bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and financial burden of hospitalised community-acquired pneumonia in patients with selected underlying comorbidities in England
Authors: Campling James , Jones Dylan , Chalmers James , Jiang Qin , Vyse Andrew , Madhava Harish , Ellsbury Gillian , Rabe Adrian , Slack Mary 
Published: October 2020

BackgroundHospitalised pneumonia may have long-term clinical and financial impact in adult patients with underlying comorbidities.MethodsWe conducted a retrospective cohort study using the Hospital Episode Statistics (HES) database to determine the clinical and financial burden over 3 years of hospitalised community-acquired pneumonia (CAP) to England’s National Health Service (NHS). Subjects were adults with six underlying comorbidities (chronic heart disease (CHD); chronic kidney disease (CKD); chronic liver disease (CLD); chronic respiratory disease (CRD); diabetes mellitus (DM) and post bone marrow transplant (post-BMT)) with an inpatient admission in 2012/2013. Patients with CAP in 2013/2014 were followed for 3 years and compared with similarly aged, propensity score-matched adults with the same comorbidity without CAP.FindingsThe RR of hospital admissions increased after CAP, ranging from 1.08 (95% CI 1.04 to 1.12) for CKD to 1.38 (95% CI 1.35 to 1.40) for CRD. This increase was maintained for at least 2 years. Mean difference in hospital healthcare costs (£) was higher for CAP patients in 2013/2014; ranging from £1115 for DM to £8444 for BMT, and remained higher for 4/6 groups for 2 more years, ranging from £1907 (95% CI £1573 to £2240) for DM to £11 167 (95% CI £10 847 to £11 486) for CRD.) The OR for mortality was significantly higher for at least 3 years after CAP, ranging from 4.76 (95% CI 4.12 to 5.51, p<0.0001) for CLD to 7.50 (95%CI 4.71 to 11.92, p<0.0001) for BMT.InterpretationFor patients with selected underlying comorbidities, healthcare utilisation, costs and mortality increase for at least 3 years after being hospitalised CAP.
Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department–led paediatric trial
Authors: Roper Louise , Lyttle Mark D , Gamble Carrol , Humphreys Amy , Messahel Shrouk , Lee Elizabeth D , Noblet Joanne , Hickey Helen , Rainford Naomi , Iyer Anand , Appleton Richard , Woolfall Kerry 
Published: October 2020

BackgroundKey challenges to the successful conduct of The Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children (EcLiPSE) trial were identified at the pre-trial stage. These included practitioner anxieties about conducting research without prior consent (RWPC), inexperience in conducting an ED-led trial and use of a medication that was not usual ED practice. As part of an embedded study, we explored parent and practitioner experiences of recruitment, RWPC and conduct of the trial to inform the design and conduct of future ED-led trials.MethodsA mixed-methods study within a trial involving (1) questionnaires and interviews with parents of randomised children, (2) interviews and focus groups with EcLiPSE practitioners and (3) audio-recorded trial discussions. We analysed data using thematic analysis and descriptive statistics as appropriate.ResultsA total of 143 parents (93 mothers, 39 fathers, 11 missing information) of randomised children completed a questionnaire and 30 (25 mothers, 5 fathers) were interviewed. We analysed 76 recorded trial recruitment discussions. Ten practitioners (4 medical, 6 nursing) were interviewed, 36 (16 medical, 20 nursing) participated in one of six focus groups. Challenges to the success of the trial were addressed by having a clinically relevant research question, pragmatic trial design, parent and practitioner support for EcLiPSE recruitment and research without prior consent processes, and practitioner motivation and strong leadership. Lack of leadership negatively affected practitioner engagement and recruitment. EcLiPSE completed on time, achieving its required sample size target.ConclusionsSuccessful trial recruitment and conduct in a challenging ED-led trial was driven by trial design, recruitment experience, teamwork and leadership. Our study provides valuable insight from parents and practitioners to inform the design and conduct of future trials in this setting.
Management of cardiovascular emergencies during the COVID-19 pandemic
Authors: Choudhary Rahul , Gautam Dinesh , Mathur Rohit , Choudhary Dinesh 
Published: October 2020

BackgroundIt has been reported that patients attending the emergency department with other pathologies may not have received optimal medical care due to the lockdown measures in the early phase of the COVID-19 pandemic.MethodsThis was a retrospective study of patients presenting with cardiovascular emergencies to four tertiary regional emergency departments in western India during the government implementation of complete lockdown.Results25.0% of patients during the lockdown period and 17.4% of patients during the pre-lockdown period presented outside the window period (presentation after 12 hours of symptom onset) compared with only 6% during the pre-COVID period. In the pre-COVID period, 46.9% of patients with ST elevation myocardial infarction underwent emergent catheterisation, while in the pre-lockdown and lockdown periods, these values were 26.1% and 18.8%, respectively. The proportion of patients treated with intravenous thrombolytic therapy increased from 18.4% in the pre-COVID period to 32.3% in the post-lockdown period. Inhospital mortality for acute coronary syndrome (ACS) increased from 2.69% in the pre-COVID period to 7.27% in the post-lockdown period. There was also a significant decline in emergency admissions for non-ACS conditions, such as acute decompensated heart failure and high degree or complete atrioventricular block.ConclusionThe COVID-19 pandemic has led to delays in patients seeking care for cardiac problems and also affected the use of optimum therapy in our institutions.
Association between faecal occult bleeding and medicines prescribed for chronic disease: a data linkage study
Authors: Libby Gillian , Barnett Karen N , Fraser Callum G , Steele Robert J C 
Published: October 2020

AimsThe presence of detectable faecal haemoglobin (f-Hb) has been shown to be associated with all-cause mortality and with death from a number of chronic diseases not known to cause gastrointestinal blood loss. This effect is independent of taking medicines that increase the risk of bleeding. To further investigate the association of f-Hb with chronic disease, the relationship between f-Hb and prescription of medicines for a variety of conditions was studied.MethodsAll subjects (134 192) who participated in guaiac faecal occult blood test (gFOBT) screening in Tayside, Scotland, between March 2000 and March 2016, were studied in a cross-sectional manner by linking their gFOBT result (abnormal or normal) with prescribing data at the time of the test.ResultsThe screening participants with an abnormal gFOBT result were more likely to have been being prescribed medicines for heart disease, hypertension, diabetes and depression than those with a normal test result. This association persisted after adjustment for sex, age and deprivation (OR 1.35 (95%CI 1.23 to 1.48), 1.39 (1.27 to 1.52), 1.35 (1.15 to 1.58), 1.36 (1.16 to 1.59), all p<0.0001, for the four medicine categories, respectively).ConclusionsThe results of this study confer further substantial weight to the concept that detectable f-Hb is associated with a range of common chronic conditions that have a systemic inflammatory component; we speculate that f-Hb might have potential in identifying individuals who are high risk of developing chronic conditions or are at an early stage of disease.
Novel, non-invasive imaging approach to identify patients with advanced non-small cell lung cancer at risk of hyperprogressive disease with immune checkpoint blockade
Authors: Vaidya Pranjal , Bera Kaustav , Patil Pradnya D , Gupta Amit , Jain Prantesh , Alilou Mehdi , Khorrami Mohammadhadi , Velcheti Vamsidhar , Madabhushi Anant 
Published: October 2020

PurposeHyperprogression is an atypical response pattern to immune checkpoint inhibition that has been described within non-small cell lung cancer (NSCLC). The paradoxical acceleration of tumor growth after immunotherapy has been associated with significantly shortened survival, and currently, there are no clinically validated biomarkers to identify patients at risk of hyperprogression.Experimental designA total of 109 patients with advanced NSCLC who underwent monotherapy with Programmed cell death protein-1 (PD1)/Programmed death-ligand-1 (PD-L1) inhibitors were included in the study. Using RECIST measurements, we divided the patients into responders (n=50) (complete/partial response or stable disease) and non-responders (n=59) (progressive disease). Tumor growth kinetics were used to further identify hyperprogressors (HPs, n=19) among non-responders. Patients were randomized into a training set (D1=30) and a test set (D2=79) with the essential caveat that HPs were evenly distributed among the two sets. A total of 198 radiomic textural patterns from within and around the target nodules and features relating to tortuosity of the nodule associated vasculature were extracted from the pretreatment CT scans.ResultsThe random forest classifier using the top features associated with hyperprogression was able to distinguish between HP and other radiographical response patterns with an area under receiver operating curve of 0.85±0.06 in the training set (D1=30) and 0.96 in the validation set (D2=79). These features included one peritumoral texture feature from 5 to 10 mm outside the tumor and two nodule vessel-related tortuosity features. Kaplan-Meier survival curves showed a clear stratification between classifier predicted HPs versus non-HPs for overall survival (D2: HR=2.66, 95% CI 1.27 to 5.55; p=0.009).ConclusionsOur study suggests that image-based radiomics markers extracted from baseline CTs of advanced NSCLC treated with PD-1/PD-L1 inhibitors may help identify patients at risk of hyperprogressions.
p50 suppresses cytotoxic T lymphocyte effector function to regulate tumor immune escape and response to immunotherapy
Authors: Lu Chunwan , Klement John D , Smith Alyssa D , Yang Dafeng , Waller Jennifer L , Browning Darren D , Munn David H , Liu Kebin 
Published: October 2020

BackgroundNF-κB is a key link between inflammation and cancer. Previous studies of NF-κB have largely focused on tumor cells, and the intrinsic function of NF-κB in T cells in tumor development and response to immunotherapy is largely unknown. We aimed at testing the hypothesis that NF-κB1 (p50) activation in T cells underlies human colon cancer immune escape and human cancer non-response to anti-PD-1 immunotherapy.MethodsWe screened NF-κB activation in human colon carcinoma and used mouse models to determine p50 function in tumor cells and immune cells. RNA-Seq was used to identify p50 target genes. p50 binding to target gene promoters were determined by electrophoresis mobility shift assay and chromatin immunoprecipitation. A p50 activation score was generated from gene expression profiling and used to link p50 activation to T-cell activation and function pre-nivolumab and post-nivolumab immunotherapy in human patients with cancer.Resultsp50 is the dominant form of NF-κB that is highly activated in immune cells in the human colorectal carcinoma microenvironment and neighboring non-neoplastic colon epithelial cells. Tumor cell intrinsic p50 signaling and T-cell intrinsic p50 signaling exert opposing functions in tumor growth control in vivo. Deleting Nfkb1 in tumor cells increased whereas in T cells decreased tumor growth in preclinical mouse models. Gene expression profiling identified Gzmb as a p50 target in T cells. p50 binds directly to a previously uncharacterized κB sequence at the Gzmb promoter in T cells, resulting in repression of Gzmb expression in tumor-infiltrating cytotoxic T lymphocytes (CTLs) to induce a dysfunctional CTL phenotype to promote tumor immune escape. p50 activation is inversely correlated with both GZMB expression and T-cell tumor infiltration in human colorectal carcinoma. Furthermore, nivolumab immunotherapy decreased p50 activation and increased GZMB expression in human patients with melanoma.ConclusionsInflammation activates p50 that binds to the Gzmb promoter to repress granzyme B expression in T cells, resulting in CTL dysfunction to confer tumor immune escape and decreased response to anti-PD-1 immunotherapy.
Extreme diurnal temperature range and cardiovascular emergency hospitalisations in a Mediterranean region
Authors: Ponjoan Anna , Blanch Jordi , Alves-Cabratosa Lia , Martí Lluch Ruth , Comas-Cufí Marc , Parramon Dídac , García-Gil Maria M , Ramos Rafel , Petersen Irene 
Published: October 2020

ObjectivesThe impact of extreme diurnal temperature range (DTR) on cardiovascular morbidity in Mediterranean regions remains uncertain. We aimed to analyse the impact of extreme low DTR (stable temperature) or high DTR (changeable temperature) on cardiovascular hospitalisations in Catalonia (Southern Europe).MethodsWe conducted a self-controlled case series study using whole-year data from the System for the Development of Research in Primary Care database and 153 weather stations from the Catalan Meteorological Service. The outcome was first emergency hospitalisation. Monthly DTR percentiles were used to define extreme DTR as low (DTR <the 5th percentile) and high (DTR>95th percentile). We assessed two effects: same-day (1-day exposure, coinciding with the extreme DTR episode) and cumulative (3-day exposure, adding two subsequent days). Incidence rate ratios (IRR) were calculated adjusted by age, season and air pollution. Stratified analyses by gender, age or cardiovascular type and regions are provided.ResultsWe computed 121 206 cardiovascular hospitalisations from 2006 to 2013. The IRR was 1.032 (95% CI 1.005 to 1.061) for same day and 1.024 (95% CI 1.006 to 1.042) for cumulative effects of extreme high DTR. The impact was significant for stroke and heart failure, but not for coronary heart disease. Conversely, extreme low DTR did not increase cardiovascular hospitalisations.ConclusionsExtreme high DTR increased the incidence of cardiovascular hospitalisations, but not extreme low DTR. Same-day effects of extreme high DTR were stronger than cumulative effects. These findings contribute to better understand the impact of outdoor temperature on health, and to help defining public health strategies to mitigate such impact.
Employment and earnings trajectories before and after sickness absence due to major depressive disorder: a nationwide case–control study
Authors: Hakulinen Christian , Böckerman Petri , Pulkki-Råback Laura , Virtanen Marianna , Elovainio Marko 
Published: October 2020

ObjectivesTo examine employment and earnings trajectories before and after the first sickness absence period due to major depressive disorder (MDD).MethodsAll individuals (n=158 813) in Finland who had a first sickness absence period (lasting longer than 9 days) due to MDD between 2005 and 2015 were matched with one randomly selected individual of the same age and gender with no history of MDD. Employment status and earnings were measured using register-based data annually from 2005 to 2015. Generalised estimating equations were used to examine the trajectories of employment and earnings before and after MDD diagnosis in men and women separately.ResultsSickness absence due to MDD was associated with increased probability of non-employment during and after the year of the first sickness absence period. In men, but not in women, the probability of being employed was lower 5 years before the sickness absence period due to MDD. When compared with the individuals in the control group, men had around 34% and women 15% lower earnings 1 year, and 40% and 23%, respectively, 5 years, after the first sickness absence period due to MDD. More severe MDD and longer duration of sickness absence period were associated with lower probability of being employed.ConclusionsSickness absence due to MDD was associated with considerable reduction in employment and earnings losses. For men and individuals with more severe MDD, this reduction was before the first sickness period. This supports a reciprocal association between employment and earnings with MDD.
Online popularity of JUUL and Puff Bars in the USA: 2019–2020
Authors: Dai Hongying , Hao Jianqiang 
Published: October 2020

BackgroundThe US Food and Drug Administration (FDA) announced a flavour ban on cartridge-based e-cigarettes in January 2020. It is unclear whether e-cigarette users will switch to disposable vaping products with a variety of kids-appealing flavours available.MethodsWe performed piece-wise regression and autoregressive integrated moving average (ARIMA) algorithms to compare the relative search volume (RSV) of JUUL and Puff Bar (a disposable vaping product) using the 1-year Google Trends data from 24 February 2019 to 20 February 2020, separated by three events that may have spurred changes in RSV for each product.ResultsThe RSV for JUUL was relatively stable before Trump Administration announced plans to ban flavoured e-cigarettes. After that, the RSV for JUUL dropped sharply (rate of change=−8.8 per week) from 11 September 2019 to 17 October 2019 when JUUL Labs announced to halt online sales of some flavoured products, and the RSV resumed the decreasing trend after FDA announced enforcement policy of cartridge-based e-cigarettes on 2 January 2020. In comparison, the RSV for Puff Bar started to increase after 11 September 2019 with a low rate of change (0.6) until 17 October 2019. After that, the increase in RSV for Puff Bar accelerated. The RSV of puff bars surpassed that of JUUL during the week of 2 February 2020.ConclusionThe popularity of Puff Bar on Google Search suggests that users may replace cartridge-based vaping products with disposable e-cigarettes in the circumvention of the partial flavour ban. Continuous surveillance and further assessment are needed to prevent potential loopholes in tobacco regulation.
Fault-Tolerant Maximal Local-Edge-Connectivity of Augmented Cubes
Authors: Zhai Liyang , Xu Liqiong , Yang Weihua 
Published: October 2020

An interconnection network is usually modeled as a graph, in which vertices and edges correspond to processors and communication links, respectively. Connectivity is an important metric for fault tolerance of interconnection networks. A connected graph [Formula: see text] is said to be maximally local-edge-connected if each pair of vertices [Formula: see text] and [Formula: see text] of [Formula: see text] are connected by [Formula: see text] pairwise edge-disjoint paths. In this paper, we show that the [Formula: see text]-dimensional augmented cube [Formula: see text] is [Formula: see text]-edge-fault-tolerant maximally local-edge-connected and the bound [Formula: see text] is sharp; under the restricted condition that each vertex has at least three fault-free adjacent vertices, [Formula: see text] is [Formula: see text]-edge-fault-tolerant maximally local-edge-connected and the bound [Formula: see text] is sharp; and under the restricted condition that each vertex has at least [Formula: see text] fault-free adjacent vertices, [Formula: see text] is [Formula: see text]-edge-fault-tolerant maximally local-edge-connected. Furthermore, we show that a [Formula: see text]-regular graph [Formula: see text] is [Formula: see text]-fault-tolerant one-to-many maximally local-connected if [Formula: see text] does not contain [Formula: see text] and is super [Formula: see text]-vertex-connected of order 1, a [Formula: see text]-regular graph [Formula: see text] is [Formula: see text]-fault-tolerant one-to-many maximally local-connected if [Formula: see text] does not contain [Formula: see text] and is super [Formula: see text]-vertex-connected of order 1.
Connectivity and Diagnosability of Leaf-Sort Graphs
Authors: Wang Mujiangshan , Xiang Dong , Wang Shiying 
Published: October 2020

The connectivity and diagnosability of a multiprocessor system and an interconnection network are two important research topics. The system and the network have an underlying topology, which is usually presented by a graph. As a topology structure of interconnection networks, the [Formula: see text]-dimensional leaf-sort graph [Formula: see text] has many good properties. In this paper, we prove that (a) [Formula: see text] is tightly [Formula: see text] super connected for odd [Formula: see text] and [Formula: see text], and tightly [Formula: see text] super connected for even [Formula: see text] and [Formula: see text]; (b) under the PMC model and MM[Formula: see text] model, the diagnosability [Formula: see text] for odd [Formula: see text] and [Formula: see text], and [Formula: see text] for even [Formula: see text] and [Formula: see text].
Observed Linkage between Tibetan Plateau Soil Moisture and South Asian Summer Precipitation and the Possible Mechanism
Authors: Ullah Waheed , Guojie Wang , Gao Zhiqiu , Tawia Hagan Daniel Fiifi , Bhatti Asher Samuel , Zhua Chenxia 
Published: October 2020

AbstractUnderstanding the Tibetan Plateau (TP) thermal processes is of utmost significance in changing climate. This study investigates the effect of soil moisture in changing the TP thermal profile and consequently summer precipitation in South Asia (SA). Soil moisture from Special Sensor Microwave Imager (SSM/I) developed from the F-08, F-11, and F-13 fundamental climate data record and atmospheric reanalysis from ERA-Interim, MERRA-2, and NCEP/CFSR during 1988–2008 are used. A generalized linear method that assesses the reciprocal forcing between two connected fields, named the coupled manifold technique (CMT), is applied to TP soil moisture and SA summer precipitation. It is revealed that interannual variations of SA precipitation are significantly (confidence level = 99%) impacted by TP soil moisture and the explained ratio of variance in SA is 0.3–0.4. Composite analysis indicates that SA summer precipitation has positive anomalies in response to dry TP soil moisture in the previous spring and vice versa. For understanding the possible mechanism, thermal processes, relative humidity, wind components, and moisture flux anomalies were calculated for dry and wet TP soil moisture and summer precipitation. The results suggested that TP soil moisture is likely to regulate near-surface energy balance and diabatic heating profile over TP. As a result, the surrounding lower-level westerlies (easterlies) (at 850 hPa) converge (diverge), associated with divergence (convergence) at the upper troposphere (200 hPa). The westerlies (easterlies) are usually moisture-rich (moisture-deficient) and thus cause more (less) precipitation in western (eastern) SA. It is thus suggested that the spring soil moisture may affect the thermal profile of TP, affecting the summer precipitation in SA as a consequence.