bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hindrances and facilitators in humanitarian migrants’ maternity care in Finland: qualitative study applying the three delays model framework
Authors: Leppälä Satu , Lamminpää Reeta , Gissler Mika , Vehviläinen‐Julkunen Katri 
Published: May 2019

RationaleHumanitarian migration to Finland nearly ten‐folded in 2015–2016 from 3 326 asylum seekers’ yearly average to 32 476. Earlier research shows that humanitarian migrants sustain suboptimal maternal health in high‐income countries, even though care facilities are available.Aim and objectiveThis study aimed to investigate what factors do maternity care professionals identify as hindrances and facilitators in humanitarian migrants’ maternity care process in Finland.Methodological designStudy employed qualitative design. Eighteen midwives and maternity care public health nurses participated in semi‐structured qualitative interviews that were audio‐recorded and transcribed verbatim. Qualitative content analysis of the interview data produced meaning units, codes and categories.Ethical IssuesResearch plan was reviewed and approved by the ethics committee of the local hospital district. Participants signed an informed consent prior the interviews.FindingsHindrances and facilitators for care were organised in theoretical framework of Three Delays Model. Participants described multiple hindrances for caring process, of which language barrier constantly raised as a significant obstacle for seeking and receiving care, and for perceived quality of care. Correspondingly, interpreters facilitated the caring process at all of its phases. Rural location of asylum centres, long distances and lacking transportation to care hindered reaching the health facility. Complicated bureaucracy was described to affect negatively in receiving adequate care. Refugee and asylum centre workers facilitated decision to seek care, and reaching of health facilities.ConclusionInterpreters can influence in the caring process in more versatile ways than we might have acknowledged this far. We recommend further research on interpreters’ role in the caring process of pregnant humanitarian migrants.
Boron demanding tissues of Brassica napus express specific sets of functional Nodulin26‐like Intrinsic Proteins and BOR1 transporters
Authors: Diehn Till Arvid , Bienert Manuela Désirée , Pommerrenig Benjamin , Liu Zhaojun , Spitzer Christoph , Bernhardt Nadine , Fuge Jacqueline , Bieber Annett , Richet Nicolas , Chaumont François , Bienert Gerd Patrick 
Published: May 2019

SummaryThe sophisticated uptake and translocation regulation of the essential element boron (B) in plants is ensured by two transmembrane transporter families: the Nodulin26‐like Intrinsic Protein (NIP) and BOR transporter family. Though the agriculturally important crop Brassica napus is highly sensitive to B deficiency, and NIPs and BORs have been suggested to be responsible for B efficiency in this species, functional information of these transporter subfamilies is extremely rare. Here, we molecularly characterized the NIP and BOR1 transporter family in the European winter‐type cv. Darmor‐PBY018. Our transport assays in the heterologous oocyte and yeast expression systems as well as in growth complementation assays in planta demonstrated B transport activity of NIP5, NIP6, NIP7 and BOR1 isoforms. Moreover, we provided functional and quantitative evidence that also members of the NIP2, NIP3 and NIP4 groups facilitate the transport of B. A detailed B‐ and tissue‐dependent B‐transporter expression map was generated by quantitative polymerase chain reaction. We showed that NIP5 isoforms are highly upregulated under B‐deficient conditions in roots, but also in shoot tissues. Moreover, we detected transcripts of several B‐permeable NIPs from various groups in floral tissues that contribute to the B distribution within the highly B deficiency‐sensitive flowers.
Characteristics of Indigenous healing strategies in Canada: a scoping review protocol
Authors: Yu Ziwa , Steenbeek Audrey , Macdonald Marilyn , MacDonald Cathy , McKibbon Shelley 
Published: May 2019

ABSTRACT

Objective:
The objective of this review is to identify the characteristics of Indigenous healing strategies in Canada and approaches to improving cultural relevance to local Indigenous contexts.

Introduction:
In the previous 150 years, Indigenous peoples of Canada have experienced colonization, forced assimilation, cultural oppression and violence, and these are associated with high rates of social distress and health disparities. Today, legacies of colonization continue to marginalize Indigenous peoples, creating healthcare institutions devoid of Indigenous worldviews. Despite the growing number of Indigenous healing strategies currently in existence, literature describing these strategies has not been systematically scoped. To address this gap, this scoping review will identify characteristics of Indigenous healing strategies in Canada, and explore culturally relevant approaches used in research process.

Inclusion criteria:
This review will consider literature that describes Indigenous healing strategies in Canada and will include First Nations, Inuit and Métis as the population of interest. Strategies may include, but are not limited to, health services and programs, policies and guidelines, models and frameworks, and Indigenous narratives and expert opinions. Healing strategies delivered in all service settings are eligible for inclusion.

Methods:
The databases/sources to be searched will include: CINAHL, Sociological Abstracts, PsycINFO, MEDLINE and Academic Search Premier. Searches for gray literature will be conducted in iPortal, Canadian Electronic Library, and a list of Canadian government and Indigenous organization websites. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Findings will be summarized in tabular forms accompanied by narrative text.
Project PHARE-2—A High-Speed UHBR Fan Test Facility for a New Open-Test Case
Authors: Brandstetter Christoph , Pages Valdo , Duquesne Pierre , Paoletti Benoit , Aubert Stéphane , Ottavy Xavier 
Published: May 2019

Abstract
A novel test facility for transonic fans has been constructed and commissioned at École Centrale de Lyon (ECL) within the Project PHARE-2. The facility is instrumented with multi-physical measurement systems to deeply investigate aeroelastic and aeroacoustic phenomena. To enable long-term fundamental research, the composite material open-test-case rotor ECL5 is currently under development, which shall be established as a new reference case for method development. Within the present publication, the project objectives, the current rotor design, ECL5v2, and details on the test facility are presented. With the goal to establish future academic collaborations, the authors aim to initiate a discussion in the research community in an early stage of the test case development to receive constructive feedback on the design and research approach.
On the Influence of Blade Aspect Ratio on Aerodynamic Damping
Authors: Buchwald Patrick , Farahmand Aydin , Vogt Damian M. 
Published: May 2019

AbstractIn order to change the blade count (BC) of axial rotor designs, a scaling technique can be applied where the blades are scaled in axial and circumferential directions while maintaining the solidity. This technique allows to adjust the blade count without changing the steady-state aerodynamics, but the influences on the aerodynamic damping are unknown. The present study is focused on the investigation of the change in aerodynamic damping of a subsonic axial compressor rotor, if the blade count is changed between 13 and 25 blades. The investigation is focused on the first bending mode family and the influences of the hub geometry on the modes are neglected. First, a comparison between the influence coefficient (IC) method and the traveling wave mode (TWM) method is conducted, which shows that the application of the IC method in combination with harmonic balance simulations offers a fast way to compute the aerodynamic damping without introducing significant errors compared with the TWM method simulations. Regarding the aerodynamic damping of the different rotor geometries, it can be noted that the amplitude of the work per cycle influence coefficient of the center blade scales linearly with the blade scaling factor and an increase in aerodynamic damping for an increase in blade count is observed. Furthermore, a simplified analytic theory is established, which explains the phase angle change of the blade influence coefficients due to the blade scaling. In the last part of the paper, an extrapolation method is proposed for the investigated geometry and mode family, which allows for the estimation of damping S-curves for scaled rotor geometries based on only one IC method simulation.
Cardiometabolic Effects of a Workplace Cycling Intervention
Authors: Peterman James E. , Morris Kalee L. , Kram Rodger , Byrnes William C. 
Published: May 2019

Background: In laboratory settings, cycling workstations improve cardiometabolic risk factors. Our purpose was to quantify risk factors following a cycling intervention in the workplace. Methods: Twenty-one office workers who sat at work ≥6 hours per day underwent baseline physiological measurements (resting blood pressure, blood lipid profile, maximum oxygen consumption [], body composition, and 2-h oral glucose tolerance test). Participants were randomly assigned to a 4-week intervention only group (n = 12) or a delayed intervention group (n = 9) that involved a 4-week control condition before beginning the intervention. During the intervention, participants were instructed to use the cycling device a minimum of 15 minutes per hour, which would result in a total use of ≥2 hours per day during the workday. Following the intervention, physiological measurements were repeated. Results: Participants averaged 1.77 (0.48) hours per day of cycling during the intervention with no changes in actigraphy-monitored noncycling physical activity. Four weeks of the workplace intervention increased (2.07 [0.44] to 2.17 [0.44] L·min−1, P < .01); end of test power output (166.3 [42.2] to 176.6 [46.1] W, P < .01); and high-density lipoprotein cholesterol (1.09 [0.17] to 1.17 [0.24] mmol·L−1, P = .04). Conclusions: A stationary cycling device incorporated into a sedentary workplace for 4 weeks improves some cardiometabolic risk factors with no compensatory decrease in noncycling physical activity.
Misclassification of coffee consumption data and the development of a standardised coffee unit measure
Authors: Poole Robin , Ewings Sean , Parkes Julie , Fallowfield Jonathan A , Roderick Paul 
Published: May 2019

BackgroundAssociations of coffee consumption with multiple health outcomes have been researched extensively. Coffee consumption, usually reported in cups a day, is a heterogeneous measure due to numerous preparation methods and cup sizes, leading to misclassification. This paper develops a new ‘unit’ measure of coffee and uses coffee consumption data from a representative sample of the UK population to assess misclassification when cup volume and preparation type are not taken into account.MethodsA coffee unit measure was created using published estimates of caffeine and chlorogenic acid concentrations, and applied across volumes and preparation types. Four-day food diary data in adults from the UK National Diet and Nutrition Survey (NDNS; 2012–2016) were used to quantify coffee intake. Participant self-reported cups a day were compared with cups a day standardised by (a) 227 mL volume and (b) 227 mL instant coffee equivalents (unit measure), and the degree of misclassification was derived. Sensitivity analyses were conducted to model coffee drinking preferences of different populations and caffeine:chlorogenic acid weighting assumptions of the unit measure.ResultsThe NDNS sample consisted of 2832 adult participants. Coffee was consumed by 62% of participants. Types varied, with 75% of caffeinated coffee cups being instant, 17% filter, 3% latte, 2% cappuccino, 2% espresso and <1% other types. Comparing reported cups to volume-standardised cups, 84% of participants had correct classification, and 73% when using the coffee unit measure, 22% underestimated and 5% overestimated, largely by one cup. Misclassification varied by gender, age and income. Sensitivity analysis highlighted the benefits of using the unit measure over volume alone to cater for different populations, and stability of the unit composition assumption.ConclusionCup volume and preparation type should be taken into account, through the application of a standardised coffee unit measure, when coffee consumption is classified in future research studies.
Exploring reasons for differences in performance between UK and international medical graduates in the Membership of the Royal College of General Practitioners Applied Knowledge Test: a cognitive interview study
Authors: Pattinson Julie , Blow Carol , Sinha Bijoy , Siriwardena Aloysius 
Published: May 2019

ObjectivesInternational medical graduates (IMGs) perform less well in national postgraduate licensing examinations compared with UK graduates, even in computer-marked multiple-choice licensing examinations. We aimed to investigate thought processes of candidates answering multiple- choice questions, considering possible reasons for differential attainment between IMGs and UK graduates.DesignWe employed a semistructured qualitative design using cognitive interviews. Systematic grounded theory was used to analyse data from ‘think aloud’ interviews of general practitioner specialty trainees (GPSTs) while answering up to 15 live questions from the UK Membership of the Royal College of General Practitioners Applied Knowledge Test (AKT).SettingEast Midlands, UK.Participants21 GPSTs including 13IMGs and 8 UK-trained doctors.OutcomesPerceptions of participants on how they answered AKT questions together with strategies used or difficulties experienced.ResultsWe interviewed 21 GPSTs (8 female, 13 male, 13 IMGs, 14 from black and minority ethnic groups, age 24–64 years) in years 1–3 of training between January and April 2017. Four themes were identified. ‘Theoretical versus real-life clinical experience’: participants reported difficulties recalling information and responding to questions from theoretical learning compared with clinical exposure; rote learning helped some IMGs recall rare disease patterns. Recency, frequency, opportunity and relevance: participants reported greater difficulty answering questions not recently studied, less frequently encountered or perceived as less relevant. Competence versus insight: some participants were over optimistic about their performance despite answering incorrectly. Cultural barriers: for IMGs included differences in undergraduate experience, lack of familiarity with UK guidelines and language barriers which overlapped with the other themes.ConclusionsThe difficulties we identified in candidates when answering AKT questions may be addressed through training. IMGs face additional difficulties which impede examination success due to differences in educational experience, content familiarity and language, which are also potentially amenable to additional training support.
Low-dose ketamine adjuvant treatment for refractory pain in children, adolescents and young adults with cancer: a pilot study
Authors: Courade Magali , Bertrand Amandine , Guerrini-Rousseau Lea , Pagnier Anne , Levy Dominique , Lervat Cyril , Cojean Nadine , Ribrault Alice , Dugue Sophie , Thouvenin Sandrine , Piguet Christophe , Schmitt Claudine , Marec-Berard Perrine 
Published: May 2019

ObjectivesKetamine, anN-methyl-D-aspartate receptor antagonist, is effective at relieving adult cancer pain, although there have been very few reports to date regarding its use in children and in adolescents and young adults (AYA). This study assessed the efficacy, safety and opioid-sparing effects of low doses of ketamine added to opioid analgesics to alleviate persistent cancer pain.MethodsThis prospective, multicentre, observational trial collected data regarding demographics, pain characteristics, pain score assessment within the first 48 hours of ketamine administration, tolerance and satisfaction from 38 patients aged 2–24 years prescribed with ketamine as an adjuvant antalgic for refractory cancer pain in 10 French paediatric oncology centres.ResultsThe mean visual analogue scale pain score decreased from 6.7 to 4.3 out of 10 (n=39, p<0.001) from day 1 to day 3 and by at least 2 points in 56% of the patients (n=22) 48 hours after initiation of ketamine. Nine patients experienced poor tolerance (≥2 side effects), all with infusion rates lower than 0.05 mg/kg/hour. None had limiting toxicities. An opioid-sparing effect was highlighted in four patients. Fifty-four per cent of the prescribers and 47% of the patients found the addition of ketamine ‘very helpful’.ConclusionsLow doses of ketamine as an adjuvant to opioids significantly reduced the intensity of pain in half of the study population. A tendency towards better pain control is shown, although a lack of statistical power somewhat limits our conclusions, especially in children. Nevertheless, ketamine may be a useful option for improving the treatment of refractory pain in children and AYA with cancer.
The association of paramedic rapid sequence intubation and survival in out-of-hospital stroke
Authors: Fouche Pieter Francsois , Smith Karen , Jennings Paul Andrew , Boyle Malcolm , Bernard Stephen 
Published: May 2019

IntroductionAmbulance transport of patients with stroke is common, with rapid sequence intubation (RSI) to secure the airway used regularly. Randomised controlled trial evidence exists to support the use of RSI in traumatic brain injuries (TBIs), but it is not clear whether the RSI evidence from TBI can be applied to the patient with stroke. To this end, we analysed a retrospective stroke dataset to compare survival of patients with RSI compared with patients that did not receive RSI.MethodsThis study was a retrospective analysis of 10 years of in-hospital and out-of-hospital data for all patients with stroke attended by Ambulance Victoria, in Victoria Australia. Generalised boosted logistic regression was used to predict propensity scores, with initial vital signs, age and demographic variables as well as measures of illness severity and comorbidity included in the prediction model. This analysis employed a 1:1 nearest-neighbour matching which was applied to generate a dataset from which we calculated the OR of survival to hospital discharge of patients receiving RSI versus no-RSI. The sensitivity of these results to unmeasured confounding was assessed with deterministic sensitivity analysis.ResultsThe propensity score-matched cohort showed a decreased survival for RSI in strokes with an OR 0.61 (95% CI 0.45 to 0.82; p=0.001) when compared with no-RSI. A subgroup analysis showed no significant survival difference for ischaemic strokes: OR 0.66 (95% CI 40 to 1.07; p=0.09). The survival for haemorrhagic stroke was OR 0.60 (95% CI 0.41 to 0.90; p=0.01) lesser for RSI. Results were likely robust to unmeasured confounding and missing data.ConclusionsOur retrospective analysis shows a decrease in survival when RSI is utilised by paramedics for stroke. Since RSI is commonly used for strokes, controlled trial evidence to support this practice is urgently needed.
Glycated hemoglobin (HbA1c) and outcome following endovascular thrombectomy for ischemic stroke
Authors: Diprose William K , Wang Michael T M , McFetridge Andrew , Sutcliffe James , Barber P Alan 
Published: May 2019

BackgroundIn ischemic stroke, increased glycated hemoglobin (HbA1c) and glucose levels are associated with worse outcome following thrombolysis, and possibly, endovascular thrombectomy.ObjectiveTo evaluate the association between admission HbA1c and glucose levels and outcome following endovascular thrombectomy.MethodsConsecutive patients treated with endovascular thrombectomy with admission HbA1c and glucose levels were included. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0–2 at 3 months. Secondary outcomes included successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b-3), early neurological improvement (reduction in National Institutes of Health Stroke Scale (NIHSS) score ≥8 points, or NIHSS score of 0–1 at 24 hours), symptomatic intracerebral hemorrhage (sICH), and mortality at 3 months.Results223 patients (136 (61%) men; mean±SD age 64.5±14.6) were included. The median (IQR) HbA1c and glucose were 39 (36-45) mmol/mol and 6.9 (5.8–8.4) mmol/L, respectively. Multiple logistic regression analysis demonstrated that increasing HbA1c levels (per 10 mmol/mol) were associated with reduced functional independence (OR=0.76; 95% CI 0.60–0.96; p=0.02), increased sICH (OR=1.33; 95% CI 1.03 to 1.71; p=0.03), and increased mortality (OR=1.26; 95% CI 1.01 to 1.57; p=0.04). There were no significant associations between glucose levels and outcome measures (all p>0.05).ConclusionsHbA1c levels are an independent predictor of worse outcome following endovascular thrombectomy. The addition of HbA1c to decision-support tools for endovascular thrombectomy should be evaluated in future studies.
Deaths from smoking and from HIV/AIDS among gay and bisexual men in California, 2005–2050
Authors: Max Wendy B , Stark Brad B , Sung Hai-Yen , Offen Naphtali B 
Published: May 2019

IntroductionDeaths from HIV/AIDS have long been of concern to the gay community, but less attention has focused on smoking-attributable deaths despite the relatively high smoking rates among gay and bisexual men. This study compared deaths from HIV/AIDS with smoking-attributable deaths among California gay and bisexual men from 2005 to 2050.MethodsSmoking-attributable fractions (SAFs) were estimated using smoking prevalence for gay and bisexual men from the 2011–2014 California Health Interview Surveys and published relative risks of death. Smoking-attributable deaths were calculated by multiplying the SAFs by deaths among gay and bisexual men. Deaths from HIV/AIDS among men who have sex with men was obtained from the California Department of Public Health. Future deaths from smoking and HIV/AIDS were projected using regression equations based on time trends.ResultsFrom 2005 to 2014, smoking caused over 6800 deaths among gay and bisexual men, while nearly 9500 died from HIV/AIDS. Mortality from both causes has been falling, but deaths from HIV/AIDS have been falling more rapidly. Projections suggest that in the mid-2040s, more gay/bisexual men will die from smoking than from HIV/AIDS.ConclusionSmoking will surpass HIV/AIDS as a cause of death among gay and bisexual men in California within a few decades. The lesbian, gay, bisexual and transgender (LGBT) community was highly effective in drawing attention and resources to the fight against HIV/AIDS, saving untold lives by hastening effective treatments. Lessons learnt in the fight against AIDS should be used to help fight the tobacco epidemic.