bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early radiation‐induced oral pain signaling responses are reduced with pentoxifylline treatment
Authors: Price Mikayla L. , Lai Yen‐Hao (Erik) , Marcus Karen L. , Robertson James B. , Lascelles B. Duncan X. , Nolan Michael W. 
Published: December 2020

AbstractRadiation‐induced acute oral mucositis is associated with inflammation and pain. In other realms of pain research, nociceptors are known to be activated by inflammatory cytokines; for example, tumor necrosis factor alpha (TNF‐α) can activate transient receptor potential ion channels on sensory neurons. But there is an unclear relationship between inflammatory cytokines and molecular mediators of pain in radiation‐induced mucositis (RIM) and radiation‐associated pain (RAP). In this prospective, analytical, experimental pilot study, a common drug (pentoxifylline [PTX]) was used with the goal of inhibiting TNF‐α signaling in mice that underwent lingual irradiation to induce severe acute oral RIM/RAP. Body weight and glossitis scores were recorded daily. Eye wiping behaviors were assayed as a surrogate measure of oral discomfort (which is possible due to cross‐sensitization of the mandibular and ophthalmic branches of the trigeminal nerve). Quantitative real‐time reverse transcription polymerase chain reaction was performed on irradiated tongue tissue to measure changes in expression of TNF‐α, its receptor, nuclear factor kappa‐light‐chain‐enhancer of activated B cells, transient receptor potential vanilloid type 1 (TRPV1), and transient receptor potential vanilloid type 4 (TRPV4). Responsiveness of afferent sensory trigeminal neurons to TNF‐α, a TRPV1 agonist (capsaicin), and a partial TRPV4 agonist (histamine) was measured via calcium imaging. Although PTX treatment did not reduce glossitis severity or mitigate weight loss in mice with RIM/RAP, it did inhibit the upregulation of TNF‐α’s receptor that normally accompanies RIM, and it also reduced neuronal responsiveness to each of the aforementioned chemical stimuli. These results provide provisional evidence that inhibition of TNF‐α signaling with PTX treatment may serve as a useful tool for reducing pain in head and neck cancer patients.
Medidas de excepción previas a la justicia de transición en Colombia y sus efectos de legalidad penal: periodo 1948-1962
Authors: Prieto-Sanjuan Rafael A. , Sandoval-Mesa Jaime A. 
Published: December 2020

El objeto del presente artículo consiste en estudiar las medidas de excepción que afectaron la legalidad penal en el período comprendido de 1948 a 1962, que para muchos constituye el punto de partida del conflicto armado en Colombia. De manera específica, se pretende analizar las fórmulas jurídicas que desde entonces fueron ejercidas para mitigar las causas de la violencia, que tarde o temprano devinieron en subversión y luego, en confluencia de diversos escenarios protagonizados por actores armados, representó la ejecución de medidas especiales que afectaron la legalidad penal, el sistema como tal y el orden constitucional vigente en dicho momento. Es decir, el sistema del Código Penal vigente en el momento (1936) y la Constitución de 1886. Lo anterior se desarrolla a partir del método hermenéutico analítico desde la visión de Arthur Kaufmann[i] que considera los cuatro pilares del derecho vigente, a saber: El histórico, necesario para la descripción de las fuentes directas del período bajo examen y sus medidas; el elemento lógico y sistemático, que revela la validez del derecho vigente para la época; y, finalmente, el elemento teleológico, que resulta pertinente para verificar los elementos que sustentaban las medidas de excepción, así como también su contenido material verificable en la actualidad como lesivo de las garantías judiciales y que puede generar los cuestionamientos críticos del sistema actual y su transición desde la Constitución de 1991.

[i] Arthur Kauffman, Filosofía del Derecho, 120-125 (1.a ed., Editorial Universidad Externado de Colombia, 1998).
Effectiveness of a Shell and Helically Coiled Tube Heat Exchanger Operated With Gold Nanofluids at Low Concentration: A Multi-Level Factorial Analysis
Authors: Fogaça Marina Borsuk , Dias Daniele Toniolo , Gómez Sergio Leonardo , Behainne Jhon Jairo Ramirez , Turchiello Rozane de Fátima 
Published: December 2020

Abstract
This work assesses the thermal performance of gold nanofluid as a cooling liquid in a shell and helically coiled tube (SHCT) heat exchanger (HE) built at the bench scale. Tests planned under a multi-level factorial experimental design were carried out to evaluate the effects of the volumetric fraction of the gold nanoparticles, the volumetric flowrate of the working fluid, and the inlet temperature of the hot fluid (water) on the SHCT heat exchanger effectiveness. Spherical gold nanoparticles with a mean diameter of 14 ± 2 nm were produced using Turkevich’s method to be used at two concentrations of approximately 10−5 vol%. The heat transfer tests were performed at volumetric flowrates of 20, 30, and 40 l/h for both working fluids using heated water at inlet temperatures of 40, 50, and 60 °C. Results showed that the less concentrated nanofluids were comparatively more efficient, suggesting the presence of a range of gold concentration values for improving the heat transfer effectiveness.
Travel time and perinatal mortality after emergency caesarean sections: an evaluation of the 2-hour proximity indicator in Sierra Leone
Authors: van Duinen Alex J , Adde Håvard A , Fredin Ola , Holmer Hampus , Hagander Lars , Koroma Alimamy P , Koroma Michael M , Leather Andrew JM , Wibe Arne , Bolkan Håkon A 
Published: December 2020

IntroductionLonger travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance.MethodsWomen who delivered by caesarean section in nine hospitals were followed up with home visits at 1 month and 1 year. Travel times between the location before the delivery and the facility where caesarean section was performed were estimated, based on two models (model I Oumaet al; model II Munozet al). Patient-reported and modelled travel times were compared applying a univariable linear regression analysis, and the relation between travel time and perinatal mortality was assessed.ResultsThe median reported travel time was 60 min, compared with 13 and 34 min estimated by the two models, respectively. The 2-hour access threshold correlated with a patient-reported travel time of 5.7 hours for model I and 1.8 hours for model II. Longer travel times were associated with transport by boat and ambulance, visiting one or two facilities before reaching the final facility, lower education and poverty. Lower perinatal mortality was found both in the group with a reported travel time of 2 hours or less (193 vs 308 per 1000 births, p<0.001) and a modelled travel time of 2 hours or less (model I: 209 vs 344 per 1000 births, p=0.003; model II: 181 vs 319 per 1000 births, p<0.001).ConclusionThe standard model, used to estimate geographical proximity, consistently underestimated the travel time. However, the conservative travel time model corresponded better to patient-reported travel times. The 2-hour threshold as determined by the Lancet Commission on Global Surgery, is clinically relevant with respect to reducing perinatal death, not a clear cut-off.
Machine-learning-based hospital discharge predictions can support multidisciplinary rounds and decrease hospital length-of-stay
Authors: Levin Scott , Barnes Sean , Toerper Matthew , Debraine Arnaud , DeAngelo Anthony , Hamrock Eric , Hinson Jeremiah , Hoyer Erik , Dungarani Trushar , Howell Eric 
Published: December 2020

BackgroundPatient flow directly affects quality of care, access and financial performance for hospitals. Multidisciplinary discharge-focused rounds have proven to minimise avoidable delays experienced by patients near discharge. The study objective was to support discharge-focused rounds by implementing a machine-learning-based discharge prediction model using real-time electronic health record (EHR) data. We aimed to evaluate model predictive performance and impact on hospital length-of-stay.MethodsDischarge prediction models were developed from hospitalised patients on four inpatient units between April 2016 and September 2018. Unit-specific models were implemented to make individual patient predictions viewable with the EHR patient track board. Predictive performance was measured prospectively for 12 470 patients (120 780 patient-predictions) across all units. A pre/poststudy design applying interrupted time series methods was used to assess the impact of the discharge prediction model on hospital length-of-stay.ResultsProspective discharge prediction performance ranged in area under the receiver operating characteristic curve from 0.70 to 0.80 for same-day and next-day predictions; sensitivity was between 0.63 and 0.83 and specificity between 0.48 and 0.80. Elapsed length-of-stay, counts of labs and medications, mobility assessments and measures of acute kidney injury were model features providing the most predictive value. Implementing the discharge predictions resulted in a reduction in hospital length-of-stay of over 12 hours on a medicine unit (p<0.001) and telemetry unit (p=0.002), while no changes were observed for the surgery unit (p=0.190) and second medicine unit (p<0.555).ConclusionsIncorporating automated patient discharge predictions into multidisciplinary rounds can support decreases in hospital length-of-stay. Variation in execution and impact across inpatient units existed.
Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a protocol of a systematic review
Authors: Tersa-Miralles Carlos , Pastells-Peiró Roland , Rubí-Carnacea Francesc , Bellon Filip , Rubinat Arnaldo Esther 
Published: December 2020

IntroductionPhysical inactivity due to changes in our society towards more sedentary behaviours is leading to health problems. Increasing physical activity might be a good strategy to improve physical strength and reduce the prevalence of illnesses associated with prolonged sitting. Office workers exhibit a sedentary lifestyle with short rest periods or even without pauses during the workday. It is important to perform workplace interventions to treat musculoskeletal disorders caused by prolonged sitting and lack of movement adopted on the office setting. This article describes a protocol for a systematic review to evaluate the effectiveness of exercise interventions on office workers in their work environment.Methods and analysisA literature search will be performed in the PubMed, CINAHL Plus, Cochrane Library, Scopus, ISI WoS and PeDRO databases for randomised controlled trials and studies published from 1 January 2010 to 31 July 2020 in English or Spanish. The participants will be office workers who spend most of their work time in a sitting position. The interventions performed will include any type of exercise intervention in the workplace. The outcome measures will vary in accordance with the aim of the intervention observed. The results of the review and the outcomes from the studies reviewed will be summarised with a narrative synthesis. The review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.Ethics and disseminationEthical approval is not required. The review outcomes and the additional data obtained will be disseminated through publications and in scientific conferences.PROSPERO registration numberCRD42020177462.
Cost-effectiveness of pembrolizumab for treatment of platinum-resistant recurrent or metastatic head and neck squamous cell carcinoma in China: an economic analysis based on a randomised, open-label, phase III trial
Authors: Xin Wenxiu , Ding Haiying , Fang Qilu , Zheng Xiaowei , Tong Yinghui , Xu Gaoqi , Yang Guonong 
Published: December 2020

BackgroundPembrolizumab was recently demonstrated to have survival benefit in patients with recurrent or metastatic head and neck squamous cell carcinoma (r/mHNSCC). However, the cost-effectiveness of pembrolizumab versus chemotherapy in China remains uncertain.ObjectiveThis analysis aimed to describe the cost-effectiveness of pembrolizumab versus standard-of-care (SOC) therapy in r/mHNSCC in China.DesignA Markov model consisting of three health states (stable, progressive and dead) was developed to compare the cost and effectiveness of pembrolizumab with SOC in platinum-resistant r/mHNSCC. Model inputs for transition probabilities and toxicity were collected from the KEYNOTE-040 trial, while health utilities were estimated from a literature review. Cost data were acquired for the payer’s perspective in China. Costs and outcomes were discounted at an annual rate of 3.0%. Sensitivity analyses were conducted to test the uncertainties surrounding model parameters.Outcome measuresThe primary outcome was incremental cost-effectiveness ratios (ICERs), which were calculated as the cost per quality-adjusted life years (QALYs).ResultsThe total mean cost of pembrolizumab and SOC was US$45 861 and US$41 950, respectively. As for effectiveness, pembrolizumab yielded 0.31 QALYs compared with 0.25 QALYs for SOC therapy. The ICER for pembrolizumab versus SOC was US$65 186/QALY, which was higher than the willingness-to-pay threshold (WTP) of US$28 130/QALY in China. The univariate sensitivity analysis indicated that utility values for progressive state, probability from stable to progressive in the SOC group, as well as cost of pembrolizumab were the three most influential variables on ICER. The probabilistic sensitivity analysis demonstrated that standard therapy was more likely to be cost-effective compared with pembrolizumab at a WTP value of US$28 130/QALY. Results were robust across both univariate analysis and probabilistic sensitivity analysis.ConclusionsPembrolizumab is not likely to be a cost-effective strategy compared with SOC therapy in patients with platinum-resistant r/mHNSCC in China.Trial registration numberNCT02252042; Post-results.
How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study
Authors: Østervang Christina , Lassen Annmarie Touborg , Jensen Charlotte Myhre , Coyne Elisabeth , Dieperink Karin Brochstedt 
Published: December 2020

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.
Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions
Authors: Qu Wen , Yue Qing , Wang Yan , Yang Jin Liuxing , Jin Xi , Huang Xiaona , Tian Xiaobo , Martin Kathryn , Narayan Anuradha , Xu Tao 
Published: December 2020

ObjectiveTo explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).DesignA pre-comparison and post-comparison study.SettingThe study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.Participants46 hospitals that provide delivery services participated in the study.InterventionsEENC practices were introduced and implemented in the 46 hospitals.Outcome measuresThe changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).Results54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.ConclusionsThe introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.
Implementing large-system, value-based healthcare initiatives: a realist study protocol for seven natural experiments
Authors: Sarkies Mitchell N , Francis-Auton Emilie , Long Janet C , Partington Andrew , Pomare Chiara , Nguyen Hoa Mi , Wu Wendy , Westbrook Johanna , Day Richard O , Levesque Jean-Frederic , Mitchell Rebecca , Rapport Frances , Cutler Henry , Tran Yvonne , Clay-Williams Robyn , Watson Diane E , Arnolda Gaston , Hibbert Peter D , Lystad Reidar , Mumford Virginia , Leipnik George , Sutherland Kim , Hardwick Rebecca , Braithwaite Jeffrey 
Published: December 2020

IntroductionValue-based healthcare delivery models have emerged to address the unprecedented pressure on long-term health system performance and sustainability and to respond to the changing needs and expectations of patients. Implementing and scaling the benefits from these care delivery models to achieve large-system transformation are challenging and require consideration of complexity and context. Realist studies enable researchers to explore factors beyond ‘what works’ towards more nuanced understanding of ‘what tends to work for whom under which circumstances’. This research proposes a realist study of the implementation approach for seven large-system, value-based healthcare initiatives in New South Wales, Australia, to elucidate how different implementation strategies and processes stimulate the uptake, adoption, fidelity and adherence of initiatives to achieve sustainable impacts across a variety of contexts.Methods and analysisThis exploratory, sequential, mixed methods realist study followed RAMESES II (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) reporting standards for realist studies. Stage 1 will formulate initial programme theories from review of existing literature, analysis of programme documents and qualitative interviews with programme designers, implementation support staff and evaluators. Stage 2 envisages testing and refining these hypothesised programme theories through qualitative interviews with local hospital network staff running initiatives, and analyses of quantitative data from the programme evaluation, hospital administrative systems and an implementation outcome survey. Stage 3 proposes to produce generalisable middle-range theories by synthesising data from context–mechanism–outcome configurations across initiatives. Qualitative data will be analysed retroductively and quantitative data will be analysed to identify relationships between the implementation strategies and processes, and implementation and programme outcomes. Mixed methods triangulation will be performed.Ethics and disseminationEthical approval has been granted by Macquarie University (Project ID 23816) and Hunter New England (Project ID 2020/ETH02186) Human Research Ethics Committees. The findings will be published in peer-reviewed journals. Results will be fed back to partner organisations and roundtable discussions with other health jurisdictions will be held, to share learnings.