bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for the derivation and external validation of a 30-day mortality risk prediction model for older patients having emergency general surgery (PAUSE score—Probability of mortality Associated with Urgent/emergent general Surgery in oldEr patients score)
Authors: Feng Simon , Van Walraven Carl , Lalu Manoj , Moloo Husein , Musselman Reilly , McIsaac Daniel I 
Published: January 2020

IntroductionPeople 65 years and older represent the fastest growing segment of the surgical population. Older age is associated with doubling of risk when undergoing emergency general surgery (EGS) procedures and often coexists with medical complexity and considerations of end-of-life care, creating prognostic and decisional uncertainty. Combined with the time-sensitive nature of EGS, it is challenging to gauge perioperative risk and ensure that clinical decisions are aligned with the patient values. Current preoperative risk prediction models for older EGS patients have major limitations regarding derivation and validation, and do not address the specific risk profile of older patients. Accurate and externally validated models specific to older patients are needed to inform care and decision making.Methods and analysisWe will derive, internally and externally validate a multivariable model to predict 30-day mortality in EGS patients >65 years old. Our derivation sample will be individuals enrolled in the National Surgical Quality Improvement Program (NSQIP) database between 2012 and 2016 having 1 of 7 core EGS procedures. Postulated predictor variables have been identified based on previous research, clinical and epidemiological knowledge. Our model will be derived using logistic regression penalised with elastic net regularisation and ensembled using bootstrap aggregation. The resulting model will be internally validated using k-fold cross-validation and bootstrap validation techniques and externally validated using population-based health administrative data. Discrimination and calibration will be reported at each step.Ethics and disseminationEthics for NSQIP data use was obtained from the Ottawa Hospital Research Ethics Board; external validation will use routinely collected anonymised data legally exempt from research ethics review. The final risk score will be published in a peer-reviewed journal. We plan to further disseminate the model as an online calculator or application for clinical use. Future research will be required to test the clinical application of the final model.
International phase 1 study protocol to develop a health state classification system for a preference-based measure for women with breast cancer: the BREAST-Q Utility module
Authors: Kaur Manraj , Pusic Andrea L , Cano Stefan J , Xie Feng , Bordeleau Louise , Zhong Toni , Klassen Anne 
Published: January 2020

IntroductionConcerns unique to women with breast cancer can include impact of cancer on body image, sexual well-being and changes in breast appearance and sensation. These important issues are not captured by the existing generic preference-based measures (PBMs) and no breast cancer-specific PBM currently exists. This Phase 1 protocol describes a mixed-methods study to develop and validate the descriptive health state classification system for a breast cancer-specific PBM, called the BREAST-Q Utility module.Methods and analysisA heterogeneous sample of women aged 18 years and older diagnosed with breast cancer who are undergoing or have had treatment for breast cancer will be invited to participate in qualitative interviews. Participants will be asked to describe impact of their diagnosis and treatment(s) on their health-related quality of life (HRQOL). Interviews will be audio recorded, transcribed verbatim and coded using a line-by-line approach. At the end of each interview, based on each participant’s cancer treatment history, patients will complete the mastectomy, breast-conserving therapy or reconstruction module of BREAST-Q, with modified 5-point Likert scale to measure importance of the BREAST-Q concepts. Both sources of data will be analysed to identify the most important HRQOL concerns.A conceptual framework and item pool will be developed from the qualitative dataset. Preliminary version of the BREAST-Q Utility module will be created and refined at an in-person meeting of multidisciplinary experts. Content validity of the Utility module will be examined (cognitive debriefing, expert feedback). Psychometric properties of Utility module will be evaluated in a large sample of women with breast cancer.Ethics and disseminationThe study has been approved by Hamilton Integrated Research Ethics Board, Canada. Results of this study will be presented at international conferences and published in peer-reviewed journals.
Exploring failure of antimicrobial prophylaxis and pre-emptive therapy for transplant recipients: a systematic review
Authors: Märtson Anne-Grete , Bakker Martijn , Blokzijl Hans , Verschuuren Erik A M , Berger Stefan P , Span Lambert F R , van der Werf Tjip S , Alffenaar Jan-Willem C 
Published: January 2020

ObjectivesInfections remain a threat for solid organ and stem cell transplant recipients. Antimicrobial prophylaxis and pre-emptive therapy have improved survival of these patients; however, the failure rates of prophylaxis are not negligible. The aim of this systematic review is to explore the reasons behind failure of antimicrobial prophylaxis and pre-emptive therapy.SettingThis systematic review included prospective randomised controlled trials and prospective single-arm studies.ParticipantsThe studies included were on prophylaxis and pre-emptive therapy of opportunistic infections in transplant recipients. Studies were included from databases MEDLINE, CENTRAL and Embase published until October first 2018.Primary and secondary outcome measuresPrimary outcome measures were breakthrough infections, adverse events leading to stopping of treatment, switching medication or dose reduction. Secondary outcome measures were acquired resistance to antimicrobials, antifungals or antivirals and death.ResultsFrom 3317 identified records, 30 records from 24 studies with 2851 patients were included in the systematic review. Seventeen focused on prophylactic and pre-emptive treatment of cytomegalovirus and seven studies on invasive fungal infection. The main reasons for failure of prophylaxis and pre-emptive therapy were adverse events and breakthrough infections, which were described in 54% (13 studies) and 38% (9 studies) of the included studies, respectively. In 25%, six of the studies, a detailed description of patients who experienced failure of prophylaxis or pre-emptive therapy was unclear or lacking.ConclusionsOur results show that although failure is reported in the studies, the level of detail prohibits a detailed analysis of failure of prophylaxis and pre-emptive therapy. Clearly reporting on patients with a negative outcome should be improved. We have provided guidance on how to detect failure early in a clinical setting in accordance to the results from this systematic review.PROSPERO registration numberCRD42017077606.
Concerns about disclosing a high-risk cervical human papillomavirus (HPV) infection to a sexual partner: a systematic review and thematic synthesis
Authors: Bennett Kirsty F , Waller Jo , Ryan Mairead , Bailey Julia V , Marlow Laura A V 
Published: January 2020

BackgroundHuman papillomavirus (HPV)-based cervical screening is now replacing cytology-based screening in several countries and many women in screening programmes will consequently receive HPV-positive results. Because of the sexually transmitted nature of HPV, receiving an HPV-positive result may raise questions about disclosing the infection to a sexual partner.ObjectiveTo review the quantitative and qualitative literature exploring women’s concerns about disclosing a high-risk cervical HPV infection to a sexual partner.MethodsWe searched MEDLINE, PsycINFO, CINAHL Plus, Web of Science and EMBASE for studies reporting at least one disclosure-related outcome among women with high-risk HPV. We also searched the grey literature and carried out forward/backward citation searches. A narrative synthesis for quantitative studies and a thematic synthesis for qualitative studies were conducted.ResultsThirteen articles met the inclusion criteria (12 qualitative, 1 quantitative). In the quantitative study, 60% of HPV-positive women felt disclosing an HPV result was ‘risky’. Concerns about disclosing HPV to a sexual partner were influenced by the stigma that is associated with having an STI and uncertainty about how their partner would respond. Women questioned how, when and to whom they should disclose their HPV-positive status.ConclusionsThe studies included in this review provide rich information about the range of concerns women have, the reasons for these concerns, and the questions women have about disclosing HPV to sexual partners. As studies were predominantly qualitative, the prevalence of concerns is unclear.
Seven-day vonoprazan and low-dose amoxicillin dual therapy as first-lineHelicobacter pyloritreatment: a multicentre randomised trial in Japan
Authors: Suzuki Sho , Gotoda Takuji , Kusano Chika , Ikehara Hisatomo , Ichijima Ryoji , Ohyauchi Motoki , Ito Hirotaka , Kawamura Masashi , Ogata Yohei , Ohtaka Masahiko , Nakahara Moriyasu , Kawabe Koichi 
Published: January 2020

ObjectiveTo date, no randomised trials have compared the efficacy of vonoprazan and amoxicillin dual therapy with other standard regimens forHelicobacter pyloritreatment. This study aimed to investigate the efficacy of the 7-day vonoprazan and low-dose amoxicillin dual therapy as a first-lineH. pyloritreatment, and compared this with vonoprazan-based triple therapy.DesignThis prospective, randomised clinical trial was performed at seven Japanese institutions. Patients withH. pylori–positive culture test and naive to treatment were randomly assigned in a 1:1 ratio to either VA-dual therapy (vonoprazan 20 mg+amoxicillin 750 mg twice/day) or VAC-triple therapy (vonoprazan 20 mg+amoxicillin 750 mg+clarithromycin 200 mg twice/day) for 7 days, with stratification by age, sex,H. pyloriantimicrobial resistance and institution. Eradication success was evaluated by13C-urea breath test at least 4 weeks after treatment.ResultsBetween October 2018 and June 2019, 629 subjects were screened and 335 were randomised. The eradication rates of VA-dual and VAC-triple therapies were 84.5% and 89.2% (p=0.203) by intention-to-treat analysis, respectively, and 87.1% and 90.2% (p=0.372) by per-protocol analysis, respectively. VA-dual was non-inferior to VAC-triple in the per-protocol analysis. The eradication rates in strains resistant to clarithromycin for VA-dual were significantly higher than those for VAC-triple (92.3% vs 76.2%; p=0.048). The incidence of adverse events was equal between groups.ConclusionThe 7-day vonoprazan and low-dose amoxicillin dual therapy provided acceptableH. pylorieradication rates and a similar effect to vonoprazan-based triple therapy in regions with high clarithromycin resistance.Trial registration numberUMIN000034140.
Association of designated open water swim area regulations and open water drowning rates
Authors: Quan Linda , Mills Brianna , Chau Suet Sen , Bennett Elizabeth , Bolt Kaylin , Gomez Anthony 
Published: January 2020

BackgroundAlthough most persons over 5 years of age drown in open water, few laws have sought to regulate open water swim sites. We examined the association between regulations for designated open water swim sites and open water drowning death rates by state.MethodsUsing International Classification of Disease (ICD)-10 codes in the CDC Web-based Injury Statistics Query and Reporting System (WISQARS), we identified and calculated open water drowning deaths involving all ages from 2012 to 2017 for 50 states and calculated open water drowning death rates. We then identified and categorised types of state regulations (lifeguards, water quality, rescue equipment, tracking/planning/reporting and signage) for open water swim sites in place in 2017 for a sample of 30 states (20 high-drowning, 10 low-drowning). Analyses evaluated associations between open water drowning rates in three groups (overall, youth and non-white) and the total number and types of state regulations.ResultsSwim site regulations and open water drowning death rates for 10 839 victims were associated in all regression models. States with more types of regulations had lower open water drowning death rates in a dose-response relationship. States lacking regulations compared with states with all five types of regulations had open water drowning death rates 3.02 times higher among youth (95% CI 1.82 to 4.99) and 4.16 times higher among non-white residents (95% CI 2.46 to 7.05). Lifeguard and tracking/planning/reporting regulations were associated with a 33% and 45% reduction in open water drowning rates overall and among those aged 0–17 years.ConclusionStates’ open water swim area regulations, especially addressing tracking/planning/reporting and lifeguards, were associated with lower open water drowning death rates.
Fatigue numeric rating scale validity, discrimination and responder definition in patients with psoriatic arthritis
Authors: Gladman Dafna , Nash Peter , Goto Hitoshi , Birt Julie A , Lin Chen-Yen , Orbai Ana-Maria , Kvien Tore K 
Published: January 2020

ObjectivesThis study assessed the psychometric properties of the fatigue numeric rating scale (NRS) and sought to establish values for clinically meaningful change (responder definition).MethodsUsing disease-specific clinician-reported and patient-reported data from two randomised clinical trials of patients with psoriatic arthritis (PsA), the fatigue NRS was evaluated for test–retest reliability, construct validity and responsiveness. A responder definition was also explored using anchor-based and distribution-based methods.ResultsTest–retest reliability analyses supported the reproducibility of the fatigue NRS in patients with PsA (intraclass correlation coefficient=0.829). Mean (SD) values at baseline and week 2 were 5.7 (2.2) and 5.7 (2.4), respectively. Supporting construct validity of the fatigue NRS, moderate-to-large correlations with other assessments measuring similar concepts as measured by Sackett’s conventions were demonstrated. Fatigue severity was reduced when the underlying disease activity was improved and reductions remained consistent at week 12 and 24. A 3-point improvement was identified as being optimal for demonstrating a level of clinically meaningful improvement in fatigue NRS after 12–24 weeks of treatment.ConclusionsFatigue NRS is a valid and responsive patient-reported outcome instrument for use in patients with PsA. The established psychometric properties from this study support the use of fatigue NRS in clinical trials and in routine clinical practice. Robust validation of reliability for use in routine clinical practice in treating patients with active PsA in less active disease states and other more diverse ethnic groups is needed.
A Universal Method for Designing Multi-Digit Ternary to Binary Converter Using CNTFET
Authors: Shahangian Maryam , Hosseini Seied Ali , Mirzaee Reza Faghih 
Published: January 2020

Ternary logic can reduce the number of interconnections, chip area and power dissipation. In addition, one of the important features of carbon nanotube field effect transistors (CNTFETs) is the capability of adjusting threshold voltage. As a result, the design complexity of ternary circuits can be decreased. The structure of a mixed radix system which is based on multi-valued and binary logic is more appropriate compared to only multiple-valued logic (MVL). Therefore, ternary-to-binary and binary-to-ternary converters are the essential components for the ternary signaling on the bus and the binary logic processing circuits. It is also important for the creation of compatibility between the binary and ternary logic. This study is about a multi-digit binary-to-ternary converter by using CNTFET. At first, the algorithm used for the multi-digit conversion from ternary to binary logic is addressed in this paper. Then, the paper proposes a block diagram suitable for designing the multi-digit ternary-to-binary converter. Some new gates including One-Active Gate and Two-Active Gate, as well as two types of binary half-and full-adders, are designed for the purpose of implementing the proposed block diagram. This is done by adjusting the proper threshold voltage for CNTFETs. The proposed algorithm can also be applied to any desired number of bits. The proper operation and high efficiency of the proposed converter are confirmed by HSPICE simulation results and 32[Formula: see text]nm CNTFET technology from the Stanford University.
Morphological signature of gully development by rapid slide retrogression in a layered coarse-grained delta foreslope
Authors: Locat Jacques , Azizian Ali , Stronach Jim , Hospital Aurélien , Young Chris , Turmel Dominique , Bevan Andrew 
Published: January 2020

Abstract
Coarse-grained deltas are often characterized by steep foreslopes (often more than 10°) that are traversed by delta-front channels. The channels thus erode into relatively steeply inclined bedding. In this context, the slopes flanking the channels can be steeper than the friction angle since they include a component of dip related to the delta-front slope as well as the channel-related erosion slope. In this study, part of the Busu River delta (Papua New Guinea) was imaged using a high-resolution multibeam bathymetry survey over an area where the angle of the slopes flanking the channels locally reaches 50°. A detailed analysis of the delta slope morphology has revealed an additional source of instability due to erosion within the main channels. In some places, erosion cuts into the channel flank forming a local knickpoint inclined in a direction approaching that of the bed dip. The cut can then initiate breaching or static liquefaction failure from that point up to the crest of the interfluve resulting in a V-shaped gully.
The influence of clay content on submarine slope failure: insights from laboratory experiments and numerical models
Authors: Silver M. M. W. , Dugan B. 
Published: January 2020

Abstract
Submarine slope failures pose risks to coastlines because they can damage infrastructure and generate tsunamis. Passive margin slope failures represent the largest mass failures on Earth, yet we know little about their dynamics. While numerous studies characterize the lithology, structure, seismic attributes and geometry of failure deposits, we lack direct observations of failure evolution. Thus, we lack insight into the relationships between initial conditions, slope failure initiation and evolution, and final deposits. To investigate submarine slope failure dynamics in relation to initial conditions and to observe failure processes we performed physical experiments in a benchtop flume and produced numerical models. Submarine slope failures were induced under controlled pore pressure within sand–clay mixtures (0–5 wt% clay). Increased clay content corresponded to increased cohesion and pore pressure required for failure. Subsurface fractures and tensile cracks were only generated in experiments containing clay. Falling head tests showed a log-linear relation between hydraulic conductivity and clay content, which we used in our numerical models. Models of our experiments effectively simulate overpressure (pressure in excess of hydrostatic) and failure potential for (non)cohesive sediment mixtures. Overall our work shows the importance of clay in reducing permeability and increasing cohesion to create different failure modes due to overpressure.
Revisiting the tsunamigenic volcanic flank collapse of Fogo Island in the Cape Verdes, offshore West Africa
Authors: Barrett Rachel , Lebas Elodie , Ramalho Ricardo , Klaucke Ingo , Kutterolf Steffen , Klügel Andreas , Lindhorst Katja , Gross Felix , Krastel Sebastian 
Published: January 2020

Abstract

Volcanic archipelagos are a source of numerous on- and offshore geohazards, including explosive eruptions and potentially tsunamigenic large-scale flank collapses. Fogo Island in the southern Cape Verdes is one of the most active volcanoes in the world, making it both prone to collapse (as evidenced by the
c.
73 ka Monte Amarelo volcanic flank collapse), and a source of widely distributed tephra and volcanic material. The offshore distribution of the Monte Amarelo debris avalanche deposits and the surrounding volcaniclastic apron were previously mapped using only medium-resolution bathymetric data. Here, using recently acquired, higher-resolution acoustic data, we revisit Fogo's flank collapse and find evidence suggesting that the deposition of hummocky volcanic debris originating from the failed eastern flank most likely triggered the contemporaneous, multi-phase failure of pre-existing seafloor sediments. Additionally, we identify, for the first time, multiple mass-transport deposits in the southern part of the volcaniclastic apron of Fogo and Santiago based on the presence of acoustically chaotic deposits in parametric echo sounder data and volcaniclastic turbiditic sands in recovered cores. These preliminary findings indicate a long and complex history of instability on the southern slopes of Fogo and suggest that Fogo may have experienced multiple flank collapses.
Electrophysiological responses to sugars and amino acids in the nucleus of the solitary tract of type 1 taste receptor double-knockout mice
Authors: Kalyanasundar B. , Blonde Ginger D. , Spector Alan C. , Travers Susan P. 
Published: January 2020

Strong evidence supports a major role for heterodimers of the type 1 taste receptor (T1R) family in the taste transduction of sugars (T1R2+T1R3) and amino acids (T1R1+T1R3), but there are also neural and behavioral data supporting T1R-independent mechanisms. Most neural evidence for alternate mechanisms comes from whole nerve recordings in mice with deletion of a single T1R family member, limiting conclusions about the functional significance and T1R independence of the remaining responses. To clarify these issues, we recorded single-unit taste responses from the nucleus of the solitary tract in T1R double-knockout (double-KO) mice lacking functional T1R1+T1R3 [KO1+3] or T1R2+T1R3 [KO2+3] receptors and their wild-type background strains [WT; C57BL/6J (B6), 129X1/SvJ (S129)]. In both double-KO strains, responses to sugars and a moderate concentration of an monosodium glutamate + amiloride + inosine 5′-monophosphate cocktail (0.1 M, i.e., umami) were profoundly depressed, whereas a panel of 0.6 M amino acids were mostly unaffected. Strikingly, in contrast to WT mice, no double-KO neurons responded selectively to sugars and umami, precluding segregation of this group of stimuli from those representing other taste qualities in a multidimensional scaling analysis. Nevertheless, residual sugar responses, mainly elicited by monosaccharides, persisted as small “sideband” responses in double-KOs. Thus other receptors may convey limited information about sugars to the central nervous system, but T1Rs appear critical for coding the distinct perceptual features of sugar and umami stimuli. The persistence of amino acid responses supports previous proposals of alternate receptors, but because these stimuli affected multiple neuron types, further investigations are necessary. NEW & NOTEWORTHY The type 1 taste receptor (T1R) family is crucial for transducing sugars and amino acids, but there is evidence for T1R-independent mechanisms. In this study, single-unit recordings from the nucleus of the solitary tract in T1R double-knockout mice lacking T1R1+T1R3 or T1R2+T1R3 receptors revealed greatly reduced umami synergism and sugar responses. Nevertheless, residual sugar responses persisted, mainly elicited by monosaccharides and evident as “sidebands” in neurons activated more vigorously by other qualities.