reference, both obtained using the multimicrophone method. Finally, two different postprocessing approaches were used to calculate the flame transfer function and discuss the applied hybrid computation method. This work demonstrated that the hybrid method can capture general features of the flame response of a complex three-dimensional combustion system.
Balance Recovery Strategy in Children With and Without Hearing or Visual Impairments
Authors: Zarei Hamed , Norasteh Ali Asghar , Lieberman Lauren J. , Brian Ali 
Published: September 2023

Purpose: The purpose of this study was to examine the balance recovery strategy in children with hearing (HI) and visual impairments (VI) compared with those without these disorders. Materials and Methods: This study featured a cross-sectional design with subjects (N = 45) placed within one of three equally stratified purposive groups (HI, VI, and comparison) within the age range of 9–13 years (mean = 11.43, SD = 1.5). Balance recovery strategy was measured in static and after-perturbation conditions by a four-camera Vicon system used to record three-dimensional lower body kinematic data. A repeated-measures analysis of variance (3 × 2, Group × Condition) was utilized to analyze data. Significance was set at p ≤ .05. Results: In the static condition, the results of the study showed that there was no significant difference between the groups in the ankle joint sway (p > .05). In hip joint sway, VI children had greater sway compared with comparison (p = .001) and HI children (p = .02). Also, HI children had greater sways than comparison (p = .02). In the after-perturbation condition, the results showed that VI children had greater sway in the hip and ankle joints than HI children (p = .001) and comparison (p = .001) to restore and maintain balance. Conclusion: It seems that comparison as well as higher proportion VI children use a hip strategy to maintain and restore balance. Also, it seems that HI children use a different strategy (ankle strategy) to maintain and restore balance compared with comparison and VI children.
First-year growth trajectory and early nutritional requirements for optimal growth in infants with congenital diaphragmatic hernia: a retrospective cohort study
Authors: Coignard Maxime , Mellul Kelly , Stirnemann Julien , Khen-Dunlop Naziha , Lapillonne Alexandre , Kermorvant-Duchemin Elsa 
Published: September 2023

ObjectiveTo describe the growth trajectory of children with congenital diaphragmatic hernia (CDH) during the first year, to assess the risk factors for growth failure (GF) at 1 year and to determine nutritional intakes at discharge required for early optimal growth.DesignSingle-centre retrospective cohort study based on data from a structured follow-up programme.Setting and patientsAll neonates with CDH (2013–2019) alive at discharge and followed up to age 1.InterventionsNone.Main outcome measuresWeight-for-age z-score (WAZ) at birth, 3, 6 and 12 months of age; risk factors for GF at age 1; energy and protein intake of infants achieving early optimal growth.ResultsSixty-three of 65 neonates who were alive at discharge were included. Seven (11%) had GF at 1 year and 3 (4.8%) had a gastrostomy tube. The mean WAZ decreased in the first 3 months before catching up at 1 year (−0.6±0.78). Children with a severe form or born preterm experienced a deeper loss (from −1.5 to −2 z-scores) with late and limited catch-up. The median energy intake required to achieve positive or null weight growth velocity differed significantly according to CDH severity, ranging from 100 kcal/kg/day (postnatal forms) to 139 kcal/kg/day (severe prenatal forms) (p=0.009).ConclusionsGrowth patterns of CDH infants suggest that nutritional risk stratification and feeding practices may influence growth outcomes. Our results support individualised and active nutritional management based on CDH severity, with energy requirements as high as 140% of recommended intakes for healthy term infants.
Steroid-induced glaucoma: an avoidable cause of irreversible blindness
Authors: Teo Benjamin H K , Au Eong Jonathan T W , Au Eong Kah Guan 
Published: September 2023

A man in his 70s on regular follow-up with an ophthalmologist for 10 years presented with blurry vision in his right eye for 4 days. He was diagnosed with elevated intraocular pressure (IOP) bilaterally 18 months earlier and treated with antiglaucoma eye-drops. On direct questioning, he admitted to using fixed combination tobramycin 0.3%/dexamethasone 0.1% eye-drops frequently to relieve ocular redness and discomfort in both eyes for 3.5 years without his ophthalmologist’s knowledge. Examination disclosed markedly elevated IOP, advanced optic disc cupping and tunnel vision due to steroid-induced glaucoma bilaterally. After cessation of the eye-drops and 2 weeks of antiglaucoma therapy, his IOP returned to normal and his visual field remained stable for 4 years.Our case highlights the danger of habitual self-treatment of prescription medications containing corticosteroids and the importance of taking a detailed medication history in the diagnosis and management of steroid-induced glaucoma.
Optimal utilization of maternal health service in Indonesia: a cross-sectional study of Riskesdas 2018
Authors: Aryastami Ni Ketut , Mubasyiroh Rofingatul 
Published: September 2023

ObjectiveThis paper analyses the optimal utilization of maternal health services in Indonesia from 2015 to 2018.DesignNational cross-sectional study.SettingThis study takes place in 34 provinces in Indonesia.ParticipantsThe population in this study were mothers in all household members in Basic Health Research of Riskesdas 2018. The sample was all mothers who had a live birth within 5 years before data collection (1 January 2013 to July 2018) and had complete data. The number of samples analysed was 70 878.Primary outcomeWe developed a scoring for the optimal utilization of maternal health services as the outcome variable.ResultsThis analysis involved 70 787 mothers. The utilization of maternal care was not optimal. Mothers who delivered in health facilities achieved 83.3% of services. Better care is experienced more by mothers who live in urban areas. Mothers who delivered at health facilities significantly used threefold optimal care (ORa=3.15; 95% CI 3.00 to 3.30; p<0001). A statistically significant difference of optimal maternal care was found in mothers with better education (ORa=1.22; 95% CI 1.18 to 1.27; p=0.001); holding health insurance (ORa=1.25; 95% CI 1.21 to 1.30; p<0001), having more access to health facilities (ORa=1.13; 95% CI 1.09 to 1.17); p<0.001), less parity (ORa=1.16; 95% CI 1.11 to 1.20; p<0.001).ConclusionThe optimal utilization of MHS is independent of the free services delivery, but having health insurance and less parity brought about a better optimal score for MHS. Mothers in rural areas were more protective of optimal utilization. Finally, the eastern region used more optimal health services.
Effectiveness of a smartphone-enabled dyadic self-care programme (SDSCP) for stroke survivors and caregivers: study protocol for a randomised controlled trial
Authors: Wang Wenna , Wang Xiaoxuan , Vellone Ercole , Zhang Zhenxiang 
Published: September 2023

IntroductionThe promotion of self-care has begun to serve as a central response strategy to the rising burden of stroke. In fact, stroke self-care can be recognised to be a dyad phenomenon having an effect on the health of stroke survivors and their caregivers. While studies have confirmed the effectiveness of smartphone-based interventions in improving self-care among stroke survivors, there remains a lack of evidence specifically regarding dyadic self-care interventions for both patients and caregivers.AimThe present single-blinded, two-arm, randomised controlled trial aims to verify the effectiveness of a smartphone-enabled dyadic self-care programme (SDSCP) for stroke survivors and their caregivers.Methods and analysisThe estimated sample size is 152 stroke survivor–caregiver dyads. The participants will be randomly classified (1:1) into either a control (N=76) or an experimental group (N=76) through block randomisation. The participants classified into the experimental group will be provided with SDSCP, and during the initial home visit, the research team members will provide instructions to all patients and caregivers on how to download and use the smartphone application. While the participants in the control group will be given the existing stroke standard care. The main outcome measures of stroke survivors will consist of the Self-Care of Stroke Inventory and a short version of the Stroke Specific Quality of Life Scale. The outcome measures of stroke caregivers will primarily cover the Caregiver Contribution to Self-Care of Stroke Inventory and Zarit burden interview. The data of this study will be collected at three time points, including baseline, 1 month and 6 months from the baseline.Ethics and disseminationThis study has been approved by the Ethics Committee of Zhengzhou University (ZZUIRB 2021–115) in January 2021. The results achieved in this study will facilitate the clinical practice to improve self-care of stroke survivors and promote dyadic health outcomes for stroke patients and caregivers.Trial registration numberThe study was registered with the Chinese Clinical Trial Registry and the registration number is ChiCTR2100053591.
Physical Activity and Its Associated Factors among Patients with Hypertension at Amhara Region Comprehensive Specialised Hospitals, Northwest Ethiopia: An Institutional Based Cross-Sectional Study
Authors: Belay Gashaw Jember , Fentanew Molla , Belay Misganaw , Gobezie Melese , Bekele Gebremariam , Getie Kefale , Shiferaw Kassaw Belay , Takele Mihret Dejen , Cherkos Kassahun , Zemariam Alemu Birara 
Published: September 2023

BackgroundAccurate evaluation of physical activity for patients with hypertension is important to determine patients’ health outcomes and intervention measures. Information about physical activity among patients with hypertension in Ethiopia is not well known.ObjectiveThis study was aimed to assess the physical activity and associated factors among patients with hypertension.Study designAn institution-based cross-sectional study was conducted.Study settingThe study was conducted at the Tertiary Hospital Northwest, Ethiopia.Outcome measuresPhysical activity was assessed by Global Physical Activity Questionnaire as the primary outcome and factors significantly associated with physical activity were secondary outcomes.ParticipantsFour hundred and twenty patients with hypertension took part in the study; among those 233 were men and 187 were women. The study participants were chosen using a systematic random sampling method. SPSS V.20 statistical software was used to analyse the data. In the multivariable logistic regression analysis model, adjusted OR (AOR) with a 95% CI and p value<0.05 were used to identify the associated factors with physical activities.ResultsOur study showed that 19.1% of study participants had inadequate physical activity, being old age with AOR: 10.27 (3.21 to 33.01), low or poor self-efficacy with AOR: 10.34 (4.89 to 21.84), poor self-rated health with AOR: 5.91 (1.73 to 20.13) and lack of adequate facilities with AOR: 4.07 (1.72 to 9.66) were significantly associated with inadequate physical activity.ConclusionInadequate physical activity was detected in one-fifth of the study participants, according to our research. Being elderly, having low self-efficacy, having inadequate facilities and having poor self-rated health were all linked to inadequate physical activity.
Clinical outcomes of non-COVID-19 orthopaedic patients admitted during the COVID-19 pandemic: a multi-centre interrupted time series analysis across hospitals in six different countries
Authors: Hoogervorst Lotje Anna , Stijnen Pieter , Albini Marco , Janda Nina , Stewardson Andrew J , Patel Kiran , Nelissen Rob G H H , Marang-van de Mheen Perla 
Published: September 2023

ObjectivesTo assess across seven hospitals from six different countries the extent to which the COVID-19 pandemic affected the volumes of orthopaedic hospital admissions and patient outcomes for non-COVID-19 patients admitted for orthopaedic care.DesignA multi-centre interrupted time series (ITS) analysis.SettingSeven hospitals from six countries who collaborated within the Global Health Data@Work collaborative.ParticipantsNon-COVID-19 patients admitted for orthopaedic care during the pre-pandemic (January/2018–February/2020) and COVID-19 pandemic (March/2020–June/2021) period. Admissions were categorised as: (1) acute admissions (lower limb fractures/neck of femur fractures/pathological fractures/joint dislocations/upper limb fractures); (2) subacute admissions (bone cancer); (3) elective admissions (osteoarthritis).Outcome measuresMonthly observed versus expected ratios (O/E) were calculated for in-hospital mortality, long (upper-decile) length-of-stay and hospital readmissions, with expected rates calculated based on case-mix. An ITS design was used to estimate the change in level and/or trend of the monthly O/E ratio by comparing the COVID-19 pandemic with the pre-pandemic period.Results69 221 (pre-pandemic) and 22 940 (COVID-19 pandemic) non-COVID-19 orthopaedic patient admissions were included. Admission volumes were reduced during the COVID-19 pandemic for all admission categories (range: 33%–45%), with more complex patients treated as shown by higher percentages of patients admitted with ≥1 comorbidity (53.8% versus 49.8%, p<0.001). The COVID-19 pandemic was not associated with significant changes in patient outcomes for most diagnostic groups. Only for patients diagnosed with pathological fractures (pre-pandemic n=1671 and pandemic n=749), the COVID-19 pandemic was significantly associated with an immediate mortality reduction (level change of −77.7%, 95% CI −127.9% to −25.7%) and for lower limb fracture patients (pre-pandemic n=9898 and pandemic n=3307) with a significantly reduced trend in readmissions (trend change of −6.3% per month, 95% CI −11.0% to −1.6%).ConclusionsAcute, subacute, as well as elective orthopaedic hospital admissions volumes were reduced in all global participating hospitals during the COVID-19 pandemic, while overall patient outcomes for most admitted non-COVID-19 patients remained the same despite the strain caused by the surge of COVID-19 patients.
Factors affecting knowledge and attitude of healthcare workers towards basic life support in Khyber Teaching Hospital, Peshawar, Pakistan: a cross-sectional analysis
Authors: Hasnain Samar , Hussan Jehan , Khan Laiba , Muhammad Shabir , Kamal Khkula , Sawaira  , Hayat Umair , Abbasi Areej , Akhlaq Muhammad , Ahmad Ali , Ahmad Khizar 
Published: September 2023

ObjectiveThis study was conducted to assess the knowledge and attitude of healthcare workers towards basic life support (BLS) in Khyber Teaching Hospital, Peshawar, and to investigate the factors affecting them.DesignCross-sectional study.SettingThis study was carried out in a tertiary care hospital in Peshawar, Pakistan.Participants201 healthcare professionals were recruited for this study through simple convenience sampling which included house officers (HOs), trained medical officers, postgraduate residents, professors, specialty registrars and nurses. Healthcare professionals who were reluctant to give consent were excluded from the study.ResultsAmong the chosen participants, only 16.4% had good knowledge whereas 63% had a good attitude towards BLS. Knowledge of participants was found to be positively associated with less time elapsed between the training sessions (p=0.041). On the other hand, factors such as age(p=0.004), designation (p=0.05), number of BLS sessions attended (p=0.012) and the time elapsed since the last BLS session attended (p=0.015), were positively associated with the attitude of healthcare professionals.ConclusionThe level of knowledge and attitude towards BLS by healthcare professionals was suboptimal. Those individuals who had attended BLS training sessions frequently had better knowledge and attitude as compared with their counterparts.
Translating digital healthcare to enhance clinical management: a protocol for an observational study using a digital health technology system to monitor medication adherence and its effect on mobility in people with Parkinson’s
Authors: Packer Emma , Debelle Héloïse , Bailey Harry G B , Ciravegna Fabio , Ireson Neil , Evers Jordi , Niessen Martijn , Shi Jian Qing , Yarnall Alison J , Rochester Lynn , Alcock Lisa , Del Din Silvia 
Published: September 2023

IntroductionIn people with Parkinson’s (PwP) impaired mobility is associated with an increased falls risk. To improve mobility, dopaminergic medication is typically prescribed, but complex medication regimens result in suboptimal adherence. Exploring medication adherence and its impact on mobility in PwP will provide essential insights to optimise medication regimens and improve mobility. However, this is typically assessed in controlled environments, during one-off clinical assessments. Digital health technology (DHT) presents a means to overcome this, by continuously and remotely monitoring mobility and medication adherence. This study aims to use a novel DHT system (DHTS) (comprising of a smartphone, smartwatch and inertial measurement unit (IMU)) to assess self-reported medication adherence, and its impact on digital mobility outcomes (DMOs) in PwP.Methods and analysisThis single-centre, UK-based study, will recruit 55 participants with Parkinson’s. Participants will complete a range of clinical, and physical assessments. Participants will interact with a DHTS over 7 days, to assess self-reported medication adherence, and monitor mobility and contextual factors in the real world. Participants will complete a motor complications diary (ON-OFF-Dyskinesia) throughout the monitoring period and, at the end, a questionnaire and series of open-text questions to evaluate DHTS usability. Feasibility of the DHTS and the motor complications diary will be assessed. Validated algorithms will quantify DMOs from IMU walking activity. Time series modelling and deep learning techniques will model and predict DMO response to medication and effects of contextual factors. This study will provide essential insights into medication adherence and its effect on real-world mobility in PwP, providing insights to optimise medication regimens.Ethics and disseminationEthical approval was granted by London—142 Westminster Research Ethics Committee (REC: 21/PR/0469), protocol V.2.4. Results will be published in peer-reviewed journals. All participants will provide written, informed consent.Trial registration numberISRCTN13156149.
Roles of doctor–patient relationship perception and job satisfaction in the impact of workplace violence on medical professionals’ turnover intentions in the early phase of COVID-19: a cross-sectional study in China
Authors: Li Tiantian , Guan Lizheng , Zhang Rui , Han Youli , Guo Rui , Li Jun , Ma Chengyu , Zhang Ning , Fan Yezhi , Huang Yumei 
Published: September 2023

ObjectiveThis study aimed to explore the role of the doctor–patient relationship (DPR) perception from the perspective of medical professionals in the association between workplace violence (WPV), job satisfaction and turnover intention in the early stages of the COVID-19 pandemic based on the affective events theory (AET).DesignA cross-sectional study.SettingNine medical institutions in Beijing were enrolled in this study.ParticipantsIn total, 792 medical professionals participated in the study, excluding administrators and logisticians.ResultsThe structural equation model was well adapted (comparative fit index (CFI) = 0.933; root mean square error of approximation (RMSEA) = 0.060). DPR mediated the association between WPV and job satisfaction, with an indirect effect of 0.247 (p<0.001). DPR perception mediated the effect of WPV on turnover intention, with an indirect effect of 0.090 (p<0.001). It also played a chain-mediating role in job satisfaction between WPV and turnover intention, with a mediation value of 0.117 (p<0.001), accounting for 53.42% of the total effect.ConclusionsThis study developed a stable model using AET. DPR perception plays an important role in the relationship between WPV and job satisfaction and turnover intention, suggesting the key impact of emotional factors. This has strong practical implications for maintaining the stability of medical teams. Therefore, medical institutions should improve the level of DPR perception from the perspective of medical professionals to effectively prevent mental health problems following WPV.