bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of the Recommendations for RBC Transfusions for Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Steffen Katherine M. , Bateman Scot T. , Valentine Stacey L. , Small Sara , Spinella Philip C. , Doctor Allan 
Published: August 2018

Objectives:
To provide context for the implementation of the Pediatric Critical Care Transfusion and Anemia Expertise Initiative recommendations for RBC transfusions including a review of prior research related to implementation of transfusion guidelines, efforts to facilitate implementation through Transfusion and Anemia Expertise Initiative, and to provide a framework for recommendation implementation.

Design:
Review of existing clinical literature and description of a comprehensive approach to implementation based on Implementation Science principles.

Results:
The Transfusion and Anemia Expertise Initiative recommendations on RBC transfusions are based on clinical evidence and aim to limit unnecessary and potentially harmful transfusions. Prior efforts to use transfusion guidelines include use of provider education, local guidelines, visual aids, prospective and retrospective audit and feedback as well as computerized decision support tools; however, no single approach has been identified as optimal for implementation in pediatric critical care settings. Evidence around provider beliefs and transfusion decision-making point to the need for additional provider education, emphasizing the importance of limiting transfusions, and the development of recommendations, such as the Transfusion and Anemia Expertise Initiative guidelines, that can be applied to specific clinical conditions.

Conclusions:
The Transfusion and Anemia Expertise Initiative guidelines will be broadly disseminated; however, coordinated implementation efforts will be required to impact practice. An approach that encourages involvement of a wide range of multiprofessional stakeholders, formal agreement on the implemented guidelines, selection of strategies that are practical and feasible, and active monitoring of clinical practice and outcomes throughout implementation is recommended. A formal second stage Transfusion and Anemia Expertise Initiative - Continuous Assessment of Blood-use is proposed to enhance implementation of the recommendations, follow uptake and impact on practice and patient outcomes, and ensure integration of new clinical evidence into the existing guideline as it is developed.
Recommendations on RBC Transfusion in Infants and Children With Acquired and Congenital Heart Disease From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Cholette Jill M. , Willems Ariane , Valentine Stacey L. , Bateman Scot T. , Schwartz Steven M. 
Published: August 2018

Objectives:To present the recommendations and supporting literature for RBC transfusions in critically ill children with acquired and congenital heart disease developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.Design:Consensus conference series of 38 international, multidisciplinary experts in RBC transfusion management of critically ill children.Methods:Experts developed evidence-based and, when evidence was lacking, expert-based clinical recommendations and research priorities for RBC transfusions in critically ill children. The cardiac disease subgroup included three experts. Electronic searches were conducted using PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017. Agreement was obtained using the Research and Development/UCLA appropriateness method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method.Results:Twenty-one recommendations were developed and reached agreement. For children with myocardial dysfunction and/or pulmonary hypertension, there is no evidence that transfusion greater than hemoglobin of 10 g/dL is beneficial. For children with uncorrected heart disease, we recommended maintaining hemoglobin greater than 7–9.0 g/dL depending upon their cardiopulmonary reserve. For stable children undergoing biventricular repairs, we recommend not transfusing if the hemoglobin is greater than 7.0 g/dL. For infants undergoing staged palliative procedures with stable hemodynamics, we recommend avoiding transfusions solely based upon hemoglobin, if hemoglobin is greater than 9.0 g/dL. We recommend intraoperative and postoperative blood conservation measures. There are insufficient data supporting shorter storage duration RBCs. The risks and benefits of RBC transfusions in children with cardiac disease requires further study.Conclusions:We present RBC transfusion management recommendations for the critically ill child with cardiac disease. Clinical recommendations emphasize relevant hemoglobin thresholds, and research recommendations emphasize need for further understanding of physiologic and hemoglobin thresholds and alternatives to RBC transfusion in subpopulations lacking pediatric literature.
Eyelash Ptosis in Unilateral Myogenic and Aponeurotic Blepharoptosis
Authors: Kashkouli Mohsen Bahmani , Abdolalizadeh Parya , Amirsardari Anahita , Hadi Yasaman , Sharepour Maria , Esmaeilkhanian Houri 
Published: August 2018

Purposes
The purposes of this study were to compare lash ptosis (LP) with contralateral eyelid in patients with unilateral myogenic (MP) and aponeurotic (AP) ptosis before and after the ptosis repair and to assess the correlation between postoperative eyelid height and LP symmetry.

Methods
Patients older than 5 years were included from June 2015 to April 2017. Eyelid examination, LP grading (0–3), and photography were performed before and at least 6 months after ptosis repair. Success of ptosis repair (levator resection) was defined as margin reflex distance 1 within 0.5 mm of the contralateral eyelid; LP improvement, as at least 1 grade improvement at the last follow-up; and LP symmetry, as 2 eyelids being within 1 grade.

Results
There were 58 patients with MP and 20 with AP, with mean age of 19.2 and 49.5 years and median follow-up of 10 months. Lash ptosis was observed in 89.5% of ptotic and 33.3% of control eyelids. Mean LP grade was significantly higher in the MP (1.5) than in the AP (1.1), which significantly improved to 0.6 and 0.4, respectively. However, it persisted in 50.9% of MP and 31.2% of AP postoperatively. Lash ptosis symmetry was observed in 97.4% of patients, which was not correlated with margin reflex distance 1 symmetry. Lower levator function was the only significant factor correlated with LP.

Conclusion
Lash ptosis was significantly worse in MP than in AP. Lower LF was correlated with more severe LP. Ptosis repair resulted in significant improvement of LP and its symmetry with the contralateral eyelid. Lash ptosis symmetry did not correlate with eyelid height symmetry postoperatively.
Genomic analysis for heavy metal resistance inS. maltophilia
Authors: Yu Wenbang , Chen Xiaoxiao , Sheng Yilin , Hong Qinghong 
Published: August 2018

AbstractStenotrophomonas maltophiliais highly resistant to heavy metals, but the genetic knowledge of metal resistance inS. maltophiliais poorly understood. In this study, the genome ofS.maltophiliaPho isolated from the contaminated soil near a metalwork factory was sequenced using PacBio RS II. Its genome is composed of a single chromosome with a GC content of 66.4% and 4434 protein-encoding genes. Comparative analysis revealed high syntney betweenS.maltophiliaPho and the model strain,S.maltophiliaK279a. Then, the type and number of mechanisms for heavy metal uptake were analyzed firstly. Results revealed 7 unspecific ion transporter genes and 13 specific ion transporter genes, most of which were involved in iron transport. But the sulfate permeases belonging to the family of SulT/CysP that can uptake chromate and the high affinity ZnuABC/SitABCD were absent. Secondly, the putative genes controlling metal efflux were identified. Results showed that this bacterium encoded 5 CDFs, 1 copper exporting ATPase and 4 RND systems, including 2 CzcABC efflux pumps. Moreover, the putative metal transformation genes including arsenate and mercury detoxification genes were also identified. This study may provide useful information on the metal resistance mechanisms ofS.maltophilia.
Leveraging experiential learning training through spaced learning
Authors: Kondratjew Hanan , Kahrens Marion 
Published: August 2018

Purpose
Spaced learning (SL) and experiential learning (EL) have been identified as being more efficient to long-term knowledge retention than other forms of learning. The purpose of this paper is to confirm these benefits of SL and EL in a work-based learning environment.

Design/methodology/approach
This case study research monitored changes in learning outcomes of a work-based EL training, the Model Warehouse, when adding SL. The Model Warehouse of the Karlsruher Institute for Technology, Germany intends to educate professionals in lean warehouse logistics. Following a pragmatic standpoint, two groups of students were considered and compared by using multiple-choice question based knowledge tests where one group participated in an additional SL session. The experiences and perceptions of students were assessed by conducting in-depth interviews.

Findings
Findings revealed that adding SL to the EL training resulted either in students’ knowledge retention or knowledge improvement. Additionally, participants of the SL session did not perceive it as being required to strengthen understanding of lean warehouse management.

Practical implications
This study recommends considering SL as an effective means to significantly enhance long-term knowledge retention of any work-based or EL training.

Originality/value
This study confirms the benefits of SL and EL drawn from laboratory-based studies in a real business context. Adopting both learning theories in training programmes which converge with realities of the workplace results in a significant improvement of long-term knowledge retention.
Vernacular architecture of Iran’s hot regions; elements and strategies for a comfortable living environment
Authors: Sahebzadeh Sadra , Dalvand Zahra , Sadeghfar Milad , Heidari Ali 
Published: August 2018

PurposeThe purpose of this paper is to introduce and discuss 11 strategies and 11 sets of tools to provide a knowledge background on how native people of Iran have come up with innovative solutions to create a sustainable and comfortable living environment within the confinement of their homes, in harsh environment of Iran’s hot-arid and hot-humid regions.Design/methodology/approachThese strategies include density, building orientation, introversion, design for four seasons, using local materials, using the ground’s thermal capacity, natural wind induced ventilation, using walls’ thickness and porosity, Panãm (insulation), using special native additive elements and integration of water and plants into the building. Discussed tools include water, courtyard, Showãdãn, Bahãr-khãb, roof, korsi room, ratio and Pãyãb, Sardãb and Howz-khãneh, Shanãshil, Bãdgir and Eivãn.FindingsIn conclusion, interrelations between these strategies and tools are illustrated in order to provide a collection of guidelines and inspirations for those involved in the building industry in Iran and Middle East to come up with innovative solutions for creating a sustainable and comfortable living environment in this region’s climates.Originality/valueThis paper provides a collection of guidelines and inspirations for those involved in the building industry in Iran and Middle East to come up with innovative solutions for creating a sustainable and comfortable living environment in this region’s climates.
Simulated versus traditional occupational therapy placements: A randomised controlled trial
Authors: Imms Christine , Froude Elspeth , Chu Eli Mang Ye , Sheppard Loretta , Darzins Susan , Guinea Stephen , Gospodarevskaya Elena , Carter Rob , Symmons Mark A. , Penman Merrolee , Nicola‐Richmond Kelli , Gilbert Hunt Susan , Gribble Nigel , Ashby Samantha , Mathieu Erin 
Published: August 2018

Background/aimProfessional practise placements in occupational therapy education are critical to ensuring graduate competence. Australian occupational therapy accreditation standards allow up to 200 of a mandated 1000 placement hours to include simulation‐based learning. There is, however, minimal evidence about the effectiveness of simulation‐based placements compared to traditional placements in occupational therapy. We evaluated whether occupational therapy students completing a 40 hour (one week block) Simulated Clinical Placement (SCP) attained non‐inferior learning outcomes to students attending a 40 hour Traditional Clinical Placement (TCP).MethodsA pragmatic, non‐inferiority, assessor‐blinded, multicentre, randomised controlled trial involving students from six Australian universities was conducted. Statistical power analysis estimated a required sample of 425. Concealed random allocation was undertaken with a 1:1 ratio within each university. Students were assigned to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP materials were developed, manualised and staff training provided. TCPs were in equivalent practice areas. Outcomes were assessed using a standardised examination, unit grades, the Student Practice Evaluation Form‐Revised and student confidence survey. A generalised estimating equation approach was used to assess non‐inferiority of the SCP to the TCP.ResultsOf 570 randomised students (84% female), 275 attended the SCP and 265 the TCP (n = 540, 94.7% retention). There were no significant differences between the TCP and SCP on (i) examination results (marginal mean difference 1.85, 95% CI: 0.46–3.24; P = 0.087); (ii) unit score (mean (SD) SCP: 71.9 (8.8), TCP: 70.34 (9.1); P = 0.066); or (iii) placement fail rate, assessed using the Student Practice Evaluation Form‐Revised (100% passed both groups).ConclusionStudents can achieve equivalent learning outcomes in a 40 hour simulated placement to those achieved in a 40 hour traditional placement. These findings provide assurance to students, educators and professional accreditation bodies that simulation can be embedded in occupational therapy education with good effect.
Implementing healthy food policies in health services: A qualitative study
Authors: Boelsen‐Robinson Tara , Blake Miranda R. , Backholer Kathryn , Hettiarachchi Janitha , Palermo Claire , Peeters Anna 
Published: August 2018

AimIn 2012, a large Australian metropolitan health service introduced a healthy food policy, where there was a requirement for food and drinks for sale within retail stores to conform to standards based on macronutrients and energy content. The aim of the present study was to evaluate the experience of those implementing a healthy food retail policy in order to inform the translation of such policies into other organisations.MethodsA qualitative approach was used, with semistructured interviews exploring informants’ involvement in, experiences of, factors affecting and perceived outcomes of policy implementation. Interviews were conducted with seven individuals participating in the introduction of the healthy food retail policy. Results were analysed using a thematic analysis approach.ResultsFour themes and 21 sub‐themes were identified, with analysis interpreted using the socio‐ecological model. Participants identified that successful policy implementation hinged on the provision of resources and support by the health service to the retail staff. Trusting relationships between retail and health service staff were built through effective and frequent communication. The fear of tensions between the policy and business income had significantly lessened after implementation. A key factor contributing to this change was the use of low‐risk trials to remove less healthy products or introduce new healthier foods.ConclusionsImplementing a healthy food retail policy within a health service benefits from dedicated resourcing, investment in relationship building with key stakeholders and introducing changes gradually with a long‐term approach.
Loss of B‐cell lymphoma 2 immunohistochemical expression in endometrial hyperplasia: A specific marker of precancer and novel indication for treatment
Authors: Travaglino Antonio , Raffone Antonio , Saccone Gabriele , Insabato Luigi , Mollo Antonio , De Placido Giuseppe , Zullo Fulvio 
Published: August 2018

AbstractIntroductionEndometrial hyperplasia is differentiated into benign or premalignant. Two histological classifications are used for this purpose: World Health Organization (WHO) classification, based on cytological atypia, disregarding glandular complexity, and endometrial intraepithelial neoplasia (EIN) classification, based on several different parameters. B‐cell lymphoma 2 (Bcl‐2) loss has been studied as immunohistochemical marker with the aim of improving the differential diagnosis between benign and premalignant hyperplasia. We aimed to evaluate: (A) Bcl‐2 loss as marker of endometrial precancer, by assessing it in proliferative endometrium, benign hyperplasia, premalignant hyperplasia, and endometrial cancer; (B) the diagnostic accuracy of Bcl‐2 in the differential diagnosis between benign and premalignant endometrial hyperplasia; (c) how the results change according to the histological classification and the thresholds of Bcl‐2 expression used.Material and methodsElectronic databases were searched from their inception to March 2018. All studies assessing Bcl‐2 immunohistochemistry in endometrial specimens were included.ResultsIn total, 20 observational studies assessing 1,278 specimens were included. Bcl‐2 loss rates were not significantly different between proliferative endometrium and benign hyperplasia (P = 0.12) and between premalignant hyperplasia and endometrial cancer (P = 0.53). Among hyperplasias, Bcl‐2 loss was significantly associated with premalignancy, according to both the WHO (OR = 4.39; P < 0.00001) and EIN classifications (OR = 6.07; P = 0.01), and also with architecture complexity (OR = 2.06; P = 0.02). Using the WHO classification, Bcl‐2 loss showed low diagnostic accuracy in detecting premalignant hyperplasia (area under the curve [AUC] = 0.708), with a sensitivity of 0.41, a specificity of 0.81, a positive likelihood ratio of 3.22, and a negative likelihood ratio of 0.69. Using the EIN classification, accuracy was high (AUC = 0.938), with a sensitivity of 0.18, a specificity of 0.97, a positive likelihood ratio of 5.16 and a negative likelihood ratio of 0.86. Thresholds of Bcl‐2 expression not involving a complete loss showed lower diagnostic accuracy with a slight increase in sensitivity, but a severe decrease in specificity.ConclusionsB‐cell lymphoma 2 loss is a marker of endometrial precancer, with a high specificity and high diagnostic accuracy if the EIN classification is used. Thresholds of Bcl‐2 expression not involving a complete loss should not be considered. Bcl‐2 loss in endometrial hyperplasia may be a novel indication for treatment when precancerous features are ambiguous in a histological examination. Bcl‐2 loss correlates better with EIN classification than with the WHO classification, suggesting that glandular complexity is an important precancerous feature.
Geographical differences in preterm delivery rates in Sweden: A population‐based cohort study
Authors: Murray Sarah R. , Juodakis Julius , Bacelis Jonas , Sand Anna , Norman Jane E. , Sengpiel Verena , Jacobsson Bo 
Published: August 2018

AbstractIntroductionPreterm delivery is a major global public health challenge. The objective of this study was to determine how preterm delivery rates differ in a country with a very high human development index and to explore rural vs urban environmental and socioeconomic factors that may be responsible for this variation.Material and methodsA population‐based study was performed using data from the Swedish Medical Birth Register from 1998 to 2013. Sweden was chosen as a model because of its validated, routinely collected data and availability of individual social data. The total population comprised 1 335 802 singleton births. A multiple linear regression was used to adjust gestational age for known risk factors (maternal smoking, ethnicity, maternal education, maternal age, height, fetal sex, maternal diabetes, maternal hypertension, and parity). A second and a third model were subsequently fitted allowing separate intercepts for each municipality (as fixed or random effects). Adjusted gestational ages were converted to preterm delivery rates and mapped onto maternal residential municipalities. Additionally, the effects of six rural vs urban environmental and socioeconomic factors on gestational age were tested using a simple weighted linear regression.ResultsThe study population preterm delivery rate was 4.12%. Marked differences from the overall preterm delivery rate were observed (rate estimates ranged from 1.73% to 6.31%). The statistical significance of this heterogeneity across municipalities was confirmed by a chi‐squared test (P < 0.001). Around 20% of the gestational age variance explained by the full model (after adjustment for known variables described above) could be attributed to municipality‐level effects. In addition, gestational age was found to be longer in areas with a higher fraction of built‐upon land and other urban features.ConclusionsAfter adjusting for known risk factors, large geographical differences in rates of preterm delivery remain. Additional analyses to look at the effect of environmental and socioeconomic factors on gestational age found an increased gestational age in urban areas. Future research strategies could focus on investigating the urbanity effect to try to explain preterm delivery variation across countries with a very high human development index.
Conservation impacts of commercial cultivation of endangered and overharvested plants
Authors: Liu Hong , Gale Stephan W. , Cheuk Mang Lung , Fischer Gunter A. 
Published: August 2018

AbstractOverharvesting is one of the greatest threats to species survival. Farming overharvested species is a conservation strategy that can meet growing market demand and conserve wild populations of the target species. This strategy is compatible with the international community's desire to uphold the right of local communities to use biological resources to support their livelihoods. However, studies investigating whether farming can alleviate poaching pressure have focused almost exclusively on animals. To address the shortfall in plant‐focused studies, we compiled information on commercial cultivation of threatened plants to assess its conservation benefits. Because China's rising middle class has rapidly intensified demand for wildlife products, we searched the scientific literature published in Chinese (China National Knowledge Infrastructure and Baidu) and in English. We found 32 reports that contained data on 193 internationally or nationally threatened plant species that were under commercial cultivation. These reports showed that cultivations of 82% of the 193 species were sustained by collecting whole plants from the wild periodically or continuously. Although based on a small sample size, species that were maintained in cultivation only through artificial propagation or seeds collected in the wild were likely associated with a reported reduction in wild harvesting of whole plants. Even so, results of correlation analyses suggested that production system, scale, and when a species began being cultivated had little effect on conservation status of the species, either globally or in China. However, species brought into cultivation relatively recently and on a smaller scale were more likely to have undergone a reduction in collecting pressure. Farming of nonmedicinal plants was most problematic for species conservation because wild plants were laundered (i.e., sold as cultivated plants). For effective conservation, policy to guide cultivation operations based on the target species’ biological characteristics, cultural significance, market demand, and conservation status is needed.