bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep decoupling in subduction zones: Observations and temperature limits
Authors: Abers Geoffrey A. , van Keken Peter E. , Wilson Cian R. 
Published: October 2020

AbstractThe plate interface undergoes two transitions between seismogenic depths and subarc depths. A brittle-ductile transition at 20–50 km depth is followed by a transition to full viscous coupling to the overlying mantle wedge at ∼80 km depth. We review evidence for both transitions, focusing on heat-flow and seismic-attenuation constraints on the deeper transition. The intervening ductile shear zone likely weakens considerably as temperature increases, such that its rheology exerts a stronger control on subduction-zone thermal structure than does frictional shear heating. We evaluate its role through analytic approximations and two-dimensional finite-element models for both idealized subduction geometries and those resembling real subduction zones. We show that a temperature-buffering process exists in the shear zone that results in temperatures being tightly controlled by the rheological strength of that shear zone’s material for a wide range of shear-heating behaviors of the shallower brittle region. Higher temperatures result in weaker shear zones and hence less heat generation, so temperatures stop increasing and shear zones stop weakening. The net result for many rheologies are temperatures limited to ≤350–420 °C along the plate interface below the cold forearc of most subduction zones until the hot coupled mantle is approached. Very young incoming plates are the exception. This rheological buffering desensitizes subduction-zone thermal structure to many parameters and may help explain the global constancy of the 80 km coupling limit. We recalculate water fluxes to the forearc wedge and deep mantle and find that shear heating has little effect on global water circulation.
A systematic review of psychological training or interventions given to UK military personnel prior to deployment
Authors: Harden Larissa , Jones N , Whelan C , Phillips A , Simms A , Greenberg N 
Published: October 2020

IntroductionPredeployment stress management/mental health training is routinely delivered in an effort to mitigate potential adverse psychological effects. Little is known about the effectiveness of such interventions.MethodsA systematic literature review explored research outcomes related to this subject, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. An electronic database search using key terms identified studies published between January 2007 and March 2019. Comprehensive inclusion/exclusion criteria were applied and study quality was appraised by two reviewers using 12 criteria adapted from the Critical Appraisal Skills Programme (CASP) checklist. Papers were excluded if they were allocated CASP scores ≤10 out of 24.Results2003 references were identified; 15 papers fulfilled inclusion criteria and quality threshold requirements. Included studies were randomised controlled trial design (n=8), quasi-experimental (n=5), case report (n=1) and cross-sectional (n=1). Duration of follow-up assessment varied from immediately postintervention to 24 months. The included studies were heterogeneous so clear recommendations relating to predeployment training for military personnel could not be made. Although somewhat disparate, predeployment interventions shared the aim of promoting prior to, during and after deployment health and well-being. Social benefits such as improved cohesion and improved stress management skills were identified in some studies, although substantial mental health and well-being benefits were not found.ConclusionsEvidence for the effectiveness of predeployment psychological interventions is scant. Every attempt should be made to use methods and measures to facilitate comparisons across studies, to attempt a longer follow-up timescale and to clarify key trainer characteristics.
Exploring the association between adverse maternal circumstances and low birth weight in neonates: a nationwide population-based study in Bangladesh
Authors: Khan Md Mostaured Ali , Mustagir Md Golam , Islam Md Rafiqul , Kaikobad Md Sharif , Khan Hafiz TA 
Published: October 2020

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates.Study designs and settingsData were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis.ParticipantsThe study is based on 4728 children aged below 5 years and born to women from selected households.ResultsThe rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased.ConclusionThis study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.
Cost-effectiveness analysis of a community paramedicine programme for low-income seniors living in subsidised housing: the community paramedicine at clinic programme (CP@clinic)
Authors: Agarwal Gina , Pirrie Melissa , Angeles Ricardo , Marzanek Francine , Thabane Lehana , O'Reilly Daria 
Published: October 2020

ObjectivesTo evaluate the cost-effectiveness of the Community Paramedicine at Clinic (CP@clinic) programme compared with usual care in seniors residing in subsidised housing.DesignA cost–utility analysis was conducted within a large pragmatic cluster randomised controlled trial (RCT). Subsidised housing buildings were matched by sociodemographics and location (rural/urban), and allocated to intervention (CP@clinic for 1 year) or control (usual care) via computer-assisted paired randomisation.SettingThirty-two subsidised seniors’ housing buildings in Ontario.ParticipantsBuilding residents 55 years and older.InterventionCP@clinic is a weekly community paramedic-led, chronic disease prevention and health promotion programme in the building common areas. CP@clinic is free to residents and includes risk assessments, referrals to resources, and reports back to family physicians.Outcome measuresQuality-adjusted life years (QALYs) gained, measured with EQ-5D-3L. QALYs were estimated using area-under-the curve over the 1-year intervention, controlling for preintervention utility scores and building pairings. Programme cost data were collected before and during implementation. Costs associated with emergency medical services (EMS) use were estimated. An incremental cost effectiveness ratio (ICER) based on incremental costs and health outcomes between groups was calculated. Probabilistic sensitivity analysis using bootstrapping was performed.ResultsThe RCT included 1461 residents; 146 and 125 seniors completed the EQ-5D-3L in intervention and control buildings, respectively. There was a significant adjusted mean QALY gain of 0.03 (95% CI 0.01 to 0.05) for the intervention group. Total programme cost for implementing in five communities was $C128 462 and the reduction in EMS calls avoided an estimated $C256 583. The ICER was $C2933/QALY (bootstrapped mean ICER with Fieller’s 95% CI was $4850 ($2246 to $12 396)) but could be even more cost effective after accounting for the EMS call reduction.ConclusionThe CP@clinic ICER was well below the commonly used Canadian cost–utility threshold of $C50 000. CP@clinic scale-up across subsidised housing is feasible and could result in better health-related quality-of-life and reduced EMS use in low-income seniors.Trial registration numberClinicaltrials.gov, NCT02152891.
Personalising Outcomes after Child Cardiac Arrest (POCCA): design and recruitment challenges of a multicentre, observational study
Authors: Fink Ericka L , Clark Robert S B , Panigrahy Ashok , Berger Rachel , Wisnowski Jessica , Bluml Stefan , Maloney David , Rubin Pamela , Haller Tamara , Bayir Hulya , Beers Sue R , Kochanek Patrick M , Fabio Anthony 
Published: October 2020

IntroductionBlood and imaging biomarkers show promise in prognosticating outcomes after paediatric cardiac arrest in pilot studies. We describe the methods and early recruitment challenges and solutions for an ongoing multicentre (n=14) observational trial, Personalising Outcomes following Child Cardiac Arrest to validate clinical, blood and imaging biomarkers individually and together in a clinically relevant panel.Methods and analysisChildren (n=164) between 48 hours and 17 years of age who receive chest compressions irrespective of provider, duration, or event location and are admitted to an intensive care unit are eligible. Blood samples will be taken on days 1–3 for the measurement of brain-focused biomarkers analysed to predict the outcome. Clinically indicated and timed brain MRI and spectroscopy biomarkers will be analysed to predict the outcome. The primary outcome for the trial is survival with favourable (Vineland Adaptive Behavioural Scale score >70) outcome at 1 year. Secondary outcomes include mortality and pre-event and postdischarge measures of emotional, cognitive, physical and family functioning and health-related quality of life. Early enrollment targets were not met due to prolonged regulatory and subcontract processes. Multiple, simultaneous interventions including modification to inclusion criteria, additional sites and site visits were implemented with successful improvement in recruitment. Study procedures including outcomes and biomarker analysis are ongoing.Ethics and disseminationTwelve of 14 sites will use the centralised Institutional Review Board (IRB) at the University of Pittsburgh (PRO14030712). Two sites will use individual IRBs: Children’s Healthcare of Atlanta Institutional Review Board and Children’s Hospital of Wisconsin IRB. Parents and/or guardians are consented and children assented (when possible) by the site Primary investigator (PI) or research coordinator for enrollment. Study findings will be disseminated through scientific conferences, peer-reviewed journal publications, public study website materials and invited lectures.Trial registration numberNCT02769026.
Mediating effect of health consciousness in the relationship of lifestyle and suboptimal health status: a cross-sectional study involving Chinese urban residents
Authors: Xue Yunlian , Liu Guihao , Feng Yefang , Xu Mengyao , Jiang Lijie , Lin Yuanqi , Xu Jun 
Published: October 2020

ObjectiveSuboptimal health status (SHS), a third state between good health and disease, can easily develop into chronic diseases, and can be influenced by lifestyle and health consciousness. No study has surveyed the intermediation of health consciousness on the relationship between lifestyle and SHS. This study aimed to analyse the association of lifestyle and SHS, and intermediation of health consciousness in Chinese urban residents.DesignA cross-sectional face-to-face survey using a four-stage stratified sampling method.ParticipantsWe investigated 5803 Chinese urban residents aged 18 years and over. We measured SHS using the Sub-Health Measurement Scale V1.0. We adopted a structural equation model to analyse relationships among lifestyle, health consciousness and SHS. We applied a bootstrapping method to estimate the mediation effect of health consciousness.ResultsLifestyle had stronger indirect associations with physical (β −0.185, 95% CI −0.228 to −0.149), mental (β −0.224, 95% CI −0.265 to −0.186) and social SHS (β −0.216, 95% CI −0.257 to −0.179) via health consciousness than direct associations of physical (β −0.144, 95% CI −0.209 to −0.081), mental (β −0.146, 95% CI −0.201 to −0.094) and social SHS (β −0.130, 95% CI −0.181 to −0.077). Health consciousness has a strong direct association with physical (β 0.360, 95% CI 0.295 to 0.427), mental (β 0.452, 95% CI 0.392 to 0.510) and social SHS (β 0.434, 95% CI 0.376 to 0.490). Ratio of mediating effect of health consciousness to direct effect of lifestyle with physical, mental and social SHS was 1.28, 1.53 and 1.66, respectively.ConclusionsHealth consciousness was more important in preventing physical, mental and social SHS than lifestyle. Therefore, it might be useful in changing unhealthy lifestyle and reducing the influence of poor lifestyle on physical, mental and social SHS.
Efficacy and safety of oral hydroxyurea in transfusion-dependent β-thalassaemia: a protocol for randomised double-blind controlled clinical trial
Authors: Yasara Nirmani , Wickramarathne Nethmi , Mettananda Chamila , Manamperi Aresha , Premawardhena Anuja , Mettananda Sachith 
Published: October 2020

IntroductionDespite being one of the first diseases to be genetically characterised, β-thalassaemia remains a disorder without a cure in a majority of patients. Most patients with β-thalassaemia receive only supportive treatment and therefore have a poor quality of life and shorter life spans. Hydroxyurea, which has shown to induce fetal haemoglobin synthesis in human erythroid cells, is currently recommended for the treatment of sickle cell disease. However, its clinical usefulness in transfusion-dependent β-thalassaemia is unclear. Here, we present a protocol for a randomised double-blind controlled clinical trial to evaluate the efficacy and safety of oral hydroxyurea in transfusion-dependent β-thalassaemia.Methods and analysisThis single-centre randomised double-blind placebo-controlled clinical trial is conducted at the Thalassaemia Centre of Colombo North Teaching Hospital, Ragama, Sri Lanka. Adult and adolescent patients with haematologically and genetically confirmed transfusion-dependent β-thalassaemia are enrolled and randomised into the intervention or control group. The intervention group receives oral hydroxyurea 10–20 mg/kg daily for 6 months, while the control group receives a placebo which is identical in size, shape and colour to hydroxyurea without its active ingredient. Transfused blood volume, pretransfusion haemoglobin level, fetal haemoglobin percentage and adverse effects of treatment are monitored during treatment and 6 months post-treatment. Cessation or reduction of blood transfusions during the treatment period will be the primary outcome measure. The statistical analysis will be based on intention to treat.Ethics and disseminationEthical approval has been obtained from the Ethics Committee of Faculty of Medicine, University of Kelaniya (P/116/05/2018) and the trial is approved by the National Medicinal Regulatory Authority of Sri Lanka. Results of the trial will be disseminated in scientific publications in reputed journals.Trial registration numberSLCTR/2018/024; Pre-results.
Age-stratified outcomes of bioprosthetic and mechanical aortic valve replacements in an Australian cohort of 13 377 patients
Authors: Sotade Oluwadamisola Temilade , Falster Michael , Girardi Leonard N , Pearson Sallie-Anne , Jorm Louisa R 
Published: October 2020

ObjectivesTo quantify age-stratified outcomes of bioprosthetic valve (BV) and mechanical valve (MV) surgical aortic valve replacement (AVR) in Australian patients.DesignRetrospective cohort study using population-based linked hospital morbidity and mortality data.SettingPublic and private hospitals.ParticipantsPatients aged 18 years and over undergoing AVR from 2001 to 2013, stratified by age (18–64 years; 65+ years).Main outcome measuresAge-standardized index AVR rates; rates and multivariable-adjusted (age, sex, Charlson Comorbidity Index) incidence rate ratios (IRRs) for reoperation, incident cardiovascular events (hospitalization or death for acute myocardial infarction (AMI), stroke, major hemorrhage or thromboembolism) and mortality (cardiovascular and all-cause).ResultsOur cohort comprised 13 377 patients, of whom 3464 (26%) were aged 18–64 years. Annual age-standardized AVR rates increased by 2.7% with BV implants increasing in both age groups. After 5 years of follow-up, patients implanted with BV had lower rates of stroke (IRR: 0.40, 95% CI 0.27 to 0.60) and hemorrhage (IRR: 0.36, 95% CI 0.26 to 0.50). Among patients 65+ years, those implanted with BV had lower rates of AMI, hemorrhage, and cardiovascular and all-cause mortality than those implanted with MV (IRR: 0.71, 95% CI 0.53 to 0.96; IRR: 0.77, 95% CI 0.62 to 0.95; IRR: 0.80, 95% CI 0.69 to 0.92 and IRR: 0.85, 95% CI 0.74 to 0.97, respectively). After 6–10 years of follow-up, reoperation rates among patients 18–64 years were markedly higher in those implanted with BV compared with MV (IRR: 5.48, 95% CI 2.38 to 12.62) and rates of AMI were lower among patients implanted with BV compared with MV (IRR: 0.49, 95% CI 0.26 to 0.94). Among patients 65+ years rates of cardiovascular and all-cause mortality remained significantly lower for patients implanted with BV compared with MV.ConclusionsThis study provides real-world evidence of AVR use and outcomes. Use of BV implants is increasing irrespective of age. Valve choice in younger patients requires thorough evaluation of patient factors influencing both short-term outcomes and longer-term risks of reoperation, stroke and hemorrhage.
Checkpoint therapeutic target database (CKTTD): the first comprehensive database for checkpoint targets and their modulators in cancer immunotherapy
Authors: Zhang Yixiao , Yao Yuan , Chen Peng , Liu Yu , Zhang Hao , Liu He , Liu­ Yu , Xu Hong , Tian Xibao , Wang Zichu , Chu Peng , Zhao Dongyu , Liu Hongxu , Zhang Chenlei , Chen Shuyuan , Zhao Yuhong , Liu Caigang , Yang Yongliang 
Published: October 2020

BackgroundCheckpoint targets play a key role in tumor-mediated immune escape and therefore are critical for cancer immunotherapy. Unfortunately, there is a lack of bioinformatics resource that compile all the checkpoint targets for translational research and drug discovery in immuno-oncology.MethodsTo this end, we developed checkpoint therapeutic target database (CKTTD), the first comprehensive database for immune checkpoint targets (proteins, miRNAs and LncRNAs) and their modulators. A scoring system was adopted to filter more relevant targets with high confidence. In addition, a few biological databases such as Oncomine, Drugbank, miRBase and Lnc2Cancer database were integrated into CKTTD to provide an in-depth information. Moreover, we computed and provided ligand-binding site information for all the targets which may support bench scientists for drug discovery efforts.ResultsIn total, CKTTD compiles 105 checkpoint protein targets, 53 modulators (small-molecules and antibody), 30 miRNAs and 18 LncRNAs in cancer immunotherapy with validated experimental evidences curated from 10 649 literatures via an enhanced text-mining system.ConclusionsIn conclusion, the CKTTD may serve as a useful platform for the research of cancer immunotherapy and drug discovery. The CKTTD database is freely available to public at http://www.ckttdb.org/.
Hospital leadership perspectives on the value of the 3 Wishes Project: a qualitative study
Authors: Swinton Marilyn , Vanstone Meredith , Phung Peter , Neville Thanh H , Takaoka Alyson , Smith Orla M , Baker Andrew , LeBlanc Allana , Foster Denise , Dhingra Vinay , Clarke France J , Hoad Neala , Woods Anne , Boyle Anne , Toledo Feli , Cook Deborah J 
Published: October 2020

BackgroundHealthcare organisations are increasingly interested in improving the work life of their employees. By encouraging individualised acts of compassion for dying patients and their families, the 3 Wishes Project (3WP) has been shown to ease grief for both families and clinicians.PurposeThe objective of this study was to explore the perspectives of hospital leaders on the value of the 3WP to the hospital and how decisions are made about which programmes to support.MethodsWe conducted semistructured interviews with 20 hospital leaders in four North American institutions. Transcripts were analysed using qualitative content analysis.ResultsInterviews with 12 clinical managers and 8 senior administrators identified the institutional value of the 3WP as improving patient and family experiences, enhancing staff morale, translating institutional mission and values into front-line practice, and creating positive public relations. Hospital leaders acknowledged potential resource challenges, including staff time, space to store supplies and funds to purchase items for some wishes. However, citing stories they had heard from families and staff, hospital leaders shared their view of how their decisions about the value of clinical programmes extend beyond quantifiable outcomes.ConclusionsWhen reflecting on this personalised palliative care programme, hospital leaders described how inspiring narratives promoted institutional values in ways that are difficult to measure quantitatively. Leaders underscored the need to balance the value that a programme brings with the resources it requires, stating how different types of evidence influence their support of new programmes.Trial registration numberNCT04147169.