bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the DIabetes Severity SCOre (DISSCO) in 139 626 individuals with type 2 diabetes: a retrospective cohort study
Authors: Zghebi Salwa S , Mamas Mamas A , Ashcroft Darren M , Salisbury Chris , Mallen Christian D , Chew-Graham Carolyn A , Reeves David , Van Marwijk Harm , Qureshi Nadeem , Weng Stephen , Holt Tim , Buchan Iain , Peek Niels , Giles Sally , Rutter Martin K , Kontopantelis Evangelos 
Published: May 2020

ObjectiveClinically applicable diabetes severity measures are lacking, with no previous studies comparing their predictive value with glycated hemoglobin (HbA1c). We developed and validated a type 2 diabetes severity score (the DIabetes Severity SCOre, DISSCO) and evaluated its association with risks of hospitalization and mortality, assessing its additional risk information to sociodemographic factors and HbA1c.Research design and methodsWe used UK primary and secondary care data for 139 626 individuals with type 2 diabetes between 2007 and 2017, aged ≥35 years, and registered in general practices in England. The study cohort was randomly divided into a training cohort (n=111 748, 80%) to develop the severity tool and a validation cohort (n=27 878). We developed baseline and longitudinal severity scores using 34 diabetes-related domains. Cox regression models (adjusted for age, gender, ethnicity, deprivation, and HbA1c) were used for primary (all-cause mortality) and secondary (hospitalization due to any cause, diabetes, hypoglycemia, or cardiovascular disease or procedures) outcomes. Likelihood ratio (LR) tests were fitted to assess the significance of adding DISSCO to the sociodemographics and HbA1cmodels.ResultsA total of 139 626 patients registered in 400 general practices, aged 63±12 years were included, 45% of whom were women, 83% were White, and 18% were from deprived areas. The mean baseline severity score was 1.3±2.0. Overall, 27 362 (20%) people died and 99 951 (72%) had ≥1 hospitalization. In the training cohort, a one-unit increase in baseline DISSCO was associated with higher hazard of mortality (HR: 1.14, 95% CI 1.13 to 1.15, area under the receiver operating characteristics curve (AUROC)=0.76) and cardiovascular hospitalization (HR: 1.45, 95% CI 1.43 to 1.46, AUROC=0.73). The LR tests showed that adding DISSCO to sociodemographic variables significantly improved the predictive value of survival models, outperforming the added value of HbA1cfor all outcomes. Findings were consistent in the validation cohort.ConclusionsHigher levels of DISSCO are associated with higher risks for hospital admissions and mortality. The new severity score had higher predictive value than the proxy used in clinical practice, HbA1c. This reproducible algorithm can help practitioners stratify clinical care of patients with type 2 diabetes.
Determinants of and barriers to adoption of digital therapeutics for mental health at scale in the NHS
Authors: Williams Matt G , Stott Richard , Bromwich Nicki , Oblak Susie K , Espie Colin A , Rose James B 
Published: May 2020

ObjectivesAlthough it is widely acknowledged that digital therapeutics will play a significant role in the future delivery of healthcare, the method by which these innovations may be commissioned by the National Health Service, at scale, remains unclear. This study explores English health commissioners’ experiences of, and attitudes towards, adopting digital healthcare innovations.Methods37 commissioners and decision-makers from a range of sectors within the health profession were invited to participate in structured interviews to gather relevant examples of experience and opinions. 14 commissioners participated and the notes from the resulting interviews were interpreted using qualitative content analysis. Controlled interpretation was applied to the categorised responses, paraphrasing and classifying into themes.ResultsCommon determinants and barriers to adoption of digital mental health expressed during the interview process included commissioners’ lack of familiarity with technology, information governance, digital literacy of users and decision-makers.ConclusionsRecognition of identified barriers may be helpful for innovators when developing engagement and market access strategies and suggest areas for focus and further development within the commissioning process to accommodate digital health solutions.
Effect of PIFR-based optimised inhalation therapy in patients recovering from acute exacerbation of chronic obstructive pulmonary disease: protocol of a prospective, multicentre, superiority, randomised controlled trial
Authors: Hua Jianlan , Zhang Wei , Cao Hui-fang , Du Chun-ling , Ma Jia-yun , Zuo Yi-hui , Zhang Jing 
Published: May 2020

IntroductionAcute exacerbation (AE) is a major cause of disease progression and death in patients with chronic obstructive pulmonary disease (COPD), accounting for majority of medical expenditures. Correct inhalation therapy is effective in preventing AE attacks. However, inappropriate usage of dry powder inhaler, partially due to the unrecovered peak inhalation flow rate (PIFR) after acute exacerbation of COPD (AECOPD), results in increased risk of early treatment failure. Therefore, we designed a multicentre, randomised clinical trial to determine whether PIFR-based optimised inhalation therapy and training on inhaler usage at discharge could effectively reduce early treatment failure events.Methods and analysisA total of 416 hospitalised patients just recovering from AECOPD will be recruited and equally randomised into the PIFR group and the control group at a 1:1 ratio. The PIFR group will receive additive support before discharge, including choice of PIFR-guided inhaler and education on its usage. PIFR is measured by InCheck DIAL. In comparison, the control group will receive inhalers based on judgement of the respiratory physician. The primary outcome of the study is 30-day treatment failure rate. Other endpoints include PIFR, error rate of inhalation device use, satisfaction with inhalation devices, 30-day mortality, 90-day mortality, symptoms and quality of life of patients, and COPD-related treatment costs.Ethics and disseminationThe trial has been approved by the Ethics Committee of Zhongshan Hospital of Fudan University (B2019-142). Participants will be screened and enrolled from hospitalised patients with AECOPD by clinicians, with no public advertisement for recruitment. After the trial has completed, the results will be reported to the public through conference presentations and peer-reviewed journals.Trial registration numberNCT04000958.
ehealth literacy and health literacy among immigrants and their descendants compared with women of Danish origin: a cross-sectional study using a multidimensional approach among pregnant women
Authors: Villadsen Sarah Fredsted , Hadi Hajer , Ismail Israa , Osborne Richard H , Ekstrøm Claus Thorn , Kayser Lars 
Published: May 2020

ObjectiveTo explore ehealth literacy, ability to actively engage with healthcare providers and health system navigation among pregnant immigrant women and their descendants compared with women of Danish origin.Design and settingA cross-sectional survey at antenatal clinics in 2016, Denmark.ParticipantsPregnant women attending antenatal care (n=405).Outcome measuresThe eHealth Literacy Questionnaire (eHLQ) and two domains from the Health Literacy Questionnaire (HLQ): ability to actively engage with healthcare providers and health system navigation. Range of response options for eHLQ (1–4) and HLQ (1–5). With mixed-effect linear regressions, eHLQ and HLQ among immigrants and their descendants compared with women of Danish origin were assessed.ResultsThe response rate was 75%. The overall trend was lower ehealth literacy and HLQ domains among immigrants and their descendants compared with women of Danish origin. For ehealth literacy, the results suggest that challenges related more to digital abilities than motivation, trust and access to technology. The mean ability to engage with digital services was 3.20 (SD 0.44) for women of Danish origin. Non-Western descendants (−0.14, 95% CI −0.31 to 0.02), non-Western (−0.20, 95% CI −0.34 to −0.06) and Western (−0.22, 95% CI −0.39 to −0.06) immigrants had lower adjusted means of this outcome. No differences in motivation to engage with digital services were found for descendants (−0.00, 95% CI −0.17 to 0.17), non-Western (0.03, 95% CI −0.11 to 0.18) or Western (−0.06, 95% CI −0.23 to 0.10) immigrants compared with the mean of the reference (2.85, SD 0.45). Lower ability to engage with healthcare providers was found for non-Western born immigrants (−0.15, CI 95% −0.30 to −0.01) compared with the mean of women with Danish origin (4.15, SD 0.47).ConclusionGenerally, descendant and immigrant women had lower levels of ehealth literacy and health literacy than women of Danish origin. These differences are potentially antecedents of adverse birth outcomes and could inform structural efforts to mitigate health inequalities.
Factors associated with symptoms of attention deficit hyperactivity disorder among medical students in Cameroon: a web-based cross-sectional study
Authors: Njuwa Karl Fai , Simo Larissa Pone , Ntani Limnyuy Loweh , Forchin Azumesi Nguni , Parviel Chirsir , Tianyi Tianyi Frank Leonel , Nsah Bernard , Agbor Valirie Ndip 
Published: May 2020

IntroductionAttention deficit hyperactivity disorder (ADHD) is a chronic mental disorder that is associated with poor productivity, with a significant impact on the quality of life.ObjectivesTo determine factors associated with symptoms of ADHD among medical students in Cameroon.DesignA web-based cross-sectional study.SettingParticipants were recruited through a social media platform, WhatsApp, from 24 June to 2 September 2018.ParticipantsMedical students aged 18 years and older from seven medical schools in Cameroon. All non-medical students and all medical residents were excluded.ResultsData from a total of 491 eligible participants were analysed. The median age was 25 (IQR 21–25) years and 54% were of the participants were female. The prevalence of self-reported symptoms of ADHD was 24.4% (95% CI 20.6% to 28.3%). Histories of chronic disease (adjusted OR (AOR) 2.96; 95% CI 1.49 to 5.86, p=0.002), family history of ADHD (AOR 3.38; 95% CI 1.04 to 10.44, p=0.035), severe depression (AOR=3.49; 95% CI 1.82 to 6.77, p<0.001) and anxiety disorder (AOR 2.06; 95% CI 1.25 to 3.36, p=0.004) were found to be independently associated with the symptoms of ADHD.ConclusionADHD may be a highly prevalent mental disorder among medical students, and is associated with severe depression, anxiety disorders and chronic diseases. There is a need to conduct a large-scale prospective cohort study with interviews to estimate the true prevalence and incidence of ADHD among medical students in Cameroon, and to determinant the risk factors associated with the disorder.
MHC-restricted phosphopeptide antigens: preclinical validation and first-in-humans clinical trial in participants with high-risk melanoma
Authors: Engelhard Victor H , Obeng Rebecca C , Cummings Kara L , Petroni Gina R , Ambakhutwala Angela L , Chianese-Bullock Kimberly A , Smith Kelly T , Lulu Amanda , Varhegyi Nikole , Smolkin Mark E , Myers Paisley , Mahoney Keira E , Shabanowitz Jeffrey , Buettner Nico , Hall Emily H , Haden Kathleen , Cobbold Mark , Hunt Donald F , Weiss Geoffrey , Gaughan Elizabeth , Slingluff, Jr Craig L 
Published: May 2020

BackgroundPhosphorylated peptides presented by MHC molecules represent a new class of neoantigens expressed on cancer cells and recognized by CD8 T-cells. These peptides are promising targets for cancer immunotherapy. Previous work identified an HLA-A*0201-restricted phosphopeptide from insulin receptor substrate 2 (pIRS2) as one such target. The purpose of this study was to characterize a second phosphopeptide, from breast cancer antiestrogen resistance 3 (BCAR3), and to evaluate safety and immunogenicity of a novel immunotherapic vaccine comprising either or both of these phosphorylated peptides.MethodsPhosphorylated BCAR3 protein was evaluated in melanoma and breast cancer cell lines by Western blot, and recognition by T-cells specific for HLA-A*0201-restricted phosphorylated BCAR3 peptide (pBCAR3126-134) was determined by51Cr release assay and intracellular cytokine staining. Human tumor explants were also evaluated by mass spectrometry for presentation of pIRS2 and pBCAR3 peptides. For the clinical trial, participants with resected stage IIA–IV melanoma were vaccinated 6 times over 12 weeks with one or both peptides in incomplete Freund’s adjuvant and Hiltonol (poly-ICLC). Adverse events (AEs) were coded based on National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) V.4.03, with provision for early study termination if dose-limiting toxicity (DLT) rates exceeded 33%. The enrollment target was 12 participants evaluable for immune response to each peptide. T-cell responses were assessed by interferon-γ ELISpot assay.ResultspBCAR3 peptides were immunogenic in vivo in mice, and in vitro in normal human donors, and T-cells specific for pBCAR3126-134controlled outgrowth of a tumor xenograft. The pIRS21097-1105peptide was identified by mass spectrometry from human hepatocellular carcinoma tumors. In the clinical trial, 15 participants were enrolled. All had grade 1 or 2 treatment-related AEs, but there were no grade 3–4 AEs, DLTs or deaths on study. T-cell responses were induced to the pIRS21097-1105peptide in 5/12 patients (42%, 90% CI 18% to 68%) and to the pBCAR3126-134peptide in 2/12 patients (17%, 90% CI 3% to 44%).ConclusionThis study supports the safety and immunogenicity of vaccines containing the cancer-associated phosphopeptides pBCAR3126-134and pIRS21097-1105, and the data support continued development of immune therapy targeting phosphopeptides. Future studies will define ways to further enhance the magnitude and durability of phosphopeptide-specific immune responses.Trial registration numberNCT01846143
O2A.3 Increased risk of central nervous system tumors with carbamate insecticide use in the prospective cohort agrican
Authors: Piel Clément , Pouchieu Camille , Migault Lucile , Béziat Beatrix , Boulanger Mathilde , Bureau Mathilde , Carles Camille , Grüber Anne , Lecluse Yannick , Rondeau Virginie , Schwall Xavier , Tual Séverine ,   the AGRICAN group, Lebailly Pierre , Baldi Isabelle 
Published: May 2020

BackgroundPesticide exposures are suspected to be implicated in the excess of Central Nervous System (CNS) tumors observed in farmers, but evidence concerning individual pesticides remains limited. Carbamate insecticides, used on a wide range of crops, have shown evidence of carcinogenicity in some experimental studies. In the cohort AGRICAN (AGRIculture and CANcer), we assessed the associations between potential exposures to carbamate insecticides and the incidence of CNS tumors, overall and by histological subtype.MethodsAGRICAN enrolled 181 842 participants involved in agriculture. Incident CNS tumors were identified by linkage with cancer registries from enrolment (2005–2007) until 2013. Carbamate exposure was assessed by combining information on lifetime periods of pesticide use on crop or livestock and the French crop-exposure matrix PESTIMAT, individually for each of the 19 carbamate insecticides registered in France since 1950. Associations were estimated using proportional hazards models with age as the underlying timescale, adjusting for gender, educational level and smoking.ResultsDuring a 6.9 year average follow-up, 381 incident cases of CNS tumors occurred, including 164 gliomas and 134 meningiomas. Analyses showed increased risks of CNS tumors with overall exposure to carbamate insecticides and linear trends with duration of use of each carbamate. Considering tumor subtypes, hazard ratios for gliomas ranged from 1.18 for thiofanox to 4.60 for formetanate and for meningiomas from 1.51 for carbaryl to 3.67 for thiofanox.ConclusionsFindings reinforce carcinogenicity evidence for already suspected active ingredients and draw attention to additional active ingredients, notably used on fruit trees, vineyards, potatoes and beets.
Undifferentiated connective tissue disease: state of the art on clinical practice guidelines
Authors: Antunes Margarida , Scirè Carlo Alberto , Talarico Rosaria , Alexander Tobias , Avcin Tadej , Belocchi Chiara , Doria Andrea , Franceschini Franco , Galetti Ilaria , Govoni Marcello , Hachulla Eric , Launay David , Lepri Gemma , Macieira Carla , Matucci-Cerinic Marco , Montecucco Carlo Maurizio , Moraes-Fontes Maria Francisca , Mouthon Luc , Paolino Sabrina , Ramoni Veronique , Tani Chiara , Tas Sander W , Tincani Angela , Van Vollenhoven Ronald , Zen Margherita , Fonseca Joao , Bombardieri Stefano , Fonseca João Eurico , Schneider Matthias , Smith Vanessa , Cutolo Maurizio , Mosca Marta , Beretta Lorenzo 
Published: May 2020

The term ‘undifferentiated connective tissue disease’ (UCTD) is generally used to describe clinical entities characterised by clinical and serological manifestations of systemic autoimmune diseases but not fulfilling the criteria for defined connective tissue diseases (CTDs). In this narrative review, we summarise the results of a systematic literature research, which was performed as part of the ERN ReCONNET project, aimed at evaluating existing clinical practice guidelines (CPGs) or recommendations.No specific CPG on UCTD were found, potential areas of intervention are absence of a consensus definition of UCTD, need for specific monitoring and therapeutic protocols, stratification of UCTD based on the risk of developing a defined CTD and preventive measure for the future development of a more severe condition.Patients feel uncertainty regarding the name of the disease and feel the need of a better education and understanding of these conditions and its possible changes over time.
Fully open-flavor tetraquark states $$bc\bar{q}\bar{s}$$ and $$sc\bar{q}\bar{b}$$ with $$J^{P}=0^{+},1^{+}$$
Authors: Wang Qi-Nan , Chen Wei 
Published: May 2020

AbstractWe have studied the masses for fully open-flavor tetraquark states $$bc\bar{q}\bar{s}$$bcq¯s¯ and $$sc\bar{q}\bar{b}$$scq¯b¯ ($$q=u, d$$q=u,d) with quantum numbers $$J^{P}=0^{+},1^{+}$$JP=0+,1+. We systematically construct all diquark–antiquark interpolating currents and calculate the two-point correlation functions and spectral densities in the framework of QCD sum rule method. Our calculations show that the masses are about $$7.1-7.2$$7.1-7.2 GeV for the $$bc\bar{q}\bar{s}$$bcq¯s¯ tetraquark states and $$7.0-7.1$$7.0-7.1 GeV for the $$sc\bar{q}\bar{b}$$scq¯b¯ tetraquarks. The masses of $$bc\bar{q}\bar{s}$$bcq¯s¯ tetraquarks are below the thresholds of $$\bar{B}_{s}D$$B¯sD and $$\bar{B}_{s}^{*}D$$B¯s∗D final states for the scalar and axial-vector channels respectively. The $$sc\bar{q}\bar{b}$$scq¯b¯ tetraquark states with $$J^{P}=1^{+}$$JP=1+ lie below the $$B_{c}^{+}K^{*}$$Bc+K∗ and $$B_{s}^{*}D$$Bs∗D thresholds. Such low masses for these possible tetraquark states indicate that they can only decay via weak interaction and thus are very narrow and stable.
Evolution of spherical overdensity in Chaplygin gas model
Authors: Akbarieh Amin Rezaei , Ahmadi Mohammad , Izadi Yousef , Aslmarand Shahabeddin M. , Miller Warner A. 
Published: May 2020

AbstractEven though many scalar field models of dark energy have been considered in the literature, there is another interesting class of dark energy models involving a fluid known as a Chaplygin gas. In addition to describing the dark energy, both scalar-tensor model and the Chaplygin gas model are suitable candidates for explaining the spherical cosmological collapse. One of the most well-known scalar field models is the quintessence model, which was first introduced to explain an accelerating expanding universe. Using a special form of the quintessence model that is equivalent to Chaplygin gas, we describe evolution of a spherical collapse. We study the cosmological properties of the quintessence field with a special potential. In addition to the quintessence model, that can be converted into a Chaplygin gas model in a particular case, we claim that the fixed-potential tachyonic model is equivalent to the Chaplygin gas model. In this work, we obtain the spherical collapse parameters: the virialized over density parameters, radius, the energy density at the turnaround moment, etc. We compare the results of the proposed model with the standard model of cosmology and the Einstein–de Sitter model. We show that the formation of the large-scale structures within the framework of a Chaplygin gas model happens earlier than predicted in the standard model.
Memória postal brasileira no Arquivo Público de Pernambuco
Authors: Salcedo Diego 
Published: May 2020

Apresenta o projeto Legado da Memória Postal Brasileira: curadoria do Fundo Correio Geral do Arquivo Público de Pernambuco. Ação realizada em 2018, coordenada pelo Grupo de Pesquisa Imago e Humanidades Digitais da Universidade Federal de Pernambuco. Teve como parceiros o Arquivo Público Estadual Jordão Emerenciano, a empresa 3Ecologias Inovação e Pesquisa, e foi financiado a partir do edital público pelo Fundo de Incentivo à Cultura de Pernambuco. Seu objetivo foi preservar documentos originais e prover acesso público ao patrimônio documental postal brasileiro constituído de documentos datados de 1818 a 1840, custodiados no volume 1 daquele Fundo. Participaram do projeto profissionais de áreas como História, Computação, Arquivologia, Jornalismo e Ciência da Informação, além de estudantes do curso de Biblioteconomia daquela Universidade. Foram realizadas leituras e debates, capacitação técnica paleográfica, de descrição para documentos arquivísticos e sobre os softwares Atom e Archivematica. Aplicou diretrizes do Conselho Nacional de Arquivos e da Norma Brasileira de Descrição Arquivística. Concluiu que urge pensar, debater e criar políticas que tenham como objetivo fomentar o desenvolvimento de coleções, a organização de acervos memoriais, a formação e a conservação de longo prazo das redes e dos conteúdos digitais de instituições memoriais diversas e distintas, considerada a relevância de equipes pluridisciplinares.