bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association and Time-Varying Effects of Body Mass Index on All-Cause Mortality in Patients With Hypertension
Authors: zhu jingjing , Liu Xiaohua , Zhang Jinling , Li Jun , Chen Linli , Xu Huilin , Qin Guoyou 
Published: November 2020

Abstract
BackgroundThe relationship between body mass index (BMI) and mortality in hypertension patients remains controversial. This study aimed to evaluate the association and the time-varying effects of different BMI categories on the risk of all-cause mortality in hypertension patients. MethodsThis retrospective cohort study was conducted among 212,394 Chinese people with hypertension. All deaths were identiﬁed based on Shanghai Vital Statistics. Cox model combined with time-by-covariate interactions was used to estimate the association and the time-varying effects of BMI on the risk of all-cause mortality. The potential non-linear effects across follow-up period for BMI were examined by the application of restricted cubic spline (RCS).ResultsOverall, 31,130 deaths occurred (14.7%) within an average follow-up of 8.24 years. Underweight (<18.5 kg/m2) showed a progressively weakening negative effect on all-cause mortality over time. For both sexes, overweight (23.0-24.9 kg/m2) and class I obesity (25.0-29.9 kg/m2) showed protective effects within 5 years after registration, but these became insignificant in later years. There was no significant difference in the effect on all-cause mortality between class II obesity (≥30.0 kg/m2) and normal weight. in the elderly patients, overweight, class I obesity and class II obesity had continuous protective effects on mortality.ConclusionsAlthough the effect of baseline body mass index on the risk of all-cause mortality varied at different follow-up periods, underweight persistently remained a risk factor for all-cause mortality in hypertension, whereas overweight and class I obesity had protective effects. Thus, in the long-term management of hypertension, more attention should be given to underweight patients.
Comparing COVID-19 Critical Care Admissions by Minority Populations to Pre-COVID-19 Critical Care Utilization
Authors: Galiatsatos Panagis , Page Kathleen , Chatterjee Souvik , Maygers Joyce , Sarkar Sauradeep , Jones Vanya , Tolson Tina , Hill-Briggs Felicia , Chen Edward , Golden Sherita 
Published: November 2020

Abstract
Background: Several months into the COVID-19 pandemic, reassessing intensive care unit (ICU) utilization, specifically with regional impact on diverse populations, should be a priority for hospitals planning for critical care resource allocation. In our study, we reviewed the impact of COVID-19 on a community hospital serving an urban region, comparing the sociodemographic distribution of ICU admissions before and during the pandemic. Methods: We executed a time sensitive analysis to see if COVID-19 ICU admissions reflect regional sociodemographic populations as well as ICU admission trends prior to the current pandemic. Collected sociodemographic variables included sex, race, ethnicity, and age of adult patients (age 18 and older) admitted to the hospital’s medical and cardiac ICUs, which were converted to COVID-19 ICUs. The time period selected was 18-months, which was then dichotomized into pre-COVID-19 admissions (December 1, 2018 to March 13, 2020) and COVID-19 ICU admissions (March 14, 2020 to May 31, 2020). Variables were compared using Fisher’s exact tests and Wilcoxon tests when appropriate.Results: During the 18-month period, 1861 patients were admitted to the aforementioned ICUs. The mean age of the 1861 patients was 62.75 + 15.57 years old, with the majority of these patients being male (52.23%), White (64.43%), and non-Hispanic/Latinx (95.75%). There were differences in racial and ethnic distribution comparing pre-COVID-19 admissions to the COVID-19 admissions. Compared to pre-COVID-19 ICU admissions, there was an increase in African American versus White admissions (p=0.01) and an increase in Hispanic/Latinx versus non-Hispanic/Latinx admissions (p<0.01), during the COVID-19 pandemic.Discussion: During the first three months of admissions to COVID-19 ICUs, there was a rise in admissions among Hispanic/Latinx and African-American patients, while non-Hispanic/Latinx and White patient admissions declined compared to the previous pre-COVID year. These findings support development of strategies to enhance allocation of resources to bolster novel, equitable strategies to mitigate the incidence of COVID-19 in minority populations.
Exploration of the Clinical Effect of Modified Peroneal Nerve Block in Foot Operation Under the Plane of the Ankle joint: A Non-Randomized Clinical Feasibility Observational Study.
Authors: tuo ya , FU XUEQIANG , QIU YI , WANG XIAODONG , YAN SHENGJUAN , HU YONGQIAN , GONG YANRU 
Published: November 2020

Abstract
Background This study was aimed at exploring the clinical effect of a modified dorsal peroneal nerve block in foot operation under the ankle plane. Methods The study was observational study, thirty patients ( n =30) were observed with single-center and non-randomized. The patients were treated with an ankle nerve block (including the posterior tibial nerve, superficial peroneal nerve, saphenous nerve, and sural nerve block in the plane of the ankle) and a deep peroneal nerve block (7.5 mg/ml). The primary outcomes were intraoperative visual analogue scale score (0-10 points), numeric rating scale score (0-10 points), and Neuropen score (0-2 points). The secondary outcomes were postoperative pain visual analogue scale and numeric rating scale scores (0-10). Histograms and normal probability QQ plots were used to test the distribution of normality. Results We analyzed the data of 30 patients. It was found that after 20 min of ankle block and deep peroneal nerve block, 23 patients achieved a perfect block effect (visual analogue scale and Neuropen scores = 0), and the operation was performed smoothly. Six patients experienced slight pain (visual analogue scale score: ≤ 3, Neuropen score = 1). An intravenous sedative drip (dexmedetomidine 4 µg/ml, 1 µg/kg dexmedetomidine hydrochloride injection 2 ml:0.2 g; Jiangsu Nhwa Pharmaceutical Co., Ltd . , China) was used. The block failed in one patient, and the operation was performed under general anesthesia with a laryngeal mask in this patient. Conclusions The modified deep peroneal nerve block combined with an ankle nerve block can meet the anesthesia needs for foot surgery under the ankle plane. However, due to the limited number of patients evaluated, it is difficult to accurately predict the effect and a large degree of uncertainty exists regarding these findings. Trial registration This study had been registered at http://www.chictr.org.cn/index.aspx with No. ChiCTR2000037880 on Sep 3, 2020.It was a retrospectively registered.
Reference Gene Selection for miRNA qRT-PCR Analysis in Lily
Authors: Zhang Qian , Gao Xue , Wang Lian-Juan , Zhao Yu-Qian , Jia Gui-Xia 
Published: November 2020

Abstract
Background: The selection of reliable reference genes is a critical element for obtaining accurate gene expression data to assess quantitative real-time polymerase chain reaction (qRT-PCR) performance. It is critical to use suitable reference genes in miRNA qRT-PCR because of short amplification products and large differences in the expression levels of target miRNAs involved in some biological processes. However, in lily, which exhibits a large complex genome but lacks a reference, the available miRNA reference genes for use in qRT-PCR under various treatment conditions are limited, and their reliability has rarely been systematically evaluated.Results: In this study, 8 candidate reference genes, including three classic housekeeping genes and five potential miRNAs from the miRNA library of L. × formolongi, were selected and assessed for expression stability utilizing the BestKeeper, geNorm and Normfinder tools, together with the Delta Ct method, across a diverse set of biotic and abiotic experimental conditions (developmental stages, tissues, heat stress and pathogen defence) to determine the best reference gene(s) for L. × formolongi and L. regale. The final ranking was reordered by using RankAggreg, and the results showed that the novel miRNA PC-3p-67_108977 and the conserved miRNAs miR399a, miR399a and U6 were the most stable genes for L. × formolongi and L. regale, respectively, under all tested experimental conditions. Additionally, PC-3p-67_108977 and U6 were the most suitable genes for qRT-PCR studies in lily.Conclusions: This study provides a comprehensive evaluation of the reliability of reference genes for miRNA studies on development and biotic and abiotic stress responses in different lilies. These results will be beneficial for miRNA identification and functional studies of lilies in the future.
Effect of Coal Particle Size on the Temperature and Pressure of Low Temperature Carbonization Square Furnace: A Combined Computational and Industrial Practice Study
Authors: Wang Yu-fei , Liu Qian-qian , Yan Long , Dan Yong , Mi Wen-xing , Li Jian , Gao Yong , Fu Feng , Zhang Qiu-li , Liu Jun-li , Shang Wen-zhi 
Published: November 2020

Abstract
Three-dimensional computational fluid dynamics according to the actual size of carbonization square furnace was performed, the standard k-ε model, the finite-rate/eddy-dissipation model and the P1 radiation model were adopted to simulate the flow of gases, the combustion of gas mixture and the heat transfer process, a mathematical model for square furnace was established when the porous medium model was selected for approximate replacement of coal seams in the furnace. The temperature and pressure fields with eight particle sizes of coal were also investigated and compared to five groups of conditions in the actual industrial production. The results showed that furnace witnessed dropped temperature, increased pressure, and gradually accelerated decline in the volume percentage of the carbonization zone with decreasing particle size of coal. However, the trends of flow field distribution were similar under different particle sizes, the maximum temperature and pressure presented an approximately linear decline and an approximately exponential growth, respectively. The temperature difference at the same height gradually narrowed with the gradual increase in the coal seam height under the same particle size. Moreover, the comparison between the numerical simulation results and industrial practice revealed a temperature and pressure error both lower than 6.25% and 12.8%, respectively.
Effects of (Mg1/3Sb2/3)4+ Substitution on the Structure and Microwave Dielectric Properties of Ce2Zr3x(Mg1/3Sb2/3)3-3x(MoO4)9 Ceramics
Authors: Xu Zhou , Jiajia Sun , Ningkang Zhang , Huazhang Sun , Wenhong Tao , haitao wu 
Published: November 2020

Abstract
Ce2[Zr1-x(Mg1/3Sb2/3)x]3(MoO4)9 (0.02≤x≤0.10) ceramics were prepared well through the traditional solid-state method. A single phase, belonging to the space group of R-3c, was detected by using X-ray diffraction at sintering temperatures ranging from 700 to 850 °C. The crystallization micro-structural of specimens was examined by applying Scanning electron microscopy. The structural refinement of these samples was investigated in detail by performing the Rietveld refinement method. The intrinsic properties were calculated and explored via far-infrared reflectivity spectroscopy. The correlations between the chemical bonds parameters and microwave dielectric properties were calculated and analyzed by P-V-L theory. Ce2[Zr0.94(Mg1/3Sb2/3)0.06]3(MoO4)9 ceramics with excellent dielectric properties: εr = 10.37, Q×f = 71748 GHz and τf = −13.6 ppm/°C sintered at 725 °C for 6 hours.
Utilization of and Demand for Reproductive Health Services among 20–39-Year-Old Women in Rural China: A Cross-Sectional Study
Authors: Yue Jing , Luo Yang , Xu Chen , Qin Si , Meng Yanting , Fan Ling , Nie Min 
Published: November 2020

Abstract
Background: The enjoyment of reproductive health (RH) services is a universal right for all human beings. The rural population serves an important role in economic and social development. However, little is known about the rural population’s RH services, especially in low and middle-income countries. Our study aimed to determine the utilization of and demand for RH services in rural China, which is the most populous country in the world with 40.42% rural populations.Methods: A cross-sectional study was conducted in four villages of four cities in Hunan province among 978 women who were 20–39 years old. A researcher-made structured questionnaire was used to collect data. The data were entered into EpiData version 3.0 and analyzed by SPSS version 18.0. Statistical significance was defined as a two-sided P value of less than 0.05.Results: Among the 980 women who were recruited in this study, 978 participants completed the questionnaire as requested (response rate: 99.8%). Age, monthly household income, employment, spousal education level, and artificial abortion history were associated with the utilization of RH services (P＜0.05). The top three RH services participants utilized were free antenatal examinations (90.2%), free postpartum visits (73.0%), and free folic acid supplements (71.6%). The top three RH services they most wanted to obtain were prevention of cervical/breast cancer (58.9%), child health care (48.2%), and reproductive tract infection/sexually transmitted disease treatment (41.1%). The most commonly used method for participants to obtain information related to RH services was the internet.Conclusions: It is necessary to further improve the accessibility and availability of RH services to ameliorate the utilization of these services in rural areas. The internet was the most effective method for improving the use of RH services. Educational interventions and policy support help promote RH services in rural China.
External Validation and Clinical Utility of Non-Invasive Prediction Models for Non-Alcoholic Fatty Liver Disease in Malaysia
Authors: Suan Mohd Azri Mohd , Chan Huan Keat , Soelar Shahrul Aiman , Hassan Muhammad Radzi Abu 
Published: November 2020

Abstract
Background: Many prediction models have been developed to detect non-alcoholic fatty liver disease (NAFLD). The drawbacks of many of models are the use of parameters that are not routinely measured locally. This study aimed to evaluate the external validity of a series of prediction models for NAFLD, which were selected based on the routinely measured and tested clinical parameters in public healthcare centers in Malaysia. Methods: A literature search of articles that described the prediction models for NAFLD on adult subjects between 2000 and 2019 was conducted. The validation cohort comprised patients who underwent liver elastography using the Fibroscan® device in a public tertiary care center between January 2017 and December 2019. Both the discrimination and calibration of each model were assessed to determine their predictive performance. Results: Out of the 404 patients undergoing liver elastography, 280 were diagnosed with NAFLD (69.3%). Six prediction models were identified from the existing literature and evaluated. The calibration assessment demonstrated that although three of the models overestimated the NAFLD risk, updating the models generally improved their calibration performance. The discriminative performance of the selected models ranged from 0.717 to 0.783. With a specificity level of 90% and 80%, the sensitivity of all the models fell between 31.1%–48.9% and 46.4%–66.8%, respectively. The Framingham Steatosis Index (FSI) model demonstrated a better predictive performance compared to the other models. Conclusions: The FSI model demonstrates an acceptable predictive performance. Its application in clinical practice could promote the screening and early treatment of NAFLD in the Malaysian population.
Association Between AST to ALT Ratio and Peripheral Artery Disease in Chinese Hypertensive Population: A Cross-Sectional Study
Authors: Liu Hui , Zha Xiaoyuan , Ding Congcong , Hu Lihua , Li Minghui , Zhou Wei , Wang Tao , Zhu Lingjuan , Bao Huihui , Cheng Xiaoshu 
Published: November 2020

Abstract
Background: Previous studies had shown the role of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) in cardiovascular disease . Peripheral artery disease(PAD) is an important risk factor for cardiovascular death. However, there are fewer investigations of the correlations between the AST/ALT ratio and Peripheral artery disease (PAD). Methods: We analyzed data of 10,900 hypertensive patients from the Chinese Hypertension Registry Study. Using a multivariate logistic regression model, we examined the association between AST / ALT and peripheral arterial disease (PAD),which was defined as ABI≤ 0.9 in either leg.Results：A total of 350 patients had peripheral arterial disease and the prevalence of PAD was 3.21%. After adjusting for potential confounders, AST / ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI: 1.13 to 1.59), and a statistically significant increased risk of PAD for the third AST / ALT ratio tertile (T3) compared to the first tertile (T1) (OR:1.49, 95% CI: 1.09 to 2.04, P-trend= 0.005) was found. Moreover, when we combined T1-T2 into one group and used it as a reference group, the risk of PAD increased with the increase of AST/ALT and the risk ratio was 1.52 (95% CI :1.20 to 1.95). Conclusion: A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggested that AST / ALT maybe help us highlight patients who was at high risk of vascular endpoints.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.
Implementing an Intervention to Improve Adverse Incident Reporting in the Hospital Setting: A Pilot Study
Authors: Akiyama Naomi , Koeda Keisuke , Uozumi Ryuji , Takahashi Fumiaki , Ogasawara Kuniaki 
Published: November 2020

Abstract
BackgroundTo improve patient safety, it is needed to collect information related to adverse events and near-miss reports. This practice constitutes one of the strategies hospital managers use to understand the kinds of errors that occur at their hospitals. This pilot study aimed to evaluate an intervention designed to improve error reporting rates among physicians. MethodsThe study was conducted at University Hospital A, where data were collected from April 2017 to March 2019. The intervention began in April 2018 and consisted of the four following steps: defining reporting standards, improving the incident reporting system, having the hospital administrators set clear goals and beginning a visualized feedback process, and achieving support and appropriate feedback as a leadership resource from the hospital administrator. ResultsPhysicians’ reporting rates were higher in FY 2018 than 2017. Particularly, differences began to occur in November of FY 2018 (p < 0.05, analyzed using Fisher’s exact test). Further, the number of reports submitted by non-physicians increased by 900 in FY 2018 compared to those in FY 2017. Physicians tend to underreport minor incidents, but reports of near-miss events increased from 16 in FY 2017 to 106 in FY 2018. Reporting standards were focused on severe cases, but they had related treatment/procedure and drug, so that not only error cases but also near-miss cases were reported. Based on these results, the intervention effectively increased incident reporting rates among not only physicians, but also other staff members. In this regard, reporting barriers were broken when hospital administrators encouraged employees to submit incident reports.ConclusionsActive intervention of hospital administrators, the executive class of the hospital, may encourage employees to submit incident reports, thus effectively removing reporting barriers.
Evaluating quality improvement at scale: design considerations for routine reporting to executive board of a healthcare organisation in the UK National Health Service
Authors: Chua Kia-Chong , Henderson Claire , Grey Barbara , Holland Michael , Sevdalis Nick 
Published: November 2020

Abstract
Background Quality improvement (QI) in healthcare is a cultural transformation process that requires long-term commitment from the executive board, a critical theme in emerging accounts of QI success in the UK National Health Service (NHS). To help sustain long-term commitment from the executive board, an organisation-wide picture of QI applications and their impact needs to be made routinely visible.Method We developed a retrospective evaluation drawing inputs from the resident QI team of a healthcare organisation and academic colleagues in the field of implementation and improvement science, as well as peer-reviewed and grey literature on what constitutes success for QI in healthcare. Formative feedback on content relevance, acceptability, and feasibility issues were used to guide evaluation design. The evaluation was conducted as an online survey so that the data accrual process resembles routine reporting to help surface implementation challenges. A purposive sample of QI projects was identified to maximise contrast between projects that were or were not successful as determined by the resident QI team. To hone strategic focus in what should be reported, we also compared factors that might affect project outcomes. For understanding implementation issues, we reviewed data quality to surface challenges in the design and sustainability of routine reporting for the executive board.Results Out of 52 QI projects, 10 led to a change in routine practice (henceforth referred to as adoption). Details of project outcomes were limited. Project team outcomes, indicative of capacity building, were not systematically documented. Service user involvement, quality of measurement plan, fidelity and documentation of plan-do-study-act (PDSA) cycles had a major impact on adoption. The proximal impact of these process factors on adoption was consistently more apparent than the distal impact of input and contextual factors.Conclusions Designing a routine reporting framework is an iterative process involving continual dialogue with frontline staff and improvement specialists to navigate data accrual demands. A retrospective evaluation, as in this study, can yield empirical insights for dialogue about the routine visibility of QI applications and their organisation-wide impact, thereby honing the implementation science of QI in a healthcare organisation.
Bronchoscopy Manifestation In Severe COVID-19 Patient: Case Series&nbsp;
Authors: Widysanto Allen , Sutanto Yusup Subagio , Soetjipto Audrey Suryani , Lugito Nata Pratama , Siahaan Sylvia Sagita 
Published: November 2020

Abstract
Background: Severe manifestation of COVID-19 are identical with significant inflammation and associated with high mortality due to severe hypoxemia. Bronchoscopy’s role in the management of COVID-19 patients is still controversial and minimally evaluatedCase presentation: Our case series reported unique bronchoscopy presentation. Three patients with COVID-19 were confirmed by PCR nasophryngeal swab suddenly complain of progressive dyspnea and impending respiratory failure not respond with oxygen therapy. An emergency bronchoscopy was performed. All three patient had a normal bronchial wall without inflammation and edema but showed significant thick and copious mucus plug resulting in sudden desaturation. Patient showed significant clinical improvement following bronchoscopy intervention showed by clinical and chest x-ray improvement. Conclusion : Deteriorating severe COVID-19 patient can have normal bronchial mucosa in bronchoscopy and showed marked thick and copious mucus plug. Bronchial washing and suction can be a life-saving modality as therapeutic effort. Significant improvements following the bronchial washing and suction was seen. Bronchoscopy should be performed with precaution and sufficient personal protective equipment to prevent infection transmission.