bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnicity and impact on the receipt of cognitive–behavioural therapy in people with psychosis or bipolar disorder: an English cohort study
Authors: Morris Rohan Michael , Sellwood William , Edge Dawn , Colling Craig , Stewart Robert , Cupitt Caroline , Das-Munshi Jayati 
Published: December 2020

Objectives(1) To explore the role of ethnicity in receiving cognitive–behavioural therapy (CBT) for people with psychosis or bipolar disorder while adjusting for differences in risk profiles and symptom severity. (2) To assess whether context of treatment (inpatient vs community) impacts on the relationship between ethnicity and access to CBT.DesignCohort study of case register data from one catchment area (January 2007–July 2017).SettingA large secondary care provider serving an ethnically diverse population in London.ParticipantsData extracted for 30 497 records of people who had diagnoses of bipolar disorder (International Classification of Diseases (ICD) code F30-1) or psychosis (F20–F29 excluding F21). Exclusion criteria were: <15 years old, missing data and not self-defining as belonging to one of the larger ethnic groups. The sample (n=20 010) comprised the following ethnic groups: white British: n=10 393; Black Caribbean: n=5481; Black African: n=2817; Irish: n=570; and ‘South Asian’ people (consisting of Indian, Pakistani and Bangladeshi people): n=749.Outcome assessmentsORs for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.ResultsIn models adjusted for risk and severity variables, in comparison with White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, 95% CI 0.66 to 0.82, p<0.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, 95% CI 0.71 to 0.98, p=0.03); Black African and Black Caribbean people were significantly less likely to receive CBT while inpatients (respectively, OR 0.76, 95% CI 0.65 to 0.89, p=0.001; OR 0.83, 95% CI 0.73 to 0.94, p=0.003).ConclusionsThis study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient vs community settings) has a relationship with disparity in access to treatment.
Comparison of the effects of intravenous propofol and inhalational desflurane on the quality of early recovery after hand-assisted laparoscopic donor nephrectomy: a prospective, randomised controlled trial
Authors: Park Jaesik , Kim Minhee , Park Yong Hyun , Shim Jung-Woo , Lee Hyung Mook , Kim Yong-Suk , Moon Young Eun , Hong Sang Hyun , Chae Min Suk 
Published: December 2020

ObjectivesWe compared early recovery outcomes between living kidney donors who received total intravenous (IV) propofol versus inhalational desflurane during hand-assisted laparoscopic nephrectomy.DesignA single-centre, prospective randomised controlled trial.SettingUniversity hospital.ParticipantsStudy participants were enrolled between October 2019 and February 2020. A total of 80 living donors were randomly assigned to an intravenous propofol group (n=40) or a desflurane group (n=40).InterventionPropofol group received intravenous propofol and desflurane group received desflurane, as a maintenance anaesthetic.Primary and secondary outcome measuresThe quality of postoperative functional recovery was primarily assessed using the Korean version of the Quality of Recovery-40 (QoR-40K) questionnaire on postoperative day 1. Secondarily, ambulation, pain score, rescue analgesics, complications and total hospital stay were assessed postoperatively.ResultsOur study population included 35 males and 45 females. The mean age was 46±13 years. The global QoR-40K score (161 (154–173) vs 152 (136–161) points, respectively, p=0.001) and all five subdimension scores (physical comfort, 49 (45–53) vs 45 (42–48) points, respectively, p=0.003; emotional state, 39 (37–41) vs 37 (33–41) points, respectively, p=0.005; psychological support, 30 (26–34) vs 28 (26–32) points, respectively, p=0.04; physical independence, 16 (11–18) vs 12 (8-14) points, respectively, p=0.004; and pain, 31 (28–33) vs 29 (25-31) points, respectively, p=0.021) were significantly higher in the intravenous propofol group than the desflurane group. The early ambulation success rate and numbers of early and total steps were higher, but the incidence of nausea/vomiting was lower, in the intravenous propofol group than the desflurane group. The total hospital stay after surgery was shorter in the intravenous propofol group than the desflurane group.ConclusionsIntravenous propofol may enhance the quality of postoperative recovery in comparison to desflurane in living kidney donors.Trial registration numberKCT0004365.
Improving primary care for diabetes and hypertension: findings from implementation research in rural South India
Authors: Lall Dorothy , Engel Nora , Srinivasan Prashanth N , Devadasan Narayanan , Horstman Klasien , Criel Bart 
Published: December 2020

BackgroundChronic conditions are a leading cause of death and disability worldwide. Low-income and middle-income countries such as India bear a significant proportion of this global burden. Redesigning primary care from an acute-care model to a model that facilitates chronic care is a challenge and requires interventions at multiple levels.ObjectivesIn this intervention study, we aimed to strengthen primary care for diabetes and hypertension at publicly funded primary healthcare centres (PHCs) in rural South India.Design and methodsThe complexities of transforming the delivery of primary care motivated us to use a ‘theory of change’ approach to design, implement and evaluate the interventions. We used both quantitative and qualitative data collection methods. Data from patient records regarding processes of care, glycaemic and blood pressure control, interviews with patients, observations and field notes were used to analyse what changes occurred and why.InterventionsWe implemented the interventions for 9 months at three PHCs: (1) rationalise workflow to include essential tasks like counselling and measurement of blood pressure/blood glucose at each visit; (2) distribute clinical tasks among staff; (3) retain clinical records at the health facility and (4) capacity building of staff.ResultsWe found that interventions were implemented at all three PHCs for the first 4 months but did not continue at two of the PHCs. This fadeout was most likely the result of staff transfers and a doctor’s reluctance to share tasks. The availability of an additional staff member in the role of a coordinator most likely influenced the relative success of implementation at one PHC.ConclusionThese findings draw attention to the need for building teams in primary care for managing chronic conditions. The role of a coordinator emerged as an important consideration, as did the need for a stable core of staff to provide continuity of care.
How do we assess resilience and grit among internal medicine residents at the Mayo Clinic? A longitudinal validity study including correlations with medical knowledge, professionalism and clinical performance
Authors: Alahdab Fares , Halvorsen Andrew J , Mandrekar Jayawant N , Vaa Brianna E , Montori Victor M , West Colin P , Murad M Hassan , Beckman Thomas J 
Published: December 2020

BackgroundThere has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.ObjectivesTo investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.MethodsWe evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).ResultsA total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=−3.4, 95% CI −6.2 to −0.5, p=0.02) and mini-CEX (β=−0.2, 95% CI −0.5 to −0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).ConclusionsThis study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.
Cardiovascular imaging of women and men visiting the outpatient clinic with chest pain or discomfort: design and rationale of the ARGUS Study
Authors: Groepenhoff Floor , Eikendal Anouk L M , Bots Sophie Heleen , van Ommen Anne-Mar , Overmars L M , Kapteijn Daniek , Pasterkamp Gerard , Reiber Johan H C , Hautemann David , Menken Roxana , Wittekoek Marianne E , Hofstra Leonard , Onland-Moret N Charlotte , Haitjema Saskia , Hoefer Imo , Leiner Tim , den Ruijter Hester M 
Published: December 2020

IntroductionChest pain or discomfort affects 20%–40% of the general population over the course of their life and may be a symptom of myocardial ischaemia. For the diagnosis of obstructive macrovascular coronary artery disease (CAD), algorithms have been developed; however, these do not exclude microvascular angina. This may lead to false reassurance of symptomatic patients, mainly women, with functionally significant, yet non-obstructive coronary vascular disease. Therefore, this study aims to estimate the prevalence of both macrovascular and microvascular coronary vascular disease in women and men presenting with chest pain or discomfort, and to subsequently develop a decision-support tool to aid cardiologists in referral to cardiovascular imaging for both macrovascular and microvascular CAD evaluation.Methods and analysisWomen and men with chest pain or discomfort, aged 45 years and older, without a history of cardiovascular disease, who are referred to an outpatient cardiology clinic by their general practitioner are eligible for inclusion. Coronary CT angiography is used for anatomical imaging. Additionally, myocardial perfusion imaging by adenosine stress cardiac MRI is performed to detect functionally significant coronary vascular disease. Electronic health record data, collected during regular cardiac work-up, including medical history, cardiovascular risk factors, physical examination, echocardiography, (exercise) ECG and blood samples for standard cardiovascular biomarkers and research purposes, are obtained. Participants will be classified as positive or negative for coronary vascular disease based on all available data by expert panel consensus (a cardiovascular radiologist and two cardiologists). After completion of the clinical study, all collected data will be used to develop a decision support tool using predictive modelling and machine-learning techniques.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of the University Medical Center Utrecht. Results will be disseminated through national and international conferences and in peer-reviewed journals in cardiovascular disease.Trial registration numberTrialregister.nl Registry NL8702.
Burnout and compassion fatigue among organ and tissue donation coordinators: a scoping review
Authors: Silva e Silva Vanessa , Hornby Laura , Almost Joan , Lotherington Ken , Appleby Amber , Silva Amina Regina , Rochon Andrea , Dhanani Sonny 
Published: December 2020

ObjectivesTo collate and synthesise available literature on burnout and compassion fatigue (CF) among organ and tissue donation coordinators (OTDCs) and to respond to the research question: what is known about burnout and CF among OTDCs worldwide?DesignScoping review using Joanna Briggs Institute methodology for scoping reviews.Data sourcesMedline, EMBASE, PsycINFO, CINAHL, LILACS, PTSpubs and grey literature (ResearchGate, OpenGrey, Organ Donation Organization (ODO) websites, open access theses and dissertations) up to April 2020.Study selectionStudies reporting aspects of burnout and CF among OTDCs, including risk and protective factors.Data extractionTwo reviewers independently screened the studies for eligibility and extracted data from chosen sources using a data extraction tool developed for this study; NVIVO was used to perform a qualitative directed content analysis.ResultsThe searches yielded 741 potentially relevant records, of which 29 met the inclusion criteria. The majority of articles were from the USA (n=7, 24%), Canada (n=6, 21%) and Brazil (n=6, 21%), published between 2013 and 2020 (n=13, 45%) in transplant journals (n=11, 38%) and used a qualitative design approach (n=12, 41%). In the thematic analysis, we classified the articles into five categories: (1) burnout characteristics, (2) CF characteristics, (3) coping strategies, (4) protective factors and (5) ambivalence.ConclusionWe identified aspects of burnout and CF among OTDCs, including defining characteristics, demographic predispositions, protective factors, coping strategies, precursors, consequences and personal ambivalences. Researchers described burnout and CF characteristics but did not use consistent terms when referring to CF and burnout, which may have hindered the identification of all relevant sources. This gap should be addressed by the application of consistent terminology, systematic approaches and appropriate research methods that combine quantitative and qualitative investigation to examine the underlying reasons for the development of burnout and CF among OTDCs.
Different exposure metrics of rotating night shift work and hyperhomocysteinaemia among Chinese steelworkers: a cross-sectional study
Authors: Zhang Shengkui , Wang Yongbin , Li Qinglin , Wang Zhende , Wang Han , Xue Chao , Zhu Ying , Guan Weijun , Yuan Juxiang 
Published: December 2020

ObjectiveTo examine the associations of rotating night shift work with hyperhomocysteinaemia (HHcy) odds by different exposure metrics.DesignCross-sectional study.SettingOccupational physical examination centre for steel production workers, Tangshan, China.ParticipantsA total of 6846 steelworkers, aged 22–60 years, from the baseline survey of a Chinese occupational cohort.Primary and secondary outcome measuresDifferent exposure metrics of night shift work, including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month), average length of night shifts (hours/night) and percentage of hours on night shifts, were used to examine the effects of past and current night shift work on HHcy odds. The total homocysteine concentration in the plasma above 15 µmol/L was defined as HHcy.ResultsCompared with those who never worked night shifts, current night shift workers had elevated odds of HHcy (OR 1.23, 95% CI 1.06 to 1.44). Considering a person’s lifetime work schedule and compared with individuals who never worked night shifts, duration of night shifts >28 years (OR 1.35, 95% CI 1.12 to 1.61), average frequency of night shifts >7 nights/month (OR 1.25, 95% CI 1.07 to 1.47) and percentage of hours on night shifts >30% (OR 1.23, 95% CI 1.05 to 1.43) were associated with higher HHcy odds. The duration of night shifts >20 years and the average frequency of night shifts >7 nights/month could significantly increase the odds of HHcy regardless of whether the average length of night shifts was greater than 8 hours/night. After stratification by sex, no significant association was found in female workers between different exposure metrics of night shift work and HHcy.ConclusionsLong duration and high frequency of night shift work are associated with higher HHcy odds among male steelworkers.
Information needs among women taking part in primary HPV screening in England: a content analysis
Authors: Marlow Laura , Forster Alice S , McBride Emily , Rockliffe Lauren , Kitchener Henry , Waller Jo 
Published: December 2020

ObjectivesIntroducing primary human papillomavirus (HPV) testing to cervical screening programmes means changes to the results women receive. We explored additional information needs among women undergoing HPV primary screening.DesignWomen were sent a postal questionnaire shortly after receiving their results and 6 and 12 months later. Each questionnaire asked if women had any unanswered questions about cervical screening or HPV testing. Free-text responses constituted the data. Themes were identified using content analysis.SettingNational Health Service (NHS) Cervical Screening Programme, England.Participants381 women who recorded one or more free-text responses.ResultsThe most common theme represented women’s emotional responses and attempts to understand their results. This theme was raised by 45% of women overall, but was as high as 59% in the HPV cleared group. General questions about the cause and epidemiology of HPV were raised by 38% of women and were more common among those testing HPV positive with normal cytology (52%). Questions about the purpose and procedure for HPV testing were most common among HPV-negative women (40%, compared with 16%–24% of the other results groups). Questions about future implications of test results were raised by 19% of women, and this theme was most common among those with persistent HPV.ConclusionsDespite provision of information alongside screening invitations, women can still have unanswered questions following receipt of their results. Details about the epidemiology of HPV and why cervical screening procedures are changing should be included with screening invitations. Some results groups may benefit from additional tailored information with their results letter.
Solar System tests in Brans–Dicke and Palatini $$f({\mathcal {R}})$$-theories
Authors: Bonino A. , Camera S. , Fatibene L. , Orizzonte A. 
Published: December 2020

AbstractWe compare Mercury’s precession test in standard general relativity, Brans–Dicke theories (BD), and Palatini$$f({\mathcal {R}})$$f(R)-theories. We avoid post-Newtonian approximation and compute exact precession in these theories. We show that the well-known mathematical equivalence between Palatini$$f({\mathcal {R}})$$f(R)-theories and a specific subset of BD theories does not extend to a really physical equivalence among theories since equivalent models still allow a different incompatible precession for Mercury depending on the solution one chooses. As a result one cannot use BD equivalence to rule out Palatini$$f({\mathcal {R}})$$f(R)-theories. On the contrary, we directly discuss that Palatini$$f({\mathcal {R}})$$f(R)-theories can (and specific models do) easily pass Solar System tests as Mercury’s precession.
Synchronizing Almost-Group Automata
Authors: Berlinkov Mikhail V. , Nicaud Cyril 
Published: December 2020

In this paper we address the question of synchronizing random automata in the critical settings of almost-group automata. Group automata are automata where all letters act as permutations on the set of states, and they are not synchronizing (unless they have one state). In almost-group automata, one of the letters acts as a permutation on [Formula: see text] states, and the others as permutations. We prove that this small change is enough for automata to become synchronizing with high probability. More precisely, we establish that the probability that a strongly-connected almost-group automaton is not synchronizing is [Formula: see text], for a [Formula: see text]-letter alphabet. We also present an efficient algorithm that decides whether a strongly-connected almost-group automaton is synchronizing. For a natural model of computation, we establish a [Formula: see text] worst-case lower bound for this problem ([Formula: see text] for the average case), which is almost matched by our algorithm.
Direct and Indirect Regulators of Epithelial–Mesenchymal Transition–Mediated Immunosuppression in Breast Carcinomas
Authors: Dongre Anushka , Rashidian Mohammad , Eaton Elinor Ng , Reinhardt Ferenc , Thiru Prathapan , Zagorulya Maria , Nepal Sunita , Banaz Tuba , Martner Anna , Spranger Stefani , Weinberg Robert A. 
Published: December 2020

Abstract

The epithelial-to-mesenchymal transition, which conveys epithelial (E) carcinoma cells to quasi-mesenchymal (qM) states, enables them to metastasize and acquire resistance to certain treatments. Murine tumors composed of qM mammary carcinoma cells assemble an immunosuppressive tumor microenvironment (TME) and develop resistance to anti-CTLA4 immune-checkpoint blockade (ICB) therapy, unlike their E counterparts. Importantly, minority populations of qM cells within a tumor can cross-protect their more E neighbors from immune attack. The underlying mechanisms of immunosuppression and cross-protection have been unclear. We demonstrate that abrogation of qM carcinoma cell–derived factors (CD73, CSF1, or SPP1) prevents the assembly of an immunosuppressive TME and sensitizes otherwise refractory qM tumors partially or completely to anti-CTLA4 ICB. Most strikingly, mixed tumors in which minority populations of carcinoma cells no longer express CD73 are now sensitized to anti-CTLA4 ICB. Finally, loss of CD73 also enhances the efficacy of anti-CTLA4 ICB during the process of metastatic colonization.

Significance:
Minority populations of qM carcinoma cells, which likely reside in human breast carcinomas, can cross-protect their E neighbors from immune attack. Understanding the mechanisms by which qM carcinoma cells resist antitumor immune attack can help identify signaling channels that can be interrupted to potentiate the efficacy of checkpoint blockade immunotherapies.
This article is highlighted in the In This Issue feature, p. 995