bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of frailty on 30-day and 1-year mortality in hospitalised elderly patients with community-acquired pneumonia: a prospective observational study
Authors: Luo Jia , Tang Wen , Sun Ying , Jiang Chunyan 
Published: October 2020

ObjectivesThis study evaluates the impact of frailty, which is a state of increased vulnerability to stressors, on 30-day and 1-year mortality among elderly patients with community-acquired pneumonia (CAP). The main hypothesis is that frailty is an independent predictor of prognosis in elderly CAP patients.DesignProspective, observational, follow-up cohort study.SettingA 2000-bed tertiary care hospital in Beijing, China.ParticipantsConsecutive CAP patients aged ≥65 years admitted to the geriatric department of our hospital between September 2017 and February 2019.Main outcome measuresThe primary outcomes were all-cause mortality at 30 days and 1 year after hospital admission. The impact of frailty (defined by frailty phenotype) on 30-day and 1-year mortality of elderly patients with CAP was assessed by Cox regression analysis.ResultsThe cohort included 256 patients. The median (IQR) age was 86 (81–90) years, and 180 (70.3%) participants were men. A total of 171/256 (66.8%) patients were frail. The prevalence of frailty was significantly associated with older age, female gender, lower body mass index, comorbidities, limitations in activities of daily living (ADLs) and poor nutritional status. Frail participants were significantly more likely to have severe CAP (SCAP) than non-frail counterparts (28.65% vs 9.41%, p<0.001). The 1-year mortality risk was approximately threefold higher in frail patients (adjusted HR, 2.70; 95% CI, 1.69 to 4.39) than non-frail patients. Subgroup analysis of patients with SCAP showed that the 1-year mortality risk was approximately threefold higher in the frail group (adjusted HR, 2.87; 95% CI, 1.58 to 4.96) than in the non-frail group. The association between frailty and 30-day mortality was not significant.ConclusionsThese findings suggest that frailty is strongly associated with SCAP and higher 1-year mortality in elderly patients with CAP, and frailty should be detected early to improve the management of these patients.
Utilisation and outcomes of allogeneic hematopoietic cell transplantation in Ontario, Canada, and New York State, USA: a population-based retrospective cohort study
Authors: Hershenfeld Samantha Aliza , Matelski John , Ling Vicki , Paterson Michael , Cheung Matthew , Cram Peter 
Published: October 2020

ObjectiveAllogeneic haematopoietic cell transplantation (HCT) is a potentially curative treatment for haematologic and oncologic diseases. There is a perception that the United States of America (USA) offers greater access to expensive therapies such as HCT. Alternatively, Canada is thought to suffer from protracted wait times, but lower spending. Our objective was to compare HCT utilisation and short-term outcomes in Ontario (ON), Canada, and New York State (NY), USA.Design, setting and participantsWe conducted a population-based cohort study using administrative health data to identify all residents of ON and NY who underwent allogeneic HCT between 2012 and 2015.Primary and secondary outcome measuresThe primary outcome measures were age and sex standardised HCT utilisation rates, in-hospital mortality, hospital length of stay (LOS) and readmission rates in ON and NY. Secondary outcomes included comparing ON and NY HCT recipients with respect to demographic characteristics and patient wealth (using neighbourhood income quintile).ResultsWe identified 547 HCT procedures in ON and 1361 HCT procedures performed in NY. HCT recipients in ON were younger than NY (mean age 49.0 vs 51.6 years; p<0.001) and a lower percentage of ON recipients resided in affluent neighbourhoods compared with NY (47.2% vs 52.6%; p=0.026). Utilisation of HCT was 14.4 per 1 million population per year in ON and 26.7 per 1 million per year in NY (p<0.001). The magnitude of the ON–NY difference in utilisation was larger for older patients. In-hospital mortality, LOS and readmission rates were lower in ON than NY in both unadjusted and adjusted analyses.ConclusionsWe found significantly lower utilisation of HCT in ON compared with NY, particularly among older patients. Higher in-hospital mortality in NY relative to ON requires further study. These differences are thought provoking for patients, healthcare providers and policy-makers in both jurisdictions.
Study protocol of a pilot study evaluating feasibility and acceptability of a psychosexual intervention for couples postallogeneic haematopoietic stem cell transplantation
Authors: Pillay Brindha , Ftanou Maria , Ritchie David , Panek-Hudson Yvonne , Jefford Michael , Garcia Teresa , Shields Cassandra , Gniel Jo , Phipps-Nelson Jo , Drosdowsky Allison , Blaschke Sarah , Ellen Steve 
Published: October 2020

IntroductionSexual dysfunction is one of the most common side effects of allogeneic haematopoietic stem cell transplantation (HSCT) for haematological cancers. Problems can persist between 5 and 10 years post-transplant and impact mood, couple intimacy and relationship satisfaction. Few intervention studies, however, target sexual dysfunction in patients post-HSCT. This pilot study aims to examine the feasibility and acceptability of implementing a psychosexual intervention for HSCT survivors and their partners post-transplantation.Methods and analysisFifteen allogeneic HSCT survivors and their partners will be recruited. Patients who are more than 3 months post-transplantation will be sent invitation letters describing the couples’ psychosexual intervention that will be offered through this study. The intervention will comprise two components: (1) psychosexual education about medical and behavioural treatment options for sexual dysfunction delivered by a haematology nurse consultant; (2) emotionally focused therapy-based relationship education programme for couples delivered by a clinical psychologist (four sessions of 1.5 hours each). Couples who consent to participate will be administered a series of measures assessing mood, relationship satisfaction and sexual dysfunction preintervention and post-intervention, as well as satisfaction with the intervention postintervention. Feasibility of the intervention will be examined via recording enrolment rate, adherence, compliance with completing outcome measures and fidelity of intervention delivery.Ethics and disseminationEthics approval has been obtained at the Peter MacCallum Cancer Centre in Melbourne, Australia. Results will be presented at national and international conferences and published in a peer-reviewed journal so that in can be accessed by clinicians involved in the care of allogeneic HSCT patients. If this intervention is found to be feasible and acceptable, its impact will be examined in a future randomised controlled trial and subsequently implemented as part of routine care in the allogeneic HSCT population.
Effect of backward walking training on knee osteoarthritis: protocol of a systematic review and meta-analysis
Authors: Wu Yuxuan , Lei Cheng , Huangfu Zhimin , Sunzi Kejimu , Yang Changmei 
Published: October 2020

IntroductionBackward walking (BW) is otherwise known as retrowalking. As opposed to forward walking, BW is a countersequential exercise and is a common method of rehabilitation training and disease-assisted treatment. Studies have shown that BW has a helpful effect on improving lower limb proprioception, gait synergy and improving limb balance. Many studies have concluded that BW can improve the symptoms of patients with knee osteoarthritis (KOA) and can be used for rehabilitation and adjunctive treatment of KOA, but there is a lack of evidence-based medical evidence.This research aims to provide an update to the most recent available evidence on the effect of BW on patients with KOA .Methods and analysesElectronic databases, such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed, will be searched by us. We will include studies identified from citation until 12 May 2020 and will not be restricted by geographical setting. The search will not be limited to the language of the publication, but the study of human subjects. Randomised controlled trials (RCTs) on the BW training of KOA will be included, with outcome measures including pain, knee function or balance function. The quality of included RCTs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. A meta-analysis or systematic review will be performed to summarise the effects of BW training. We will perform sensitivity analysis on the sample size of RCTs, meta-regression analysis of the follow-up periods, dosages and baselines of outcome measures, and publication bias analysis.Ethics and disseminationEthical approval is not required as this study will not involve confidential personal data. The results of this study will be disseminated through a peer-reviewed journal.PROSPERO registration numberCRD42020185694.
Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases
Authors: Middleton Jo , Abdad Mohammad Yazid , Beauchamp Emilie , Colthart Gavin , Cooper Maxwell J F , Dem Francesca , Fairhead James , Grundy Caroline L , Head Michael G , Inacio Joao , Jimbudo Mavis , Jones Christopher Iain , Konecna Martina , Laman Moses , MacGregor Hayley , Novotny Vojtech , Peck Mika , Paliau Jason , Philip Jonah , Pomat Willie , Roberts Chrissy H , Sui Shen , Stewart Alan J , Walker Stephen L , Cassell Jackie A 
Published: October 2020

IntroductionOur project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data.Methods and analysisThe study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author.Ethics and disseminationChallenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.
Cohort profile: healthy and active ageing in Myanmar (JAGES in Myanmar 2018): a prospective population-based cohort study of the long-term care risks and health status of older adults in Myanmar
Authors: Win Hla Hla , Nyunt Than Win , Lwin Kay Thi , Zin Poe Ei , Nozaki Ikuma , Bo Thae Zarchi , Sasaki Yuri , Takagi Daisuke , Nagamine Yuiko , Shobugawa Yugo 
Published: October 2020

PurposeMyanmar is rapidly ageing. It is important to understand the current condition of older adults in the country. To obtain such information, we conducted home-visit surveys to collect data for evaluating social determinants of health on older adults in Yangon (representative of an urban) and Bago (representative of a rural) regions of Myanmar.ParticipantsOverall, 1200 individuals aged 60 years or older and who were not bedridden or had severe dementia (defined as an Abbreviated Mental Test score ≤6) were recruited from Yangon and Bago in 2018. A population-proportionate random-sampling method was used for recruitment.Findings to dateOverall, 600 individuals from Yangon (222 men; 378 women) and 600 from Bago (261 men; 339 women) were surveyed. The average age of Yangon-based men and women was 69.4±7.6 and 69.4±7.3 years; in Bago, this was 69.2±7.1 and 70.6±7.5 years, respectively. Compared to their Yangon-based counterparts, Bago-based respondents showed significantly lower socioeconomic status and more commonly reported poor self-rated health (Bago-based men: 32.2%, women: 42.5%; Yangon: 10.8% and 24.1%, respectively). Meanwhile, some Yangon-based respondents rarely met friends (men: 17.1%, women: 27.8%), and Yangon-based respondents scored higher for instrumental activities of daily living and body mass index when compared to their Bago-based counterparts. For both regions, women showed higher physical-function decline (Yangon-based women: 40.7%, men: 17.1%; Bago: 46.3% and 23.8%, respectively) and cognitive-function decline (Yangon: 34.1% and 10.4%, respectively; Bago: 53.4% and 22.2%, respectively). Being homebound was more common in urban areas (urban-based men: 11.3%, rural-based men: 2.3%; urban-based women: 13.0%, rural-based women: 4.7%, respectively).Future plansA follow-up survey is scheduled for 2021. This will afford longitudinal data collection concerning mortality, becoming bedridden, and developing dementia and long-term care-related diseases. This will allow us to calculate long-term care risks for older adults in Myanmar.
Exercise referral to promote cardiovascular health in stroke and TIA patients: a pilot feasibility study
Authors: Baig Sheharyar , Moyle Bethany , Redgrave Jessica , Majid Arshad , Ali Ali 
Published: October 2020

ObjectivesExercise programmes studied after stroke often involve specialist supervision. Determine the feasibility and safety for people with stroke (PwS) or transient ischaemic attack (TIA) participating in readily accessible, non-stroke specialised, community-based exercise programmes.MethodsParticipants were recruited into a structured, group-based, 12-week programme of aerobic and resistance exercise delivered two times per week at one of five local leisure centres. Completion rates, successful attainment of intended exercise intensity (Borg Rating of Perceived Exertion (RPE)) and safety outcomes were recorded. Measures of physical activity (International Physical Activity Questionnaire), health-related quality of life (EQ-5D) and blood pressure (BP) were recorded at baseline and day 1 post intervention.Results79% of participants completed >75% of the intended sessions, with >90% attainment of intended RPE. Exercise was safe with no serious and very few minor adverse events related to exercise. Exercise led to significant increases in EQ-5D (Best of Health p<0.001), levels of weekly moderate physical activity (p<0.001) and decreases in systolic BP (mean change [95% CI]=−5.4 mmHg [−2.84 to −7.96]; p<0.001).ConclusionGeneralised exercise programmes delivered through existing local services, appears feasible, safe and may improve quality of life, physical activity and systolic BP, for PwS and TIA.
Unmet need for mental health medication within the migrant population of Northern Ireland: a record linkage study
Authors: Patel Kishan , Bosqui Tania , Kouvonen Anne , Donnelly Michael , Väänänen Ari , Bell Justyna , O’Reilly Dermot 
Published: October 2020

BackgroundMigrant populations are particularly at risk of not receiving the care for mental ill-health that they require for a range of reasons, including language and other barriers to health service access. This record linkage study compares, for migrant and settled communities, the likelihood that a person in Northern Ireland with poor mental health will receive psychotropic medication.MethodsA cohort of 78 267 people aged 16–64 years (including 1736 migrants) who reported chronic poor mental health in the 2011 Census records was followed for 15 months by linkage to a centralised prescribing data set to determine the rates of pharmacological treatment. Logistic regression analyses quantified the relationship between psychotropic medication uptake and migrant status, while accounting for relevant demographic and socioeconomic factors.ResultsOverall, 67% of the migrants with chronic poor mental health received at least one psychotropic medication during the study period, compared to 86% for the settled population; this equates to an OR of 0.32 (95% CI 0.29 to 0.36) in the fully adjusted models. Adjustment for English proficiency did not significantly alter these models. There was also considerable variation between individual migrant groups.ConclusionAlthough this study suggests substantial unmet need for treatment of poor mental health among the migrant population of Northern Ireland, further qualitative studies are required to better understand how different migrant groups respond to mental ill-health.
A New Description of Transverse Momentum Spectra of Identified Particles Produced in Proton-Proton Collisions at High Energies
Authors: Yang Pei-Pin , Liu Fu-Hu , Sahoo Raghunath 
Published: October 2020

The transverse momentum spectra of identified particles produced in high energy proton-proton

p
+
p

collisions are empirically described by a new method with the framework of the participant quark model or the multisource model at the quark level, in which the source itself is exactly the participant quark. Each participant (constituent) quark contributes to the transverse momentum spectrum, which is described by the TP-like function, a revised Tsallis–Pareto-type function. The transverse momentum spectrum of the hadron is the convolution of two or more TP-like functions. For a lepton, the transverse momentum spectrum is the convolution of two TP-like functions due to two participant quarks, e.g., projectile and target quarks, taking part in the collisions. A discussed theoretical approach seems to describe the

p
+
p

collisions data at center-of-mass energy

s

=
200

GeV

, 2.76 TeV, and 13 TeV very well.
Hindi Translation and Validation of Scales for Subjective Well-being, Locus of Control and Spiritual Well-being
Authors: Grover Sandeep , Dua Devakshi 
Published: October 2020

Background: Well-being and locus of control have been important areas of research over the last few years. However, limited information is available about the same from India, due to the lack of validated instruments in regional languages for the same.This research aimed to translate, adapt, and validate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), Spiritual Well-being Scale (SWBS), and Multidimensional Health Locus of Control (MHLC) Scale in Hindi. Methods: The scales were translated into Hindi by following the translation–back-translation methodology as specified by the World Health Organization. Next, the Hindi versions of the scales were completed by 102 participants, and then, the participants completed either the Hindi or the English version of the scales after 3–7 days. Results: The Hindi versions of WEMWBS, MHLC, and SWBS have high cross-language equivalence with the English version of the scale, both at the level of the individual items and the various dimensions in all three scales, which was significant (P < 0.001). Cronbach’s alpha for the Hindi version of WEMWBS, SWBS, and MHLC scales was 0.92, 0.83, and 0.77, respectively. The Spearman–Brown coefficient was 0.82, 0.63, and 0.63 for WEMWBS, SWBS, and MHLC, respectively. As measured on the Centrality of Religiosity Scale (CRS), higher religiosity was associated with greater religious and existential well-being. Conclusion: The Hindi versions of WEMWBS, SWBS, and MHLC have good cross-language equivalence, internal consistency, and test–retest reliability. It is expected that these validated scales will stimulate more research in this area, focusing on evaluating the association of clinical parameters along with well-being and locus of control.
Impact of Medical Assistance in Dying on palliative care: A qualitative study
Authors: Mathews Jean Jacob , Hausner David , Avery Jonathan , Hannon Breffni , Zimmermann Camilla , al-Awamer Ahmed 
Published: October 2020

Background: Medical Assistance in Dying comprises interventions that can be provided by medical practitioners to cause death of a person at their request if they meet predefined criteria. In June 2016, Medical Assistance in Dying became legal in Canada, sparking intense debate in the palliative care community. Aim: This study aims to explore the experience of frontline palliative care providers about the impact of Medical Assistance in Dying on palliative care practice. Design: Qualitative descriptive design using semi-structured interviews and thematic analysis Settings/participants: We interviewed palliative care physicians and nurses who practiced in settings where patients could access Medical Assistance in Dying for at least 6 months before and after its legalization. Purposeful sampling was used to recruit participants with diverse personal views and experiences with assisted death. Conceptual saturation was achieved after interviewing 23 palliative care providers (13 physicians and 10 nurses) in Southern Ontario. Results: Themes identified included a new dying experience with assisted death; challenges with symptom control; challenges with communication; impact on palliative care providers personally and on their relationships with patients; and consumption of palliative care resources to support assisted death. Conclusion: Medical Assistance in Dying has had a profound impact on palliative care providers and their practice. Communication training with access to resources for ethical decision-making and a review of legislation may help address new challenges. Further research is needed to understand palliative care provider distress around Medical Assistance in Dying, and additional resources are necessary to support palliative care delivery.
Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism
Authors: Lu Shuai , Gong Maoqi , Zha Yejun , Cui Aimin , Chen Chen , Yang Hao , Sun Weitong , Hua Kehan , Tian Wei , Jiang Xieyuan 
Published: October 2020

Objective Primary hyperparathyroidism (PHPT) is relatively common in China and results in severe damage to the skeletal system. This study aimed to investigate changes in bone mineral density (BMD) over 2 years in patients with PHPT after parathyroidectomy. Methods This retrospective cohort study included patients with PHPT who underwent parathyroidectomy between January 2010 and December 2015. BMD and T-scores and Z-scores of the lumbar spine (L1, L2, L3, and L4) and total hip (femoral neck, great trochanter, and Ward’s triangle) at baseline and 2 years after surgery were measured by dual-energy X-ray absorptiometry. Results Thirty patients with moderate to severe PHPT (17 men and 13 women) aged 38.90±15.48 years were included. BMD, and T-score and Z-score values at the lumbar spine and total hip at 6 months, 1 year, and 2 years after parathyroidectomy were significantly improved compared with preoperative values. Improvement in BMD was largest at L4 (46.7%) and smallest at L1 (37.4%) in the lumbar spine 2 years after parathyroidectomy. For the total hip, the increase in BMD was largest at Ward’s triangle (42.6%) and smallest at the femoral neck (37.5%). Conclusions BMD of the lumbar spine and total hip is improved after parathyroidectomy in patients with PHPT.