bluuebunny/crossref_metadata_2025 huggingface dataset:
A Socioeconomic Well-Being Index
Authors: Trindade A. Alexandre , Shirvani Abootaleb , Ma Xiaohan
Published: May 2020

An annual well-being index constructed from thirteen socioeconomic factors is proposed in order to dynamically measure the mood of the US citizenry. Econometric models are fitted to the log-returns of the index in order to quantify its tail risk and perform option pricing and risk budgeting. By providing a statistically sound assessment of socioeconomic contentment, the index is consistent with rational finance theory, enabling the construction and valuation of insurance-type financial instruments to serve as contracts written against it. Endogenously, the VXO volatility measure of the stock market appears to be the greatest contributor to tail risk. Exogenously, “stress-testing” the index against the politically important factors of trade imbalance and legal immigration, quantify the systemic risk. For probability levels in the range of 5% to 10%, values of trade below these thresholds are associated with larger downward movements of the index than for immigration at the same level. The main intent of the index is to serve as an early-warning mechanism for negative changes in the mood of citizens, thus alerting policy makers and private agents to potential future market downturns.
Tiroidectomía en paciente embarazada con enfermedad de Graves sin respuesta a tratamiento médico: reporte de caso
Authors: Morros González Elly , Rojas Melo Leonardo Javier , Cruz Ramírez Viviana , Imitola Angélica
Published: May 2020

Objetivo: Describir el caso de una paciente embarazada con enfermedad de Graves sin respuesta a antitiroideos, a fin de exponer las opciones terapéuticas adicionales disponibles como colestiramina, corticoesteroides, yoduro de potasio, plasmaféresis y tiroidectomía. Materiales y métodos: Se presenta el caso de una mujer de 18 años de edad con embarazo de 25 semanas y enfermedad de Graves desde hace 2 años, tratada con altas dosis de metimazol y propranolol. Se consideró diagnóstico de preeclampsia y tormenta tiroidea probable (Burch Wartofsky 25). Resultados: La evolución clínica posoperatoria fue satisfactoria; la paciente fue dada de alta con tratamiento sustitutivo con levotiroxina de 100 µg/día. A las 39 semanas de gestación, nació por cesárea una niña sana con peso 3200 g con medición de TSH neonatal en 6,21 mU/ml (0-15). Conclusiones: La tiroidectomía al final del segundo trimestre es una alternativa terapéutica favorable en pacientes embarazadas con enfermedad de Graves sin respuesta al tratamiento médico
Sobrevida de los tumores cerebrales primarios en Colombia
Authors: Gómez Vega Juan Carlos , Ocampo Navia María Isabel , De Vries Esther , Feo Lee Oscar
Published: May 2020

Introducción: En 2018, los tumores del sistema nervioso representaron aproximadamente el 1,4 % de los nuevos diagnósticos de cáncer, que causaron el 2,6 % de las muertes por esta enfermedad. En Colombia hay pocos informes sobre la epidemiología de los tumores cerebrales, y los que existen son a partir de bases de datos locales que no tienen representatividad poblacional. Objetivo: Determinar la sobrevida de los tumores cerebrales en Colombia. Materiales y métodos: Estudio observacional descriptivo y retrospectivo, mediante las bases de datos de registros de cáncer de base poblacional de Colombia para el periodo 2003-2012, sin restricción por grupo etario. Se calcularon las tasas de sobrevida por el método de Kaplan-Meier y se usó el software estadístico Stata 14.0. Resultados: En el periodo 2003-2012 se reportaron 775 pacientes adultos y 123 pediátricos con un nuevo diagnóstico de un tumor del sistema nervioso. Los más frecuentes en la edad pediátrica fueron los tumores neuroepiteliales, los embrionarios y los ependimarios; mientras que para los adultos fueron los tumores neuroepiteliales, los meningiomas y los hematolinfoides. La sobrevida global a seis meses, un año, dos años y tres años, en la población pediátrica fue de 49,9 %, 35,2 %, 21,4 % y 15,3 %, respectivamente; para los adultos fue del 70,2 %, 58,9 %, 43,3 % y 35,4 %. Conclusiones: Este estudio constituye el trabajo más reciente sobre la epidemiología de los tumores cerebrales en Colombia. Se evidenció un claro subregistro general y estadísticas inferiores a las comparadas con la literatura. Se pretende ampliar la cobertura y recolección de datos en los registros de cáncer de base poblacional.
Plasma enabled devices for the selective capture and photodynamic identification of prostate cancer cells
Authors: Shirazi Hanieh Safizadeh , Chan Kit Man , Rouget Julien , Ostrikov Kola , McNicholas Kym , Li Jordan , Butler Lisa , Gleadle Jonathan M. , Vasilev Krasimir , MacGregor Melanie
Published: May 2020

Prostate cancer is the second most common cancer in men and the second leading cause of male cancer deaths. The current blood test for detecting prostate cancers measures prostate-specific antigen. It has many limitations including a very high rate of false positives. Herein, prostate-specific membrane antigen (PSMA) based immunocapture and hexaminolevulinate (HAL) based photodetection are integrated into a new diagnostic device designed to selectively identify whole prostate cancer cells from voided urine with the aim of providing an accurate noninvasive alternative to current diagnosis methods. Prestained, prostate cancer cells spiked in urine samples at concentrations ranging from 1500 to 2000 cells/ml were captured with 89% sensitivity and 95% specificity. HAL, a cancer specific photosensitizer, was then used to circumvent the need for prestaining. Optimum HAL incubation conditions were identified (50 μM at 37 °C for 2 h) where the mean HAL-induced fluorescence intensity of LNCaP cells was three times that of healthy PNT2 cells, thus providing an independent way to discriminate captured cancer cells from background metabolites. Combining anti-PSMA immunocapture with HAL-induced fluorescent detection, 86% sensitivity and 88% selectivity were achieved, thereby proving the validity of the dual-method for the selective photospecific detection of prostate cancer cells.
Principled, Modest, and Giving … Don Hellison’s Impact Through the Eyes of His Peers
Authors: van der Mars Hans
Published: May 2020

This paper consists of reflections by a group of higher education peers on Don Hellison’s impact and legacy. The group of peers reflects a mix of gender, history and (work) experience with Hellison, and philosophical positions. Their views are presented around thematic topics, based on written responses to select questions. Some of the themes include Hellison’s impact on school physical education, physical education teacher education, his atypical role and identity as a researcher and scholar, and him being ahead of his time. The consensus view across Hellison’s peers is Hellison having impacted K–12 physical education, physical education teacher education, and the sport pedagogy research enterprise in significant ways that will be long lasting.
Sensory Reweighting During Bipedal Quiet Standing in Adolescents
Authors: Pardo-Ibáñez Alberto , Bermejo Jose L. , Gandia Sergio , Maitre Julien , Villarrasa-Sapiña Israel , Estevan Isaac , Garcia-Masso Xavier
Published: May 2020

A cross-sectional, prospective, between-subjects design was used in this study to establish the differences in sensory reweighting of postural control among different ages during adolescence. A total of 153 adolescents (five age groups; 13–17 years old) performed bipedal standing in three sensory conditions (i.e., with visual restriction, vestibular disturbance, and proprioceptive disturbance). Center of pressure displacement signals were measured in mediolateral and anteroposterior directions to characterize reweighting in the sensory system in static postural control when sensory information is disturbed or restricted during adolescent growth. The results indicate a development of postural control, showing large differences between subjects of 13–14 years old and older adolescents. A critical change was found in sensory reweighting during bipedal stance with disturbance of proprioceptive information at 15 years old. Adolescents of 13–14 years old showed less postural control and performance than older adolescents during the disturbance of proprioceptive information. Moreover, the results demonstrated that the visual system achieves its development around 15–16 years old. In conclusion, this research suggests that a difference of sensory reweighting under this type of sensorial condition and sensory reweight systems would seem to achieve stabilization at the age of 15.
Regulation and dynamics of force transmission at individual cell-matrix adhesion bonds
Authors: Tan Steven J. , Chang Alice C. , Anderson Sarah M. , Miller Cayla M. , Prahl Louis S. , Odde David J. , Dunn Alexander R.
Published: May 2020

Fluorescent molecular tension sensors reveal the dynamics of force transmission at cellular adhesion complexes.
The RNA binding protein CPEB2 regulates hormone sensing in mammary gland development and luminal breast cancer
Authors: Pascual Rosa , Martín Judit , Salvador Fernando , Reina Oscar , Chanes Veronica , Millanes-Romero Alba , Suñer Clara , Fernández-Miranda Gonzalo , Bartomeu Anna , Huang Yi-Shuian , Gomis Roger R. , Méndez Raúl
Published: May 2020

The RNA binding protein CPEB2 defines a new posttranscriptional layer in the hormone-driven gene-expression reprogramming.
Inhibition of IRF5 cellular activity with cell-penetrating peptides that target homodimerization
Authors: Banga Jaspreet , Srinivasan Dinesh , Sun Chia-Chi , Thompson Cherrie D. , Milletti Francesca , Huang Kuo-Sen , Hamilton Shannon , Song Su , Hoffman Ann F. , Qin Yajuan Gu , Matta Bharati , LaPan Margaret , Guo Qin , Lu Gang , Li Dan , Qian Hong , Bolin David R. , Liang Lena , Wartchow Charles , Qiu Jin , Downing Michelle , Narula Satwant , Fotouhi Nader , DeMartino Julie A. , Tan Seng-Lai , Chen Gang , Barnes Betsy J.
Published: May 2020

The rational targeting of a transcription factor, interferon regulatory factor 5 (IRF5), inhibits downstream functions.
The activity of sulfono-γ-AApeptide helical foldamers that mimic GLP-1
Authors: Sang Peng , Zhou Zhihong , Shi Yan , Lee Candy , Amso Zaid , Huang David , Odom Timothy , Nguyen-Tran Vân T.B. , Shen Weijun , Cai Jianfeng
Published: May 2020

The α-helix–mimicking sulfono-γ-AApeptides with entire unnatural backbone were reported as novel GLP-1R agonists.
From force-responsive molecules to quantifying and mapping stresses in soft materials
Authors: Chen Yinjun , Yeh C. Joshua , Qi Yuan , Long Rong , Creton Costantino
Published: May 2020

Embedded spiropyran mechanophores reveal and quantitatively map stresses in soft materials by changing their color.
Antimicrobial Peptide GH12 Prevents Dental Caries by Regulating Dental Plaque Microbiota
Authors: Jiang Wentao , Wang Yufei , Luo Junyuan , Chen Xiangshu , Zeng Yuhao , Li Xinwei , Feng Zening , Zhang Linglin
Published: May 2020

The anticaries effects and microecological regulation effects of the antimicrobial peptide GH12 were evaluated systematically
in vitro
and
in vivo
. GH12 inhibited the cariogenic virulence of dental plaque without overintervening in the microbial ecology of healthy individuals
in vitro
. GH12 regulated the microbial ecology of dental plaque to a certain extent
in vivo
under cariogenic conditions, increased the proportion of commensal bacteria, and decreased the abundance of caries-associated bacteria. GH12 significantly suppressed the incidence and severity of dental caries
in vivo
. This study thus describes an alternative antimicrobial therapy for dental caries.
Anaphylaxis and other allergic reactions to food: a global challenge
Authors: Reyes Antonio Jose , Hosein Amanda Sheena , Ramcharan Kanterpersad , Perot Sean
Published: May 2020

We describe a case of a biphasic anaphylactic reaction that occurred in a young woman soon after the ingestion of soy milk that led to her hospitalisation. Early recognition and appropriate treatment led to a successful outcome of this life-threatening condition. Challenges encountered in the care of this common illness are highlighted. There is a need for an increase in public awareness on dangerous allergic reactions caused by allergens present in food products in public use, thereby facilitating primary preventative measures to minimise its occurrence. Healthcare stakeholders need to implement measures of contemporary preventative medicine and efficient therapeutic protocols to safeguard the public welfare concerning this global health problem where appropriate interventions can reduce morbidity and mortality. Trial registration numbersNCT02991885andNCT02851277.
Midgut volvulus secondary to congenital malrotation in pregnancy
Authors: Chong Eelyn , Liu David S , Rajagopal Vishnupriya , Strugnell Neil
Published: May 2020

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.
Predictors of not working among treatment-seeking UK veterans: a cross-sectional study
Authors: Hendrikx Laura Josephine , Ross J , Armour C , Murphy D
Published: May 2020

Introduction

Many veterans do well reintegrating to civilian life following military service. Yet, many face difficulties in finding and securing work. Veterans are more likely than civilians to experience work difficulties, but there remains little research investigating contributing factors, particularly among samples of treatment-seeking veterans. As such, the study examines predictors of not working among UK treatment-seeking veterans.

Design

The study employed a cross-sectional design.

Methods

Of 667 treatment-seeking UK veterans, 403 (Mage=50.94) provided information on a range of demographic variables, military-related experiences, the total number of physical health conditions and mental health outcomes. Work status was categorised as not working due to illness (Mage=48.15), not working due to other reasons (Mage=61.92) and currently working (Mage= 46.13).

Results

Prevalence rates of not working was 69%. Not working was predicted by a greater number of physical health problems as well as more years since leaving the military. Not working due to poor health was independently predicted by symptoms of post-traumatic stress disorder (PTSD) and younger age, while not working due to other reasons was predicted by older age.

Conclusions

The study revealed that treatment-seeking veterans of younger age with a high number of physical health difficulties, symptoms of PTSD and more years since leaving the military are most at risk of not working due to ill health. The findings have important implications for identifying veterans most at risk of not working and offer the opportunity to tailor rehabilitation programmes to promote successful veteran reintegration into civilian life.
Broader impacts of an intervention to transform school environments on student behaviour and school functioning: post hoc analyses from the INCLUSIVE cluster randomised controlled trial
Authors: Bonell Christopher , Dodd Matthew , Allen Elizabeth , Bevilacqua Leonardo , McGowan Jennifer , Opondo Charles , Sturgess Joanna , Elbourne Diana , Warren Emily , Viner Russell M
Published: May 2020

Background

We have previously reported benefits for reduced bullying, smoking, alcohol and other drug use and mental health from a trial of ‘Learning Together’, an intervention that aimed to modify school environments and implement restorative practice and a social and emotional skill curriculum.

Objectives

To conduct post hoc theory-driven analyses of broader impacts.

Design

Cluster randomised trial.

Settings

40 state secondary schools in southern England.

Participants

Students aged 11/12 years at baseline.

Outcomes

Student self-reported measures at 24 and 36 months of: cyberbullying victimisation and perpetration; observations of other students perpetrating aggressive behaviours at school; own perpetration of aggressive behaviours in and outside school; perceived lack of safety at school; participation in school disciplinary procedures; truancy and e-cigarette use.

Results

We found evidence of multiple impacts on other health (reduced e-cigarette use, cyberbullying perpetration, perpetration of aggressive behaviours) and educational (reduced participation in school disciplinary procedures and truancy) outcomes.

Conclusion

These analyses suggested that the intervention was effective in bringing about a broader range of beneficial outcomes, adding to the evidence that the intervention is a promising approach to promote adolescent health via an intervention that is attractive to schools.

Trial registration number

ISRCTN10751359.
Impact of point-of-care tests in community pharmacies: a systematic review and meta-analysis
Authors: Albasri Ali , Van den Bruel Ann , Hayward Gail , McManus Richard J , Sheppard James Peter , Verbakel Jan Yvan Jos
Published: May 2020

Objectives

To summarise the literature regarding the use of point-of-care
test (POCT) in pharmacies versus control/usual care.

Design and setting

Systematic review and random-effects meta-analysis in community pharmacy.

Data sources

MEDLINE, Cochrane Central Register of Controlled Trials, Embase, ClinicalTrial.gov and Web of Science databases were searched.

Eligibility criteria

Articles were included if they: involved a POCT conducted by a community pharmacist, member of pharmacy staff or local equivalent; measured a clinically relevant outcome for example, clinical parameter monitoring. No clinical condition or language limits were set.

Patient and public involvement

No patient involvement.

Data extraction and synthesis

Data were independently extracted by two members of the review team to capture changes in clinical care that resulted from the use of the POCTs. The methodological quality of included studies was assessed, using the Cochrane Risk of Bias tool and Newcastle-Ottawa scale.

Results

Thirteen of the 1584 articles found were included in the meta-analyses. Studies covered four therapeutic areas: targeted anti-malarial therapy (n=3 studies), glycated
haemoglobin (HbA1c) in diabetes (n=2 studies), lipid control (n=3 studies) and international normalised ratio (INR) control in patients taking warfarin (n=5 studies). POCT in pharmacies reduced the risk of receiving antimalarial treatment when not clinically indicated (risk
ratio 0.34, 95% CI 0.31 to 0.37). Lipid and HbA1c control appeared largely unaffected by pharmacy POCTs, and the impact on INR time-in-therapeutic-range was inconclusive.

Conclusions

Only 4 out of 13 included studies used a gold-standard randomised controlled trial (RCT) design, limiting our ability to conclusively determine the clinical utility of POCT conducted in pharmacies. Further RCTs are needed, particularly in areas such as upper respiratory tract infections, which have gathered momentum among service commissioners in recent years.

PROSPERO registration number

CRD42017048578.
Response process validity of three patient reported outcome measures for people requiring kidney care: a think-aloud study using the EQ-5D-5L, ICECAP-A and ICECAP-O
Authors: Mitchell Paul Mark , Caskey Fergus John , Scott Jemima , Sanghera Sabina , Coast Joanna
Published: May 2020

Objectives

To determine the response process validity, feasibility of completion, acceptability and preferences for three patient-reported outcome measures that could be used in economic evaluation—the EQ-5D-5L, ICECAP-A and ICECAP-O—in people requiring kidney care.

Design

Participants were asked to ‘think-aloud’ while completing the EQ-5D-5L, ICECAP-A and ICECAP-O, followed by a semistructured interview. Five raters identified errors or struggles in completing the measures from the think-aloud component of the transcripts. Patient preferences for measures were extracted from the semistructured interview.

Setting

Eligible patients were identified through a large UK secondary care renal centre.

Participants

In total, 30 participants were included in the study, consisting of patients attending renal outpatients for chronic kidney disease (n=18), with a functioning kidney transplant (n=6) and receiving haemodialysis (n=6).

Results

Participants had few errors and struggles in completing the EQ-5D-5L (11% error rate, 3% struggle rate), ICECAP-A (2% error rate, 2% struggle rate) and ICECAP-O (4% error rate, 3% struggle rate). The main errors with the EQ-5D-5L were judgements that did not comply with the ‘your health today’ instruction. Comprehension errors were most prominent on ICECAP-O. Judgement errors were the only errors reported on ICECAP-A. Although the EQ-5D-5L had slightly more errors and struggles, it was the measure most preferred, with participants able to make a clearer link with EQ-5D-5L and their health condition.

Conclusions

The EQ-5D-5L, ICECAP-A and ICECAP-O are feasible for people requiring kidney care to complete and can be included in studies conducting economic evaluations of kidney care interventions. Further research is required to assess how health (eg, EQ-5D) and capability (eg, ICECAP) measures can be included in an economic evaluation simultaneously, as well as what ICECAP measure(s) to include when patient groups straddle the age ranges for ICECAP-A (18 years and older) and ICECAP-O (65 years and older).
Trends in oral anticoagulant prescribing in individuals with type 2 diabetes mellitus: a population-based study in the UK
Authors: Alwafi Hassan , Wei Li , Naser Abdallah Y , Mongkhon Pajaree , Tse Gary , Man Kenneth K C , Bell J Simon , Ilomaki Jenni , Fang Gang , Wong Ian C K
Published: May 2020

Objective

To evaluate oral anticoagulant (OAC) prescribing trends in type 2 diabetes mellitus (T2DM) in the UK from 2001 to 2015.

Design

A cross-sectional drug utilisation study.

Setting

Electronic health records from The Health Improvement Network primary care database in the UK.

Participants

Individuals with T2DM who received a record of OAC prescription.

Outcome measures

The prescribing trends of OAC medications in individuals with T2DM were examined from 2001 to 2015, stratified by age, gender and therapeutic classifications.

Results

A total of 361 635 individuals with T2DM were identified, of whom 36 570 were prescribed OAC from 2001 to 2015. The prevalence of OAC prescribing increased by 50.0%, from 1781 individuals receiving OAC prescriptions (IROACP) (4.4 (95% CI 4.2 to 4.6) per 100 persons) in 2001, to 17 070 IROACP (6.6 (95% CI 6.5 to 6.7) per 100 persons) in 2015. The prevalence of warfarin prescribing decreased by 14.0%, from 1761 individuals receiving warfarin prescriptions (IRWP) (98.9 (95% CI 98.4 to 99.4) per 100 persons) in 2001, to 14 533 IRWP (85.1 (95% CI 84.6 to 85.7) per 100 persons) in 2015. This corresponded with increased prescribing of direct oral anticoagulants (DOACs), from 18 individuals receiving DOAC prescriptions (IRDOACP) (0.1 (95% CI 0.08 to 0.23) per 100 persons) in 2010, to 3016 IRDOACP (17.6 (95% CI 17.1 to 18.2) per 100 persons) in 2015, during the same period.

Conclusions

Prescribing of OACs in individuals with T2DM increased from 2001 to 2015. Since the introduction of DOACs, there has been a clear shift in prescribing towards these agents. Future studies are needed to assess the safety of coadministration of OAC medications and antidiabetic therapy with T2DM.
Assessing care models implemented in primary healthcare for persons with dementia: a mixed-methods study protocol
Authors: Vedel Isabelle , McAiney Carrie , Couturier Yves , Pakzad Sarah , Arsenault-Lapierre Geneviève , Godard-Sebillotte Claire , Sourial Nadia , Simmons Rachel , Bergman Howard
Published: May 2020

Introduction

Dementia is on the rise in Canada and globally. Ensuring accessibility to diagnosis, treatment and management throughout the course of the disease is a very significant problem worldwide. In order to provide comprehensive care to patients and their caregivers, enhancing primary care-based dementia care is seen as the way forward. In many Canadian provinces various collaborative care models (collCMs) anchored in primary care to improve dementia care have been developed and implemented. The overall objective of our research programme is to identify key factors for the successful implementation of collCMs, and to facilitate dissemination and scale-up of dementia best practices.

Methods and analysis

We will use a convergent mixed-methods design. An observational study using chart review (2014–2016) and questionnaires (2014–2018; repeated in 2020) will measure application of guidelines and implementation of collCMs. This study will be complemented with a qualitative descriptive study using interviews (2017–2020) conducted in parallel. Quantitative and qualitative results will be further integrated using a matrix representing sites and findings. An integrated knowledge exchange strategy will ensure uptake by principal stakeholders throughout the research.

Ethics and dissemination

Our study has been approved by all relevant ethics committees. Our dissemination plan follows an integrated knowledge transfer strategy using provincial, national and international councils. We will present the results individually to the clinical sites and then to these councils. Our research will be the first provincial and cross jurisdictional evaluation of primary care models for patients living with dementia, providing evidence on the ongoing debate on the respective role of clinicians in primary care and specialists in caring for patients with dementia.
Geographic variation in preventable hospitalisations across Canada: a cross-sectional study
Authors: Wilk Piotr , Ali Shehzad , Anderson Kelly K , Clark Andrew F , Cooke Martin , Frisbee Stephanie J , Gilliland Jason , Haan Michael , Harris Stewart , Kiarasi Soushyant , Maltby Alana , Norozi Kambiz , Petrella Robert , Sarma Sisira , Singh Sarah S , Stranges Saverio , Thind Amardeep
Published: May 2020

Objective

The objective of this study is to examine the magnitude and pattern of small-area geographic variation in rates of preventable hospitalisations for ambulatory care-sensitive conditions (ACSC) across Canada (excluding Québec).

Design and setting

A cross-sectional study conducted in Canada (excluding Québec) using data from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) linked prospectively to hospitalisation records from the Discharge Abstract Database (DAD) for the three fiscal years: 2006–2007, 2007–2008 and 2008–2009.

Primary outcome measure

Preventable hospitalisations (ACSC).

Participants

The 2006 CanCHEC represents a population of 22 562 120 individuals in Canada (excluding Québec). Of this number, 2 940 150 (13.03%) individuals were estimated to be hospitalised at least once during the 2006–2009 fiscal years.

Methods

Age-standardised annualised ACSC hospitalisation rates per 100 000 population were computed for each of the 190 Census Divisions. To assess the magnitude of Census Division-level geographic variation in rates of preventable hospitalisations, the global Moran’s I statistic was computed. ‘Hot spot’ analysis was used to identify the pattern of geographic variation.

Results

Of all the hospitalisation events reported in Canada during the 2006–2009 fiscal years, 337 995 (7.10%) events were ACSC-related hospitalisations. The Moran’s I statistic (Moran’s I=0.355) suggests non-randomness in the spatial distribution of preventable hospitalisations. The findings from the ‘hot spot’ analysis indicate a cluster of Census Divisions located in predominantly rural and remote parts of Ontario, Manitoba and Saskatchewan and in eastern and northern parts of Nunavut with significantly higher than average rates of preventable hospitalisation.

Conclusion

The knowledge generated on the small-area geographic variation in preventable hospitalisations can inform regional, provincial and national decision makers on planning, allocation of resources and monitoring performance of health service providers.
Consensus on the exercise and dosage variables of an exercise training programme for chronic non-specific neck pain: protocol for an international e-Delphi study
Authors: Price Jonathan , Rushton Alison , Tyros Vasileios , Heneghan Nicola R
Published: May 2020

Introduction

Clinical guidelines and systematic reviews recommend exercise in the management of chronic non-specific neck pain. Although exercise training programmes that consist of both motor control exercise and exercises for the superficial cervical muscles (segmental exercises) are effective, the exercise variables including dosage vary considerably across trials or are poorly reported. This study aims to gain expert consensus on these exercise variables so that they can be described clearly using intervention reporting checklists to inform clinical practice and future clinical trials.

Methods and analysis

This protocol for an international Delphi study is informed by the Guidance on Conducting and REporting DElphi Studies recommendations and published to ensure quality, rigour and transparency. The study will consist of three rounds using anonymous online questionnaires. Expert exercise professionals (physiotherapists, strength and conditioning coaches and so on) and academics in neck pain management will be identified through literature searches, peer referral and social media calls for expression of interest. In round 1, participants will answer open-ended questions informed by intervention and exercise reporting checklists. Responses will be analysed thematically by two independent reviewers. In round 2, participants will rate their level of agreement with statements generated from round 1 and previous clinical trials using a 5-point Likert scale where 1=strongly disagree and 5=strongly agree. In round 3, participants will re-rate their agreement with statements that achieved consensus in round 2. Statements reaching consensus among participants must meet progressively increased a priori criteria at rounds 2 and 3, measured using descriptive statistics: median, IQR and percentage agreement. Inferential statistics will be used to evaluate measures of agreement between participants (Kendall’s coefficient of concordance) and stability between rounds (Wilcoxon rank-sum test). Statements achieving consensus in round 3 will provide expert recommendations of the key exercise and dosage variables in the management of chronic non-specific neck pain.

Ethics and dissemination

Ethical approval was provided by the University of Birmingham Ethics Committee (Ref:ERN_19–1857). Results will be disseminated through peer-reviewed publications and conference presentations.
Role of ethnicity and socioeconomic status (SES) in the presentation of retinoblastoma: findings from the UK
Authors: Bourkiza Rabia , Cumberland Phillippa , Fabian Ido Didi , Abeysekera Hiranya , Parulekar Manoj , Sagoo Mandeep S , Rahi Jugnoo , Reddy M Ashwin
Published: May 2020

Background

The relationship between the ethnic background or socioeconomic status (SES) and late retinoblastoma (Rb) presentation in the UK is unclear. We aimed to investigate if such correlations exist in a cohort of non-familial Rb cases.

Methods

A cross-sectional study based at the two centres providing Rb care in the UK. Included were non-familial Rb cases that presented from January 2006 to December 2011. Epidemiological and clinical data were retrieved from medical charts, as well as patients’ postcodes used to obtain the Index of Multiple Deprivation (IMD) score. A postal questionnaire was sent to participants’ parents to collect further, person-level, information on languages spoken and household socioeconomic position. Statistical correlations to advanced Rb at presentation as well as to treatment by enucleation and need for adjuvant chemotherapy were investigated.

Results

The cohort included 189 cases, 98 (51.8%) of which were males. The median age at diagnosis was 16 months (IQR 8–34 months). Of the study patients, 153 (81%) presented with advanced Rb; 78 (41%) with group D and 75 (40%) with group E Rb. A total of 134 (72%) patients were treated with enucleation. South Asian ethnicity and being in the most deprived IMD quintile were associated with a higher likelihood of presentation with advanced disease, but these estimates did not reach statistical significance. Older age at presentation was associated with enucleation and bilateral disease with adjuvant chemotherapy.

Conclusions

In this national UK study of patients with non-familial Rb, there was no evidence of an association of ethnicity or SES and the risk of presenting with advanced disease. These findings may reflect equality in access of healthcare in the UK.
Neuroleptic malignant syndrome in patients with cancer: a systematic review
Authors: Sato Izumi , Onishi Hideki , Kawanishi Chiaki , Yamada Shuhei , Ishida Mayumi , Kawakami Koji
Published: May 2020

Background

Antipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist.

Aims

We aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer.

Methods

We conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS.

Results

Eleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32–83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary.

Conclusion

Although NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.
Delirium screening practice in specialist palliative care units: a survey
Authors: Woodhouse Rebecca , Siddiqi Najma , Boland Jason W , Featherstone Imogen , Johnson Miriam J
Published: May 2020

Objectives

Delirium is common and distressing in palliative care settings. This survey aims to describe current practice regarding delirium identification in specialist palliative care units (SPCU), such as inpatient hospices, in the UK.

Methods

An 18-item anonymous online survey was distributed by Hospice UK to their network of clinical leads (n=223), and to their research mailing list (n=228). The survey was also sent to the chair of the Hospice UK executive clinical leads forum for direct dissemination to forum representatives (n=20). Clinical leads and forum representatives were asked to distribute the survey to healthcare staff in their SPCUs.

Results

220 SPCU staff (48% nurses; 31% doctors; 10% healthcare assistants) completed the survey. Approximately half reported using clinical judgement alone to screen (97/204; 48%) and/or diagnose (124/220; 56%) delirium. Over a third used an assessment tool to screen for delirium (76/204; 37%). The majority (150/220; 68%) reported screening in response to clinical symptoms, while few reported routine on-admission (11/220; 5%) or daily-during-admission (12/220; 6%) screening. Most respondents had received some training on delirium (137/220; 62%). However, 130/220 (59%) said their SPCU did not have a training programme for delirium screening and only 79/220 (36%) reported that their SPCU had delirium clinical guidelines. The main barriers to routine screening included: lack of delirium training, lack of guidelines and complexity of patient’s conditions.

Conclusion

There is variation in practice for delirium screening and diagnosis in SPCUs. Clinical guidelines for delirium, including consensus on which screening tools to use, are needed for this setting.
Advance care planning: the future
Authors: Rietjens Judith , Korfage Ida , Taubert Mark
Published: May 2020

Objectives

There is increased global focus on advance care planning (ACP) with attention from policymakers, more education programmes, laws and public awareness campaigns.

Methods

We provide a summary of the evidence about what ACP is, and how it should be conducted. We also address its barriers and facilitators and discuss current and future models of ACP, including a wider look at how to best integrate those who have diminished decisional capacity.

Results

Different models are analysed, including new work in Wales (future care planning which includes best interest decision-making for those without decisional capacity), Asia and in people with dementia.

Conclusions

ACP practices are evolving. While ACP is a joint responsibility of patients, relatives and healthcare professionals, more clarity on how to apply best ACP practices to include people with diminished capacity will further improve patient-centred care.
Halting the haematochezia
Authors: Mistry Meera , Fiske Joseph , Chaudhry Tehreem , Cross Timothy J , Mehta Shemin , Ballal Khaled , Diwakar Previn , Chambers James , Smith Philip J
Published: May 2020

An elderly gentleman with primary sclerosing cholangitis (PSC) was admitted with rectal bleeding, shown on flexible sigmoidoscopy to be arising from rectal varices, which bled despite endoscopic therapy with histoacryl glue. Therapeutic options were limited with surgery and transjugular intrahepatic portosystemic shunt deemed too high risk, and endovascular embolisation through interventional radiology was sought. Coil-assisted retrograde transvenous obliteration was used to good effect. This rare approach has advantages over balloon occlusion, avoiding long indwelling balloon time and risk of rupture or infection, as well as time efficiency.
Characterization of organ dysfunction and mortality in pediatric patients with trauma with acute traumatic coagulopathy
Authors: Nair Alison , Flori Heidi , Cohen Mitchell Jay
Published: May 2020

Background

Traumatic injuries are a leading cause of mortality and morbidity in pediatric patients and abnormalities in hemostasis play an important role in these poor outcomes. One such abnormality, acute traumatic coagulopathy (ATC), is a near immediate endogenous response to injury and has recently been described in the pediatric population. This study aims to evaluate the epidemiology of pediatric ATC, specifically its association with organ dysfunction.

Methods

All patients with trauma presenting to the University of California, Benioff Children’s Hospital Oakland between 2006 and 2015 with coagulation testing drawn at presentation were included. Patients were excluded if they (1) were >18 years of age, (2) were admitted with a non-mechanical mechanism of injury, (3) were on anticoagulation medications, or (4) had coagulation testing >4 hours after injury. ATC was defined as an international normalized ratio (INR) ≥1.3. The primary outcome was new or progressive multiple organ dysfunction syndrome (MODS) and secondary outcomes included in-hospital mortality and other morbidities.

Results

Of the 7382 patients that presented in the 10-year study period, 545 patients met criteria for analysis and 88 patients (16%) presented with ATC. Patients with ATC were more likely to develop MODS than those without ATC (68.4% vs 7.7%, p<0.001) and had higher in-hospital mortality (26.1% vs 0.4%, p<0.001) than those without ATC. Along with arterial hypotension and an Injury Severity Score ≥30, ATC was independent predictor of MODS and in-hospital mortality. An isolated elevated INR was associated with MODS and in-hospital mortality while an isolated elevated partial thromboplastin time was not.

Conclusions

Pediatric ATC was associated with organ dysfunction, mortality, and other morbidities. ATC along with arterial hypotension and high injury severity were independent predictors of organ dysfunction and mortality. Pediatric ATC may be biologically distinct from adult ATC and further studies are needed.

Level of evidence

IV, epidemiologic.
Comparison between smartphone electrocardiography and standard three‐lead base apex electrocardiography in healthy horses
Authors: Welch‐Huston Brittany , Durward‐Akhurst Sian , Norton Elaine , Ellingson Lacey , Rendahl Aaron , McCue Molly
Published: May 2020

Background

Cardiac arrhythmias are commonly auscultated during routine physical examinations in horses and determining the underlying electrical abnormality using an ECG is important. The most commonly used device is a three‐lead base apex system (Televet), however few practitioners carry this for routine visits. With recognition of the utility of smartphone‐based ECGs in humans, dogs and ruminants, the AliveCor single‐lead bipolar smartphone‐based ECG has gained popularity. The objective of this study was to determine if AliveCor and Televet ECG measurements were comparable in healthy horses using multiple observers.

Methods

ECGs were performed on 15 healthy horses simultaneously using the AliveCor and Televet.

Results

There was very good to perfect interdevice and interobserver agreement for heart rate and RR interval measurement, and moderate‐to‐good interdevice and interobserver agreement for detection of non‐pathological arrhythmias. Interdevice agreement for measurement of P‐wave and QRS duration, QT, PR and T‐peak to T‐end interval was poor to fair. Interestingly, interobserver agreement for P‐wave and QRS duration, QT, PR, and T‐peak to T‐end interval measurements was fair to good.

Conclusion

Overall, the AliveCor is comparable to the Televet for heart rate and RR measurement, and for the detection of non‐pathogenic arrhythmias with acceptable agreement between observers.
Probing quantum field theory particle mixing and dark-matter-like effects with Rydberg atoms
Authors: Capolupo A. , Giampaolo S. M. , Lambiase G. , Quaranta A.
Published: May 2020

We analyze the oscillations of Rydberg atoms in the framework of quantum field theory and analyze the analogy with flavor mixing and oscillations. We reveal a non trivial vacuum energy which has the equation of state analogous to that of cold dark matter. This energy is formally similar to that expected for mixed neutrinos and affects the thermal capacity of the gas. Therefore, deflection of the thermal capacity of Rydberg atoms could prove the condensate structure of vacuum for mixing fermions and open new scenarios in the study of the dark components of the universe. We also derive new Rabi oscillation formulae which are, in principle, testable experimentally.
Spin-dependent Pomeron and Odderon in elastic proton–proton scattering
Authors: Hagiwara Yoshikazu , Hatta Yoshitaka , Pasechnik Roman , Zhou Jian
Published: May 2020

We introduce a new model of near-forward elastic proton–(anti)proton scattering at high energy based on the modern formulation of Pomeron and Odderon in terms of Wilson lines and generalized transverse momentum dependent distributions. We compute the helicity-dependent elastic amplitudes $$\phi _{1,2,3,4,5}$$ϕ1,2,3,4,5 in this model and study their energy dependence from the nonlinear small-x evolution equations. While both Pomeron and Odderon contribute to helicity-flip processes in general, in the forward limit $$t=0$$t=0 only the double helicity-flip amplitude $$\phi _2$$ϕ2, dominated by the spin-dependent Odderon, survives. This may affect the extraction of the $$\rho $$ρ parameter as well as the total cross section in the LHC energy domain and beyond.
INDIVISIBLE LABOR SUPPLY AND INVOLUNTARY UNEMPLOYMENT: MONOPOLISTIC COMPETITION MODEL
Authors: TANAKA YASUHITO
Published: May 2020

This paper is an attempt to provide a micro-theoretical basis for Keynesian economics while maintaining as much of the neoclassical framework as possible, such as utility maximization for consumers and profit maximization for firms. We show the existence of involuntary unemployment without assuming wage rigidity when labor supplies of individuals are indivisible. We derive involuntary unemployment using an overlapping generations model under monopolistic competition with constant returns to scale technology and indivisible labor supply.
Covariant variational evolution and Jacobi brackets: Particles
Authors: Ciaglia F. M. , Di Cosmo F. , Ibort A. , Marmo G. , Schiavone L.
Published: May 2020

The formulation of covariant brackets on the space of solutions to a variational problem is analyzed in the framework of contact geometry. It is argued that the Poisson algebra on the space of functionals on fields should be read as a Poisson subalgebra within an algebra of functions equipped with a Jacobi bracket on a suitable contact manifold.
Coherent state truncation by conditional interferometry
Authors: Xu Xue-Xiang , Yuan Hong-Chun
Published: May 2020

Based on a conditional interferometry proposed by Paris [Phys. Rev. A 62, 033813 (2000)], we prepare any chosen superposition of the vacuum, one-photon, and two-photon states, which is truncating from an input coherent state. Feeding two perfect single-photon states and a coherent state into the interferometry and employing two one-photon detections, the conditional state can be obtained in the signal port. Ideal and realistic features of the one-photon counting are taken into account together with the effect on the fidelity between the ideal state and the realistic case. The ideal state is just a particular case of the realistic state with the unit efficiency. We study the antibunching effect and Wigner function of the generated states. The results show that the generated states will exhibit their specular character.
Investigation of tungsten/MA956 steel diffusion bonding with an Nb/Ni composite interlayer
Authors: Chen Boyan , Li Xianfen , Cui Hanlin , Hua Peng , Chen Yuanting , Wang Cheng , Wu Yucheng , Zhou Wei
Published: May 2020

Diffusion bonding is an effective method for joining dissimilar materials. In this study, dissimilar metals of MA956 steel and tungsten (W) were diffusion bonded with Ni/Nb composite interlayer. The experiments were carried out at [Formula: see text], 20 MPa for 20 min in vacuum by spark plasma sintering (SPS) technique. The microstructure and mechanical properties of the bonded joints were evaluated. SEM images and the results of elementary composition indicate that no intermetallics formed at Ni/MA956 steel and Nb/W interfaces, but [Formula: see text] and [Formula: see text] formed at the Nb/Ni interface. Compared with the directly bonded joint between W and MA956 steel, the average shear strength of the joint with Nb/Ni composite interlayer significantly increased to 270 MPa. Although the result of joint residual stresses simulation shows that the maximum residual stress was near the W substrate, the joints with composite interlayer in shear experiments fractured at Nb/Ni interface. The hardness changes along joint interfaces indicate the formation of intermetallic compounds and solid solution phases in the diffusion layers.