bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators for the implementation of nurse-delivered chronic disease management within general practice: a mixed methods systematic review protocol
Authors: Grivell Nicole , Brown Brandon , Fuller Jeffrey , Chai-Coetzer Ching Li , McEvoy R. Doug , Hoon Elizabeth 
Published: September 2022

Objective:
The objective of this review is to identify the barriers and facilitators for the implementation of nurse-delivered models of care for chronic diseases to inform the development and evaluation of nurse-delivered models of care for chronic sleep disorders.

Introduction:
Increasing prevalence of sleep disorders and subsequent demand for specialist-led sleep services has prompted investigation into the management of uncomplicated sleep disorders by general practitioners. Models of sleep health care with enhanced roles for general practice nurses have been investigated within the context of randomized controlled trials; however, it is unclear how best to implement these models into clinical practice. With limited research exploring the implementation of nurse-delivered models of sleep health care within general practice, this review will examine the barriers and facilitators for the implementation of nurse-delivered models of care for chronic disease. This will inform the integration of new nurse-delivered models of care for chronic sleep disorders into routine general practice.

Inclusion criteria:
Studies that report barriers and facilitators for the implementation of nurse-delivered models of care for chronic diseases for adults into a general practice setting will be included.

Methods:
Six databases will be searched: MEDLINE, CINAHL, Embase, Scopus, Cochrane Library, and Emcare. The search will be limited to qualitative, quantitative, and mixed methods studies. Studies will be included if they contain data that report on barriers and facilitators for implementation of nurse-delivered models of care for chronic diseases. This review will be conducted in accordance with the JBI approach to mixed methods convergent integrated systematic reviews.

Systematic review registration number:
PROSPERO CRD42021273346
Evaluating the Aerodynamic Damping At Shock Wave Boundary Layer Interacting Flow Conditions With Harmonic Balance
Authors: Heners Jan Philipp , Frey Christian , Grüber Björn , Carraro Thomas 
Published: September 2022

Abstract
The aerodynamic damping of a stator vane located in a rear stage of a high pressure compressor is evaluated at transonic flow conditions by numerical means. The results of a solution method based on temporal linearization around a steady RANS state are compared to results generated by relying on a state-of-the-art harmonic balance solver. It is found that the time-linearized method is not capable to reproduce the damping behavior in a sufficient manner for the majority of assessed nodal diameters. The limitations of the time-linearized method consisting of expansion around an imperfect steady RANS state, neglecting nonlinear contributions, and considering turbulence to be frozen at its steady-state are evaluated and quantified. Furthermore, the presence of unsteady content induced by shock wave boundary layer interaction can be identified by performing a full-annulus URANS simulation based on time-integration. For a limited range of nodal diameters, this shock boundary layer interaction locks in to the assessed flutter motion and affects the damping behavior substantially. It is demonstrated that the mechanism of the shock wave boundary layer interaction can be reproduced with harmonic balance in accordance with the time-integration method. Coupling the eigenmode of interest and the identified shock boundary layer interaction via the harmonic balance method allows us to predict the aerodynamic damping for the affected nodal diameters.
Modeling of Dynamic Response of a Radial Turbine to Pulsatile Incoming Flow
Authors: Yang Mingyang , Xue Yingxian , Pan Lei , Yang Bijie , Martinez-Botas Ricardo 
Published: September 2022

Abstract
The unsteady response of a turbine exposed to pulsatile incoming flow is studied via the analytical model in this article. First, the response of output torque of the turbine to pulsatile condition is theoretically studied and a correlation of the torque response is deduced. The results confirm that the fluctuations of the torque are proportional to the fluctuations of velocity at the rotor inlet. Next, the unsteady response of turbine system is modeled by the method of transfer matrixes of quasi-2D flow elements connected in sequence. The correlations of swallowing capacity and output torque with the imposed pulsatile inlet pressure are obtained via the models. The results prove that the unsteadiness of turbine performance is proportionally enhanced by the pulse magnitude and the acoustic throttle slope in swallowing capacity curve. In particular, the unsteadiness increases first, but then reduces as the Strouhal number increases. The strongest unsteady performance is achieved when the resonance of the system happens at the Strouhal number as 1. Furthermore, the model proves that the total torque deviation of the turbine is proportional to the mass accumulation in a pulse period. This justifies the validity of the widely used assumption of the mass accumulation as an indicator of turbine performance unsteadiness. Finally, the results of the theoretical model are validated against the 1D gas-dynamic simulation via in-house developed code.
The Role of Turbine Operating Conditions on Combustor–Turbine Interaction—Part I: Change in Expansion Ratio
Authors: Notaristefano Andrea , Gaetani Paolo 
Published: September 2022

Abstract
Aeroengine lean-burn combustors release vorticity and temperature perturbations that, interacting with the first turbine stage, impact the stage aerodynamics, the blade cooling, and noise production. The first of these issues is addressed in this paper that is Part I of a two-fold contribution. A detailed experimental analysis is carried out to study the impact on the combustor–turbine interaction of the off-design conditions experienced by aero-engines in their duty. Engine-representative disturbances are generated by a combustor simulator able to produce swirling entropy waves. Two injection positions and four injection cases are studied. Experimental measurements are carried out at three traverses: upstream of the stator, at the interstage, and downstream of the rotor. This paper analyses the effect of the stage expansion ratio: two values are studied, namely 1.4 and 1.76, representative of subsonic and transonic flow conditions. They are chosen imposing similar velocity triangles at the rotor inlet. Results show that the swirl profile considerably impacts the stage aerodynamics. The aerothermal flow field downstream of the stator is modified significantly by the combustor disturbances. Conversely, downstream of the rotor, the differences in aerodynamics lessen. However, the entropy wave persists at the stage outlet and its transport depends on both the operating point and the injection position.
The Role of Turbine Operating Conditions on Combustor–Turbine Interaction—Part II: Loading Effects
Authors: Notaristefano Andrea , Gaetani Paolo 
Published: September 2022

Abstract
Aero-engine combustors burn a lean and premixed blend releasing vorticity and temperature perturbations. Interacting with the first turbine stage, these disturbances impact the cascade aerodynamics, add criticality to the blade cooling, and are sources of noise. The first of these issues is addressed in this paper, focusing on off-design turbine conditions, as experienced by aero-engines in their duty. This paper, Part II of a two-fold contribution, analyses the effect of the stage loading obtained by changing the rpm (three different values) at the same expansion ratio of 1.4, representative of subsonic flow conditions. Engine-representative disturbances are generated by a combustor simulator able to produce a swirling entropy wave. Two injection positions and four injection patterns are considered. Experimental measurements are carried out through the stage, measuring the injected disturbance and the aerothermal flow field downstream of the stator and the rotor. Results show that the swirl profile mostly impacts the stage aerodynamics. The different work extraction and the interaction with secondary flow structures change the entropy wave transport, diffusion, and decay through the rotor. Furthermore, the increased angle of the incidence caused by the injected disturbance can make the blade stall under the most loaded operating condition.
Numerical Prediction of Long-Term Droplet Erosion and Washing Efficiency of Axial Compressors Through the Use of a Discrete Mesh Morphing Approach
Authors: Agati Giuliano , Castorrini Alessio , Gruttola Francesca Di , Gabriele Serena , Rispoli Franco , Simone Domenico , Venturini Paolo , Borello Domenico 
Published: September 2022

Abstract
Online water washing represents an operation strategy commonly used to reduce compressor performance deterioration due to blade fouling. Since this kind of washing is applied when the machine operates close to full load conditions, injected droplets are strongly accelerated and consequently impact the rotor blades at high velocity, thus inducing undesirable phenomena like erosion. Here, we present a novel technique to study long-term water droplets erosion by also considering the geometry modification caused by droplets impacts. Two-phase unsteady numerical simulations were carried out, considering the injection of water droplets and their transport across the fluid flow in the first part of a real compressor, which is modeled in the region extending from the inlet to the rotor blades of the first stage. Simulations are performed on the whole machine to account for the asymmetric distribution of the spray injectors, the machine struts, inlet guide vanes (IGVs), and rotor blades. The k−ɛ realizable turbulence model with standard wall functions was coupled with the discrete phase model to track injected droplets motion. Droplets-wall interaction is modeled following the Stanton–Rutland approach aiming at detecting the effect of droplet impact (deposit, rebound, and splashing) depending on the impact conditions. Moreover, a semi-empirical erosion model developed by the authors was used to evaluate the erosion induced by the droplets injection. Material removal due to erosion is converted into nodal mesh displacement that is used by a secondary routine to implement the mesh morphing scheme. The mesh modification is applied at discrete steps to reduce the computational load. This technique is adopted to account for the blades geometry modification due to water droplet erosion leading to performance losses. Moreover, an estimation of the compressor operating life before maintenance operations is given and the water washing efficiency during the whole life of the machine is evaluated by means of proper indices. At the end of the simulation workflow, erosion phenomena are observed in all the compressor regions, especially in the rotor where erosion peaks are reached at the hub of the blades leading edge. The rotor blades wet surface was found to remain almost constant at around 50% during compressor water washing. Erosive phenomena were proved to evolve nonlinearly with time indicating the need to account for the geometry modification for obtaining an accurate prediction of the long-time process.
A New Model for Circular Cylindrical Kirchhoff–Love Shells Incorporating Microstructure and Flexoelectric Effects
Authors: Qu Y. L. , Guo Z. W. , Zhang G. Y. , Gao X.-L. , Jin F. 
Published: September 2022

Abstract
A new model for circular cylindrical Kirchhoff–Love shells of flexoelectric–elastic materials with the centrosymmetric cubic symmetry is developed by considering both microstructure and flexoelectric effects. The couple stress theory is used to describe microstructure effects, and a curvature-based flexoelectricity theory is applied to account for flexoelectric effects. The governing equations and boundary conditions are simultaneously derived through a variational formulation based on Hamilton’s principle. The newly developed shell model recovers the model for Kirchhoff plates of cubic flexoelectric–elastic materials as a special case when the shell radius tends to infinity. To illustrate the new shell model, static bending, free vibration, and forced vibration problems of a simply supported axisymmetric circular cylindrical shell are analytically solved by directly applying the model. Numerical results reveal that the microstructure and flexoelectric effects lead to enhanced extensional and bending stiffnesses of the shell. In addition, the first and second natural frequencies of the shell predicted by the new model are found to be higher than those predicted by the classical elasticity-based model, but the difference is diminishing with the increase in the shell thickness. Furthermore, the results for both the mechanically and electrically forced vibrations given by the current model show that the deflection amplitude and the electric potential distribution in the shell are both frequency-dependent and can be tailored by controlling the excitation frequency. These findings indicate that a flexoelectric–elastic shell of a centrosymmetric cubic material can be used as a sensor for energy harvesting by converting mechanical energy to electricity or as an actuator by converting electrical energy to mechanical work.
Training patterns associated with injury in New York City Marathon runners
Authors: Toresdahl Brett G , Metzl Jordan D , Kinderknecht James , McElheny Kathryn , de Mille Polly , Quijano Brianna , Fontana Mark A 
Published: September 2022

ObjectiveTraining patterns are commonly implicated in running injuries. The purpose of this study was to measure the incidence of injury and illness among marathon runners and the association of injuries with training patterns and workload.MethodsRunners registered for the New York City Marathon were eligible to enrol and prospectively monitored during the 16 weeks before the marathon, divided into 4-week ‘training quarters’ (TQ) numbered TQ1–TQ4. Training runs were tracked using Strava, a web and mobile platform for tracking exercise. Runners were surveyed at the end of each TQ on injury and illness, and to verify all training runs were recorded. Acute:chronic workload ratio (ACWR) was calculated by dividing the running distance in the past 7 days by the running distance in the past 28 days and analysed using ratio thresholds of 1.3 and 1.5.ResultsA total of 735 runners participated, mean age 41.0 (SD 10.7) and 46.0% female. Runners tracked 49 195 training runs. The incidence of injury during training was 40.0% (294/735), and the incidence of injury during or immediately after the marathon was 16.0% (112/699). The incidence of illness during training was 27.2% (200/735). Those reporting an initial injury during TQ3 averaged less distance/week during TQ2 compared with uninjured runners, 27.7 vs 31.9 miles/week (p=0.018). Runners reporting an initial injury during TQ1 had more days when the ACWR during TQ1 was ≥1.5 compared with uninjured runners (injured IQR (0–3) days vs uninjured (0–1) days, p=0.009). Multivariable logistic regression for training injuries found an association with the number of days when the ACWR was ≥1.5 (OR 1.06, 95% CI (1.02 to 1.10), p=0.002).ConclusionIncreases in training volume ≥1.5 ACWR were associated with more injuries among runners training for a marathon. These findings can inform training recommendations and injury prevention programmes for distance runners.
Development of a 5-year risk prediction model for type 2 diabetes in individuals with incident HbA1c-defined pre-diabetes in Denmark
Authors: Nicolaisen Sia K , Thomsen Reimar W , Lau Cathrine J , Sørensen Henrik T , Pedersen Lars 
Published: September 2022

IntroductionPre-diabetes increases the risk of type 2 diabetes, but data are sparse on predictors in a population-based clinical setting. We aimed to develop and validate prediction models for 5-year risks of progressing to type 2 diabetes among individuals with incident HbA1c-defined pre-diabetes.Research design and methodsIn this population-based cohort study, we used data from the Danish National Health Survey (DNHS; n=486 495), linked to healthcare registries and nationwide laboratory data in 2012–2018. We included individuals with a first HbA1c value of 42–47 mmol/mol (6.0%–6.4%), without prior indications of diabetes. To estimate individual 5-year cumulative incidences of type 2 diabetes (HbA1c ≥48 mmol/mol (6.5%)), Fine-Gray survival models were fitted in random 80% development samples and validated in 20% validation samples. Potential predictors were HbA1c, demographics, prescriptions, comorbidities, socioeconomic factors, and self-rated lifestyle.ResultsAmong 335 297 (68.9%) participants in DNHS with HbA1c measurements, 26 007 had pre-diabetes and were included in the study. Median HbA1c was 43.0 mmol/mol (IQR 42.0–44.0 mmol/mol, 6.1% (IQR 6.0%–6.2%)), median age was 69.6 years (IQR 61.0–77.1 years), and 51.9% were women. During a median follow-up of 2.7 years, 11.8% progressed to type 2 diabetes and 10.1% died. The final prediction model included HbA1c, age, sex, body mass index (BMI), any antihypertensive drug use, pancreatic disease, cancer, self-reported diet, doctor’s advice to lose weight or change dietary habits, having someone to talk to, and self-rated health. In the validation sample, the 5-year area under the curve was 72.7 (95% CI 71.2 to 74.3), and the model was well calibrated.ConclusionsIn addition to well-known pre-diabetes predictors such as age, sex, and BMI, we found that measures of self-rated lifestyle, health, and social support are important and modifiable predictors for diabetes. Our model had an acceptable discriminative ability and was well calibrated.
Mass cytometry-based peripheral blood analysis as a novel tool for early detection of solid tumours: a multicentre study
Authors: Zhang Qi , Ye Mao , Lin Cheng , Hu Manyi , Wang Yangyang , Lou Yu , Kong Quanming , Zhang Jungang , Li Junjian , Zhang Yuhua , Yang Tianxing , Sun Xu , Yao Weiyun , Hua Yongfei , Huang Haifeng , Xu Minghui , Wang Xiaoguang , Yu Xin , Tao Weifeng , Liu Runtian , Gao Yuming , Wang Tian , Wang Jianing , Wei Xiaobao , Wu Jiangchao , Yu Zhengping , Zhang Chengwu , Yu Chaohui , Bai Xueli , Liang Tingbo 
Published: September 2022

ObjectiveEarly detection of a tumour remains an unmet medical need, and approaches with high sensitivity and specificity are urgently required. Mass cytometry time-of-flight (CyTOF) is a powerful technique to profile immune cells and could be applied to tumour detection. We attempted to establish diagnostic models for hepatocellular carcinoma (HCC) and pancreatic ductal adenocarcinoma (PDAC).DesignWe performed CyTOF analysis for 2348 participants from 15 centres, including 1131 participants with hepatic diseases, 584 participants with pancreatic diseases and 633 healthy volunteers. Diagnostic models were constructed through random forest algorithm and validated in subgroups.ResultsWe determined the disturbance of systemic immunity caused by HCC and PDAC, and calculated a peripheral blood immune score (PBIScore) based on the constructed model. The PBIScore exhibited good performance in detecting HCC and PDAC, with both sensitivity and specificity being around 80% in the validation cohorts. We further established an integrated PBIScore (iPBIScore) by combining PBIScore and alpha-fetoprotein or carbohydrate antigen 19-9. The iPBIScore for HCC had an area under the curve (AUC) of 0.99, 0.97 and 0.96 in training, internal validation and external validation cohorts, respectively. Similarly, the iPBIScore for PDAC showed an AUC of 0.99, 0.98 and 0.97 in the training, internal validation and external validation cohorts, respectively. In early-stage and tumour-marker-negative patients, our iPBIScore-based models also showed an AUC of 0.95–0.96 and 0.81–0.92, respectively.ConclusionOur study proved that the alterations of peripheral immune cell subsets could assist tumour detection, and provide a ready-to-use detection model for HCC and PDAC.
Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial
Authors: Kroshus Emily , Chrisman Sara P D , Glang Ann , Hunt Tamerah , Hays Rachel , Lowry Sarah , Peterson Alexis , Garrett Kimberly , Ramshaw Dane , Hafferty Kiana , Kinney Erin , Manzueta Maria , Steiner Mary Kathleen , Bollinger Beth J , Chiampas George , Rivara Frederick P 
Published: September 2022

ObjectivesDetermine whether Pre-Game Safety Huddles, a novel and low-resource approach to concussion education, increase the expected likelihood of concussion reporting for youth athletes.MethodsA cluster-randomised trial compared Safety Huddles to usual care. Safety Huddles bring together athletes and coaches from both teams before the start of each game for coaches to briefly affirm the importance of speaking up if a concussion is suspected. Participants were athletes from 22 competitive community-based American football and girls and boys soccer teams (ages 9–14), and randomisation into intervention or control occurred at the level of the bracket (group of teams that compete against each other during the regular season). The primary outcome was expected likelihood of reporting concussion symptoms to the coach, measured via validated athlete survey at the beginning and end of the season.ResultsOf 343 eligible participants, 339 (99%) completed baseline surveys and 303 (88%) completed surveys at season end. The mean (SD) age was 11.4 (1.1) years, 26% were female soccer athletes, 27% were male soccer athletes and 47% were football athletes. In adjusted analyses accounting for baseline values and clustering by sport and team via random effects, expected likelihood of concussion reporting at the end of the season was significantly higher in the intervention group compared to controls (mean difference=0.49, 95% CI 0.11 to 0.88; Cohen’s d=0.35).Conclusions and relevancePre-Game Safety Huddles increased the expected likelihood of athletes reporting concussion symptoms. While further study is warranted, sport organisations should consider this approach a promising low-resource option for improving concussion safety in their setting.Trial registration numberNCT04099329.