bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP6  Long term outcomes of participants in the paramedic-2 randomised trial of adrenaline in out of hospital cardiac arrest
Authors: Haywood Kirstie L , Ji Chen , Quinn Tom , Nolan Jerry P , Deakin Charles D , Scomparin Charlotte , Lall Ranjit , Gates Simon , Long John , Regan Scott , Fothergill Rachael T , Pocock Helen , Rees Nigel , O’Shea Lyndsey , Perkins Gavin D 
Published: September 2020

BackgroundWe recently reported early outcomes in patients enrolled in a randomised trial of adrenaline in out-of-hospital cardiac arrest: the PARAMEDIC-2 (Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest) trial. The purpose of the present paper is to report long-term survival, quality of life, functional and cognitive outcomes in cardiac arrest patients who survived.MethodsPARAMEDIC-2 was a pragmatic, individually randomised, double blind, controlled trial and economic evaluation. Patients were randomised to either adrenaline or placebo. The 12-months survival post randomisation was checked. The 3- and 6-months outcomes included the modified Rankin Scale (0–3 defined as favourable neurological outcome), Two Simple Questions, the Mini Mental State Examination, the Informant Questionnaire on Cognitive Decline Evaluation for Cardiac Arrest, Hospital Anxiety and Depression Scale, the Post Traumatic Stress Disorder Checklist - Civilian Version and general health-related quality of life (HRQoL) assessed with both the Short-Form 12-item Health Survey and the EuroQoL EQ-5D-5L.Results8,014 patients were randomised with confirmed trial drug administration. Adrenaline survivors had marginally better 12-months survival (adjusted odds ratio: 1.385, 95% confidence interval: [1.000, 1.917], p=0.050). There was no significant treatment difference in favourable neurological outcome at both follow-ups. Similarly, no significant difference was found in other outcomes. Moderate to large effect sizes are reported in both arms when survivors were compared to the UK general population regarding general HRQoL and physical health.ConclusionsAdrenaline had a short to long-term effect on survival to 12-months post OHCA, compared to placebo, but more survivors in the adrenaline arm had poor functional, cognitive and HRQoL. A large proportion of the survivors experienced significant cognitive impairment and an important reduction in mental and physical wellbeing over the initial 6-months when compared to the general population.
OP7  Did west midlands ambulance service paramedics’ usage of adrenaline change after the publication of the paramedic2 results, but prior to any guideline change? A service evaluation
Authors: Gunson Imogen M 
Published: September 2020

BackgroundThis project evaluated whether practice change occurred amongst Paramedics directly after the publication of the PARAMEDIC2 trial, regarding adrenaline administration during out-of-hospital cardiac arrest (OHCA) without a change in guidelines. When Paramedics are exposed to a seminal publication there is anecdotal concern their autonomous practice changes, based on comprehension of findings ahead of potential guideline changes, however little evidence appraises whether this really occurs.MethodsA service evaluation to determine any variation in adrenaline administration during OHCA, before and after publication of the PARAMEDIC2 trial.WMAS electronic patient record data that has been collected for use within OHCA ambulance quality indicators was used to evaluate practice variation.Proportion of adult patients receiving adrenaline, number of administrations and time to first administration from EMS arrival (or arrest if EMS witnessed) are reported.This evaluation assesses from the day after recruitment ended on 18th October 2017 until the trial results publication on 19th July 2018, and the same timeframe (273 days) post-publication.ResultsProportion receiving adrenalinePre-publication: 88.7% of 3026 casesPost-publication: 88.0% of 2682 casesMean number of adrenaline administrationsPre-publication: 4Post-publication: 4Mean time to adrenalinePre-publication: 30:02 minutesPost-publication: 30:11 minutesConclusionsIn both datasets, average time to first adrenaline administration and number of administrations were found to be similar. This suggests Paramedic practice adheres to current guidelines when a highly anticipated article is published, however this may vary by intervention so further work is recommended. Limitations of retrospective observational evaluations include uncontrolled treatment variables; however randomised controlled trials cannot assess standard practice. Individuals need continued awareness for implications of changing practice following a trial publication, as patient safety could be breached whilst the wider medical community are scrutinising the trial results. This demonstrates how routine data can be used to evaluate practice and changes within it.
Exploring the structure of social media application-based information-sharing clinical networks in a community in Japan using a social network analysis approach
Authors: Haruta Junji , Tsugawa Sho , Ogura Kazunari 
Published: September 2020

ObjectiveCurrently, use of social networking services (SNSs) for interprofessional collaboration is increasing. However, few studies have reported on virtual interprofessional interactions in community healthcare services. Revealing such structural characteristics of the networks can provide insight into the functions of the interprofessional information-sharing network and lead to smoother collaboration. Thus, we aimed to explore the structure of SNS-based information-sharing clinical networks.DesignSocial network analysis (SNA).SettingWe selected a community in City X in Japan.Data collectionWe analysed SNS-based information-sharing clinical network data linked to patients receiving home medical care or care services between January and December 2018. A network was created for each patient to allow healthcare professionals to post and view messages on the web platform. In the SNA, healthcare professions registered in a patient group were represented as nodes, and message posting/viewing relationships were represented as links in the patient network. We investigated the structural characteristics of the target networks using several measures for SNA, including indegree centrality and outdegree centrality, which reflect the number of incoming and outgoing links to/from a node, respectively. Additionally, the professions forming the most central nodes were investigated based on their ranking to identify those with a central role in the networks. Finally, to compare the networks of nursing care levels 1–3 (lighter care requirement) and those with nursing care levels 4–5 (heavier care requirement), we analysed the structural differences in the networks and investigated the roles of healthcare professionals using centrality measures of nodes.ResultsAmong 844 groups, 247 groups with any nursing care level data were available for analysis. Increasing nursing care level showed higher density, reciprocity and lower centralisation. Healthcare professions with high indegree centrality (physicians, care workers and physical therapists) differed from those with high outdegree centrality (home care workers, physical therapists, and registered dieticians). Visiting nurses and nurses in the clinic played a central role, but visiting nurses tended to have higher indegree and outdegree centrality, while nurses in the clinic had higher closeness and betweenness centrality in networks with heavier care requirement.ConclusionThe SNS-based information-sharing clinical network structure showed that different professions played some form of a central role. Associations between network structures and patient outcomes, cost effectiveness and other factors warrant further investigation.
Bacteria-derived long chain fatty acid exhibits anti-inflammatory properties in colitis
Authors: Pujo Julien , Petitfils Camille , Le Faouder Pauline , Eeckhaut Venessa , Payros Gaelle , Maurel Sarah , Perez-Berezo Teresa , Van Hul Matthias , Barreau Frederick , Blanpied Catherine , Chavanas Stephane , Van Immerseel Filip , Bertrand-Michel Justine , Oswald Eric , Knauf Claude , Dietrich Gilles , Cani Patrice D , Cenac Nicolas 
Published: September 2020

ObjectiveData from clinical research suggest that certain probiotic bacterial strains have the potential to modulate colonic inflammation. Nonetheless, these data differ between studies due to the probiotic bacterial strains used and the poor knowledge of their mechanisms of action.DesignBy mass-spectrometry, we identified and quantified free long chain fatty acids (LCFAs) in probiotics and assessed the effect of one of them in mouse colitis.ResultsAmong all the LCFAs quantified by mass spectrometry inEscherichia coliNissle 1917 (EcN), a probiotic used for the treatment of multiple intestinal disorders, the concentration of 3-hydroxyoctadecaenoic acid (C18-3OH) was increased in EcN compared with otherE. colistrains tested. Oral administration of C18-3OH decreased colitis induced by dextran sulfate sodium in mice. To determine whether other bacteria composing the microbiota are able to produce C18-3OH, we targeted the gut microbiota of mice with prebiotic fructooligosaccharides (FOS). The anti-inflammatory properties of FOS were associated with an increase in colonic C18-3OH concentration. Microbiota analyses revealed that the concentration of C18-3OH was correlated with an increase in the abundance inAllobaculum,HoldemanellaandParabacteroides. In culture,Holdemanella biformisproduced high concentration of C18-3OH. Finally, using TR-FRET binding assay and gene expression analysis, we demonstrated that the C18-3OH is an agonist of peroxisome proliferator activated receptor gamma.ConclusionThe production of C18-3OH by bacteria could be one of the mechanisms implicated in the anti-inflammatory properties of probiotics. The production of LCFA-3OH by bacteria could be implicated in the microbiota/host interactions.
Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study
Authors: Niedzwiedz Claire L , Green Michael James , Benzeval Michaela , Campbell Desmond , Craig Peter , Demou Evangelia , Leyland Alastair , Pearce Anna , Thomson Rachel , Whitley Elise , Katikireddi Srinivasa Vittal 
Published: September 2020

BackgroundThere are concerns that COVID-19 mitigation measures, including the ‘lockdown’, may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.MethodsRepeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of over 27,000 adults (aged 18+) interviewed in four survey waves between 2015 and 2020. A total of 9748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.ResultsPsychological distress increased 1 month into lockdown with the prevalence rising from 19.4% (95% CI 18.7% to 20.1%) in 2017–2019 to 30.6% (95% CI 29.1% to 32.3%) in April 2020 (RR=1.3, 95% CI 1.2 to 1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI 0.6 to 1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI 1.3 to 1.5), as did binge drinking (RR=1.5, 95% CI 1.3 to 1.7).ConclusionsPsychological distress increased 1 month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate negative impacts on health.
Critical factors for successful management of VUCA times
Authors: Pandit Meghana 
Published: September 2020

BackgroundCOVID-19 pandemic exposed leadership teams to novel challenges that required many changes to their practices. This has been the most volatile, uncertain, complex and ambiguous (VUCA) times in healthcare.InterventionsThis brief report uses experiences at Oxford University Hospitals to propose that an organisation’s culture serves as a bedrock on which management of a crisis such as the COVID-19 pandemic is reliant. The other two critical factors are partnership working and clarity of the strategic intent of the organisation.ConclusionsWhile many of the actions described in this report are likely to be in common with those of other leadership teams across the National Health Service, some organisations seem to manage the response to the VUCA situations better than others and the three factors are repeatedly observed in these organisations. This brief report explores what actions support the three critical factors that make some organisations more resilient and their leaders’ actions more effective.
Payment in challenge studies: ethics, attitudes and a new payment for risk model
Authors: Grimwade Olivia , Savulescu Julian , Giubilini Alberto , Oakley Justin , Osowicki Joshua , Pollard Andrew J , Nussberger Anne-Marie 
Published: September 2020

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated.
Fermion number 1/2 of sphalerons and spectral mirror symmetry
Authors: Mehraeen M. , Gousheh S. S. 
Published: September 2020

AbstractWe present a rederivation of the baryon and lepton numbers $$\frac{1}{2}$$

1
2

of the $$SU(2)_L$$

S
U

(
2
)

L

S sphaleron of the standard electroweak theory based on spectral mirror symmetry. We explore the properties of a fermionic Hamiltonian under discrete transformations along a noncontractible loop of field configurations that passes through the sphaleron and whose endpoints are the vacuum. As is well known, CP transformation is not a symmetry of the system anywhere on the loop, except at the endpoints. By augmenting CP with a chirality transformation, we observe that the Dirac Hamiltonian is odd under the new transformation precisely at the sphaleron, and this ensures the mirror symmetry of the spectrum, including the continua. As a consistency check, we show that the fermionic zero mode presented by Ringwald in the sphaleron background is invariant under the new transformation. The spectral mirror symmetry which we establish here, together with the presence of the zero mode, are the two necessary conditions whence the fermion number $$\frac{1}{2}$$

1
2

of the sphaleron can be inferred using the reasoning presented by Jackiw and Rebbi or, equivalently, using the spectral deficiency $$\frac{1}{2}$$

1
2

of the Dirac sea. The relevance of this analysis to other solutions is also discussed.
Partial spectral flow and the Aharonov–Bohm effect in graphene
Authors: Katsnelson Mikhail I. , Nazaikinskii Vladimir 
Published: September 2020

AbstractWe study the Aharonov–Bohm effect in an open-ended tube made of a graphene sheet whose dimensions are much larger than the interatomic distance in graphene. An external magnetic field vanishes on and in the vicinity of the graphene sheet and its flux through the tube is adiabatically switched on. It is shown that, in the process, the energy levels of the tight-binding Hamiltonian of $$\pi $$
π
-electrons unavoidably cross the Fermi level, which results in the creation of electron–hole pairs. The number of pairs is proven to be equal to the number of magnetic flux quanta of the external field. The proof is based on the new notion of partial spectral flow, which generalizes the ordinary spectral flow already having well-known applications (such as the Kopnin forces in superconductors and superfluids) in condensed matter physics.
Characteristics and Outcomes of In-Hospital Cardiac Arrest Events During the COVID-19 Pandemic
Authors: Miles Jeremy A. , Mejia Mateo , Rios Saul , Sokol Seth I. , Langston Matthew , Hahn Steven , Leiderman Ephraim , Salgunan Reka , Soghier Israa , Gulani Perminder , Joshi Keval , Chung Virginia , Morante Joaquin , Maggiore Diane , Uppal Dipan , Friedman Ari , Katamreddy Adarsh , Abittan Nathaniel , Ramani Gokul , Irfan Wakil , Liaqat Wasla , Grushko Michael , Krouss Mona , Cho Hyung J. , Bradley Steven M. , Faillace Robert T. 
Published: September 2020

Background:
Patients hospitalized for severe coronavirus disease 2019 (COVID-19) infection are at risk for in-hospital cardiac arrest (IHCA). It is unknown whether certain characteristics of cardiac arrest care and outcomes of IHCAs during the COVID-19 pandemic differed compared with a pre-COVID-19 period.

Methods:
All patients who experienced an IHCA at our hospital from March 1, 2020 through May 15, 2020, during the peak of the COVID-19 pandemic, and those who had an IHCA from January 1, 2019 to December 31, 2019 were identified. All patient data were extracted from our hospital’s Get With The Guidelines–Resuscitation registry, a prospective hospital-based archive of IHCA data. Baseline characteristics of patients, interventions, and overall outcomes of IHCAs during the COVID-19 pandemic were compared with IHCAs in 2019, before the COVID-19 pandemic.

Results:

There were 125 IHCAs during a 2.5-month period at our hospital during the peak of the COVID-19 pandemic compared with 117 IHCAs in all of 2019. IHCAs during the COVID-19 pandemic occurred more often on general medicine wards than in intensive care units (46% versus 33%; 19% versus 60% in 2019;
P
<0.001), were overall shorter in duration (median time of 11 minutes [8.5–26.5] versus 15 minutes [7.0–20.0],
P
=0.001), led to fewer endotracheal intubations (52% versus 85%,
P
<0.001), and had overall worse survival rates (3% versus 13%;
P
=0.007) compared with IHCAs before the COVID-19 pandemic.

Conclusions:
Patients who experienced an IHCA during the COVID-19 pandemic had overall worse survival compared with those who had an IHCA before the COVID-19 pandemic. Our findings highlight important differences between these 2 time periods. Further study is needed on cardiac arrest care in patients with COVID-19.
Comparison of Tropical Cyclone Center Positions Determined from Satellite Observations at Infrared and Microwave Frequencies
Authors: Hu Y. , Zou X. 
Published: September 2020

AbstractDetermining tropical cyclone (TC) center positions is of interest to many researchers who conduct TC analysis and forecasts. In this study, we develop and apply a TC centering technique to Cross-Track Infrared Sounder (CrIS) and Advanced Technology Microwave Sounder (ATMS) observations of brightness temperature and report on an improvement of accuracy by adding a TC spectral analysis to the state of the art [Automated Rotational Center Hurricane Eye Retrieval (ARCHER)], especially for ATMS. We show that the ARCHER TC center-fixing algorithm locates TC centers more successfully based on the infrared channel with center frequency at 703.75 cm−1 (channel 89) of the CrIS than the ATMS channel 22 (183.31 ± 1.0 GHz) due to small-scale features in ATMS channel’s brightness temperature field associated with strong convective clouds. We propose to first apply the ARCHER TC center-fixing algorithm to ATMS channel 4 (51.76 GHz) that is less affected by small-scale convective clouds, and then to perform a set of the azimuthal spectral analysis of the ATMS channel-22 observations with tryout centers within a squared box centered at the ATMS channel-4-determined center. The center that gives the largest symmetric component is the final ATMS-determined center. Compared to the National Hurricane Center best track, the root-mean-square center-fixing errors determined from the two ATMS channels (one single CrIS channel) are 29.9 km (35.8 km) and 28.0 km (30.9 km) for 104 tropical storm and 81 hurricane cases, respectively, in the 2019 hurricane season.
Mental health of frontline healthcare workers exposed to COVID-19 in Egypt: A call for action
Authors: Elkholy Hussien , Tawfik Fairouz , Ibrahim Islam , Salah El-din Waleed , Sabry Mohamed , Mohammed Suzan , Hamza Mohamed , Alaa Mohamed , Fawzy Al Zahraa , Ashmawy Rasha , Sayed Maha , Omar Abdel Nasser 
Published: September 2020

Background: World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19) as a pandemic in March 2020. Such widespread outbreaks are associated with adverse mental health consequences. Aims: To evaluate mental health outcomes among Egyptian healthcare workers (HCW) treating patients with confirmed or suspected Coronavirus Disease 2019 (COVID-19) to direct the promotion of mental wellbeing, by screening for symptoms of anxiety, insomnia, depression and stress, and analyzing potential risk factors. Methods: This cross-sectional, hospital-based survey study collected demographic data and mental health measurements from 502 HCW dealing with COVID-19. HCW were surveyed in 20 hospitals (Fever, Chest, and Quarantine hospitals) in different parts of Egypt, in April and May 2020. Results: Among the 502 HCW surveyed; 60.0% were physicians, 16.1% were specialized nurses, and 23.9% were non-specialized nurses. About 35.3% worked in chest hospitals, 17.5% in fever hospitals, and 47.2% in quarantine hospitals. A considerable proportion of HCW had symptoms of anxiety, insomnia, depression, and stress. Females were at higher risk of experiencing symptoms of severe anxiety (odds ratio [OR], 1.85; 95% CI, 1.12–3.05; p = .016), severe depression (OR, 2.013; 95% CI, 1.17–3.4; p = .011), and severe stress (OR, 2.68; 95% CI, 1.5–4.6; p < .001). Fever hospital workers were at higher risk of severe depression (OR, 1.52; 95% CI, 1.11–2.09; p < .01), compared to Quarantine hospital workers. Conclusion: Ensuring proper mental health support for HCW is an important component of public health measures for addressing the COVID-19 epidemic and safeguarding the continuity of appropriate medical service.