bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing red blood cell transfusion practice in obstetrics and gynaecology: A before and after study of hospital‐wide education
Authors: Thiel Peter S. , Mah Alicia C. , Siddiqui Muhammad , Lett Christine D. 
Published: November 2021

AbstractObjectivesTo assess transfusion practices at a Canadian tertiary care center before and after a hospital‐wide blood management educational campaign based on the Choosing Wisely toolkit.BackgroundRed blood cell (RBC) transfusions are an essential intervention in obstetrics and gynaec ology (O&G). However, with limited guidelines outlining the appropriate use of RBC transfusions, clinicians routinely transfuse based on haemoglobin values and habits.Methods/MaterialsWe conducted a retrospective chart review of all patients who received a RBC transfusion while admitted under an O&G provider in two 12‐month periods—before and after the intervention. The campaign consisted of Grand Rounds, formal and informal teaching, and posters placed within the hospital. We judged appropriateness from a set of criteria guided by the status of ongoing bleeding, pre‐transfusion haemoglobin, and the number of units ordered simultaneously.ResultsTransfusion appropriateness was poor in pre‐ and post‐intervention periods (46% vs. 51%, p = 0.59). The overall rate of RBC transfusion was reduced from 1.8% to 1.2% (83/4610 vs. 55/4618, p = 0.02) after the intervention. There was a 52% reduction in the total number of RBC units of transfused (229 vs. 111, p < 0.001), a 33% reduction in the number of patients transfused (83 vs. 55, p = 0.016), and fewer multiple‐unit transfusions without reassessment (39 vs. 13, p = 0.005).ConclusionRBC transfusion appropriateness remained low after a hospital‐wide educational campaign. However, there was a marked decrease in overall transfusion use, reflecting the adoption of more restrictive transfusion practices. The low rate of transfusion appropriateness represents an opportunity for further improvement.
Genetic variations in ZmSAUR15 contribute to the formation of immature embryo‐derived embryonic calluses in maize
Authors: Wang Yanli , He Shijiang , Long Yun , Zhang Xiaoling , Zhang Xiaoxiang , Hu Hongmei , Li Zhaoling , Hou Fengxia , Ge Fei , Gao Shibin , Pan Guangtang , Ma Langlang , Shen Yaou 
Published: November 2021

SUMMARYThe ability of immature maize (Zea mays) embryos to form embryonic calluses (ECs) is highly genotype dependent, which limits transgenic breeding development in maize. Here, we report the association map‐based cloning of ZmSAUR15 using an association panel (AP) consisting of 309 inbred lines with diverse formation abilities for ECs. We demonstrated that ZmSAUR15, which encodes a small auxin‐upregulated RNA, acts as a negative effector in maize EC induction. Polymorphisms in the ZmSAUR15 promoter that influence the expression of ZmSAUR15 transcripts modulate the EC induction capacity in maize. ZmSAUR15 is involved in indole‐3‐acetic acid biosynthesis and cell division in immature embryo‐derived callus. The ability of immature embryos to induce EC formation can be improved by the knockout of ZmSAUR15, which consequently increases the callus regeneration efficiency. Our study provides new insights into overcoming the genotypic limitations associated with EC formation and improving genetic transformation in maize.
Parameter Identification of Cardiovascular System Model Used for Left Ventricular Assist Device Algorithms
Authors: Pawar Suraj R. , Rapp Ethan S. , Gohean Jeffrey R. , Longoria Raul G. 
Published: November 2021

Abstract
Advancement of implanted left ventricular assist device (LVAD) technology includes modern sensing and control methods to enable online diagnostics and monitoring of patients using on-board sensors. These methods often rely on a cardiovascular system (CVS) model, the parameters of which must be identified for the specific patient. Some of these, such as the systemic vascular resistance (SVR), can be estimated online while others must be identified separately. This paper describes a three-staged approach for designing a parameter identification algorithm (PIA) for this problem. The approach is demonstrated using a two-element Windkessel model of the systemic circulation (SC) with a time-varying elastance for the left ventricle (LV). A parameter identifiability stage is followed by identification using an unscented Kalman filter (UKF), which uses measurements of LV pressure (Plv), aortic pressure (Pao), aortic flow (Qa), and known input measurement of LVAD flowrate (Qvad). Both simulation and experimental data from animal experiments were used to evaluate the presented methods. By bounding the initial guess for left ventricular volume, the identified CVS model is able to reproduce signals of Plv, Pao, and Qa within a normalized root mean squared error (nRMSE) of 5.1%, 19%, and 11%, respectively, during simulations. Experimentally, the identified model is able to estimate SVR with an accuracy of 3.4% compared with values from invasive measurements. Diagnostics and physiological control algorithms on-board modern LVADs could use CVS models other than those shown here, and the presented approach is easily adaptable to them. The methods also demonstrate how to test the robustness and accuracy of the identification algorithm.
Validation and Parametric Investigations of an Internal Permanent Magnet Motor Using a Lumped Parameter Thermal Model
Authors: Sequeira Sebastien , Bennion Kevin , Cousineau J. Emily , Narumanchi Sreekant , Moreno Gilbert , Kumar Satish , Joshi Yogendra 
Published: November 2021

Abstract
One of the key challenges for the electric vehicle industry is to develop high-power-density electric motors. Achieving higher power density requires efficient heat removal from inside the motor. In order to improve thermal management, a multiphysics modeling framework that is able to accurately predict the behavior of the motor, while being computationally efficient, is essential. This paper first presents a detailed validation of a lumped parameter thermal network (LPTN) model of an Internal Permanent Magnet synchronous motor within the commercially available motor-cad modeling environment. The validation is based on temperature comparison with experimental data and with more detailed finite element analysis (FEA). All critical input parameters of the LPTN are considered in detail for each layer of the stator, especially the contact resistances between the impregnation, liner, laminations, and housing. Finally, a sensitivity analysis for each of the critical input parameters is provided. A maximum difference of 4%—for the highest temperature in the slot-winding and the end-winding—was found between the LPTN and the experimental data. Comparing the results from the LPTN and the FEA model, the maximum difference was 2% for the highest temperature in the slot-winding and end-winding. As for the LPTN sensitivity analysis, the thermal parameter with the highest sensitivity was found to be the liner-to-lamination contact resistance.
An Experimental Study on Cryogenic Spray Quenching of a Circular Metal Disk, Part I: Effects of Mass Flux, Spray Fluid Inlet Subcooling, and Gravity
Authors: Dong Jun , Wang Hao , Darr S. R. , Hartwig J. W. , Chung J. N. 
Published: November 2021

Abstract
This is the first part of a two-paper series that reports the design, experimentation, and results of a spray quenching experiment of a circular metal disk in terrestrial gravity condition. The objective of this experiment is to provide experimental data and corresponding analysis on the heat transfer characteristics and chilldown performance of the cryogenic spray quenching process. In this paper, the presented continuous-flow spray quenching results include the spray-cone angle visualization, spray cooling heat transfer characteristics represented by chilldown curves and boiling curves, gravity effects, and Leidenfrost rewet point temperatures. Additionally, detailed discussion is given on the film boiling heat transfer and rewet temperature in terms of various contributing factors such as gravitational acceleration, spray mass flux, and radial position on the plate. Based on the experimental data, empirical correlations for film boiling heat transfer coefficient, and rewet temperatures are provided. We expect that the current terrestrial study would offer invaluable information for the design of a robust in-space cryogenic propellant storage tank spray chilldown system.
Subnational mortality estimates for India in 2019: a baseline for evaluating excess deaths due to the COVID-19 pandemic
Authors: Rao Chalapati , John Amrit Jose , Yadav Ajit Kumar , Siraj Mansha 
Published: November 2021

BackgroundEstimates of excess mortality are required to assess and compare the impact of the COVID-19 pandemic across populations. For India, reliable baseline prepandemic mortality patterns at national and subnational level are necessary for such assessments. However, available data from the Civil Registration System (CRS) is affected by incompleteness of death recording that varies by sex, age and location.MethodsUnder-reporting of CRS 2019 deaths was assessed for three age groups (< 5 years, 15–59 years and ≥60 years) at subnational level, through comparison with age-specific death rates from alternate sources. Age-specific corrections for under-reporting were applied to derive adjusted death counts by sex for each location. These were used to compute life expectancy (LE) at birth by sex in 2019, which were compared with subnational LEs from the Global Burden of Disease (GBD) 2019 Study.ResultsA total of 9.92 million deaths (95% UI 9.70 to 10.02) were estimated across India in 2019, about 2.28 million more than CRS reports. Adjustments to under-five and elderly mortality accounted for 30% and 56% of additional deaths, respectively. Adjustments in Bihar, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh accounted for 75% of all additional deaths. Adjusted LEs were below corresponding GBD estimates by ≥2 years for males at national level and in 20 states, and by ≥1 year for females in 12 states.ConclusionsThese results represent the first-ever subnational mortality estimates for India derived from CRS reported deaths, and serve as a baseline for assessing excess mortality from the COVID-19 pandemic. Adjusted life expectancies indicate higher mortality patterns in India than previously perceived. Under-reporting of infant deaths and those among women and the elderly is evident in many locations. Further CRS strengthening is required to improve the empirical basis for local mortality measurement across the country.
Simple scoring algorithm to identify community-dwelling older adults with limited health literacy: a cross-sectional study in Taiwan
Authors: Hou Wen-Hsuan , Kuo Ken N , Chen Mu-Jean , Chang Yao-Mao , Tsai Han-Wei , Chan Ding-Cheng , Su Chien-Tien , Han Der-Sheng , Shen Hsiu-Nien , Li Chung-Yi 
Published: November 2021

ObjectiveHealth literacy (HL) is the degree of individuals’ capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL.DesignA cross-sectional study.SettingFour communities in northern, central and southern Taiwan.ParticipantsA total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model.Primary and secondary outcome measuresPearson’s χ2test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity.ResultsA total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%).ConclusionThis simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.
Childhood abuse and its association with adults’ mental health problems: a cross-sectional study among men and women in the Yangon Region of Myanmar
Authors: Aye Win Thuzar , Lien Lars , Stigum Hein , Bjertness Espen 
Published: November 2021

ObjectivesTo estimate the prevalence of emotional, physical and sexual childhood abuse, and symptoms of post-traumatic stress disorder (PTSD) and to examine the association between childhood abuse and adult mental health problems, including mental distress and PTSD symptoms.DesignA community-based cross-sectional study was conducted. Childhood abuse was assessed with the NorVold Abuse Questionnaire, and mental distress and symptoms of PTSD were measured using the Hopkins Symptom Checklist 10 and the Impact of Event Scale—Revised, respectively. The Wald test and multiple linear regression analysis were applied for testing differences between proportions and the association between childhood abuse and adult mental health outcomes, respectively.SettingUrban and rural areas of the Yangon Region, Myanmar.ParticipantsA total of 2377 men and women aged 18–49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded.ResultsOverall, 21.1% (95% CI 18.8 to 23.6) reported any form of childhood abuse, 10.4% (95% CI 8.9 to 12.4) physical abuse, 10.4% (95% CI 8.8 to 12.2) emotional abuse and 7.3% (95% CI 5.7 to 9.3) sexual abuse. Childhood abuse was more common in women (29.8%) than in men (12.4%). The prevalence of PTSD symptoms in the total sample was 6.6%. After adjusting for confounding variables, positive associations were found between childhood abuse with adult mental distress and PTSD symptoms among women and older men.ConclusionsChildhood abuse is prevalent among both men and women in the Yangon Region of Myanmar and associated with adult mental health problems. Approximately 7% of people report PTSD symptoms. It should prompt local health professionals and policy makers to establish prevention programmes to eliminate violence against children and to organise services for victims of childhood abuse. Care should be taken in generalising findings for less populated areas.
Parents’ preferences for follow-up care in a type 1 diabetes paediatric population: a survey-based study in Quebec, Canada
Authors: Laberge Maude , Rekik Monia , Djiffa Kodjo Mawuegnigan 
Published: November 2021

ObjectivesExamine variations in parent’s preferences for their child’s type 1 diabetes (T1D) follow-up care and the determinants of the preferred intensity of care. Clinical guidelines recommend multidisciplinary management of T1D, with follow-up visits with an endocrinologist at least every 3 months in the paediatric population. However, there could be heterogeneity in parents’ needs, and preferences in terms of care management may deviate from clinical guidelines.SettingNot applicable.ParticipantsParents who have a child living with T1D and who reside in Quebec, Canada.InterventionIn collaboration with a patient-partner (a parent of a child with T1D), we developed a survey to collect data from parents of children living with T1D. Our primary outcome of interest was the preferred time in months between two appointments. We ran a probit model to analyse longer time (over 3 months between appointments), compared with the standard of care (3 months or less).ResultsResults suggest that about one-third (33%) of parents want to deviate from the guideline. Parents who want to increase the time between appointments are more experienced in the management of the disease and have higher costs than those who wish to follow the 3-month guideline. The number of years since the diagnosis is positively associated with a preference for a longer time between appointments, while the perceived useful of information provided during the consultation, and a parent having made a change in their professional life were negatively associated with a desire to space out appointments. The child’s gender is not a significant factor in parents’ preferences.ConclusionsAdapting visit protocols could make the health system more efficient to respond to T1D patients and their parent’s needs.
Correlation between masked hypertension and endothelial dysfunction measured by flow-mediated dilation: a protocol of systematic review and meta-analysis
Authors: Zhang Xiaohua , Li Yong , Gao Ling , Yu Qian , Zhou Congliang , Zou Wenshu 
Published: November 2021

IntroductionA surrogate marker to evaluate artery endothelial response when stimulated by reactive hyperaemia, known as brachial flow-mediated dilation (FMD), has prognostic value in predicting hypertensive organ damage and cardiovascular disease events. However, the degree of correlation between brachial FMD and masked hypertension (MH) outcomes is still unclear. Therefore, the purpose of this study is to pool data regarding FMD with respect to MH.Methods and analysisElectronic databases MEDLINE, EMBASE, China National Knowledge Infrastructure and Cochrane Library will be searched for the following keywords: endothelial dysfunction, flow-mediated dilation, and masked hypertension, masked uncontrolled hypertension (MUCH) and prehypertension. The following are the eligibility criteria: population—adults (18 years old or older) without hypertension at baseline, with suspected endothelial dysfunction, or from MH/MUCH populations (office blood pressure <140/90 mm Hg and home blood pressure ≥135 mm Hg and/or 85 mm Hg) and from controlled clinical trials, cohort studies, or randomised and controlled trials; exposures—any metrics for FMD; comparisons—participants without MH or MUCH; and outcome—change in FMD between the case group and the control group. Two authors will be engaged in screening and collecting data independently; disagreements will be resolved through discussion. Data extraction will include primary data designated as HR, OR, correlations and regression coefficients. Comprehensive Meta-Analysis V.2.0 will be used to conduct related subgroup and sensitivity analyses and publication bias.Ethics and disseminationThis study does not require ethics approval. It will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42020208362.
Differences in beliefs about COVID-19 by gun ownership: a cross-sectional survey of Texas adults
Authors: Johnson Renee M , Crifasi Cassandra , Anderson Goodell Erin M , Wiśniowski Arkadiusz , Sakshaug Joseph W , Thrul Johannes , Owens Mark 
Published: November 2021

ObjectivesWe investigated the association between gun ownership and perceptions about COVID-19 among Texas adults as the pandemic emerged. We considered perceived likelihood that the pandemic would lead to civil unrest, perceived importance of taking precautions to prevent transmission and perceptions that the threat of COVID-19 has been exaggerated.MethodsData were collected from 5 to 12 April 2020, shortly after Texas’ stay-at-home declaration. We generated a sample using random digit dial methods for a telephone survey (n=77, response rate=8%) and by randomly selecting adults from an ongoing panel to complete the survey online (n=1120, non-probability sample). We conducted a logistic regression to estimate differences in perceptions by gun ownership. To account for bias associated with use of a non-probability sample, we used Bayesian data integration and ran linear regression models to produce more accurate measures of association.ResultsAmong the 60% of Texas adults who reported gun ownership, estimates of past 7-day gun purchases, ammunition purchases and gun carrying were 15% (n=78), 20% (n=100) and 24% (n=130), respectively. We found no evidence of an association between gun ownership with perceived importance of taking precautions to prevent transmission or with perceived likelihood of civil unrest. Results from the logistic regression (OR 1.27, 95% CI 0.99 to 1.63) and the linear regression (β=0.18, 95% CI 0.07 to 0.29) suggest that gun owners may be more likely to believe the threat of COVID-19 was exaggerated.ConclusionsCompared with those without guns, gun owners may have been inclined to downplay the threat of COVID-19 early in the pandemic.
Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
Authors: Vesela Renata , Elenjord Renate , Lehnbom Elin C , Ofstad Eirik Hugaas , Johnsgård Tine , Zahl-Holmstad Birgitte , Risør Torstein , Wisløff Torbjørn , Røslie Lars , Filseth Ole Magnus , Valle Per-Christian , Svendsen Kristian , Frøyshov Hanne Mathilde , Garcia Beate H 
Published: November 2021

IntroductionThe ‘emergency department (ED) pharmacist’ is an integrated part of the ED interdisciplinary team in many countries, which have shown to improve medication safety and reduce costs related to hospitalisations. In Norway, few EDs are equipped with ED pharmacists, and research describing effects on patients has not been conducted. The aim of this study is to investigate the impact of introducing clinical pharmacists to the interdisciplinary ED team. In this multicentre study, the intervention will be pragmatically implemented in the regular operation of three EDs in Northern Norway; Tromsø, Bodø and Harstad. Clinical pharmacists will work as an integrated part of the ED team, providing pharmaceutical care services such as medication reconciliation, review and/or counselling. The primary endpoint is ‘time in hospital during 30 days after admission to the ED’, combining (1) time in ED, (2) time in hospital (if hospitalised) and (3) time in ED and/or hospital if re-hospitalised during 30 days after admission. Secondary endpoints include time to rehospitalisation, length of stay in ED and hospital and rehospitalisation and mortality rates.Methods and analysisWe will apply a non-randomised stepped-wedge study design, where we in a staggered way implement the ED pharmacists in all three EDs after a 3, 6 and 9 months control period, respectively. We will include all patients going through the three EDs during the 12-month study period. Patient data will be collected retrospectively from national data registries, the hospital system and from patient records.Ethics and disseminationThe Regional Committee for Medical and Health Research Ethics and Local Patient Protection Officers in all hospitals have approved the study. Patients will be informed about the ongoing study on a general basis with ads on posters and flyers.Trial registration numberNCT04722588.