bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Thermal Barrier Coating Surface Temperature on the Adhesion Behavior of CMAS Deposits
Authors: Clark Robert A. , Plewacki Nicholas , Gnanaselvam Pritheesh , Bons Jeffrey P. , Viswanathan Vaishak 
Published: January 2021

Abstract
The interaction of thermal barrier coating’s surface temperature with calcium magnesium aluminosilicate (CMAS) like deposits in gas turbine hot flowpath hardware is investigated. Small Hastelloy X coupons were coated in thermal barrier coatings (TBC) using the air plasma spray (APS) method and then subjected to a thermal gradient via backside impingement cooling and frontside impingement heating using the High-Temperature Deposition Facility (HTDF) at The Ohio State University (OSU). A one-dimensional (1D) heat transfer model was used to estimate TBC surface temperatures and correlate them to intensity values taken from infrared (IR) images of the TBC surface. TBC frontside surface temperatures were varied by changing backside mass flow (kept at a constant temperature) while maintaining a constant hot-side gas temperature and jet velocity representative of modern commercial turbofan high-pressure turbine (HPT) inlet conditions (approximately 1600 K and 200 m/s, or Mach 0.25). In this study, Arizona Road Dust (ARD) was utilized to mimic the behavior of CMAS attack on TBC. To identify the minimum temperature at which particles adhere, the backside cooling mass flow was set to the maximum amount allowed by the test setup, and trace amounts of 0–10 µm ARD particles were injected into the hot-side flow to impinge on the TBC surface. The TBC surface temperature was increased through coolant reduction until noticeable deposits formed, as evaluated through an IR camera. Accelerated deposition tests were then performed where approximately 1 g of ARD was injected into the hot side flow while the TBC surface temperature was held at various points above the minimum observed deposition temperature. Surface deposition on the TBC coupons was evaluated using an infrared camera and a backside thermocouple. Coupon cross-sections were also evaluated under a scanning electron microscope for any potential CMAS ingress into the TBC. Experimental results of the impact of surface temperature on CMAS deposition, and deposit evolution and morphology are presented. In addition, an Eulerian–Lagrangian solver was used to model the hot-side impinging jet with particles at four TBC surface temperatures and deposition was predicted using the OSU deposition model. Comparisons to experimental results highlight the need for more sophisticated modeling of deposit development through a conjugate heat transfer and mesh morphing of the target surface. These results can be used to improve physics-based deposition models by providing valuable data relative to CMAS deposition characteristics on TBC surfaces, which modern commercial turbofan high-pressure turbines use almost exclusively.
Approach for Importance–Performance Analysis of Product Attributes From Online Reviews
Authors: Joung Junegak , Kim Harrison M. 
Published: January 2021

Abstract
The importance–performance analysis (IPA) is a widely used technique to guide strategic planning for the improvement of customer satisfaction. Compared with surveys, numerous online reviews can be easily collected at a lower cost. Online reviews provide a promising source for the IPA. This paper proposes an approach for conducting the IPA from online reviews for product design. Product attributes from online reviews are first identified by latent Dirichlet allocation. The performance of the identified attributes is subsequently estimated by the aspect-based sentiment analysis of IBM Watson. Finally, the importance of the identified attributes is estimated by evaluating the effect of sentiments of each product attribute on the overall rating using an explainable deep neural network. A Shapley additive explanation-based method is proposed to estimate the importance values of product attributes with a low variance by combining the effect of the input features from multiple optimal neural networks with a high performance. A case study of smartphones is presented to demonstrate the proposed approach. The performance and importance estimates of the proposed approach are compared with those of previous sentiment analysis and neural network-based method, and the results exhibit that the former can perform IPA more reliably. The proposed approach uses minimal manual operation and can support companies to take decisions rapidly and effectively, compared with survey-based methods.
Lost in Translation: Examining the Complex Relationship Between Prototyping and Communication
Authors: Krishnakumar Sandeep , Berdanier Catherine , McComb Christopher , Menold Jessica 
Published: January 2021

Abstract
Prototyping plays a pivotal role in the engineering design process. Prototypes represent physical or digital manifestations of design ideas, and as such act as effective communication tools for designers. While the benefits of prototyping are well-documented in research, the fundamental ways in which the construction of a prototype affects designers' reflection on and evaluation of their design outcomes and processes are not well understood. The relationships between prototypes, designers' communication strategies, and recollection of design processes is of particular interest in this work, as preliminary research suggests that novice designers tend to struggle to clearly articulate the decisions made during the design process. This work serves to extend prior work and build foundational knowledge by exploring the evaluation of design outcomes and decisions, and communication strategies used by novice designers during prototyping tasks. A controlled in situ study was conducted with 45 undergraduate engineering students. Results from qualitative analyses suggest that a number of rhetorical patterns emerged in students' communications, suggesting that a complicated relationship exists between prototyping and communication.
Impact of transcatheter aortic valve implantation on left ventricular function recovery, mass regression and outcome in patients with aortic stenosis: protocol of the TAVI-NOR prospective study
Authors: Mohamed Ali Abukar , Wasim Daanyaal , Løland Kjetil Halvorsen , Rotevatn Svein , Bleie Øyvind , Saeed Sahrai 
Published: January 2021

IntroductionTranscatheter aortic valve implantation (TAVI) is a widely used treatment option as an alternative to surgical aortic valve replacement in patients with severe aortic stenosis (AS) at high or intermediate surgical risk. TAVI improves symptoms, induces reverse left ventricular (LV) remodelling and increases overall survival. However, a careful patient selection is essential to achieve better outcome. Evidence on LV functional recovery and LV mass regression after TAVI based on contemporary registry data is scarce. The impact of TAVI on the arterial vasculature is also less explored.Method and analysesThis is a study of 600 consecutive patients with AS who underwent a TAVI at Haukeland University Hospital, Bergen, Norway. Demographics, clinical data, arterial haemodynamics and echocardiographic parameters were prospectively collected. In the present paper, we describe the design, major scientific objectives and echocardiography imaging protocol of the TAVI-NOR (TAVI in western NORway) study. The main objectives are: To explore the impact of TAVI on cardiac structure and function in patients with severe AS, identify the echocardiographic predictors of reverse LV remodelling, assess survival benefits according to baseline risk profile, evaluate long-term therapeutic success as reflected by reduction in valvular-arterial impedance and to investigate the impact of various types of blood pressure response immediately after TAVI on clinical outcome.Ethics and disseminationThe study was approved by the Regional Committees for Medical and Health Research Ethics (REK vest, ref. number 33814) and the Institutional Data Protection Services. Patients’ consent was waived. The study findings will be disseminated via peer-reviewed publications and presentation in national and international scientific meetings and conferences.Trail registration numberThe study was registered in the international database: ClinicalTrials.gov, Identifier:NCT04417829.
Effective coverage of nutrition interventions across the continuum of care in Bangladesh: insights from nationwide cross-sectional household and health facility surveys
Authors: Nguyen Phuong Hong , Khương Long Quỳnh , Pramanik Priyanjana , Billah Sk Masum , Menon Purnima , Piwoz Ellen , Leslie Hannah H 
Published: January 2021

IntroductionImproving the impact of nutrition interventions requires adequate measurement of both reach and quality of interventions, but limited evidence exists on advancing coverage measurement. We adjusted contact-based coverage estimates, taking into consideration the inputs required to deliver quality nutrition services, to calculate input-adjusted coverage of nutrition interventions across the continuum of care from pregnancy through early childhood in Bangladesh.MethodsWe used data from the 2014 Bangladesh Demographic and Health Surveys to assess use of maternal and child health services and the 2014 Service Provision Assessment to determine facility readiness to deliver nutrition interventions. Service readiness captured availability of nutrition-specific inputs (including human resources and training, equipment, diagnostics and medicines). Contact coverage was combined with service readiness to create a measure of input-adjusted coverage at the national and regional levels, across place of residence, and by maternal education and household socioeconomic quintiles.ResultsContact coverage varied from 28% for attending at least four ANC visits to 38% for institutional delivery, 35% for child growth monitoring and 81% for sick child care. Facilities demonstrated incomplete readiness for nutrition interventions, ranging from 48% to 51% across services. Nutrition input-adjusted coverage was suboptimal (18% for ANC, 23% for institutional delivery, 20% for child growth monitoring and 52% for sick child care) and varied between regions within the country. Inequalities in input-adjusted coverage were large during ANC and institutional delivery (14–17 percentage points (pp) between urban and rural areas, 15 pp between low and high education, and 28-34 pp between highest and lowest wealth quintiles) and less variable for sick child care (<2 pp).ConclusionNutrition input-adjusted coverage was suboptimal and varied subnationally and across the continuum of care in Bangladesh. Special efforts are needed to improve the reach as well as the quality of health and nutrition services to achieve the Sustainable Development Goals.
Effectiveness of pretend medical play in improving children’s health outcomes and well-being: a systematic review
Authors: Rashid Aneesa Abdul , Cheong Ai Theng , Hisham Ranita , Shamsuddin Nurainul Hana , Roslan Dalila 
Published: January 2021

BackgroundThe healthcare setting is stressful for many people, especially children. Efforts are needed to mitigate children’s healthcare-related anxiety. Medical play using the Teddy Bear Hospital (TBH) concept can expose children to healthcare settings and help them develop positive experiences in these settings. In this role-playing game, children bring their soft toys and act as parents to the ‘sick’ teddies in a pretend hospital or clinic play setting. The objective of this systematic review is to evaluate the effectiveness of the TBH in improving children’s health outcomes and well-being.MethodsWe searched the reference lists of included studies from four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) from inception until November 2020. We included pre-post, quasiexperimental and case–control studies, as well as randomised controlled trials (RCTs) that discussed medical play using the TBH concept as an intervention. Studies that involved sick patients and used interventions unlike the TBH were excluded. We assessed the quality of the included studies using the Cochrane Collaboration’s ‘Risk of bias’ tool.ResultsTen studies were included in this systematic review. Five specifically investigated the TBH method, while the others involved the same concept of medical play. Only three studies were RCTs. All of the studies report more than one outcome—mostly positive outcomes. Two report lower anxiety levels after intervention. Two found better healthcare knowledge, with one reporting increased feelings of happiness regarding visiting a doctor. Two studies found no change in anxiety or feelings, while another two found increased levels of fear and lowered mood after the medical play (which involved real medical equipment).ConclusionsThe practice of TBH has mostly positive outcomes, with lower anxiety levels and improved healthcare knowledge. Its effectiveness should be verified in future studies using a more robust methodology.PROSPERO registration numberCRD42019106355.
REACT study protocol: resilience after the COVID-19 threat (REACT) in adolescents
Authors: Smith Alicia Joanne , Moreno-López Laura , Davidson Eugenia , Dauvermann Maria , Orellana Sofia , Soneson Emma , Ioannidis Konstantinos , Kaser Muzaffer , van Harmelen Anne-Laura 
Published: January 2021

IntroductionCOVID-19-related social isolation and stress may have significant mental health effects, including post-traumatic stress, anxiety and depression. These factors are thought to disproportionately affect populations at risk of psychopathology, such as adolescents with a history of childhood adversity (CA). Therefore, examining which factors may buffer the impact of COVID-19-related stress and isolation in vulnerable adolescents is critical. The Resilience After the COVID-19 Threat (REACT) study assesses whether emotion regulation capacity, inflammation and neuroimmune responses to stress induced in the laboratory prior to the pandemic predict responses to COVID-19-related social isolation and stress in adolescents with CA. We aim to elucidate the mechanisms that enable vulnerable adolescents to maintain or regain good mental health when confronted with COVID-19.Methods and analysisWe recruited 79 adolescents aged 16–26 with CA experiences from the Resilience After Individual Stress Exposure study in which we assessed emotion regulation, neural and immune stress responses to an acute stress task. Our sample completed questionnaires at the start of the UK lockdown (‘baseline’; April 2020) and three (July 2020) and 6 months later (October 2020) providing crucial longitudinal information across phases of the pandemic progression and government response. The questionnaires assess (1) mental health, (2) number and severity of life events, (3) physical health, (4) stress perception and (5) loneliness and friendship support. We will use multilevel modelling to examine whether individual differences at baseline are associated with responses to COVID-19-related social isolation and stress.Ethics and disseminationThis study has been approved by the Cambridge Psychology Research Ethics Committee (PRE.2020.037). Results of the REACT study will be disseminated in publications in scientific peer-reviewed journals, presentations at scientific conferences and meetings, publications and presentations for the general public, and through social media.
Effect of stroke early supported discharge on length of hospital stay: analysis from a national stroke registry
Authors: Fisher Rebecca J , Byrne Adrian , Chouliara Niki , Lewis Sarah , Paley Lizz , Hoffman Alex , Rudd Anthony , Robinson Thompson , Langhorne Peter , Walker Marion 
Published: January 2021

ObjectiveThe first observational study to investigate the impact of early supported discharge (ESD) on length of hospital stay in real-world conditions.DesignUsing historical prospective Sentinel Stroke National Audit Programme (SSNAP) data (1 January 2013–31 December 2016) and multilevel modelling, cross-sectional (2015–2016; 30 791 patients nested within 55 hospitals) and repeated cross-sectional (2013–2014 vs 2015–2016; 49 266 patients nested within 41 hospitals) analyses were undertaken.SettingHospitals were sampled across a large geographical area of England covering the West and East Midlands, the East of England and the North of England.ParticipantsStroke patients whose data were entered into the SSNAP database by hospital teams.InterventionsReceiving ESD along the patient care pathway.Primary and secondary outcome measuresLength of hospital stay.ResultsWhen adjusted for important case-mix variables, patients who received ESD on their stroke care pathway spent longer in hospital, compared with those who did not receive ESD. The percentage increase was 15.8% (95% CI 12.3% to 19.4%) for the 2015–2016 cross-sectional analysis and 18.8% (95% CI 13.9% to 24.0%) for the 2013–2014 versus 2015–2016 repeated cross-sectional analysis. On average, the increased length of hospital stay was approximately 1 day.ConclusionsThis study has shown that by comparing ESD and non-ESD patient groups matched for important patient characteristics, receiving ESD resulted in a 1-day increase in length of hospital stay. The large reduction in length of hospital stay overall, since original trials were conducted, may explain why a reduction was not observed. The longer term benefits of accessing ESD need to be investigated further.Trial registration numberhttp://www.isrctn.com/ISRCTN15568163.
301 CAN news2 be used to predict A&E re-attendances during the covid-19 pandemic?
Authors: Gopalakrishna Pillai Krishna Prasad , Naing Zeyar Win , Muniswamy Hemavathi , Pathan Abdul Sajjad 
Published: January 2021

Aims/Objectives/BackgroundThe NEWS2 (National Emergency Warning Score 2) is a widely used tool in Emergency Departments (ED) to identify patients who may be at increased risk of deterioration. NEWS2 is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice, when patients present to, or are being monitored in hospital. Currently there are no predictive scoring systems to evaluate ED re-attendances. The objective of this study was to investigate whether calculated NEWS2 had any influence on the ED re-attendances during the COVID-19 pandemic.Methods/DesignData for the study was compiled from Symphony, the department’s electronic patient records. Data was retrospectively compiled for the month of April 2020 and was subsequently followed up to 28 days for re-attendances. Patients aged 18 years and older, presenting with COVID-19 symptoms who were discharged from ED were only included (n=310). Case definitions for COVID-19 symptomatology were in accordance to the Public Health England guidance. Correlation was made between NEWS2 and the total number of re-attendances within 28 days using regression analysis.Results/ConclusionsSimple linear regression analyses the influence of NEWS2 and the total number of re-attendances within 28 days and gives us the value of R2 as 0.007, which suggests that 0.7 percent of variation of NEWS2 is attributable to regression (figure 1).The regression line is almost flat which tells us that there is no relationship between the two variables. NEWS2 alone is not a useful tool to predict re-attendances to ED for patients presenting with COVID-19 symptoms.Abstract 301 Figure 1
93 Acute magnetic resonance imaging for mild traumatic brain injury
Authors: Richter Sophie , Winzeck Stefan , Kornaropoulos Evgenios , Das Tilak , Williams Guy B , Correia Marta M , Menon David , Newcombe Virginia 
Published: January 2021

Aims/Objectives/BackgroundMild traumatic brain injury (mTBI) accounts for one million emergency department attendances in the UK every year. Whilst 30–50% of patients suffer from persistent symptoms, unselected follow up would overwhelm the health care system. Magnetic resonance imaging (MRI), may help to stratify patients for clinical follow up and interventional trials. We therefore aimed to identify:Neuroanatomical features of concussion on MRI andthe optimal timing for magnetic resonance imaging (<72h or 2–3 weeks after injury).This is the largest study to date using serial scanning acutely in patients with mTBI.Methods/DesignData originated from two prospective cohorts: the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study (2014–2017) and a local cohort (2012–2013). Eligible patients presented to hospital within 24h of a mTBI (Glasgow Coma Score 13–15), satisfied local criteria for computed tomography scanning and received two MRIs: one within 72h (MR1) and one 2–3 weeks after injury (MR2). In addition, 104 controls were enrolled. Volumes and diffusion parameters for brain regions of interest were extracted via automated pipelines. Symptoms were measured using the Rivermead Post-Concussion Questionnaire acutely and the extended Glasgow Outcome Score at three months.Results/ConclusionsThe study included 81 patients (73 from CENTER-TBI, 8 local) with a median age of 44 years (range 14–85) and 57 (70%) men. Within patients, cerebral white matter volume decreased (MR1/MR2 0.98, p=0.001) and ventricular volume increased (MR1/MR2 1.06, p<0.001). Compared to controls, white matter volume was normal on MR1 (patient/control 1.00, p=0.277) but reduced on MR2 (patient/control 0.97, p<0.001). Diffusion changes followed one of three trajectories: progressive injury, minimal change, or pseudonormalisation. Concussion symptoms worsened, improved and were variable in the three groups respectively (delta [IQR] + 5.00 [+2.00-+5.00], -4.5 [-9.25-+1.75], 0.00 [-6.25 to +9.00], p=0.018). MR1 predicted three-month outcome better than MR2 (AUC [95% CI]: 0.93 [0.83–1.00] vs 0.72 [0.51–0.92]).
106 The types and effects of feedback received by emergency ambulance staff: A systematic mixed studies review with narrative synthesis
Authors: Wilson Caitlin , Benn Jonathan , Janes Gillian , Lawton Rebecca 
Published: January 2021

Aims/Objectives/BackgroundThe phenomenon of feedback is well-researched within the wider healthcare context, where it is suggested that feedback can improve patient care and patient safety by enhancing clinical performance and staff mental health. Within prehospital care, reviews have been conducted for automated feedback from defibrillators and debrief after simulation, but not on the wider concept of feedback. The aim of this systematic review is to identify, describe and synthesize the published literature on the types and effects of feedback received by emergency ambulance staff. PROSPERO CRD42020162600.Methods/DesignThe search strategy consisted of three facets: ambulance staff synonyms, feedback synonyms and feedback content. Databases searched from inception were MEDLINE, EMBASE, AMED, PsycInfo, HMIC, CINAHL and Web of Science. Studies were included if they were qualitative or quantitative empirical research exploring the concept of feedback, i.e. the systematised provision of information to emergency ambulance staff regarding their performance within prehospital practice. Study quality was appraised using the Mixed Methods Appraisal Tool and data analysed using narrative synthesis.Results/ConclusionsThe search strategy yielded 2424 articles excluding duplicates. 94 studies met the inclusion criteria after full-text review, of which 36 fleetingly mentioned increased feedback as a solution to improving specific circumstances (e.g. decision-making, burnout). The remaining 58 studies consisted of 48 interventional prehospital feedback studies, 8 non-interventional studies and 2 feasibility studies. Narrative synthesis revealed a wide range of prehospital feedback types with the majority of studies focusing on performance or patient outcome feedback. The effects of feedback encompassed both personal and professional development, such as improved decision-making, reflection and closure. Mechanisms of providing prehospital feedback varied from electronic dashboards to case reviews and performance appraisals. Further empirical research is required to explore whether the published literature reflects current prehospital practice, as well as to determine the when, what, how and why of ambulance staff desiring feedback.