bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stable Numerical Implementation of a Turbulence Scheme with Two Prognostic Turbulence Energies
Authors: Mašek Ján , Ďurán Ivan Bašták , Brožková Radmila 
Published: March 2022

Abstract
In this paper, we present a new and more stable numerical implementation of the two-energy configuration of the Third Order Moments Unified Condensation and N-dependent Solver (TOUCANS) turbulence scheme. The original time-stepping scheme in TOUCANS tends to suffer from spurious oscillations in stably stratified turbulent flows. Because of their high frequency, the oscillations resemble the so-called fibrillations that are caused by the coupling between turbulent exchange coefficients and the stability parameter. However, our analysis and simulations show that the oscillations in the two-energy scheme are caused by the usage of a specific implicit–explicit temporal discretization for the relaxation terms. In TOUCANS, the relaxation technique is used on source and dissipation terms in prognostic turbulence energy equations to ensure numerical stability for relatively long time steps. We present both a detailed linear stability analysis and a bifurcation analysis, which indicate that the temporal discretization is oscillatory for time steps exceeding a critical time-step length. Based on these findings, we propose a new affordable time discretization of the involved terms that makes the scheme more implicit. This ensures stable solutions with enough accuracy for a wider range of time-step lengths. We confirm the analytical outcomes in both idealized 1D and full 3D model experiments.

Significance Statement
The vertical turbulent transport of momentum, heat, and moisture has to be parameterized in numerical weather prediction models. The parameterization typically employs nonlinear damping equations, whose numerical integration can lead to unphysical, time-oscillating solutions. In general, a presence of such numerical noise negatively affects the model performance. In our work, we address numerical issues of the recently developed scheme with two prognostic turbulence energies that have more realism and physical complexity. Specifically, we detect, explain, and design a numerical treatment for a new type of spurious oscillations that is connected to the temporal discretization. The treatment suppresses the oscillations and allows us to increase the model time step more than 4 times while keeping an essentially non-oscillatory solution.
Design guidelines for hybrid continuous/discontinuous carbon fibre laminates
Authors: Evans Anthony D , Turner Thomas A , Harper Lee T , Warrior Nicholas A 
Published: March 2022

Combining discontinuous carbon fibre moulding compounds with unidirectional (UD) non-crimp fabric has been studied as a potential solution for producing cost effective composite structures, with short cycle times via compression moulding. The tensile stiffness and strength of a composite with a hybrid fibre architecture were found to be up to 60% and 110% higher, respectively, than the baseline discontinuous fibre moulding compound, when 20% (by vol.) of UD fibres were aligned in the primary loading direction. However, stress concentrations arising from the dissimilar material properties can result in the strength of the hybrid architecture being reduced to below that of the baseline composite if the UD fibres are not incorporated effectively. This paper focusses on optimising the stress transfer within the transition zone (inter-material interface) between the UD material and the discontinuous fibre moulding compound, when local isolated patches of continuous fibre are used rather than full coverage plies. This is key if hybrid architectures are to be adopted for structural applications, minimising the stress concentration effects from the UD ply ends, whilst maintaining the low cycle times and costs associated with compression moulding. Following aerospace laminate design guidelines, a range of step sizes and joint configurations have been considered for different ply drop strategies, minimising the magnitude of the stress concentration at the UD ply ends. Results indicate that the step length must be at least 20 times the thickness of the UD ply to ensure the bending strength at the joint is the same as the baseline discontinuous fibre material. An ‘alternating joint' yields 18% higher bending strengths than a conventional ‘stepped joint’ design, as the stress concentrations at the dropped ply ends are reduced in comparison to the inherent stress concentrations within the discontinuous fibre material.
Engineering the geometry of novel yarns for flexible, hybrid composites Part I: Multiple breaks
Authors: Alshukur Malek , Stylios George 
Published: March 2022

This study reports on the development of a novel form of yarn reinforcement for making super tough, flexible composites. The concept is based on the rupturing of components of the composite yarn many times before totally breaking. The composite yarn structure has a configuration of three main components − helical, straight and sinusoidal. The components are not restricted by the type of raw material, and any type of fibre or blend can be used. Experimentally, the hollow-spindle spinning system was used to make nine variants of this composite yarn. These variants were tested for their tensile behaviour at an extension rate of 250 mm/min. It was found that the core component of two of the nine variants had eight breakages, while the core component of the remaining variants had four to five breakages before the final break of the core component. The main mechanism that allows the core component yarn to break so many times is a locking applied to it by the wrapping yarn during stretching. The gain in strength for these variants was 21–81% in comparison with a typical twistless composite yarn. Flexible composites made of such yarn configurations can find numerous uses in construction, geotextiles, ballistic protective garments, aerospace, automotive and shipping industries.
Primary and metastatic primitive neuroectodermal tumor of the heart: A systematic review
Authors: Hajsadeghi Shokoufeh , Iranpour Aida , Amouei Erfan , Tehrani Nasim Hoshangian , Ghavidel Alireza , Ziaie Hossein , Asadi Omolbanin , Moradians Vahan , Tayebi Ali , Mestres Carlos-A. , Manqoutaei Sanaz Abdollahzade 
Published: March 2022

Objective Primary and metastatic primitive neuroectodermal tumors of the pericardium are uncommon. Two cases are presented and discussed. Methods The cases of a 17- and 38-year-old male patients with neuroectodermal tumors of the pericardium are presented. In addition, a systematic review was performed according to the Preferred Reporting Items and checklist for Systematic reviews and Meta-Analyses (PRISMA). All selected articles’ quality assessment was done using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports. Results The systematic review yielded 29 patients with primary or metastatic PNET. Two patients underwent cardiac transplantation. It seems that unlike considering total resection in other organs, pericardiectomy in PNET patients with pericardial origin may lead to further invasion of the lesions, and it is not recommended. The average disease-free follow-up was 10 months. The combination of neoadjuvant and adjuvant chemotherapy along with surgery and radiotherapy offered the best disease-free outcomes. Conclusion Neuroectodermal heart tumors are rare, aggressive tumors requiring chemotherapy and radiotherapy in association with tumor resection surgery to have the best disease-free duration.
Assessment of the reporting quality of resistance training interventions in randomised controlled trials for lower limb tendinopathy: A systematic review
Authors: Burton Ian , McCormack Aisling 
Published: March 2022

Objectives 1. To describe what exercises and intervention variables are used in resistance training interventions in randomised controlled trials for lower limb tendinopathy 2. To assess completeness of reporting as assessed by the Consensus on Exercise Reporting Template (CERT) and the Toigo and Boutellier framework. 3. To assess the implementation of scientific resistance training principles. 4. To assess therapeutic quality of exercise interventions with the i-CONTENT tool. Data sources We searched MEDLINE, CINAHL, AMED, EMBase, SPORTDiscus, and the Cochrane library databases. Review methods Systematic review of randomised controlled trials that reported using resistance exercises for lower limb tendinopathies. Results We included 109 RCTs. Eccentric heel drops were the most common exercise (43 studies), followed by isotonic heel raises (21), and single leg eccentric decline squats (18). Reporting of exercise descriptor items from the Toigo and Boutellier framework ranged from 0–13, with an average score of 9/13, and only 7 studies achieved a full 13/13. Reporting of items from the CERT ranged from 0–18, with an average score of 14/19. No study achieved a full 19/19, however 5 achieved 18/19. Scoring for resistance training principles ranged from 1–10, with only 11 studies achieving 10/10. Reporting across studies for the i-CONTENT tool ranged from 2–7, with an average score of 5 across included studies. A total of 19 studies achieved a full 7/7 score. Less than 50% of studies achieved an overall low risk of bias, highlighting the methodological concerns throughout studies. Conclusion The reporting of exercise descriptors and intervention content was generally high across RCTs for lower limb tendinopathy, with most allowing exercise replication. However, reporting for some tendinopathies and content items such as adherence was poor, limiting optimal translation to clinical practice.
Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review
Authors: Fu Yu , Chapman Emma J , Boland Alison C , Bennett Michael I 
Published: March 2022

Background: Patients with chronic obstructive pulmonary disease (COPD) face limited treatment options and inadequate access to palliative care. Aim: To provide a pragmatic overview of clinical guidelines and produce evidence-based recommendations for severe COPD. Interventions for which there is inconsistent evidence to support their use and areas requiring further research were identified. Design: Practice review of guidelines supported by scoping review methodology to examine the evidence reporting the use of guideline-recommended interventions. Data sources: An electronic search was undertaken in MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Database of Systematic Reviews, complemented by web searching for guidelines and publications providing primary evidence (July 2021). Guidelines published within the last 5 years and evidence in the last 10 years were included. Results: Severe COPD should be managed using a multidisciplinary approach with a holistic assessment. For stable patients, long-acting beta-agonist/long-acting muscarinic antagonist and pulmonary rehabilitation are recommended. Low dose opioids, self-management, handheld fan and nutritional support may provide small benefits, whereas routine corticosteroids should be avoided. For COPD exacerbations, systematic corticosteroids, non-invasive ventilation and exacerbation action plans are recommended. Short-acting inhaled beta-agonists and antibiotics may be considered but pulmonary rehabilitation should be avoided during hospitalisation. Long term oxygen therapy is only recommended for patients with chronic severe hypoxaemia. Short-acting anticholinergic inhalers, nebulised opioids, oral theophylline or telehealth are not recommended. Conclusions: Recommended interventions by guidelines are not always supported by high-quality evidence. Further research is required on efficacy and safety of inhaled corticosteroids, antidepressants, benzodiazepines, mucolytics, relaxation and breathing exercises.
Z-score regression model for coronary artery diameter in healthy Chinese Han children
Authors: Yang Yanzhang , Wang Li , Yang Yanfang , Wu Xiaojing , Xu Lijin , Bi Changbo 
Published: March 2022

Background Coronary artery distension and aneurysm are complications of Kawasaki disease in children. Purpose To develop a Z-score regression model for coronary artery diameter in children that could be used as reference. Material and Methods This retrospective analysis included children with normal heart structure between March 2013 and April 2017. Body surface area (BSA) was calculated. The diameters of the right coronary, left main coronary, left anterior descending, and circumflex arteries were measured by echocardiography. Pearson correlation analysis was used to establish linear, exponential, logarithmic, power, and square root regression models. Results The analysis included 509 children (280 boys) aged 1 day to 15.2 years. Coronary artery diameters were significantly correlated with age, height, body mass, BSA, and [Formula: see text] (r = 0.663–0.826; P < 0.05), with a stronger correlation for [Formula: see text] than BSA ( P < 0.05). The adjusted determination coefficients ([Formula: see text]) were higher for the exponential and square root models than for the other models ( P < 0.05). The random error term variance was constant for the exponential model ( P > 0.05), and processing with the weighted least-square methods eliminated heteroscedasticity in the other models. The Z-scores were normally distributed for the exponential and square root models ( P > 0.05). Conclusion Overall, the square root model was the optimal equation for the calculation of coronary artery Z-score in Chinese Han children. This model could be used to facilitate the diagnosis of coronary artery distension in children with suspected Kawasaki disease.
Economic Evaluation of Early Psychosis Interventions From A Canadian Perspective
Authors: Tarride Jean-Eric , Blackhouse Gord , Abdel-Baki Amal , Latimer Eric , Mulvale Gillian , Cooper Brian , Langill Gord , Milinkovic Deborah , Stennett Rosain , Hurley Jeremiah 
Published: March 2022

BackgroundCompared to treatment as usual (TAU), early psychosis intervention programs (EPI) have been shown to reduce mortality, hospitalizations and days of assisted living while improving employment status.AimsThe study aim was to conduct a cost-benefit analysis (CBA) and a cost-effectiveness analysis (CEA) to compare EPI and TAU in Canada.MethodsA decision-analytic model was used to estimate the 5-year costs and benefits of treating patients with a first episode of psychosis with EPI or TAU. EPI benefits were derived from randomized controlled trials (RCTs) and Canadian administrative data. The cost of EPI was based on a published survey of 52 EPI centers in Canada while hospitalizations, employment and days of assisted living were valued using Canadian unit costs. The outcomes of the CBA and CEA were expressed in terms of net benefit (NB) and incremental cost per life year gained (LYG), respectively. Scenario analyses were conducted to examine the impact of key assumptions. Costs are reported in 2019 Canadian dollars.ResultsBase case results indicated that EPI had a NB of $85,441 (95% CI: $41,140; $126,386) compared to TAU while the incremental cost per LYG was $26,366 (95% CI: EPI dominates TAU (less costs, more life years); $102,269). In all sensitivity analyses the NB of EPI remained positive and the incremental cost per LYG was less than $50,000.ConclusionsIn addition to EPI demonstrated clinical benefits, our results suggest that large-scale implementation of EPI in Canada would be desirable from an economic point of view .
Understanding Medication Adherence in Bhutanese Refugees With Diabetes in a Midwestern City
Authors: Timsina Muna K. , Peltzer Jill N. , Pokharel Yashashwi , Peterson JoAnn M. , Schwartz Lori J. , LeMaster Joseph W. 
Published: March 2022

Introduction: Bhutanese refugees have a higher prevalence of type 2 diabetes but are less likely to achieve medication adherence and glycemic control. The purpose of this project was to understand factors affecting diabetes medication adherence in this population. Methodology: This was a qualitative project using focus groups of adult Bhutanese refugees with type 2 diabetes ≥18 years old and hemoglobin A1C ≥8% and their caregivers from a family medicine clinic at the University of Kansas. Data were analyzed using content analysis. Results: A total of 23 individuals participated. Three themes emerged from data analysis: desire to engage in care but face multiple barriers, family and community support invaluable for health, and considerations for culturally contextual person-centered care. Participants provided specific recommendations to address the barriers, with emphasis on improving health literacy. Discussion: Integrating the identified factors can foster person-centered, culturally congruent care to improve diabetes medication adherence in Bhutanese refugees.
What are the Soft Tissue Risk Factors for Obstructive Sleep Apnea in Patients with Down's Syndrome?
Authors: Stanbouly Dani , Steinberg Barry , Chuang Sung-Kiang 
Published: March 2022

Objective To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients. Design Retrospective cohort study. Patients The 2016 Kids’ Inpatient Database (KID) was queried to identify all patients diagnosed with DS. Main Outcome Measures The primary predictor variables were tonsillar hypertrophy (TH), adenoidal hypertrophy (AH), Hypertrophy of Tonsils & Adenoids (HTA), Laryngeal Stenosis (LS), Hypotonia, Glossoptosis, Congenital Laryngomalacia (CL), and Overweight & Obesity (OO). The primary outcome variable was OSA. Results The final sample consisted of 18,181 patients with a diagnosis of DS. Relative to patients aged 0-5, patients aged 6-10 (OR 3.5, P < 0.01), 11-5 (OR 3.4, P < 0.01), and 16 & above (OR 3.6, P < 0.01) were each independently associated with increased odds of OSA. Further, TH (OR 23.2, P < 0.01), AH (OR 20.3, P < 0.01), HTA (OR 64.2, P < 0.01), glossoptosis (OR 5.0, P < 0.01), CL (OR 4.3, P < 0.01), and OO (OR 3.7, P < 0.01) were all independent risk factors for OSA. Conclusions The presence of hypertrophied tonsils and adenoids together was the strongest risk factor for OSA. DS patients aged six and above were at risk for OSA development relative to younger patients. Patients with DS should be tested for OSA, which otherwise will deteriorate their existing comorbidities.
EGFR-mutated advanced lung cancer. Data from a single institution, the Hospital of Leon, in Spain
Authors: Delgado Sillero Irene , Lopetegui Lia Nerea , Sánchez Cousido Luis Felipe , Rojas Piedra Mariam , Távara Silva Blanca , Garrido Onecha Maria Luisa , Medina Valdivieso Soledad , Alonso Horcajo Nieves , Díez Tascón Cristina , López González Ana , Castañón López Carmen , Pedraza Lorenzo Manuela , García Palomo Andrés , Martín Vicente , Diz Tain Pilar 
Published: March 2022

Introduction 10–16% of non-small cell lung cancer (NSCLC) cases have the epidermal growth factor receptor (EGFR) amplified and/or mutated. Studies show that EGFR tyrosine kinase inhibitors (TKIs) significantly prolong progression-free survival (PFS) in patients with advanced NSCLC compared to those treated with platinum-based chemotherapy (CT) doublets. Our aim is to perform a real-world survival analysis of patients treated with TKI as first-line therapy at the Hospital of Leon (CAULE) in Spain. The impact on global survival rates and responses to clinical and histopathological factors were also analyzed. Material and methods We retrospectively reviewed patients diagnosed with EGFR-mutated NSCLC who received treatment with EGFR-TKI in the Department of Oncology at the University of Leon Health Center complex between March 2011 and June 2018. Data was analyzed with Kaplan-Meier and Cox regression models to show overall survival (OS), progression-free survival (PFS), and the associated variables. Results 53 patients were included in the study, 50% (n = 27) were treated with gefitinib, 32% (n = 18) with erlotinib and 10% (n = 6) with afatinib. The median OS and PFS were 27.7 months (95% CI: 21–33.8 months) and 18 months (95% CI 14.25–21.89 months), respectively. The variables associated with OS and with PFS were exon19 deletion as a protective factor and presence of extrathoracic metastasis as a risk factor. The most frequent adverse effects were rash, diarrhea, asthenia, and conjunctivitis. Conclusions Real-world analysis of this data confirms that treatment with TKI is beneficial for patients diagnosed with EGFR-mutated NSCLC. Our OS outcomes were similar to those reported in clinical trials.
Complementary and Alternative Medicine Online Learning Intervention for Oncology Healthcare Providers: A Mixed-Methods Study
Authors: Baydoun Mohamad , Levin Gregory , Balneaves Lynda G. , Oberoi Devesh , Sidhu Aven , Carlson Linda E. 
Published: March 2022

Introduction: With the increased usage of complementary approaches in oncology comes the need for its integration into healthcare professional (HCP) education. The purpose of this single-arm, mixed-methods study was to examine the feasibility and benefits of a brief complementary and alternative medicine (CAM) learning intervention for improving HCP knowledge, attitudes, and practices regarding CAM use in cancer care, and explore the experiences of participating HCPs. Methods: HCPs from the Tom Baker Cancer Centre in Alberta, Canada, were invited to participate in 3 online interactive learning modules that reviewed: (1) basic CAM information, (2) HCP-patient CAM communication, and (3) evidence-based CAM decision support. The study survey consisted of attitude (n = 14), knowledge (n = 31), and practice (n = 31) items, administered at baseline and two-months post-intervention. Semi-structured interviews were conducted with a subset of participants. Results: Approximately 300 HCPs were invited to participate, of which 105 expressed interest in the study (35%), and 83 of them consented to participate (79%). The intervention completion rate was 73% (61/83 HCPs). There was a significant pre-post change in HCPs’ attitudes and, to a lesser extent, knowledge and practices related to CAM (8/14 attitude items changed pre-post compared to 13/31 knowledge items and 5/31 practice items), in which more HCPs reported patients should be assisted in making complementary therapy (CT) decisions, exhibited greater knowledge about CAM, and more often engaged in a CAM-related clinical practice. Qualitative findings supported the beneficial effects of the modules, with HCPs describing themselves as being more likely to ask patients about their CAM use and referring them to credible CAM resources. Nonetheless, the majority did not feel adequately prepared to make recommendations about specific CTs, even after the intervention. Conclusion: The current study suggests that online CAM learning offers a feasible and potentially promising intervention for improving oncology HCP knowledge, attitudes, and practices regarding CAM, warranting further investigation. This study highlights a need for institutional resources to help HCPs fully integrate CT decision support into cancer patient care. A coordinated evidence-based CAM program at cancer centers may help ensure that all patients’ CAM-related needs are properly attended to.