bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Non-Parametric Projection-Based Estimator for the Probability of Causation, with Application to Water Sanitation in Kenya
Authors: Cuellar Maria , Kennedy Edward H. 
Published: January 2020

SummaryCurrent estimation methods for the probability of causation ‘PC’ make strong parametric assumptions or are inefficient. We derive a non-parametric influence-function-based estimator for a projection of PC, which allows for simple interpretation and valid inference by making weak structural assumptions. We apply our estimator to real data from an experiment in Kenya. This experiment found, by estimating the average treatment effect, that protecting water springs reduces childhood disease. However, before scaling up this intervention, it is important to determine whether it was the exposure, and not something else, that caused the outcome. Indeed, we find that some children, who were exposed to a high concentration of bacteria in drinking water and had a diarrhoeal disease, would probably have contracted the disease absent the exposure since the estimated PC for an average child in this study is 0.12 with a 95% confidence interval of (0.11, 0.13). Our non-parametric method offers researchers a way to estimate PC, which is essential if we wish to determine not only the average treatment effect, but also whether an exposure probably caused the observed outcome.
How to … be reflexive when conducting qualitative research
Authors: Barrett Aileen , Kajamaa Anu , Johnston Jenny 
Published: January 2020

SummaryReflexivity can be a complex concept to grasp when entering the world of qualitative research. In this article, we aim to encourage new qualitative researchers to become reflexive as they develop their critical research skills, differentiating between the familiar concept of reflection and reflective practice and that of reflexivity. Although reflection is, to all intents and purposes, a goal‐oriented action with the aim of improving practice, reflexivity is a continual process of engaging with and articulating the place of the researcher and the context of the research. It also involves challenging and articulating social and cultural influences and dynamics that affect this context. As a hallmark of high‐quality qualitative research, reflexivity is not only an individual process but one that needs to be considered a collective process within a research team, and communicated throughout the research process. In keeping with our previous articles in this series, we have illustrated the theoretical concept of reflexivity using practical examples of published research.
An importin‐beta‐like protein mediates lignin‐modification‐induced dwarfism in Arabidopsis
Authors: Panda Chinmayee , Li Xin , Wager Amanda , Chen Han‐Yi , Li Xu 
Published: January 2020

SummaryPerturbation of lignin biosynthesis often results in severe growth and developmental defects in plants, which imposes practical limitations to genetic enhancement of lignocellulosic biomass for biofuel production. Currently, little information is known about the cellular and genetic mechanisms of this important phenomenon. Here we show that defects in both cell division and cell expansion underlie the dwarfism of an Arabidopsis lignin mutant ref8, and report the identification of a GROWTH INHIBITION RELIEVED 1 (GIR1) gene from a suppressor screen. GIR1 encodes an importin‐beta‐like protein required for the nuclear import of MYB4, a transcriptional repressor of phenylpropanoid metabolism. Disruption of GIR1 and MYB4 similarly alleviates the cellular defects and growth inhibition in ref8, suggesting that the growth rescue effect of gir1 is likely due to compromised MYB4 transport and function. Importantly, the phenylpropanoid perturbation is not alleviated in gir1 ref8 and myb4 ref8, suggesting that the function of MYB4 in growth inhibition of lignin‐modified plants is likely to be distinct from its known role in transcriptional regulation of phenylpropanoid biosynthetic genes. This study also provides evidence that lignin‐modification‐induced dwarfism is not merely due to compromised water transport brought about by lignin deficiency, as gir1 has no effect on the growth inhibition of other lignin mutants that show the collapsed xylem phenotype.
Efficacy of HLA virtual cross‐matched platelet transfusions for platelet transfusion refractoriness in hematopoietic stem cell transplantation
Authors: Seike Keisuke , Fujii Nobuharu , Asano Naomi , Ohkuma Shigenori , Hirata Yasushi , Fujii Keiko , Sando Yasuhisa , Nakamura Makoto , Naito Kazunori , Saeki Kyosuke , Meguri Yusuke , Asada Noboru , Ennishi Daisuke , Nishimori Hisakazu , Matsuoka Ken‐ichi , Tsubaki Kazuo , Otsuka Fumio , Maeda Yoshinobu 
Published: January 2020

BACKGROUNDCross‐matched platelet (cross‐matched PLT) transfusion is effective for immune‐mediated platelet transfusion refractoriness (PTR), but is more costly and time‐consuming for physical cross‐match than using standard PLT units. Recent studies have reported the utility of human leucocyte antigens (HLA) virtual cross‐matched PLT (HLA‐matched PLT) that is defined as HLA‐A/B matched or no antibody against donor‐specific antigen. Here, we evaluated the effect of HLA‐matched PLTs for PTR in post hematopoietic stem cell transplant (HSCT) recipients.STUDY DESIGN AND METHODSOur study included a total of 241 PLTs in 16 patients who underwent HSCT at Okayama University Hospital between 2010 and 2017, receiving either HLA‐matched or cross‐matched PLTs. We calculated the 24‐hour corrected count increments (CCI‐24) to evaluate the effect of PLTs. A CCI‐24 ≥ 4500 was considered to be a successful transfusion.RESULTSWe analyzed 139 cross‐matched PLTs and 102 HLA‐matched PLTs. In the immune‐mediated PTR, the rate of successful transfusion was 60.5% for cross‐matched PLT and 63.4% for HLA‐matched PLT (p = 0.825). On the other hand, the median CCI‐24 for cross‐matched PLT transfusions and HLA‐matched PLT transfusions were 1856 and 5824 (p < 0.001), with a success rate of 28.1 and 54.1% in cases with non‐immune‐mediated PTR, respectively (p = 0.001).CONCLUSIONThe effectiveness of HLA‐matched PLT is not inferior to cross‐matched PLT. This result indicates that physical cross‐match can be omitted in post HSCT PTR.
The effect of entrustable professional activities on pathology resident confidence in blood banking/transfusion medicine
Authors: Ju Jennifer Y. , Wehrli Gay 
Published: January 2020

BACKGROUNDThe Accreditation Council for Graduate Medical Education requires milestone reporting of the Six General Core Competencies. Additionally, Graduate Medical Education (GME) is transitioning to adopt competency‐based education methodologies including entrustable professional activities (EPAs) for objective, observable, and measurable milestone progression. The College of American Pathologists published 19 EPAs, including one for transfusion‐related adverse events. This survey study includes developing EPAs for transfusion reaction evaluation and assessing residents before and after implementing these EPAs.STUDY DESIGN AND METHODSThree transfusion reaction EPAs were developed and implemented in July 2018 for the Postgraduate Year (PGY) 2 pathology residents. An online, anonymous survey was sent to all 21 pathology trainees before and one year after EPA implementation. In July 2018 and August 2019, each survey included the same six multiple‐choice, single‐response, confidence questions, with a rating scale of extremely, very, slightly, or not at all confident. This study was approved by the hospitalʼs Institutional Review Board for Health Sciences Research and GME Committee.RESULTSAnalysis was performed on PGY2‐4 residents. In 2018, 13 of 20 participants were analyzed. In 2019, 15 of 19 participants were analyzed. Number and percentage of responses were reported. The results showed an increase in trainee confidence, with the greatest improvement among the first class to use the EPAs.CONCLUSIONEPAs provide an effective framework for objective and measurable progression of trainees. One year after the implementation of transfusion reaction EPAs at our site, the trainees showed enhanced confidence levels in handling Blood Bank and Transfusion Medicine Services coverage.
Long‐term clinical outcomes of dogs with single congenital extrahepatic portosystemic shunts attenuated with thin film banding or ameroid ring constrictors
Authors: Otomo Aki , Singh Ameet , Jeong Junemoe , Dobberstein Rachel , Lundhild Alexandra , Peter Elyse , Brisson Brigitte , Oblak Michelle , Milovancev Milan 
Published: January 2020

AbstractObjectiveTo compare long‐term clinical outcomes of dogs with single congenital extrahepatic portosystemic shunts (CEHPSS) treated with thin film banding (TFB) consisting of polyolefin fiber or ameroid ring constrictor (ARC) placement in dogs.DesignRetrospective, two‐center clinical study.AnimalsClient‐owned dogs (n = 123) with single CEHPSS undergoing gradual attenuation via TFB (n = 85) or ARC (n = 38).MethodsMedical records of dogs with CEHPSS were reviewed. Follow‐up data were collected from the referring veterinarian and/or owner via standardized questionnaire. Data were analyzed to compare short‐term mortality rate and long‐term outcome (>6 months).ResultsDogs in the TFB group were older than dogs in the ARC group (median age, 19 vs 12 months, respectively; P = .01). There was no difference in survival to discharge between dogs in the TFB (81/85 [95.3%]) and ARC (37/38 [97.4%]; P > .99) groups. Preoperative levetiracetam was more frequently administered to dogs treated with TFB (64/85 [75.3%]) than to dogs treated with ARC (15/38 [39.5%;] P = .0002). Postoperative seizures were reported in 10 (8.1%) dogs; their prevalence did not differ between dogs treated with TFB (9/85 [10.6%]) and dogs treated with ARC (1/38 [2.6%]; P = .17). Median follow‐up time for dogs treated with TFB (58.0 months, range 8‐130) and ARC (63.3 months, range 7‐138; P = .24) did not differ.ConclusionGradual attenuation of a single CEHPSS with either TFB or ARC resulted in similar long‐term clinical outcomes and low postoperative morbidity and mortality rates.Clinical significanceThin film banding (polyolefin fiber) offers an alternative leading to clinical outcomes similar to ARC in dogs with single CEHPSS.
A Review of Switched Inertance Hydraulic Converter Technology1
Authors: Yuan Chenggang , Pan Min , Plummer Andrew 
Published: January 2020

Abstract
Digital hydraulics is a new technology providing an alternative to conventional proportional or servovalve-controlled systems in the area of fluid power. Digital hydraulic applications, such as digital pumps, digital valves and actuators, switched inertance hydraulic converters (SIHCs), and digital hydraulic power management systems, promise high-energy efficiency and less contamination sensitivity. Research on digital hydraulics is driven by the need for highly energy efficient hydraulic machines but is relatively immature compared to other energy-saving technologies. This review introduces the development of SIHCs particularly focusing on the work being undertaken in the last 15 years and evaluates the device configurations, performance, and control strategies that are found in the current SIHC research. Various designs for high-speed switching valves are presented, and their advantages and limitations are compared and discussed. The current limitations of SIHCs are discussed and suggestions for the future development of SIHCs are made.
Experimental Investigation of Solid Particle Erosion in Successive Elbows in Gas Dominated Flows
Authors: Asgharpour Alireza , Zahedi Peyman , Arabnejad Khanouki Hadi , Shirazi Siamack A. , McLaury Brenton S. 
Published: January 2020

Abstract
When a fluid containing erosive particles flows through two or more elbows mounted in series with short distances between them, the downstream elbows which are installed after the first elbow are exposed to erosion from a flow that is not fully developed, and therefore, the characteristics of erosive wear in the second elbow can be different than the first. In this work, the erosion magnitude and pattern in two standard successive vertical–horizontal and horizontal–vertical elbows are examined experimentally. Utilizing an ultrasonic technique (UT), erosion measurements are performed in gas–sand and gas–liquid–sand annular flows to investigate the effects of particle size and flowrates. A paint removal study is also performed to capture the erosion patterns in two elbows for different flow conditions. Using two clear elbows, a flow visualization is performed which shows the quality of phase distribution in the two elbows in series in annular and stratified flows. Measurements show the erosion in the second elbow for this geometry and these flow conditions are less than or in a few cases nearly equal to the first elbow. The location of maximum erosion for all the cases considered is around 45 and 65 deg from the inlet of the elbow in the first and second elbows, respectively. Two areas of high impact frequencies are identified in both elbows. One high-intensity particle impact region which is affected primarily by first impact of particles, and another pattern is formed due to rebounded particles from the first impact.
What does integrated care mean from an older person’s perspective? A scoping review
Authors: Lawless Michael T. , Marshall Amy , Mittinty Manasi Murthy , Harvey Gillian 
Published: January 2020

ObjectiveTo systematically map and synthesise the literature on older adults’ perceptions and experiences of integrated care.SettingVarious healthcare settings, including primary care, hospitals, allied health practices and emergency departments.ParticipantsAdults aged ≥60 years.InterventionsIntegrated (or similarly coordinated) healthcare.Primary and secondary outcome measuresUsing scoping review methodology, four electronic databases (EMBASE, CINAHL, PubMed and ProQuest Dissertation and Theses) and the grey literature (Open Grey and Google Scholar) were searched to identify studies reporting on older adults’ experiences of integrated care. Studies reporting on empirical, interpretive and critical research using any type of methodology were included. Four independent reviewers performed study selection, data extraction and analysis.ResultsThe initial search retrieved 436 articles, of which 30 were included in this review. Patients expressed a desire for continuity, both in terms of care relationships and management, seamless transitions between care services and/or settings, and coordinated care that delivers quick access, effective treatment, self-care support, respect for patient preferences, and involves carers and families.ConclusionsParticipants across the studies desired accessible, efficient and coordinated care that caters to their needs and preferences, while keeping in mind their rights and safety. This review highlights the salience of the relational, informational and organisational aspects of care from an older person’s perspective. Findings are transferable and could be applied in various healthcare settings to derive patient-centred success measures that reflect the aspects of integrated care that are deemed important to older adults and their supporters.
Novel quality improvement method to reduce cost while improving the quality of patient care: retrospective observational study
Authors: Mate Kedar S , Rakover Jeffrey , Cordiner Kay , Noble Amy , Hassan Noura 
Published: January 2020

BackgroundHealthcare cost management strategies are limited in number and resource intensive. Budget constraints in the National Health Service Scotland (NHS Scotland) apply pressure on regional health boards to improve efficiency while preserving quality.MethodsWe developed a technical method to assist health systems to reduce operating costs, called continuous value management (CVM). Derived from lean accounting and employing quality improvement (QI) methods, the approach allows for management to reduce or repurpose resources to improve efficiency. The primary outcome measure was the cost per patient admitted to the ward in British pounds (£).InterventionsThe first step of CVM is developing a standard care model. Teams then track system performance weekly using a tool called the ‘box score’, and improve performance using QI methods with results displayed on a visual management board. A 29-bed inpatient respiratory ward in a mid-sized hospital in NHS Scotland pilot tested the method.ResultsWe included 5806 patients between October 2016 and May 2018. During the 18-month pilot, the ward realised a 21.8% reduction in cost per patient admitted to the ward (from an initial average level of £807.70 to £631.50 as a new average applying Shewhart control chart rules, p<0.0001), and agency nursing spend decreased by 30.8%. The ward realised a 28.9% increase in the number of patients admitted to the ward per week. Other quality measures (eg, staff satisfaction) were sustained or improved.ConclusionCVM methods reduced the cost of care while improving quality. Most of the reduction came by way of reduced bank nursing spend. Work is under way to further test CVM and understand leadership behaviours supporting scale-up.
Percutaneous mitral commissurotomy versus surgical commissurotomy for rheumatic mitral stenosis: a systematic review and meta-analysis of randomised controlled trials
Authors: Singh Achintya Dinesh , Mian Agrima , Devasenapathy Niveditha , Guyatt Gordon , Karthikeyan Ganesan 
Published: January 2020

AimPatients with severe mitral stenosis (MS) and their clinicians typically choose percutaneous transvenous mitral commissurotomy (PTMC) over surgical commissurotomy (SC). However, the durability of PTMC relative to SC is uncertain. We compared the efficacy, safety and durability of PTMC with SC for the treatment of MS.MethodsWe searched EMBASE, MEDLINE and WHO ICTRP registers for randomised controlled trials (RCTs) comparing PTMC, and open and/or closed mitral commissurotomy. The principal outcomes were rate of re-intervention and symptomatic improvement as inferred from the surrogate measures of immediate postprocedural mitral valve area (MVA), MVA at ≥6 month follow-up, incidence of mitral regurgitation (MR) and restenosis. We calculated weighted mean differences (WMD) for continuous outcomes, relative risks (RR) for binary outcomes and pooled outcomes using random-effects models and assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.ResultsSeven RCTs with 553 patients proved eligible. Pooled estimates showed no convincing difference in the risk of restenosis or re-intervention (15/100 fewer with PTMC, 95% CI (−20 to +8); quality of evidence: moderate) or in symptoms as inferred from immediate MVA (WMD 0.15, 95% CI (−0.18 to 0.48): very low), from the incidence of postprocedural severe MR (3/100 more with PTMC, 95% CI (−1 to +10): moderate) or from MVA at 30 months.ConclusionUntil data demonstrating convincing superiority of SC over PTMC become available, our results support the current practice of recommending PTMC to young patients with MS and favourable valve morphology, as it is associated with lower peri-procedural morbidity.PROSPERO registration numberPROSPERO 2017 (CRD42017079512).
Comorbidity and bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest
Authors: Hirlekar Geir , Jonsson Martin , Karlsson Thomas , Bäck Maria , Rawshani Araz , Hollenberg Jacob , Albertsson Per , Herlitz Johan 
Published: January 2020

​ObjectiveCardiopulmonary resuscitation (CPR) performed before the arrival of emergency medical services (EMS) is associated with increased survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to determine whether patients who receive bystander CPR have a different comorbidity compared with patients who do not, and to determine the association between bystander CPR and 30-day survival when adjusting for such a possible difference.​MethodsPatients with witnessed OHCA in the Swedish Registry for Cardiopulmonary Resuscitation between 2011 and 2015 were included, and merged with the National Patient Registry. The Charlson Comorbidity Index (CCI) was used to measure comorbidity. Multiple logistic regression was used to examine the effect of CCI on the association between bystander CPR and outcome.​ResultsIn total, 11 955 patients with OHCA were included, 71% of whom received bystander CPR. Patients who received bystander CPR had somewhat lower comorbidity (CCI) than those who did not (mean±SD: 2.2±2.3 vs 2.5±2.4; p<0.0001). However, this difference in comorbidity had no influence on the association between bystander CPR and 30-day survival in a multivariable model including other possible confounders (OR 2.34 (95% CI 2.01 to 2.74) without adjustment for CCI and OR 2.32 (95% CI 1.98 to 2.71) with adjustment for CCI).​ConclusionPatients who undergo CPR before the arrival of EMS have a somewhat lower degree of comorbidity than those who do not. Taking this difference into account, bystander CPR is still associated with a marked increase in 30-day survival after OHCA.
Approach to haemoabdomen in small animal patients
Authors: Pratschke Kathryn 
Published: January 2020

Background: Haemoabdomen (also sometimes called haemoperitoneum) is the pathological accumulation of blood within the peritoneal cavity and can present a challenging clinical scenario. It frequently combines an emergency presentation with a condition that can have many different causes, some of which carry a poor prognostic outlook and limited likely survival times. The main objectives for patients with haemoabdomen include re‐establishing and supporting an effective circulating blood volume, confirming the diagnosis and identifying the extent of abnormalities present, maintaining oxygen‐carrying capacity to the tissues and arresting/controlling ongoing haemorrhage.Aim of the article: This article discusses how to provide an efficient and comprehensive but logical diagnostic approach to haemoabdomen, and how to combine it with sound decision making and excellent client communication to achieve the optimum outcome for each patient.
Diagnosis and management of the itchy horse
Authors: Curnow Ben 
Published: January 2020

Background: Out in the field, it can be particularly challenging to work up a case of the itchy horse. The history can be vague, the patient is large with a dense coat, and the microscope is located back at the practice. Management can also cause frustration for both the clinician and the client, with tasks that may be manageable for dogs and cats proving impractical in ponies and horses.Aim of the article: This article outlines some of the common causes of pruritus in horses, how to get an accurate diagnosis, and how to treat them effectively.