bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hydrodynamic Responses of a Novel Modular Floating Structure System With Multi-Direction Expansion
Authors: Li Yanwei , Li Xiang , Ren Nianxin , Ou Jinping 
Published: November 2022

Abstract
In order to comprehensively utilize ocean resources and renewable energy, a novel modular floating structure (MFS) system with multi-direction expansibility has been proposed, which includes inner hexagonal tension leg platform (TLP) modules and outermost floating artificial reef modules coupled with the function of the wave energy converter (WEC). Considering both the hydrodynamic interaction effect and the mechanical coupling effect, the main dynamic responses of the MFS system have been analyzed under different incident wave directions, and the corresponding physical mechanism has been clarified. Results indicate that connector loads slightly increase, but motion responses of the MFS system are more stable when the outermost floating artificial reefs serve as the up-wave modules. Outermost floating artificial reef modules have shown good wave-attenuation capacity for inner TLP modules, as well as producing considerable output wave power. The effect of key power take-off (PTO) parameters on the WECs’ performance has been investigated, and the optimal PTO damping coefficient has been suggested. In addition, extreme responses of the proposed MFS system have been further studied, and its safety has been well verified under typical extreme sea conditions. The main results of this work can serve as a helpful reference for the construction of future offshore floating cities.
Research on Tribo-Dynamic Characteristics of Double Involute Gears Based on Multiphysics Coupling
Authors: Yin Zhaoming , Fan Yu , Xu Jun , Fan Zhimin , Duan Zhenya 
Published: November 2022

Abstract
In order to accurately obtain the dynamic characteristics of double involute gears (DIGs), according to the characteristics of tooth profile engagement, a tribo-dynamic model of DIGs with multiphysics coupling characteristics is proposed by integrating the thermal elastohydrodynamic lubrication (TEHL) model, the temperature field analysis model and the dynamic model. The influence of different factors on its dynamic behaviors and the difference in dynamic characteristics between DIGs and common involute gears (CIGs) are comparatively analyzed. The results show that the thermal effect and tooth friction can intensify the dynamic response of the gear transmission. The variation of rotational velocity and torque has a significant impact on the dynamic behaviors of DIGs, the change of tooth waist order parameters have little effect on its dynamic characteristics, and the dynamic characteristics between DIGs and CIGs exist difference, but the difference is not obvious. Additionally, the theoretical model is verified through experiments.
Techno-Economic Optimization of a Hybrid PV-CSP Plant With Molten Salt Thermal Energy Storage and Supercritical CO2 Brayton Power Cycle
Authors: Guccione Salvatore , Trevisan Silvia , Guedez Rafael , Laumert Björn , Maccarini Simone , Traverso Alberto 
Published: November 2022

Abstract
High-efficient supercritical CO2 (sCO2) power blocks and the hybridization with solar photovoltaic (PV) plants have been identified as two viable solutions to enhance the economic competitiveness of Concentrating Solar Power (CSP) plants. This work introduces an innovative hybrid PV-CSP system layout with molten salt thermal energy storage and a sCO2 power block. An active hybridization has been proposed employing a molten salt electric heater that allows storing the excess PV production as thermal energy. The scalability of the plant has been investigated using size-dependent cost functions and introducing a novel methodology for scaling the sCO2 turbomachinery efficiencies. The conducted techno-economic optimizations show that the proposed hybrid PV-CSP plants can be cost-competitive. For a European solar resource location - 1900 kWh/(m2yr) - Levelized Cost of Electricity (LCOE) values lower than 66 EUR/MWh and capacity factors higher than 70 % can be achieved at 100 MWe. For a high-irradiance location - 3400 kWh/(m2yr) - a capacity factor of 85 % and a LCOE of 46 EUR/MWh have been found for the same scale. The selection of the sCO2 power cycle has a marginal impact on these results so that a simple recuperated cycle can yield similar LCOEs as the recompressed, reheated, and intercooled layouts. For smaller scales, systems with large gaps between the PV and CSP capacities are preferred, laying the optimal conditions for the electric heater integration with utilization factors up to 21 %.
An Alternate Means to Form Non-Dimensional Products in Dimensional Analysis
Authors: Clark John P. 
Published: November 2022

Abstract
Dimensional analysis is taught early in an undergraduate curriculum for mechanical engineering, usually during the very first course in fluid mechanics. Such analysis has its roots in the work of Lord Rayleigh, and the mechanics of the process as typically taught to undergraduates follows directly from the classic paper due to Buckingham on what is now known as the Pi Theorem. Students are meant to learn that dimensional analysis is a powerful tool for: developing insight with respect to flow physics, creating new models of physical processes, guiding the performance of experiments and flowfield simulations, aiding the sensible presentation of technical results, and fostering the replication of experiments and simulations. Unfortunately, the usual method for finding non-dimensional products taught to undergraduates requires the selection of scaling variables that can seem arbitrary and the solution of a number of sets of simultaneous equations that is typically tedious and prone to simple errors of arithmetic. As a consequence, students often fail to gain the intended appreciation for the usefulness of dimensional analysis. Fortunately, another technique for forming Π products that does not suffer from these same drawbacks was presented by the late Prof. B. S. Massey of University College London. This paper is intended to disseminate his so-called “step-by-step method” to a wider audience and thus to encourage the adoption of the technique for use in undergraduate curricula.
Gas Turbine’s Role in Energy Transition
Authors: Gülen S. Can , Curtis Martin 
Published: November 2022

Abstract
Modern heavy duty industrial gas turbines in combined cycle configuration, with rated efficiencies (at ISO base load) above 60% net LHV, are expected to play a significant role in reducing the carbon footprint of utility scale electricity generation. Even without post-combustion capture, simply switching from coal-fired generation to natural gas-fired generation reduces carbon dioxide emissions by 60% (on a kg per MWh of generation basis). In simple cycle mode, with efficiencies above 40% net LHV and startup times around 20 minutes, 300 to 400+ MW gas turbines can easily serve as peakers to support variable renewable resources, i.e., wind and solar. In this paper, a close quantitative look is taken at the capabilities of gas turbines firing natural gas, hydrogen, or a blend thereof, both in simple and combined cycle configurations. Furthermore, using published data, first-principles calculations, and software simulations, it will be shown that the gas turbine constitutes an efficient and cost-effective technology, with and without carbon capture, as a key player in decarbonization of the electric power sector.
Patients’ perceptions of conflicting information on chronic medications: a prospective survey in Switzerland
Authors: Santos Beatriz , Blondon Katherine S , Van Gessel Elisabeth , Cerutti Bernard , Backes Claudine , Locher Sophie , Guignard Bertrand , Bonnabry Pascal , Carpenter Delesha , Schneider Marie P 
Published: November 2022

ObjectiveThe number of patients with chronic diseases and subsequent visits to various healthcare professionals has been rising over the past decades, exposing patients to potential risks of receiving conflicting medication information. This study aims to investigate the prevalence of conflicting information on medications perceived by chronic patients in Switzerland and to understand its impact on patients’ medication self-management and navigation in the healthcare system.ParticipantsThis cross-sectional study included adult patients taking at least one prescribed medication for at least 6 months, who had visited at least two physicians in the past 3 months.Main outcome measuresData on patients’ perceptions of conflicting information were collected in person through a 17-item questionnaire available on paper and electronically with four domains: (1) whether the patient had perceived any conflicting information, (2) categories of conflicting information, (3) impact and (4) sources involved in the conflicting information.ResultsOf the 405 included patients, 47% perceived conflicting information related to one or more medication topics including indication, schedule, dosage, risk, severity or duration of side effects. Patients who perceived conflicting information were prescribed more drugs than those perceiving no conflicting information (p<0.01). Consequently, 65% of the participants modified their navigation of the healthcare system and 34% reported medication non-adherence. General practitioners (82%), specialist physicians (74%) and pharmacists (49%) were the healthcare professionals most often involved in conflicting information. Experience with the medication, its package insert and significant others were more frequently involved in conflicting information than internet or social media.ConclusionNearly half the patients in our study perceived conflicting information in the outpatient healthcare system, which can decrease medication effectiveness and pose safety issues. This issue is widely overlooked and unaddressed. Consistency of information among healthcare providers in partnership with patients should be reinforced through guidelines and new models of interprofessional care.
Is laparoscopic excision for superficial peritoneal endometriosis helpful or harmful? Protocol for a double-blinded, randomised, placebo-controlled, three-armed surgical trial
Authors: Marschall Henrik , Forman Axel , Lunde Sigrid Juhl , Kesmodel Ulrik Schiøler , Hansen Karina Ejgaard , Vase Lene 
Published: November 2022

IntroductionPlacebo-controlled surgical designs are recommended to ascertain treatment effects for elective surgeries when there is genuine doubt about the effectiveness of the surgery. Some elective surgeries for pain have been unable to show an effect beyond sham surgery, suggesting contributions from contextual factors. However, the nature of contextual factors in elective surgery is largely unexplored. Further, methodological difficulties in placebo-controlled surgical trials impact the ability to estimate the effectiveness of a surgical procedure. These include an overall lack of testing the success of blinding, absence of comparison to a no-surgery control group and dearth of test for neuropathic pain.For women with peritoneal endometriosis, there is uncertainty regarding the pain-relieving effect of surgery. Surgery may put patients at risk of complications such as postsurgical neuropathic pain, without guarantees of sufficient pelvic pain relief. The planned placebo-controlled trial aims to examine the effect of surgery on pelvic pain, widespread pain and neuropathic pain symptoms in women with peritoneal endometriosis, and to test the contribution of contextual factors to pain relief.Methods and analysisOne hundred women with peritoneal endometriosis will be randomised to either diagnostic laparoscopy with excision of endometrial tissue (active surgery), purely diagnostic laparoscopy (sham surgery) or delayed surgery (no-surgery control group). Outcomes include pelvic pain relief, widespread pain, neuropathic pain symptoms and quality of life. Contextual factors are also assessed. Assessments will be obtained at baseline and 1, 3 and 6 months postrandomisation. Mixed linear models will be used to compare groups over time on all outcome variables.Ethics and disseminationThe trial is approved by the Regional Ethics Committee in the Central Denmark Region (1-10-72-152-20). The trial is funded by a PhD scholarship from Aarhus University, and supported by a grant from ‘Helsefonden’ (20-B-0448). Findings will be published in international peer-reviewed journals and disseminated at international conferences.Trial registration numberNCT05162794.
Factors affecting providers’ comfort and fear during intubations of patients with COVID-19
Authors: Lee Esther , Al Shabeeb Reem Qabas , El Shatanofy Muhammad , Mulcahy Collin F , Yamane David P , Sherman Marian L , Heinz Eric R 
Published: November 2022

BackgroundProviders performing endotracheal intubation are at high risk of contracting SARS-CoV-2. The objective was to assess various demographic, exposure and institutional preparedness factors affecting intubators’ comfort and fear level during COVID-19 intubations.MethodsWe conducted a cross-sectional, survey-based study during the COVID-19 pandemic from September 2020 to January 2021 at a single academic medical centre in Washington, DC, USA. Inclusion criteria were healthcare providers who had an experience in intubating patients confirmed with or suspected of COVID-19. The survey assessed various factors related to the providers’ comfort with intubation and fear during COVID-19 intubations.ResultsA total of 329 surveys from 55 hospitals were analysed. Of the respondents, 173 (52.6%) were from emergency medicine providers. Factors that were associated with a higher comfort level of intubating patients with COVID-19 included attending physician position (adjusted OR (aOR)=2.6, 95% CI 1.4 to 4.8; p=0.003), performing more than 20 COVID-19 intubations (aOR=3.3, 95% CI 1.5 to 6.6; p=0.002), participation in an intubation team (aOR=1.6, 95% CI 1.1 to 2.7; p=0.031) and adequate levels of personal protective equipment (PPE) (aOR=4.3, 95% CI 2.0 to 8.8; p<0.0005). Compared with emergency physicians, anaesthesiology providers had higher fear levels of contracting SARS-CoV-2 during both first and subsequent SARS-CoV-2 intubations (first: OR=1.7, 95% CI 1.1 to 2.6, p=0.006; subsequent: OR=2.0, 95% CI 1.4 to3.2, p<0.0005).ConclusionA higher degree of comfort in intubating patients suspected of or confirmed with COVID-19 was demonstrated in more senior physicians, members of intubation teams, providers who performed a higher number of intubations and providers who reported adequate PPE. These findings highlight potential targets for improving the experience of providers in this setting.
Use of the ISUP e-learning module improves interrater reliability in prostate cancer grading
Authors: Flach Rachel N , Egevad Lars , Eklund Martin , van der Kwast Theodorus H , Delahunt Brett , Samaratunga Hemamali , Suelmann Britt B M , Willemse Peter-Paul M , Meijer Richard P , van Diest Paul J 
Published: November 2022

AimsProstate cancer (PCa) grading is an important prognostic parameter, but is subject to considerable observer variation. Previous studies have shown that interobserver variability decreases after participants were trained using an e-learning module. However, since the publication of these studies, grading of PCa has been enhanced by adopting the International Society of Urological Pathology (ISUP) 2014 grading classification. This study investigates the effect of training on interobserver variability of PCa grading, using the ISUP Education web e-learning on Gleason grading.MethodsThe ISUP Education Prostate Test B Module was distributed among Dutch pathologists. The module uses images graded by the ISUP consensus panel consisting of 24 expert uropathologists. Participants graded the same 10 images before and after e-learning. We included those who completed the tests before and after training. We evaluated variation in PCa grading in a fully crossed study design, using linearly weighted kappa values for each pathologist, comparing them to other pathologists and to the ISUP consensus panel. We analysed the improvement in median weighted kappas before and after training, using Wilcoxon’s signed rank-test.ResultsWe included 42 pathologists. Inter-rater reliability between pathologists improved from 0.70 before training to 0.74 after training (p=0.01). When compared with the ISUP consensus panel, five pathologists improved significantly, whereas the kappa of one pathologist was significantly lower after training. All pathologists who improved significantly, graded with less than substantial agreement before training.ConclusionsISUP Prostate Test B e-learning reduces variability in PCa grading. E-learning is a cost-effective method for standardisation of pathology.
Contemporary study of multiple sclerosis disability in South East Wales
Authors: Harding Katharine Elizabeth , Ingram Gillian , Tallantyre Emma Clare , Joseph Fady , Wardle Mark , Pickersgill Trevor P , Willis Mark D , Tomassini Valentina , Pearson Owen Rhys , Robertson Neil P 
Published: November 2022

BackgroundA contemporary understanding of disability evolution in multiple sclerosis (MS) is an essential tool for individual disease management and planning of interventional studies. We have used prospectively collected longitudinal data to analyse disability progression and variation in a British MS cohort.MethodsCox proportional hazards regression was used to estimate hazard of Expanded Disability Status Scale (EDSS) 4.0 and 6.0. A continuous Markov model was used to estimate transitional probabilities for individual EDSS scores. Models were adjusted for age at MS onset, sex and disease-modifying treatments (DMTs) exposure.Results2135 patients were included (1487 (70%) female, 1922 (89%) relapsing onset). 865 (41%) had used DMTs. Median time to EDSS 4.0 and 6.0 was 18.2 years (95% CI 16.3 to 20.2) and 22.1 years (95% CI 20.5 to 24.5). In the Markov model, the median time spent at EDSS scores of <6 (0.40–0.98 year) was shorter than the time spent at EDSS scores of ≥6 (0.87–4.11 year). Hazard of change in EDSS was greatest at EDSS scores <6 (HR for increasing EDSS: 1.02–1.33; decreasing EDSS: 0.34–1.27) compared with EDSS scores ≥6 (HR for increasing EDSS: 0.08–0.61; decreasing EDSS: 0.18–0.54).ConclusionsThese data provide a detailed contemporary model of disability outcomes in a representative population-based MS cohort. They support a trend of increasing time to disability milestones compared with historical reference populations, and document disability variation with the use of transitional matrices. In addition, they provide essential information for patient counselling, clinical trial design, service planning and offer a comparative baseline for assessment of therapeutic interventions.
The PO4-tential for Less Toxic CAR T-cell Therapies
Authors: Tobin Joshua W.D. , Green Michael R. , Gandhi Maher K. 
Published: November 2022

AbstractChimeric antigen receptor (CAR) T-cell therapy has yielded remarkable and durable responses for some patients with relapsed and refractory blood cancers. However, life-threatening toxicities such as immune effector cell–associated neurotoxicity syndrome (ICANS) remain a challenge for broad delivery of such therapies. In this issue, Tang and colleagues demonstrate an association between hypophosphatemia and CAR T cell–induced ICANS. Prospective studies are required to establish if phosphate monitoring is an early predictor for ICANS occurrence and if maintenance of phosphate levels has a role as a preventative strategy.See related article by Tang et al., p. 1433 (4).
Long‐Term Risks of Stroke in Patients With Type A Aortic Dissection: A Nationwide Cohort Study
Authors: Hsu Jin‐Yi , Liu Peter Pin‐Sung , Liu An‐Bang , Huang Huei‐Kai , Loh Ching‐Hui 
Published: November 2022

Background
Patients with type A aortic dissection (TAAD) have a high short‐term risk of stroke. However, whether patients with TAAD have an increased long‐term risk of stroke is still undetermined, and our study aims to address this knowledge gap.

Methods and Results
A nationwide retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database. We included patients with TAAD as well as age‐ and sex‐matched aortic disease–free individuals between 2003 and 2016. Inverse probability of treatment weighting was performed to balance patient characteristics between the groups. The primary outcome was the development of stroke, regardless of subtype; the secondary outcomes were the risk of developing either ischemic or hemorrhagic stroke. The hazard ratios (HRs) of stroke were estimated using the Cox proportional hazards model. After inverse probability of treatment weighting, 3556 and 7023 patients were categorized into the TAAD and aortic disease–free cohorts, respectively. The mean follow‐up period was 5.71 years. The HRs for overall, ischemic, and hemorrhagic strokes in the TAAD cohort were 3.01 (95% CI, 2.40–3.78), 3.18 (95% CI, 2.47–4.10), and 2.32 (95% CI, 1.58–3.41), respectively, compared with the aortic disease–free cohort. Consistent trends of higher stroke risk in patients with TAAD were revealed in the analyses stratified by age; sex; antiplatelet use; and history of hypertension, diabetes, or dyslipidemia.

Conclusions
Our study findings revealed that patients with TAAD had an increased long‐term risk of both ischemic and hemorrhagic strokes. Further studies are warranted to establish optimal strategies for stroke prevention in these patients.
Knowledge Models on Biosphere Reserves for Visual and Sustainable Meaningful Learning in Pre-Service Teachers
Authors: Pérez de Villarreal Maider , Scotton Paolo 
Published: November 2022

Abstract
It is undeniable that climate change has become one of the greatest global challenges facing humanity in the coming decades. Since the Earth Summit held in Rio de Janeiro in 1992, all climate summits have emphasized the importance of sustainability through commitments that set the framework for a low-emission development model. Education, as a training field for the rest of the professions, has the responsibility to promote sustainability and this would be feasible considering environmental education as the backbone of the rest of the subjects of the different educational stages. This article presents the visual methodology of knowledge modeling through the use of concept maps and the free software Cmap Tools (ihmc, Florida) as a possibility to promote environmental awareness and sustainability in teachers in training. In compliance with the 4th and 15th sdg s of the 2030 Agenda, the theme of “biosphere reserves” was selected. The intention was to develop conceptually transparent audiovisual teaching material which would enhance environmental education. This material can be used by any primary school anywhere in the world as an alternative to textbooks and as a proposal for motivation and meaningful learning for their future primary school students.
Dissonance between Masoretic Vocalisation and Cantillation in Biblical Verse Division
Authors: Breuer Yochanan 
Published: November 2022

The Masoretic text is the final stage of a process during which the Masoretes had to decide between numerous various readings in order to produce a fixed and consistent text. Although the final production is a remarkable achievement, the Masoretic text still contains cases of inconsistencies. The prominent example is the discrepancy between the ketiv (the way the word should be written) and the qere (the way the word should be pronounced), where we find two contradictory readings in the same word. In this article, a similar phenomenon is described regarding the vocalisation and the cantillation. Although the vocalisation and the
cantillation usually reflect division of a verse according to the same interpretation, there are also cases where they reflect two opposing divisions based on different interpretations. Awareness of this may enrich our understanding of the complexity that was involved in the fixing of the Masoretic text.