bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with going outdoors frequently: a cross-sectional study among Swiss community-dwelling older adults
Authors: Spaltenstein Julia , Bula Christophe , Santos-Eggimann Brigitte , Krief Helene , Seematter-Bagnoud Laurence 
Published: August 2020

ObjectiveThis study examines potential risk and protective factors associated with going outdoors frequently among older persons, and whether these factors vary according to physical limitations.DesignCross-sectional analysis.Setting and participantsCommunity-dwelling participants of the Lausanne cohort Lc65+ in 2016, aged 68–82 years (n=3419).MethodsAssociations between going outdoors frequently and physical limitations, sociodemographic, health, psychological and social variables were examined using logistic regression models. Subgroup analyses were performed according to the severity of physical limitations.Main outcome measures‘Going outdoors frequently’ was defined as going out ≥5 days/week and not spending most of the time sitting or lying down.ResultsThree in four (73.9%) participants reported going outdoors frequently. Limitations in climbing stairs (adjusted OR (AdjOR) 0.61, 95% CI 0.47 to 0.80) and walking (AdjOR 0.24, 95% CI 0.18 to 0.31), as well as depressive symptoms (AdjOR 0.58, 95% CI 0.47 to 0.70), dyspnoea (AdjOR 0.60, 95% CI 0.48 to 0.75), age (AdjORolder age group0.73, 95% CI 0.59 to 0.92) and fear of falling (AdjOR 0.75, 95% CI 0.62 to 0.91) reduced the odds of going outdoors frequently. In contrast, living alone (AdjOR 1.30, 95% CI 1.08 to 1.56), reporting a dense (AdjOR 1.57, 95% CI 1.26 to 1.96) and a high-quality (AdjOR 1.28, 95% CI 1.06 to 1.53) social network increased the odds of going outdoors frequently. Among participants with severe limitations, 44.6% still went outdoors frequently. Among this subgroup, a new emotional relationship (AdjOR 2.52, 95% CI 1.18 to 5.38) was associated with going outdoors, whereas cognitive complaints (AdjOR 0.66, 95% CI 0.47 to 0.93), urinary incontinence (AdjOR 0.67, 95% CI 0.46 to 0.97), dyspnea (AdjOR:0.67, 95%CI:0.48-0.93), and depressive symptoms (AdjOR 0.67, 95% CI 0.48 to 0.93) lowered the odds of going outdoors.ConclusionPhysical limitations are associated with decreased odds of going outdoors frequently. However, social characteristics appear to mitigate this association, even among older persons with severe limitations. Further studies are needed to determine causality and help guide interventions to promote going outdoors as an important component of active ageing.
Design and rationale of DUTCH-AF: a prospective nationwide registry programme and observational study on long-term oral antithrombotic treatment in patients with atrial fibrillation
Authors: Chu Gordon , Seelig Jaap , Trinks-Roerdink Emmy M , van Alem Anouk P , Alings Marco , van den Bemt Bart , Boersma Lucas VA , Brouwer Marc A , Cannegieter Suzanne C , ten Cate Hugo , Kirchhof Charles JHJ , Crijns Harry JGM , van Dijk Ewoud J , Elvan Arif , van Gelder Isabelle C , de Groot Joris R , den Hartog Frank R , de Jong Jonas SSG , de Jong Sylvie , Klok Frederikus A , Lenderink Timo , Luermans Justin G , Meeder Joan G , Pisters Ron , Polak Peter , Rienstra Michiel , Smeets Frans , Tahapary Giovanni JM , Theunissen Luc , Tieleman Robert G , Trines Serge A , van der Voort Pepijn , Geersing Geert-Jan , Rutten Frans H , Hemels Martin EW , Huisman Menno V 
Published: August 2020

IntroductionAnticoagulation therapy is pivotal in the management of stroke prevention in atrial fibrillation (AF). Prospective registries, containing longitudinal data are lacking with detailed information on anticoagulant therapy, treatment adherence and AF-related adverse events in practice-based patient cohorts, in particular for non-vitamin K oral anticoagulants (NOAC). With the creation of DUTCH-AF, a nationwide longitudinal AF registry, we aim to provide clinical data and answer questions on the (anticoagulant) management over time and of the clinical course of patients with newly diagnosed AF in routine clinical care. Within DUTCH-AF, our current aim is to assess the effect of non-adherence and non-persistence of anticoagulation therapy on clinical adverse events (eg, bleeding and stroke), to determine predictors for such inadequate anticoagulant treatment, and to validate and refine bleeding prediction models. With DUTCH-AF, we provide the basis for a continuing nationwide AF registry, which will facilitate subsequent research, including future registry-based clinical trials.Methods and analysisThe DUTCH-AF registry is a nationwide, prospective registry of patients with newly diagnosed ‘non-valvular’ AF. Patients will be enrolled from primary, secondary and tertiary care practices across the Netherlands. A target of 6000 patients for this initial cohort will be followed for at least 2 years. Data on thromboembolic and bleeding events, changes in antithrombotic therapy and hospital admissions will be registered. Pharmacy-dispensing data will be obtained to calculate parameters of adherence and persistence to anticoagulant treatment, which will be linked to AF-related outcomes such as ischaemic stroke and major bleeding. In a subset of patients, anticoagulation adherence and beliefs about drugs will be assessed by questionnaire.Ethics and disseminationThis study protocol was approved as exempt for formal review according to Dutch law by the Medical Ethics Committee of the Leiden University Medical Centre, Leiden, the Netherlands. Results will be disseminated by publications in peer-reviewed journals and presentations at scientific congresses.Trial registration numberTrial NL7467, NTR7706 (https://www.trialregister.nl/trial/7464).
CASNET2: evaluation of an electronic safety netting cancer toolkit for the primary care electronic health record: protocol for a pragmatic stepped-wedge RCT
Authors: Fleming Susannah , Nicholson Brian D , Bhuiya Afsana , de Lusignan Simon , Hirst Yasemin , Hobbs Richard , Perera Rafael , Sherlock Julian , Yonova Ivelina , Bankhead Clare 
Published: August 2020

IntroductionSafety-netting in primary care is the best practice in cancer diagnosis, ensuring that patients are followed up until symptoms are explained or have resolved. Currently, clinicians use haphazard manual solutions. The ubiquitous use of electronic health records provides an opportunity to standardise safety-netting practices.A new electronic safety-netting toolkit has been introduced to provide systematic ways to track and follow up patients. We will evaluate the effectiveness of this toolkit, which is embedded in a major primary care clinical system in England:Egerton Medical Information System(EMIS)-Web.Methods and analysisWe will conduct a stepped-wedge cluster RCT in 60 general practices within the RCGP Research and Surveillance Centre (RSC) network. Groups of 10 practices will be randomised into the active phase at 2-monthly intervals over 12 months. All practices will be activated for at least 2 months. The primary outcome is the primary care interval measured as days between the first recorded symptom of cancer (within the year prior to diagnosis) and the subsequent referral to secondary care. Other outcomes include referrals rates and rates of direct access cancer investigation.Analysis of the clustered stepped-wedge design will model associations using a fixed effect for intervention condition of the cluster at each time step, a fixed effect for time and other covariates, and then include a random effect for practice and for patient to account for correlation between observations from the same centre and from the same participant.Ethics and disseminationEthical approval has been obtained from the North West—Greater Manchester West National Health Service Research Ethics Committee (REC Reference 19/NW/0692). Results will be disseminated in peer-reviewed journals and conferences, and sent to participating practices. They will be published on the University of Oxford Nuffield Department of Primary Care and RCGP RSC websites.Trial registration numberISRCTN15913081; Pre-results.
Decisions to use antibiotics for upper respiratory tract infections across China: a large-scale cross-sectional survey among university students
Authors: Lin Leesa , Fearon Elizabeth , Harbarth Stephan , Wang Xiaomin , Lu Chunling , Zhou Xudong , Hargreaves James R 
Published: August 2020

ObjectivesTo investigate the decision-making process of Chinese university students with respect to antibiotic use for upper respiratory tract infections (URTIs).DesignA cross-sectional questionnaire study.SettingThe participants recruited from six universities across all Chinese regions from September to November 2015.ParticipantsA total of 2834 university students sampled across six Chinese regions who self-reported experiencing symptoms of URTI within the past month completed the survey.Outcome measuresThe prevalence of decisions for treatment and antibiotic use for URTIs as well as knowledge about antibiotic use were measured by a self-administrated questionnaire. Using regular and multinomial logistic regression a nd adapted health belief model, we identified and measured a number of variables as potential risk factors for antibiotic misuse behaviours in order to explain and predict people’s treatment decisions and antibiotic use including knowledge, perceptions, access to antibiotics and cues to action.ResultsOf the 2834 university students who self-diagnosed a URTI, 947 (33.4%) self-reported having taken antibiotics; among them, 462 (48.8%) used non-prescription antibiotics, which came principally from left-over prescriptions (29.0%) and over-the-counter purchases at retail pharmacies (67.3%). One in four who sought care pressured their doctors for antibiotics; all received them. Those who perceived greater severity of the disease, had access to antibiotics, perceived benefits of using antibiotics (for the common cold: adjusted OR (aOR)=2.55, 95% CI 1.93 to 3.38 or as anti-inflammatory drugs: aOR=1.35, 95% CI 1.12 to 1.63), and were cued to action (eg, seeing presence of fever: aOR=2.05, 95% CI 1.62 to 2.60 or self-diagnosing their current infection as severe: aOR=1.86, 95% CI 1.41 to 2.45), keeping antibiotics at home (aOR=2.27, 95% CI 1.83 to 2.81) and access to over-the-counter antibiotics (aOR=2.00, 95% CI 1.63 to 2.45), were more likely to misuse antibiotics.ConclusionsMisconceptions of antibiotic efficacy and easy access to antibiotics—with or without a prescription—were associated with antibiotic misuse among Chinese university students, which calls for context-appropriate multifaceted interventions in order to effectively reduce antibiotic misuse.
Rapid cycle system improvement for COVID-19 readiness: integrating deliberate practice, psychological safety and vicarious learning
Authors: Chan Albert Kam Ming , Rudolph Jenny W , Lau Vivian Nga Man , Wong Henry Man Kin , Wong Rosinni Si Ling , Lo Thomas S F , Choi Gordon Y S , Joynt Gavin Matthew 
Published: August 2020

IntroductionIn the face of a rapidly advancing pandemic with uncertain pathophysiology, pop-up healthcare units, ad hoc teams and unpredictable personal protective equipment supply, it is difficult for healthcare institutions and front-line teams to invent and test robust and safe clinical care pathways for patients and clinicians. Conventional simulation-based education was not designed for the time-pressured and emergent needs of readiness in a pandemic. We used ‘rapid cycle system improvement’ to create a psychologically safe learning oasis in the midst of a pandemic. This oasis provided a context to build staff technical and teamwork capacity and improve clinical workflows simultaneously.MethodsAt the Department of Anaesthesia and Intensive Care in Prince of Wales Hospital, a tertiary institution, in situ simulations were carried out in the operating theatres and intensive care unit (ICU). The translational simulation design leveraged principles of psychological safety, rapid cycle deliberate practice, direct and vicarious learning to ready over 200 staff with 51 sessions and achieve iterative system improvement all within 7 days. Staff evaluations and system improvements were documented postsimulation.Results/FindingsStaff in both operating theatres and ICU were significantly more comfortable and confident in managing patients with COVID-19 postsimulation. Teamwork, communication and collective ability to manage infectious cases were enhanced. Key system issues were also identified and improved.DiscussionTo develop readiness in the rapidly progressing COVID-19 pandemic, we demonstrated that ‘rapid cycle system improvement’ can efficiently help achieve three intertwined goals: (1) ready staff for new clinical processes, (2) build team competence and confidence and (3) improve workflows and procedures.
Important relation between self-efficacy, sense of coherence, illness perceptions, depression and anxiety in patients with inflammatory bowel disease
Authors: Eindor- Abarbanel Adi , Naftali Timna , Ruhimovich Nahum , Bar-Gil Shitrit Ariella , Sklerovsky-Benjaminov Fabiana , Konikoff Fred , Matalon Shay , Shirin Haim , Milgrom Yael , Ziv-Baran Tomer , Broide Efrat 
Published: August 2020

IntroductionAnxiety and depression are common disturbances in patients with inflammatory bowel diseases (IBD), and were found to impact the disease course. Illness perceptions (IPs), self-efficacy (SE) and sense of coherence (SOC) are important psychological functions, used by the individual to cope with his chronic disease.Aimsto investigate the association of IP, SE and SOC on anxiety and depression among patients with IBD.Patients and methodsPatients filled questionnaires including: demographic, socioeconomic and clinical features. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. IP, SE and SOC were assessed using the Brief Illness perception Questionnaire, IBD-SE and SOC scales.ResultsThe study sample consisted of 299 patients with IBD, median age 34.15, 63% females, 70.9% had Crohn’s disease, filled the questionnaires. In the multivariate analysis, lower results in IP, SE and SOC were found to be associated with significantly increase anxiety (OR 8.35, p<0.001; OR 4.18, p=0.001; OR 4.67, p<0.001, respectively) and depression (OR 15.8, p=0.001; OR 10.99, p=0.029; OR 6.12, p=0.014ConclusionsAnxiety and depression are associated with IP, SE and SOC in patients with IBD. Clinicians should be aware of this impact, recognise their patients’ psychological abilities to cope with the disease and improve those abilities, when needed, in order to achieve a better coping with the disease and to prevent the development of anxiety and depression.
IL-31 induces antitumor immunity in breast carcinoma
Authors: Kan Tal , Feldman Erik , Timaner Michael , Raviv Ziv , Shen-Orr Shai , Aronheim Ami , Shaked Yuval 
Published: August 2020

BackgroundImmunomodulatory agents that induce antitumor immunity have great potential for treatment of cancer. We have previously shown that interleukin (IL)-31, a proinflammatory cytokine from the IL-6 family, acts as an antiangiogenic agent. Here, we characterize the immunomodulatory effect of IL-31 in breast cancer.MethodsIn vivo breast carcinoma models including EMT6 and PyMT cell lines were used to analyze the effect of IL-31 on the composition of various immune cells in the tumor microenvironment using high-throughput flow cytometry. In vitro studies using isolated cytotoxic T cells, CD4+T cells, myeloid-derived suppressor cells (MDSCs) and macrophages were carried out to study IL-31 immunological activity. The generation of recombinant IL-31 bound to IgG backbone was used to test IL-31 therapeutic activity.ResultsThe growth rate of IL-31-expressing breast carcinomas is decreased in comparison with control tumors due, in part, to antitumor immunomodulation. Specifically, cytotoxic T cell activity is increased, whereas the levels of CD4+T cells, MDSCs, and tumor-associated macrophages are decreased in IL-31-expressing tumors. These cellular changes are accompanied by a cytokine profile associated with antitumor immunity. In vitro, IL-31 directly inhibits CD4+Th0 cell proliferation, and the expression of Th2 canonical factors GATA3 and IL-4. It also promotes CD8+T cell activation through inhibition of MDSC activity and motility. Clinically, in agreement with the mouse data, alterations in immune cell composition in human breast cancer biopsies were found to correlate with high expression of IL-31 receptor A (IL-31Ra) . Furthermore, high coexpression of IL-31Ra, IL-2 and IL-4 in tumors correlates with increased survival. Lastly, to study the therapeutic potential of IL-31, a recombinant murine IL-31 molecule was fused to IgG via a linker region (IL-31-L-IgG). This IL-31-L-IgG therapy demonstrates antitumor therapeutic activity in a murine breast carcinoma model.ConclusionsOur findings demonstrate that IL-31 induces antitumor immunity, highlighting its potential utility as a therapeutic immunomodulatory agent.
Soil nitrogen and phosphorus were greater in overlapping areas of fields in Alberta, Saskatchewan, Manitoba, and Ontario
Authors: Crittenden S.J. , Fitzmaurice J. , Lewis M. , Reid K. , Irvine B. 
Published: August 2020

A total of 344 soil cores were taken in annually cropped fields of Alberta, Saskatchewan, Manitoba, and Ontario from 2011 to 2013 in areas where the field shapes, or obstacles within fields, required the driving pattern of farm operations to overlap. Soil nitrate-N concentrations in overlapping areas were 60% greater, soil Olsen-P concentrations were 23% greater, and pH was 0.5 units greater at 0–15 cm depth compared with non-overlapping areas, suggesting smaller nutrient use efficiency and potential for greater nutrient loss.
Isentropic evolution of the matter in heavy-ion collisions and the search for the critical endpoint
Authors: Motta Mario , Stiele Rainer , Alberico Wanda Maria , Beraudo Andrea 
Published: August 2020

AbstractWe study the isentropic evolution of the matter produced in relativistic heavy-ion collisions for various values of the entropy-per-baryon ratio of interest for the ongoing and future experimental searches for the critical endpoint (CEP) in the QCD phase diagram: these includes the current beam-energy-scan (BES) program at RHIC and the fixed-target collisions foreseen for the near future at various facilities. We describe the hot-dense matter through two different effective Lagrangians: the PNJL (Polyakov–Nambu–Jona–Lasinio) and the PQM (Polyakov-quark-meson) models. We focus on quantities expected to have a direct experimental relevance: the speed of sound, responsible for the collective acceleration of the fireball, and the generalized susceptibilities, connected to the cumulants of the distributions of conserved charges. In principle they should affect the momentum spectra and the event-by-event fluctuations of the yields of identified particles. Taking realistic values for the initial temperature and the entropy-per-baryon ratio we study the temporal evolution of the above quantities looking for differences along isentropic trajectories covering different regions of the QCD phase diagram, passing far or close to the CEP or even intersecting the first-order critical line.
Strategic Issues in One-to-One Matching with Externalities
Authors: Mumcu Ayşe , Saglam Ismail 
Published: August 2020

We consider strategic issues in one-to-one matching with externalities. We show that no core (stable) mechanism is strategy-proof, extending an impossibility result of [Roth, A. E. [1982] The economics of matching: Stability and incentives, Math. Oper. Res. 7(4), 617–628] obtained in the absence of externalities. Moreover, we show that there are no limits on successful manipulation of preferences by coalitions of men and women, in contrast with the result of [Demange, G., Gale, D. and Sotomayor, M. [1987] A further note on the stable matching problem, Discrete Appl. Math. 16(3), 217–222] obtained in the absence of externalities.
Performance analysis of the convolutional recurrent neural network on acoustic event detection
Authors: Jung Suk-Hwan , Chung Yong-Joo 
Published: August 2020

In this study, we attempted to find the optimal hyper-parameters of the convolutional recurrent neural network (CRNN) by investigating its performance on acoustic event detection. Important hyper-parameters such as the input segment length, learning rate, and criterion for the convergence test, were determined experimentally. Additionally, the effects of batch normalization and dropout on the performance were measured experimentally to obtain their optimal combination. Further, we studied the effects of varying the batch data on every iteration during the training. From the experimental results using the TUT sound events synthetic 2016 database, we obtained optimal performance with a learning rate of 1/10000. We found that a longer input segment length aided performance improvement, and batch normalization was far more effective than dropout. Finally, performance improvement was clearly observed by varying the starting points of the batch data for each iteration during the training.
Long-Term Analysis of Functional Outcomes in Traumatic Brain Injury Patients
Authors: Schroeppel Thomas J. , Sharpe John P. , Melendez Claudia I. , Jepson Brian , Dunn Rebekah , Paige Clement L. , Khan Abid D. , Croce Martin A. , Fabian Timothy C. 
Published: August 2020

Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality. The purpose of this study is to examine outcomes after discharge and identify factors from the index admission that may contribute to long-term mortality. Methods The study population is composed of patients who survived to discharge from a previously published study examining TBI. Demographics, injury severity, and length of stay were abstracted from the index study. Phone surveys of surviving patients were performed to evaluate each patient’s Glasgow Outcome Scale-Extended (GOSE). Patients who were deceased at the time of the survey were compared with those who were alive. Results 1615 patients were alive at the end of the first study period and 211 (13%) comprised the study population. Overall, the median age was 54 years, and the majority were male (74%). The median time to follow-up was 80 months. The population was severely injured, with a median injury severity score (ISS) of 25 and a median head abbreviated injury score (AIS) of 4. Overall mortality was 57%. The group that survived at the time of the survey was younger, more injured, less likely to have received beta-blockers (BB) during the index admission, and had a longer time to follow-up. After adjusting for ISS, age, base deficit, and BB, age was the only variable predictive of mortality (HR 1.03; HL 1.02-1.04). Conclusion Despite being more severely injured, younger patients were more likely to survive to follow-up. Further investigation is needed to determine if aggressive care in older TBI patients in the acute phase leads to good long-term outcomes.