bluuebunny/crossref_metadata_2025_split huggingface dataset:
A second look at the mortality in thrombotic thrombocytopenic purpura score: An external validation study
Authors: Andanamala Haripriya , Brunton Nichole , Pai Rima , Sostin Oleg 
Published: January 2023

AbstractBackgroundDespite high effectiveness of therapeutic plasma exchange as the first‐line therapy, thrombotic thrombocytopenic purpura (TTP) remains a life‐threatening condition and may require utilization of adjunct modalities in certain patients. Mortality In TTP Score (MITS) is a prognostic risk stratified scoring tool designed to predict mortality in hospitalized patients with TTP. There has not been an external validation of MITS to date.Study Design and MethodsWe performed an external validation of MITS in patients hospitalized with TTP using the National Inpatient Sample database from 2016 to 2019. We identified 4589 patients who met the selection criteria. Univariate and multivariable logistic regression models were run based on the MITS parameters of arterial thrombosis, intracranial haemorrhage, age, renal failure, ischemic stroke, platelet transfusion, and myocardial infarction to evaluate prognostic performance and discriminatory power of this tool.ResultsAll‐cause mortality was reported more frequently in female subjects (57.8%), Caucasian race (58.9%), and ages 60 years, and above (52.3%). In a multivariable analysis, the variables included in the MITS criteria remained significant predictors of mortality. Moreover, MITS correlated with mortality risk. Our model's area under the receiving operator character curve was 71%, compared to 78.6% in the derivation cohort study.DiscussionIn this external validation cohort, performance of MITS was similar to the derivation cohort, validating it as a valuable clinical tool that may guide management of TTP patients.
Using Machine Learning for Loss Prediction in a Hybrid Meanline Modeling Method to Deliver Improved Radial Turbine Performance Prediction
Authors: Ren Pangbo , Stuart Charles , Spence Stephen , Inomata Ryosuke , Kobayashi Takayuki , Morita Isao 
Published: January 2023

Abstract
Low fidelity modeling approaches remain attractive due to an unrivaled ability to predict full turbine performance maps quickly compared to high-fidelity approaches such as computational fluid dynamics (CFD), especially in the preliminary design process. As improvements in performance on a component level approach a point of diminishing returns, the ability to efficiently optimize the complete charging system for a given duty is a topic attracting significant research interest. In the case of turbocharging applications, existing engine and powertrain simulations require turbine maps to calculate the turbine performance, which are usually obtained from experimental testing. Unfortunately, the need for extrapolation is unavoidable because of the limited range of testing data available, leading to inaccuracies especially at off-design conditions. To enable intensive modeling and optimization of complete vehicle powertrains for different drive cycles, the current piece of work seeks to combine the advantages of machine learning techniques and physical meanline modeling to facilitate faster, more accurate predictions of complete turbocharger maps. This paper presents a novel methodology for turbocharger turbine rotor and nozzle performance prediction based on hybrid modeling. The turbine rotor and nozzle were parameterized to conduct CFD simulations for a wide variety of turbine geometries, which were used to form a database to train an artificial neural network (ANN). The predicted losses provided by the ANN were then utilized in the meanline code, substituting for the conventional empirical loss models. As well as removing the need for empirical loss models, modifications were undertaken to the meanline approach to further enhance modeling accuracy. First, in order to accurately characterize the stage mass flow capacity, the losses occurring in the nozzle and rotor were subdivided into those occurring before and after the throat. A second novel aspect is that the aerodynamic blockage level at the rotor throat was implemented as a variable rather than a constant value. By training the ANN to predict the variation of blockage with geometry and operating condition, a more accurate depiction of the changing secondary flow fields could be achieved. The capabilities of the hybrid meanline modeling method were evaluated on several unseen test cases. The resulting predictions of efficiency and mass flowrate demonstrated strong correlation with CFD results and experimental test results. The hybrid meanline modeling method therefore displays great potential in wide range radial turbine performance prediction with enhanced accuracy in comparison to traditional approaches.
Side effects of Zataria multiflora Boiss (Lamiaceae) essential oil on predation and life table parameters of Amblyseius swirskii Athias-Henriot (Acari: Phytoseiidae)
Authors: Shirvani Zeinab , Allahyari Hosein , Zahedi Golpayegani Azadeh , Talebi Jahromi Khalil , Döker Ismail 
Published: January 2023

The predatory mite, Amblyseius swirskii Athias-Henriot (Acari: Phytoseiidae) is one of the most promising candidates for biological control of some economically important mites and insect pests such as spider mites, whiteflies, and thrips. Western Flower Thrips (WFT), Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae) is a severe economic pest for many crops in the world. In this study the lethal concentrations of Shirazicum thymus: Zataria multiflora Boiss (Lamiaceae) essential oil was calculated to the adult stage of the WFT. Side effects LC30 and LC50 of the essential oil were assessed on life table parameters and functional response of A. swirskii. Experiments were carried out in growth chambers at 25 ± 1 °C, 60 ± 10% RH, and 16: 8 h (Light: Dark) photoperiod. We utilized the age-stage, two-sex life table method to evaluate the life history features and population growth of A. swirskii on WFT. For assessing the functional response, the first instar of WFT was offered as prey to the adult female of A. swirskii with densities of 2, 4, 8, 16, 32, and 64. The LC50 concentration of the essential oil resulted in lower fecundity (15.05 eggs/female) in comparison with the control (19.8 eggs/female). The application of LC50 and LC30 concentrations also resulted in a significant decrease in net reproductive rate (R0) (8.9, 6.6, and 4.5 eggs per individuals), intrinsic rate of increase (rm) (0.116, 0.093, and 0.077 day -1), finite rate of increase (λ) (1.123, 1.097, and 1.079 day -1), but an increase in mean generation time (T) (18.5, 20.1, and 19.5 days) (for control, LC30, and LC50, applications, respectively). A type II functional response was detected for A. swirskii fed on WFT first instar in all treatments. Adult females of A.swirskii had the highest attack rate (a) (0.11± 0.01 h-1) and shortest handling time (1.61± 0.46h) on control treatment. In conclusion, although Z. multiflora essential oil had potential against F. occidentalis to be applied in integrated pest management programs, the lethal side effects of selected essential oil on the predatory mite, A. swirskii should be considered.
A zinc-conducting chalcogenide electrolyte
Authors: Zhi Jian , Zhao Siwei , Zhou Min , Wang Ruiqi , Huang Fuqiang 
Published: January 2023

A solid-state zinc-ion battery can fundamentally eliminate dendrite formation and hydrogen evolution on the zinc anode from aqueous systems. However, enabling fast zinc ion
+
conduction in solid crystals is thought to be impossible. Here, we demonstrated a fluorine-doping approach to achieving fast Zn
2+
transport in mesoporous Zn

y

S

1−
x

F

x

. The substitutional doping of fluoride ion with sulfide substantially reduces Zn
2+
migration barrier in a crystalline phase, while mesopore channels with bounded dimethylformamide enable nondestructive Zn
2+
conduction along inner pore surface. This mesoporous conductor features a high room-temperature Zn
2+
conductivity (0.66 millisiemens per centimeter, compared with 0.01 to 1 millisiemens per centimeter for lithium solid-state electrolyte) with a superior cycling performance (89.5% capacity retention over 5000 cycles) in a solid zinc-ion battery and energy density (0.04 watt-hour per cubic centimeter) in a solid zinc-ion capacitor. The universality of this crystal engineering approach was also verified in other mesoporous zinc chalcogenide materials, which implies various types of potential Zn
2+
-conducting solid electrolytes.
Mantle serpentinization and associated hydrogen flux at North Atlantic magma-poor rifted margins
Authors: Liu Zhonglan , Perez-Gussinye Marta , García-Pintado Javier , Mezri Leila , Bach Wolfgang 
Published: January 2023

AbstractMantle serpentinization influences the rheology of altered peridotites and the global fluxes of energy and volatiles, the generation of seafloor and sub-seafloor chemolithotrophic life, and the carbon cycle. As a by-product of serpentinization, molecular hydrogen (H2) is generated, which supports chemosynthetic communities, and this mechanism may have driven the origin of life on early Earth. At continent-ocean transition zones (COTs) of magma-poor rifted margins, the mantle is exposed and hydrated over hundreds of kilometers across the rift, but the H2 fluxes associated with this process are poorly known. Here, we coupled a thermomechanical model with serpentinization reaction equations to estimate associated H2 release during mantle exhumation at COTs. This reproduced a tectonic structure similar to that of the West Iberia margin, one of the best-studied magma-poor margins. We estimated the rate of H2 production from mantle hydration at (7.5 ± 2.5) × 107 mol/(yr × km). By estimating the area of exhumed mantle from wide-angle seismic profiles at North Atlantic magma-poor margins, we calculated that the accumulated H2 production could have been as high as ~4.3 × 1018 mol (~8.6 × 1012 metric tons) prior to opening of the North Atlantic Ocean, at a rate of ~1.4 × 1017 mol/m.y. This is one quarter of the total predicted flux produced by the global system of mid-ocean ridges, thus highlighting the significance of H2 generation at magma-poor margins in global H2 fluxes, to hydrogenothropic microbial life, and, perhaps, as a potential energy source.
Correlation of disability with quality of life in patients with multiple sclerosis treated with natalizumab: primary results and post hoc analysis of the TYSabri ImPROvement study (PROTYS)
Authors: Achtnichts Lutz , Zecca Chiara , Findling Oliver , Kamm Christian P , Mueller Stefanie , Kuhle Jens , Lutterotti Andreas , Gobbi Claudio , Viviani Camille , Villiger-Borter Emanuela , Nedeltchev Krassen 
Published: January 2023

BackgroundIn patients with multiple sclerosis (MS), relapses and disability progression have been associated with decreased health-related quality of life (HRQoL).MethodsPROTYS, a prospective, multicentre, single-arm, observational study in seven Swiss MS centres, evaluated correlations between change in disability status (measured through the Expanded Disability Status Scale (EDSS)) and HRQoL changes (measured through the global Multiple Sclerosis International Quality of Life (MusiQoL) index questionnaire) in 35 patients with relapsing remitting MS on natalizumab for 1 year. In addition, several other scales were also used, such as: Multiple Sclerosis Intimacy and Sexuality Questionnaire-19, EuroQoL-5 Dimension, and Fatigue Scale of Motor and Cognitive Function. A post hoc analysis further assessed the association between HRQoL changes after 1 year and the MusiQoL subscores and other patient-reported outcome (PRO) measures.ResultsAt 1 year, patients were categorised into ‘EDSS improved’ (6/35), ‘EDSS stable’ (28/35) and ‘EDSS worsened’ (1/35). Mean disability scores decreased for ‘EDSS improved’ and ‘EDSS stable’ but increased for ‘EDSS worsened’. Mean MusiQoL index score for ‘EDSS improved’ increased from 61.2 at baseline to 66.3 at 1 year, while the ‘EDSS stable’ group increased from 67.9 to 70.8. No meaningful statistical relationship was observed between EDSS group and changes in MusiQoL score. For the post hoc analysis, patients were categorised in ‘MusiQoL improved’ (n=21) and ‘MusiQoL worsened’ (n=14) groups. MusiQoL subscores for ‘symptoms,’ ‘psychological well-being’ and ‘activities of daily living’, as well as scores for several related PRO measures, correlated with improvement of the MusiQoL global index. There was no correlation between the changes in MusiQoL global index and EDSS score.ConclusionsNatalizumab treatment for 1 year resulted in either improved or stable EDSS status in most patients, and although no significant relationship was observed between global HRQoL change and EDSS change, several domains of HRQoL seemed to improve with natalizumab treatment.Trial registration numberNCT02386566.
Exploring the experiences of healthcare professionals in South Africa and Uganda around communicating with children about life-threatening conditions: a workshop-based qualitative study to inform the adaptation of communication frameworks for use in these settings
Authors: Rapa Elizabeth , Hanna Jeffrey R , Pollard Teresa , Santos-Paulo Stephanie , Gogay Yasmin , Ambler Julia , Namukwaya Elizabeth , Kavuma David , Nabirye Elizabeth , Kemigisha Ruth Mary , Namyeso Juliet , Brand Tracey , Walker Louise , Neethling Beverley G , Downing Julia , Ziebland Sue , Stein Alan , Dalton Louise J 
Published: January 2023

ObjectivesThis study aimed to explore how published communication frameworks could be amended to ensure applicability and cultural appropriateness for professionals to support family-centred conversations by investigating’ healthcare professionals’ (1) experiences of providing support to families when a caregiver or a dependent child (<18 years old) has a life-threatening condition, (2) perceived challenges for caregivers and healthcare professionals in communicating with children about illness, (3) perceptions of how clinicians could be equipped to facilitate conversations between caregivers and children about an adult or the child’s own life-threatening condition and (4) suggestions for amendments to previously published guidelines to ensure cultural relevance in South Africa and Uganda.DesignA qualitative study involving two 2-day workshops with embedded focus group discussions, break out rooms and consensus discussions.SettingHealth and social care and third sector organisations in South Africa and Uganda.ParticipantsThirty-two professionals providing care to families affected by life-threatening conditions in South Africa or Uganda who were aged 18 years or older and able to converse in English.ResultsParticipants identified obstacles to having conversations with caregivers about children and to telling children about serious illness during consultations. These included patients’ beliefs about illness, medicine and death, language barriers between families and the healthcare team, and emotional and practical challenges for professionals in having these conversations. Culturally appropriate adaptations were made to previously published communication frameworks for professionals to support family-centred conversations.ConclusionsCulturally sensitive communication frameworks could help healthcare professionals to talk with families about what children need to know when they or a caregiver have a serious illness. More broadly, effective communication could be facilitated by promoting healthcare professionals’ and communities’ understanding of the benefits of telling children about illness within the family. Together these strategies may mitigate the psychological impact of global disease on children and their families.
Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales
Authors: Romanis Elizabeth Chloe , Parsons Jordan A 
Published: January 2023

BackgroundTelemedical early medical abortion (TEMA) was introduced in England and Wales as a temporary measure in 2020 and was made permanent in 2022. While there are considerable data showing the safety, efficacy, and acceptability of TEMA for patients, there have been objections raised to TEMA based on safeguarding—particularly for people under 18 years of age. Little is known about abortion care providers’ views and experiences of carrying out their safeguarding duties with people aged under 18 in the shift to TEMA.MethodsThis is a qualitative study involving online semi-structured interviews and reflexive thematic analysis. Audio-recorded, semi-structured interviews with abortion providers in England and Wales (n=20) generated data about their views and experiences of safeguarding in telemedical abortion care. Recordings were transcribed verbatim and then subject to reflexive thematic analysis to construct themes.ResultsWhile the study was designed with adult safeguarding in mind, the safeguarding of under 18s became a key area of discussion. Three major themes were constructed in relation to under 18s: (1) age as a risk factor in safeguarding; (2) telemedicine as improving access to care; and (3) telemedicine as enhancing communication.ConclusionCare providers believe TEMA has benefitted the under 18s. There was a strong feeling both that TEMA had improved access (which, in turn, improved safeguarding) and that under 18s were comfortable communicating using remote means. Providers believe safeguarding proformas must account for the different nature of risks where service users are under 18, but that it is disproportionate to assume that TEMA is unsuitable for all under 18s or groups of under 18s.
Direct and indirect effects of socioeconomic status on sepsis risk and mortality: a mediation analysis of the HUNT Study
Authors: Stensrud Vilde Hatlevoll , Gustad Lise Tuset , Damås Jan Kristian , Solligård Erik , Krokstad Steinar , Nilsen Tom Ivar Lund 
Published: January 2023

BackgroundSocioeconomic status (SES) may influence risk of sepsis and sepsis-related mortality, but to what extent lifestyle and health-related factors mediate this effect is not known.MethodsThe study included 65 227 participants of the population-based HUNT Study in Norway linked with hospital records to identify incident sepsis and sepsis-related deaths. Cox regression estimated HRs of sepsis risk and mortality associated with different indicators of SES, whereas mediation analyses were based on an inverse odds weighting approach.ResultsDuring ~23 years of follow-up (1.3 million person-years), 4200 sepsis cases and 1277 sepsis-related deaths occurred. Overall, participants with low SES had a consistently increased sepsis risk and sepsis-related mortality using education, occupational class and financial difficulties as indicators of SES. Smoking and alcohol consumption explained 57% of the sepsis risk related to low education, whereas adding risk factors of cardiovascular disease and chronic diseases to the model increased the explained proportion to 78% and 82%, respectively.ConclusionThis study shows that SES is inversely associated with sepsis risk and mortality. Approximately 80% of the effect of education on sepsis risk was explained by modifiable lifestyle and health-related factors that could be targets for prevention.
SARS-CoV-2 infections in pediatric and young adult recipients of chimeric antigen receptor T-cell therapy: an international registry report
Authors: McNerney Kevin Owen , Richards Rebecca M , Aguayo-Hiraldo Paibel , Calkoen Friso G , Talano Julie-An , Moskop Amy , Balduzzi Adriana , Krajewski Jennifer , Dave Hema , Vatsayan Anant , Callahan Colleen , Liu Hongyan , Li Yimei , Davis Kara Lynn , Maude Shannon L 
Published: January 2023

BackgroundImmunocompromised patients are at increased risk of SARS-CoV-2 infections. Patients undergoing chimeric antigen receptor (CAR) T-cell therapy for relapsed/refractory B-cell malignancies are uniquely immunosuppressed due to CAR T-mediated B-cell aplasia (BCA). While SARS-CoV-2 mortality rates of 33%–40% are reported in adult CAR T-cell recipients, outcomes in pediatric and young adult CAR T-cell recipients are limited.MethodsWe created an international retrospective registry of CAR T recipients aged 0–30 years infected with SARS-CoV-2 within 2 months prior to or any time after CAR T infusion. SARS-CoV-2-associated illness was graded as asymptomatic, mild, moderate, or severe COVID-19, or multisystem inflammatory syndrome in children (MIS-C). To assess for risk factors associated with significant SARS-CoV-2 infections (infections requiring hospital admission for respiratory distress or supplemental oxygen), univariate and multivariable regression analyses were performed.ResultsNine centers contributed 78 infections in 75 patients. Of 70 SARS-CoV-2 infections occurring after CAR T infusion, 13 (18.6%) were classified as asymptomatic, 37 (52.9%) mild, 11 (15.7%) moderate, and 6 (8.6%) severe COVID-19. Three (4.3%) were classified as MIS-C. BCA was not significantly associated with infection severity. Prior to the emergence of the Omicron variant, of 47 infections, 19 (40.4%) resulted in hospital admission and 7 (14.9%) required intensive care, while after the emergence of the Omicron variant, of 23 infections, only 1 (4.3%) required admission and the remaining 22 (95.7%) had asymptomatic or mild COVID-19. Death occurred in 3 of 70 (4.3%); each death involved coinfection or life-threatening condition. In a multivariable model, factors associated with significant SARS-CoV-2 infection included having two or more comorbidities (OR 7.73, CI 1.05 to 74.8, p=0.048) and age ≥18 years (OR 9.51, CI 1.90 to 82.2, p=0.014). In the eight patients infected with SARS-CoV-2 before CAR T, half of these patients had their CAR T infusion delayed by 15–30 days.ConclusionsIn a large international cohort of pediatric and young adult CAR-T recipients, SARS-CoV-2 infections resulted in frequent hospital and intensive care unit admissions and were associated with mortality in 4.3%. Patients with two or more comorbidities or aged ≥18 years were more likely to experience significant illness. Suspected Omicron infections were associated with milder disease.
Parental mosaicism detection and preimplantation genetic testing in families with multiple transmissions of de novo mutations
Authors: Xu Naixin , Shi Weihui , Cao Xianling , Zhou Xuanyou , Jin Li , Huang He-Feng , Chen Songchang , Xu Chenming 
Published: January 2023

BackgroundDe novo mutations (DNMs) are linked with many severe early-onset disorders ranging from rare congenital malformation to intellectual disability. Conventionally, DNMs are considered to have an estimated recurrence rate of 1%. Recently, studies have revealed a higher prevalence of parental mosaicism, leading to a greater recurrence risk, resulting in a second child harbouring the same DNM as a previous child.MethodsIn this study, we included 10 families with DNMs leading to adverse pregnancy outcomes. DNA was extracted from tissue samples, including parental peripheral blood, parental saliva and paternal sperm. High-throughput sequencing was used to screen for parental mosaicism with a depth of more than 5000× on average and a variant allele fraction (VAF) detection limit of 0.5%.ResultsThe presence of mosaicism was detected in sperms in two families, with VAFs of 2.8% and 2.5%, respectively. Both families have a history of multiple adverse pregnancies and DNMs shared by siblings. Preimplantation genetic testing (PGT) and prenatal diagnosis were performed in one family, thereby preventing the reoccurrence of DNMs.ConclusionThis study is the first to report the successful implementation of PGT for monogenic/single gene defects in the parental mosaicism family. Our study suggests that mosaic detection of paternal sperm is warranted in families with recurrent DNMs leading to adverse pregnancy outcomes, and PGT can effectively block the transmission of the pathogenic mutation.