bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental and Numerical Investigations of Extended Jet Effects on Multiple-Jet Impingement Heat Transfer Characteristics
Authors: Yang Xing , Wu Hang , Feng Zhenping 
Published: March 2022

Abstract
A jet impingement system equipped with extended jet holes was experimentally evaluated in this study. To reproduce a strong crossflow condition, the jet impingement configuration featured a multiple-jet array of 16 × 5 rows in the streamwise and pitchwise directions, respectively, and the crossflow was exhausted from one open side of the impingement channel only. The transient thermochromic liquid crystal (TLC) technique was used to measure heat transfer on the target surface for different extended lengths of 1.0–2.5 jet hole diameters with Reynolds numbers from 1.0 × 104 to 3.0 × 104. To provide complementary flow physics for elaborating the heat transfer patterns observed from the experiments, well-validated numerical simulations were carried out. Comparisons with a baseline jet hole configuration showed that the extended jet holes helped to significantly improve the heat transfer levels as well as to generate a more uniform distribution pattern by suppressing the crossflow. Despite an aerodynamic penalty, the extended jet holes provided much higher heat transfer levels at equal pumping power consumption. The flow fields obtained by the numerical simulations revealed that the jets issued from the extended jet holes were straighter and had less mixing with the crossflow, resulting in a higher jet momentum impinging onto the target. Most importantly, it was found that the dominated flow mechanism of the extended jet holes was to prevent the jets from being redirected by the crossflow in strong crossflow conditions, rather than reducing the jet-to-target distance.
Longitudinal Tibia Stress Fracture Risk During High-Volume Training: A Multiscale Modeling Pipeline Incorporating Bone Remodeling
Authors: Pyles Connor O. , Dunphy Melissa , Vavalle Nicholas A. , Vignos Michael F. , Luong Quang T. , Ott Kyle , Drewry David G. 
Published: March 2022

Abstract
Tibia stress fractures are prevalent during high-intensity training, yet a mechanistic model linking longitudinal training intensity, bone health, and long-term injury risk has yet to be demonstrated. The objective of this study was to develop and validate a multiscale model of gross and tissue level loading on the tibia including bone remodeling on a timescale of week. Peak tensile tibial strain (3517 μstrain) during 4 m/s running was below injury thresholds, and the peak anteromedial tibial strain (1248 μstrain) was 0.17 standard deviations away from the mean of reported literature values. An initial study isolated the effects of cortical density and stiffness on tibial strain during a simulated eight week training period. Tibial strains and cortical microcracking correlated with initial cortical modulus, with all simulations presenting peak anteromedial tensile strains (1047–1600 μstrain) near day 11. Average cortical densities decreased by 7–8% of their nominal value by day 11, but the overall density change was &lt;2% by the end of the simulated training period, in line with reported results. This study demonstrates the benefits of multiscale models for investigating stress fracture risk and indicates that peak tibial strain, and thus injury risk, may increase early in a high intensity training program. Future studies could optimize training volume and recovery time to reduce injury risk during the most vulnerable training periods.
Bioaugmentation of Anammox Activated Sludge with a Nitrifying Bacterial Community as a Way to Increase the Nitrogen Removal Efficiency
Authors: Pimenov N. V. , Nikolaev Yu. A. , Dorofeev A. G. , Grachev V. A. , Kallistova A. Yu. , Mironov V. V. , Vanteeva A. V. , Grigor’eva N. V. , Berestovskaya Yu. Yu. , Gruzdev E. V. , Begmatov Sh. A. , Ravin N. V. , Mardanov A. V. 
Published: March 2022

Abstract—
Bioaugmentation, i.e., increasing the abundance of certain microorganisms in the community by adding appropriate cells or establishing the conditions promoting their growth, is widely used in environmental technologies. Its application for launching of the anammox reactors is usually limited to introduction of anammox bacteria. We expected addition of nitrifiers during anammox bioreactor launching to stimulate the anammox process due to rapid production of nitrite, which anammox bacteria use for ammonium oxidation. The present work investigated the effect of introduction of a nitrifying community on the composition and activity of the microbial community in an anammox reactor. At the time of inoculation of a laboratory SBR reactor, an active nitrifying community (5 days old) (ASB) (bioaugmenting activated sludge, ASB) containing group I nitrifiers, primarily Nitrosospira, was added (1 : 100 by biomass) to anammox activated sludge (ASA) stored for 1 month at 4°C and exhibiting low metabolic activity. The use of ASB resulted in increased efficiency of nitrogen removal. While noticeable nitrogen removal in the control (7%) was observed since day 11 of incubation, nitrogen removal in the experimental reactor began on day 4 at the level of 20%. Nitrogen removal after 30 days of incubation was ~60% in the experiment and 20% in the control. The rate of ammonium oxidation in the presence of ASB increased due to activity of nitrifying bacteria (during the first 10 days of operation) and anammox bacteria of the genus Brоcadia, which were already present in ASA (throughout all period of operation). Activity of group II nitrifiers (genera Nitrobacter and Nitrococcus), which were present in ASB, prevented accumulation of nitrite, which in high concentrations is toxic to both nitrifiers and anammox bacteria. High activity of the Nitrosospira nitrifiers introduced with ASB probably provided the anammox bacteria with one of the substrates (nitrite), promoting their rapid growth. During subsequent operation of the reactor, nitrifiers of the genus Nitrosomonas from the initial ASA community were mainly responsible for growth of the anammox bacteria. Thus, ASA bioaugmentation at the loading of the anammox reactor by active nitrifiers resulted in significantly improved efficiency of ammonium removal via the anammox process and accelerated transition of the reactor to the working mode.
Antisynthetase syndrome sine myositis presenting as severe acute respiratory failure
Authors: Archer Christian , Nazim Khola , Panchatsharam Selva 
Published: March 2022

A female in her late 40s presented to the emergency department during the COVID-19 pandemic with shortness of breath, fever and productive cough following a recent diagnosis of bilateral non-massive pulmonary emboli. She had elevated inflammatory markers and her chest X-ray revealed bilateral infiltrates. Her SARS-CoV-2 PCR was negative, and she was treated for community-acquired pneumonia. However, despite treatment she rapidly deteriorated and developed severe respiratory failure, requiring mechanical ventilation.On further investigation, she tested positive for anti-Jo-1 antibodies and a diagnosis of antisynthetase syndrome sine myositis was made. This led to successful treatment with high dose corticosteroids and intravenous immunoglobulin.This case highlights an uncommon presentation of a rare condition, as well as the benefits of working in a multidisciplinary team on the intensive care unit.
Comparison of cognitive function in older adults with type 1 diabetes, type 2 diabetes, and no diabetes: results from the Study of Longevity in Diabetes (SOLID)
Authors: Lacy Mary E , Moran Chris , Gilsanz Paola , Beeri Michal S , Karter Andrew J , Whitmer Rachel A 
Published: March 2022

IntroductionThe incidence of both type 1 diabetes (T1D) and type 2 diabetes (T2D) is increasing. Life expectancy is improving in T1D, resulting in a growing population of elderly adults with diabetes. While it is well established that older adults with T2D are at increased risk of cognitive impairment, little is known regarding cognitive aging in T1D and how their cognitive profiles may differ from T2D.Research design and methodsWe compared baseline cognitive function and low cognitive function by diabetes status (n=734 T1D, n=232 T2D, n=247 without diabetes) among individuals from the Study of Longevity in Diabetes (mean age=68). We used factor analysis to group cognition into five domains and a composite measure of total cognition. Using linear and logistic regression models, we examined the associations between diabetes type and cognitive function, adjusting for demographics, comorbidities, depression, and sleep quality.ResultsT1D was associated with lower scores on total cognition, language, executive function/psychomotor processing speed, and verbal episodic memory, and greater odds of low executive function/psychomotor processing speed (OR=2.99, 95% CI 1.66 to 5.37) and verbal episodic memory (OR=1.92, 95% CI 1.07 to 3.46), compared with those without diabetes. T2D was associated with lower scores on visual episodic memory. Compared with T2D, T1D was associated with lower scores on verbal episodic memory and executive function/psychomotor processing speed and greater odds of low executive function/psychomotor processing speed (OR=1.74, 95% CI 1.03 to 2.92).ConclusionsOlder adults with T1D had significantly poorer cognition compared with those with T2D and those without diabetes even after accounting for a range of comorbidities. Future studies should delineate how to reduce risk in this vulnerable population who are newly surviving to old age.
FreeStyle Libre Flash Glucose Monitoring system for people with type 1 diabetes in the UK: a budget impact analysis
Authors: Blissett Robert , Blissett Deirdre , Levrat-Guillen Fleur , Deshmukh Harshal , Wilmot Emma G , Ryder Robert E J , Walton Chris , Sathyapalan Thozhukat 
Published: March 2022

IntroductionThis study aims to estimate the budget impact of increased uptake of the FreeStyle Libre Flash Glucose Monitoring system in people with type 1 diabetes mellitus (T1DM) in the UK.Research design and methodsA budget impact model was developed, applying real-world data collected in the Association of British Clinical Diabetologists (ABCD) FreeStyle Libre Nationwide Audit. Costs of diabetes glucose monitoring in a T1DM population (n=1790) using self-monitoring of blood glucose (SMBG) or the FreeStyle Libre system were compared with a scenario with increased use of the FreeStyle Libre system.ResultsThe ABCD audit demonstrates FreeStyle Libre system use reduces diabetes-related resource utilization. The cost analysis found that higher acquisition costs are offset by healthcare costs avoided (difference £168 per patient per year (PPPY)). Total costs were £1116 PPPY with FreeStyle Libre system compared with £948 PPPY with SMBG. In an average-sized UK local health economy, increasing FreeStyle Libre system uptake from 30% to 50% increased costs by 3.4% (£1 787 345–£1 847 618) and when increased to 70% increased by a further 3.3%.ConclusionIncreased uptake of the FreeStyle Libre system in the T1DM population marginally increases the cost to UK health economies and offers many system benefits.
Empowering consumers to PREVENT diet-related diseases through OMICS sciences (PREVENTOMICS): protocol for a parallel double-blinded randomised intervention trial to investigate biomarker-based nutrition plans for weight loss
Authors: Aldubayan Mona Adnan , Pigsborg Kristina , Gormsen Sophia M O , Serra Francisca , Palou Mariona , Mena Pedro , Wetzels Mart , Calleja Alberto , Caimari Antoni , Del Bas Josep , Gutierrez Biotza , Magkos Faidon , Hjorth Mads Fiil 
Published: March 2022

IntroductionPersonalised nutrition holds immense potential over conventional one-size-fits-all approaches for preventing and treating diet-related diseases, such as obesity. The current study aims to examine whether a personalised nutritional plan produces more favourable health outcomes than a standard approach based on general dietary recommendations in subjects with overweight or obesity and elevated waist circumference.Methods and analysisThis project is a 10-week parallel, double-blinded randomised intervention trial. We plan to include 100 adults aged 18–65 years interested in losing weight, with body mass index ≥27 but<40 kg/m2 and elevated waist circumference (males >94 cm; females >80 cm). Participants will be categorised into one of five predefined ‘clusters’ based on their individual metabolic biomarker profile and genetic background, and will be randomised in a 1:1 ratio to one of two groups: (1) personalised plan group that will receive cluster-specific meals every day for 6 days a week, in conjunction with a personalised behavioural change programme via electronic push notifications; or (2) control group that will receive meals following the general dietary recommendations in conjunction with generic health behaviour prompts. The primary outcome is the difference between groups (personalised vs control) in the change in fat mass from baseline. Secondary outcomes include changes in weight and body composition, fasting blood glucose and insulin, lipid profile, adipokines, inflammatory biomarkers, and blood pressure. Other outcomes involve measures of physical activity and sleep patterns, health-related quality of life, dietary intake, eating behaviour, and biomarkers of food intake. The effect of the intervention on the primary outcome will be analysed by means of linear mixed models.Ethics and disseminationThe protocol has been approved by the Ethics Committee of the Capital Region, Copenhagen, Denmark. Study findings will be disseminated through peer-reviewed publications, conference presentations and media outlets.Trial registration numberNCT04590989.
Burden of cancer in the general surgical population in the eastern region of Ghana
Authors: Olecki Elizabeth Josephine , Ssentongo Paddy , Dao Joseph , Wong William G , Stahl Kelly A , Ofosu-Akromah Richard , Amponsah-Manu Foster , Pameijer Colette 
Published: March 2022

ObjectiveTo estimate the surgical burden of malignant disease in the Eastern Region of Ghana.DesignDescriptive cross-sectional study.SettingRegional hospital in the eastern region of Ghana.ParticipantsPatients treated by the surgery department at Eastern Regional Hospital in Koforidua, Ghana.InterventionsNone.Primary and secondary outcome measuresPrimary outcome was incidence of malignancy and secondary outcome descriptive differences between patients who had a benign indication for surgery compared with those with a malignant indication for surgery.ResultsA total of 1943 inpatient surgical procedures were performed from 2015 to 2017 with 13.4% (261) of all procedures ultimately performed for malignancy. Of all breast procedures performed, 95.2% of procedures resulted in a malignant diagnosis. The remaining subtypes of procedures had rates ranging from <1% to 41.2% of procedures performed for malignant disease. Additionally, this study found over 13% of patients admitted to the surgical service for breast cancer ultimately did not undergo a surgical procedure.ConclusionThis is the first study investigating the burden of malignant disease in the Eastern Region of Ghana. We found a substantial prevalence of malignant disease in the surgical population in this region. This information can be used to aid in future medical resource planning in this region.
Barriers and facilitators for implementation of a national recommended specialty core-curriculum across UK medical schools: a cross-sectional study using an online questionnaire
Authors: Sharma Maulina , Murphy Ruth , Doody Gillian A 
Published: March 2022

ObjectivesThe National Health Service (NHS) Long-Term plan published in 2019 set out healthcare reforms to meet the healthcare demands of UK. Undergraduate specialty core-curricula like dermatology aligns well to the training needs of the future workforce but lacks representation, consistency and implementation. This study explores the barriers and facilitators influencing the implementation of a specialty-specific (dermatology) national core-curriculum across UK medical schools.DesignA constructivist approach was used to develop an online questionnaire and data collected using mixed methodology.ParticipantsUndergraduate dermatology teaching leads across all UK medical schools.Results30 out of 42 UK medical schools responded to the survey (71%). 16 out of 30 (53%) responders were unaware of the planned Medical Licensing Assessments (MLA) for all UK graduates in 2024–2025; 43% were unaware if dermatology was mapped to national standards; 50% were unsure if the dermatology was blueprinted on school curricula. Barriers to implementation included competing NHS service commitments, the specialty not seen as a priority and difficulty influencing curricula changes at school level. Facilitators included workforce planning and transparency in funding to support leadership in undergraduate education. Domains identified for curriculum implementation were: (1) awareness of the role of General Medical Council and the MLA, (2) medical education training for teaching leads, (3) lack of recognition and resources for leadership, (4) skills development to map, blueprint and assess specialty core-components, (5) medical school and specialty engagement.ConclusionsThis study identifies the potential barriers and facilitators to specialty specific core-curricular implementation across UK medical schools. Lack of standardised training in medical education, time and resources undermine the role of specialty teaching leads as medical educators. Medical school engagement with specialties with mutual support would aid the forthcoming educational reforms.
Mapping evidence of community health workers delivering physical rehabilitation services in sub-Saharan Africa: a scoping review protocol
Authors: Mapulanga Miriam , Dlungwane Thembelihle 
Published: March 2022

IntroductionSub-Saharan Africa (SSA) is one of the low-income regions in the world which is affected by the critical shortage of human resources for health amid a high disease burden, including physical disability. Community health workers are viewed as the possible solution to increase population access to health services, including rehabilitation at the community level. The purpose of this scoping review is to map the evidence and scope of physical rehabilitation services delivered by community health workers in SSA.Methods and analysisThe framework by Arksey and O’Malley will be used to guide the scoping review protocol. Database searching will be conducted using PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. Other sources of literature will include reference lists, conference presentations and publications on organisational websites such as WHO, Ministries of Health, and Non-governmental Organisations in SSA. The screening will be guided by the inclusion and exclusion criteria. Thematic content analysis aided by NVivo V.12 will be done to present the narrative account of the review. The Mixed Methods Appraisal Tool version 2018 will be used to evaluate the methodological quality of the studies.Ethics and disseminationThe review is part of a larger study that has received ethical clearance. The result will be disseminated using print and electronic media.
Individual goal-based plan based on nursing theory for adults with type 2 diabetes and self-care deficits: a study protocol of a randomised controlled trial
Authors: Rosman Jessica , Eriksson Jan W , Martinell Mats , Lindholm Olinder Anna , Leksell Janeth 
Published: March 2022

IntroductionThe prevalence and costs of type 2 diabetes are increasing worldwide. A cornerstone in the treatment and care of diabetes is supporting each patient in self-management. In Sweden, most patients with type 2 diabetes are cared for in the primary care setting, which is heavily burdened. Because of implementation difficulties regarding evidenced-based diabetes self-management education and support in this setting, there is a need for an instrument that is easy to use and implement. We developed an individual care plan based on the self-care deficit nursing theory of Dorothea Orem as an instrument to facilitate more individualised self-care support for patients with type 2 diabetes. In this study, we aim to determine whether a written, theory-based, individual goal-based plan for patients with type 2 diabetes and self-management deficits can affect their glycaemic control and health-related quality of life, as well as their experiences of living with diabetes and of support from diabetes care.Methods and analysisThe study design is a randomised controlled trial using a quantitative approach. A total of 110 patients will be included. Additionally, a qualitative interview study will be conducted 12 months after the intervention. The primary outcome will be glycosylated haemoglobin levels. Secondary outcomes will be health-related quality of life measured using the RAND-36, and the patient’s experience of living with diabetes and of the support from diabetes care measured using the Diabetes Questionnaire. Quantitative data will be analysed using the paired t-test, unpaired t-test, and Mann–Whitney U test with IBM SPSS V.26.0 software. Qualitative content analysis will be used for qualitative data.Ethics and disseminationThis study has been approved by the Ethical Review Authority in Uppsala, Sweden (Etikprövningsmyndigheten, Uppsala, Sverige) (Dnr: 2020-03421). The results will be disseminated in peer-reviewed publications.Trial registration numberISRCTN10030245.
Prevalence of lateral violence in nurse workplace: a systematic review and meta-analysis
Authors: Zhang Yue , Cai Jianzheng , Yin Rulan , Qin Shuwen , Wang Haifang , Shi Xiaoqing , Mao Lifen 
Published: March 2022

BackgroundThe prevalence of inter-nurse lateral violence (LV) reported in current studies is inconsistent, ranging from 7% to 83%. The purpose of this study is to quantify the prevalence of LV in nurses’ workplaces.MethodsSystematic review and meta-analysis. Cochrane, PubMed, Embase, CINAHL, CNKI and Wanfang databases were searched for relevant studies (up to 27 January 2021). We included cross-sectional, case–control or cohort studies in which both abusers and victims were nurses. Studies that did not provide specific data on abusers were excluded. Stata V.16.0 was used for statistical analysis. Fixed-effect or random-effect model was adopted according to heterogeneity, which was evaluated by Cochran’s Q and I2 values. The main indicator was LV prevalence. Sensitivity analysis, subgroup analysis and meta-regression were performed to investigate the sources of heterogeneity.ResultsA total of 14 studies with 6124 nurses were included. Further, 13 articles with 5745 nurses were included in the meta-analysis, and the pooled prevalence of LV among nurses was 33.08% (95% CI: 23.41% to 42.75%, p<0.05; I2=99.0%). The remaining one study containing 370 samples reported that the prevalence of inter-nurse LV was 7.92%. Subgroup analysis showed that region, sample size, sampling, study’s quality, response rate and publication time might not be the sources of heterogeneity. Meta-regression indicated that sample size had the main influence on model heterogeneity. Egger’s test showed the existence of publication bias (p=0.03).DiscussionThe prevalence of inter-nurse LV is high in nurse workplace. It is suggested that scholars pay more attention to the cultural differences of inter-nurse LV between regions in the future. This study has the following limitations: there is a lack of studies on LV prevalence in many countries; lack of standard assessment tools; no grey literature was searched.