bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study
Authors: Santosh Paramala , Singh Jatinder , Adams Laura , Mastroianni Mathilde , Heaney Natalie , Lievesley Kate , Sagar-Ouriaghli Ilyas , Allibrio Giovanni , Appleton Rebecca , Davidović Nikolina , de Girolamo Giovanni , Dieleman Gwen , Dodig-Ćurković Katarina , Franić Tomislav , Gatherer Charlotte , Gerritsen Suzanne , Gheza Elisa , Madan Jason , Manenti Lidia , Maras Athanasios , Margari Francesco , McNicholas Fiona , Pastore Adriana , Paul Moli , Purper-Ouakil Diane , Rinaldi Francesco , Sakar Vehbi , Schulze Ulrike , Signorini Giulia , Street Cathy , Tah Priya , Tremmery Sabine , Tuffrey Amanda , Tuomainen Helena , Verhulst Frank , Warwick Jane , Wilson Anna , Wolke Dieter , Fiori Federico , Singh Swaran 
Published: June 2020

ObjectiveYoung people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16–18 years of age in Europe). The objective of this study was to develop and validate the Transition Readiness and Appropriateness Measure (TRAM) for assessing a young person’s readiness for transition, and their outcomes at the transfer boundary.DesignMILESTONE prospective study.SettingEight European Union (EU) countries participating in the EU-funded MILESTONE study.ParticipantsThe first phase (MILESTONE validation study) involved 100 adolescents (pre-transition), young adults (post-transition), parents/carers and both CAMHS and AMHS clinicians. The second phase (MILESTONE cohort study and nested cluster randomised trial) involved over 1000 young people.ResultsThe development of the TRAM began with a literature review on transitioning and a review of important items regarding transition by a panel of 34 mental health experts. A list of 64 items of potential importance were identified, which together comprised the TRAM. The psychometric properties of the different versions of the TRAM were evaluated and showed that the TRAM had good reliability for all versions and low-to-moderate correlations when compared with other established instruments and a well-defined factor structure. The main results of the cohort study with the nested cluster randomised trial are not reported.ConclusionThe TRAM is a reliable instrument for assessing transition readiness and appropriateness. It highlighted the barriers to a successful transition and informed clinicians, identifying areas which clinicians on both sides of the transfer boundary can work on to ease the transition for the young person.Trial registration numberISRCTN83240263 (Registered 23 July 2015), NCT03013595 (Registered 6 January 2017); Pre-results.
Delays in emergency obstetric referrals in Addis Ababa hospitals in Ethiopia: a facility-based, cross-sectional study
Authors: Assefa Endalkachew Mekonnen , Berhane Yemane 
Published: June 2020

ObjectiveTo assess where the delays occur in the referral chain of most maternal health outcomes in Addis Ababa, Ethiopia, based on the three-delay model.DesignThe study was a facility-based, cross-sectional study.SettingTwo public and tertiary hospitals in Addis Ababa.ParticipantsAll pregnant women who were referred only for labour and delivery services after 28 weeks of gestation between December 2018 and February 2019 in Zewditu and Gandhi Memorial Hospitals.Primary and secondary outcome measuresThe primary outcome was the type of delays, from the three-delay model, which met operationally defined time. The secondary outcome was maternal health outcomes based on the three-delay model.ResultsA total of 403 pregnant women referred for delivery to the study hospitals were included in the study. Three-fourths (301, 74.7%) of the referred pregnant women experienced the third delay (delay in receiving appropriate care); 211 (52.4%) experienced the first delay (delay in making a decision to seek care). Overall 366 (90.8%) pregnant women had experienced at least one of the three delays and 71 (17.6%) experienced all three delays. Twenty-nine (7.2%) referred women had severe maternal outcomes. The leading causes/diagnoses of severe maternal outcomes were blood transfusion (17, 58.6%), followed by postpartum haemorrhage (15, 52%) and eclampsia (9, 31%). In addition, women who experienced severe maternal outcomes were 2.9 times more likely to have experienced at least one of the three delays.Conclusion and recommendationThis study highlights the persistence of delays at all levels, and especially the third delay and its contribution to severe maternal outcomes. We recommend strengthening the health referral systems and addressing specific health system bottlenecks during labour and birth in order to ensure no mother is endangered. We also recommend conducting a qualitative method of study (focus group discussion and indepth interview) and observing tertiary hospitals’ set-up and readiness to manage obstetric emergencies.
Ecological study of playground space and physical activity among primary school children
Authors: Grunseit Anne C , O'Hara Blythe Jane , Drayton Bradley , Learnihan Vincent , Hardy Louise L , Clark Eve , Klarenaar Paul , Engelen Lina 
Published: June 2020

ObjectivesTo examine the relationship between school playground size and total physical activity (PA), fitness and fundamental movement skills (FMS) of primary school students.DesignCross-sectional ecological analysis.Setting43 primary schools in New South Wales, Australia.ParticipantsData were from 5238 students, aged 5 to 12 years, participating in the Schools Physical Activity and Nutrition Survey.Outcome measuresSelf (for age ≥11 years) and parent (for age <11 years) report of PA (meeting PA recommendations and number of days meeting recommendations), objectively measured FMS and cardiorespiratory and muscular fitness.ResultsAssociations between playground space and measures of PA and fitness were mostly non-linear and moderated by loose equipment. Students in schools with no loose equipment showed a weak association between space and meeting PA recommendations (self-report). In schools with equipment, students’ predicted probability of meeting PA recommendations increased sharply between 15 m2 and 25 m2 per student from 0.04 (95% CI: 0.01 to 0.08) to 0.30 (95% CI: 0.14 to 0.46), but at 30 m2 returned to levels comparable to students in schools with no equipment (0.18, 95% CI: 0.07 to 0.28). For cardiorespiratory fitness, in schools with no loose equipment, probabilities for being in the healthy cardiovascular fitness zone varied between 0.66 and 0.77, showing no consistent trend. Students in schools with loose equipment had a predicted probability of being in the healthy fitness zone of 0.56 (95% CI: 0.41 to 0.71) at 15 m2 per student, which rose to 0.75 (95% CI: 0.63 to 0.86) at 20 m2 per student. There was no relationship between space and FMS.ConclusionsSchool space guidelines need to incorporate sufficient playground space for students. Our study provides evidence supporting better PA outcomes with increasing space up to 25 m2 per student, and access to loose equipment, however further research is required to determine precise thresholds for minimum space. Intersectoral planning and cooperation is required to meet the needs of growing school populations.
Identification of cardiovascular and molecular prognostic factors for the medium-term and long-term outcomes of sepsis (ICROS): protocol for a prospective monocentric cohort study
Authors: Coldewey Sina M , Neu Charles , Baumbach Philipp , Scherag Andre , Goebel Björn , Ludewig Katrin , Bloos Frank , Bauer Michael 
Published: June 2020

IntroductionSepsis is one of the most prevalent life-threatening conditions in the intensive care unit. Patients suffer from impaired organ function, reduced physical functional capacity and decreased quality of life even after surviving sepsis. The identification of prognostic factors for the medium-term and long-term outcomes of this condition is necessary to develop personalised theragnostic approaches. Sepsis can cause cardiac impairment. The impact of this septic cardiomyopathy on patient’s long-term outcome remains unclear. This study aims to evaluate cardiovascular risk factors, particularly the occurrence of septic cardiomyopathy, regarding their suitability as prognostic factors for the short-term and long-term outcomes of septic patients. Additionally, the study seeks to validate preclinical pathophysiological findings of septic cardiomyopathy in the clinical setting.Methods and analysisIn this prospective monocentric cohort study, patients will be clinically assessed during the acute and postacute phase of sepsis and two follow-ups after 6 and 12 months. To determine the effect of septic cardiomyopathy and concomitant cellular and molecular changes on patient mortality and morbidity, a comprehensive cardiovascular and molecular deep phenotyping of patients will be performed. This includes an echocardiographic and electrocardiographic assessment, and the evaluation of heart rate variability, body composition, mitochondrial oxygen metabolism, macrocirculation and microcirculation, and endothelial barrier function. These analyses are complemented by routine immunological, haematological and biochemical laboratory tests and analyses of the serum metabolome and lipidome, microbiome and epigenetic modifications of immune cells. The reversibility of patients’ organ dysfunction, their quality of life and physical functional capacity will be investigated in the follow-ups. Patients with cardiomyopathy without infection and healthy subjects will serve as control groups.Ethics and disseminationApproval was obtained from the Ethics Committee of the Friedrich Schiller University Jena (5276-09/17). The results will be published in peer-reviewed journals and presented at appropriate conferences.Trial registration numbersDRKS00013347; NCT03620409.
ILD-specific health-related quality of life in systemic sclerosis-associated ILD compared with IPF
Authors: Durheim Michael T , Hoffmann-Vold Anna-Maria , Eagan Tomas M , Hovden Arnt-Ove , Lund May Brit , Bjerke Gisle , Birring Surinder S , Jonassen Trygve M , Johansen Odd Erik , Sjåheim Tone 
Published: June 2020

IntroductionIdiopathic pulmonary fibrosis (IPF) and systemic sclerosis-associated interstitial lung disease (SSc-ILD) are fibrotic ILDs with divergent disease populations. Little is known about health-related quality of life (HRQL) in SSc-ILD relative to IPF.MethodsWe used the Kings Brief Interstitial Lung Disease Questionnaire (K-BILD) to compare HRQL in a cross-sectional study of 57 patients with IPF and 29 patients with SSc-ILD. Analysis of covariance was used to adjust for age, gender and lung function.ResultsThe unadjusted mean K-BILD score was 63.1 (95% CI 57.1 to 69.1) among patients with SSc-ILD, as compared with 54.7 (51.8–57.5) among those with IPF (p=0.005). However, this difference in HRQL was attenuated after adjustment for age, gender and lung function. In a multivariable model, only forced vital capacity was associated with K-BILD scores. K-BILD scores were correlated with both forced vital capacity and with other relevant HRQL measures, regardless of ILD diagnosis.DiscussionPatients with SSc-ILD may have better ILD-specific quality of life than patients with IPF, but this difference appears to be driven primarily by better lung function. These results underscore the impact of lung function on HRQL in fibrotic ILD and the utility of K-BILD to assess HRQL in SSc-ILD.
Multisystem chronic illness prognostication in non-oncologic integrated care
Authors: Bretos-Azcona Pablo E , Ibarrola Guillén Cristina , Sánchez-Iriso Eduardo , Cabasés Hita Juan M , Gorricho Javier , Librero López Julián 
Published: June 2020

ObjectivesTo develop a mortality-predictive model for correct identification of patients with non-cancer multiple chronic conditions who would benefit from palliative care, recognise predictive indicators of death and provide with tools for individual risk score calculation.DesignRetrospective observational study with multivariate logistic regression models.ParticipantsAll patients with high-risk multiple chronic conditions incorporated into an integrated care strategy that fulfil two conditions: (1) they belong to the top 5% of the programme’s risk pyramid according to the adjusted morbidity groups stratification tool and (2) they suffer simultaneously at least three selected chronic non-cancer pathologies (n=591).Main outcome measure1 year mortality since patient inclusion in the programme.ResultsAmong study participants, 201 (34%) died within the 1 year follow-up. Variables found to be independently associated to 1 year mortality were the Barthel Scale (p<0.001), creatinine value (p=0.032), existence of pressure ulcers (p=0.029) and patient global status (p<0.001). The area under the curve (AUC) for our model was 0.751, which was validated using bootstrapping (AUC=0.751) and k-fold cross-validation (10 folds; AUC=0.744). The Hosmer-Lemeshow test (p=0.761) showed good calibration.ConclusionsThis study develops and validates a mortality prediction model that will guide transitions of care to non-cancer palliative care services. The model determines prognostic indicators of death and provides tools for the estimation of individual death risk scores for each patient. We present a nomogram, a graphical risk calculation instrument, that favours a practical and easy use of the model within clinical practices.
Inflammatory bowel disease is associated with higher dementia risk: a nationwide longitudinal study
Authors: Zhang Bing , Wang Hohui E , Bai Ya-Mei , Tsai Shih-Jen , Su Tung-Ping , Chen Tzeng-Ji , Wang Yen-Po , Chen Mu-Hong 
Published: June 2020

ObjectiveIncreasing evidence supports reciprocal communication between the enteric and the central nervous system in disease, termed the ‘gut–brain axis’. Recent findings suggest a connection between IBD and development of Parkinson’s disease. The role of IBD in dementia, another insidious neurodegenerative disorder, has not been explored.DesignUsing the Taiwanese National Health Insurance Research Database, we performed comparative analysis of 1742 patients with IBD ≥45 years old against 17 420 controls to assess dementia risk following IBD diagnosis. Controls were matched on bases of sex, access to healthcare, income and dementia-related comorbidities. All individuals were followed for dementia diagnosis for up to 16 years. Subanalyses included the relationship between sex, ulcerative colitis (UC) and Crohn’s disease (CD), and dementia risk.ResultsOverall incidence of dementia among patients with IBD was significantly elevated (5.5% vs 1.4% among controls). Patients with IBD were diagnosed with dementia at 76.24 years old on average, compared with 83.45 among controls. The HR of developing dementia among patients with IBD was 2.54 (95% CI 1.91 to 3.37). Among dementia types, the risk of developing Alzheimer’s dementia demonstrated the greatest increase. Dementia risk did not differ between sex differences nor UC versus CD.ConclusionThis population-based cohort study demonstrates significant association between IBD and subsequent development of dementia. Dementia was diagnosed at an earlier age among patients with IBD, and disease risk appeared to increase with IBD chronicity. These findings highlight the need for future research to elucidate the relationship between IBD and dementia.
Exome and genome sequencing in adults with undiagnosed disease: a prospective cohort study
Authors: Shickh Salma , Gutierrez Salazar Mariana , Zakoor Kathleen-Rose , Lázaro Conxi , Gu Jessica , Goltz Jamie , Kleinman Dakota , Noor Abdul , Khalouei Sam , Mighton Chloe , Reble Emma , Kodida Rita , Bombard Yvonne , DiTroia Stephanie , Baxter Samantha , Watkins Nicholas , Care Melanie , Adler Arnon , Horsburgh Sheri , Morar Oana , Murphy Jillian , Nevay Dayna-Lynn , Szybowska Marta , Aronson Melyssa , Panchal Seema , Godoy Ruth , Holter Spring , Randall Armel Susan , Semotiuk Kara , Elser Christine , Kim Raymond H , Chitayat David , So Joyce , Faghfoury Hanna , Silver Josh , Morel Chantal F , Lerner-Ellis Jordan 
Published: June 2020

BackgroundExome and genome sequencing have been demonstrated to increase diagnostic yield in paediatric populations, improving treatment options and providing risk information for relatives. There are limited studies examining the clinical utility of these tests in adults, who currently have limited access to this technology.MethodsPatients from adult and cancer genetics clinics across Toronto, Ontario, Canada were recruited into a prospective cohort study evaluating the diagnostic utility of exome and genome sequencing in adults. Eligible patients were ≥18 years of age and suspected of having a hereditary disorder but had received previous uninformative genetic test results. In total, we examined the diagnostic utility of exome and genome sequencing in 47 probands and 34 of their relatives who consented to participate and underwent exome or genome sequencing.ResultsOverall, 17% (8/47) of probands had a pathogenic or likely pathogenic variant identified in a gene associated with their primary indication for testing. The diagnostic yield for patients with a cancer history was similar to the yield for patients with a non-cancer history (4/18 (22%) vs 4/29 (14%)). An additional 24 probands (51%) had an inconclusive result. Secondary findings were identified in 10 patients (21%); three had medically actionable results.ConclusionsThis study lends evidence to the diagnostic utility of exome or genome sequencing in an undiagnosed adult population. The significant increase in diagnostic yield warrants the use of this technology. The identification and communication of secondary findings may provide added value when using this testing modality as a first-line test.
Endocrine changes in SARS-CoV-2 patients and lessons from SARS-CoV
Authors: Agarwal Shubham , Agarwal Sanjeev Kumar 
Published: June 2020

AbstractCoronavirus infection outbreaks have occurred frequently in the last two decades and have led to significant mortality. Despite the focus on reducing mortality by preventing the spread of the virus, patients have died due to several other complications of the illness. The understanding of pathological mechanisms and their implications is continuously evolving. A number of symptoms occur in these patients due to the involvement of various endocrine glands. These clinical presentations went largely unnoticed during the first outbreak of severe acute respiratory syndrome (SARS) in 2002–2003. A few of these derangements continued during the convalescence phase and sometimes occurred after recovery. Similar pathological and biochemical changes are being reported with the novel coronavirus disease outbreak in 2020. In this review, we focus on these endocrine changes that have been reported in both SARS coronavirus and SARS coronavirus-2. As we battle the pandemic, it becomes imperative to address these underlying endocrine disturbances that are contributing towards or predicting mortality of these patients.
Maintaining vascular trauma proficiency for military non-vascular surgeons
Authors: Hall Andrew , Qureshi Iram , Brumagen Kegan , Glaser Jacob 
Published: June 2020

BackgroundVascular injuries in combat casualty patients are common and remain an ongoing concern. In civilian trauma centers, vascular surgeons are frequently available to treat vascular injuries. Within the military, vascular surgeons are not available at all locations where specialty expertise may be optimal. This study aims to determine if a visiting surgeon model, where a general surgeon can visit a civilian trauma center, would be practical in maintaining proficiency in vascular surgery.MethodsAll vascular trauma relevant cases done by any surgical service were identified during a 2-year period at Saint Louis University Hospital between October 1, 2016 and September 30, 2018. These included cases performed by trauma/general, thoracic, vascular, and orthopedic surgery. Predictions on the number of call days to experience an operative case were then calculated.ResultsA total of 316 vascular cases were performed during the time period. A surgeon on call for five 24-hour shifts would experience 2.1 urgent vascular cases with 95% certainty. To achieve five cases with 95% certainty, a surgeon would have to be on call for 34 24-hour shifts.DiscussionA visiting surgeon model would be very difficult to maintain to acquire or maintain proficiency in vascular surgery. High-volume trauma centers, or centers with significant open vascular cases in addition to trauma, may have more reasonable time requirements, but would have to be evaluated using these methods.Level of evidenceEconomic and value-based evaluations, level II.
Iron status is associated with worker productivity, independent of physical effort in Indian tea estate workers
Authors: Blakstad Mia M. , Nevins Julie E.H. , Venkatramanan Sudha , Przybyszewski Eric M. , Haas Jere D. 
Published: June 2020

Iron deficiency is the most common nutrient deficiency in the world, affecting roughly 40% of women in nonindustrialized countries. Iron is the essential element in hemoglobin, the major carrier of blood oxygen and oxidative metabolism that supports physical and cognitive performance. The relationship between iron and physical work capacity suggests that iron deficient individuals could experience reduced work output. Participants were 138 experienced tea pluckers aged 18–55 years from the Panighatta Tea Estate in Darjeeling District of northern West Bengal, India. Hemoglobin, serum ferritin, and soluble transferrin receptor were measured from venous blood. Energy expenditure was estimated from accelerometry and heart rate, and plucking productivity was measured as amount of tea plucked during the morning work session when temperature and rainfall conditions are optimal. At a given level of energy expenditure, iron deficient, anemic, and iron deficient anemic women plucked less tea during a 3-h period. The results warrant further research as to whether interventions providing supplemental iron might improve worker productivity and work efficiency. Further study should examine evidence of economic incentives for policies and programs targeting nutritional deficiencies. Novelty Anemia predicts up to 2.02 kg (9.1%) less tea plucked per 3 h, or 4.0% lower wage per 3 h, compared with nonanemic women, controlling for physical effort. An increase of 1.0 g/L in hemoglobin concentration predicts 0.71 kg (3.3%) more tea plucked over 3 h. An increase of 1.0 g/L in hemoglobin concentration predicts a 1.6% wage increase.
PhaseTracer: tracing cosmological phases and calculating transition properties
Authors: Athron Peter , Balázs Csaba , Fowlie Andrew , Zhang Yang 
Published: June 2020

AbstractWe present a C++ software package called for mapping out cosmological phases, and potential transitions between them, for Standard Model extensions with any number of scalar fields. traces the minima of effective potential as the temperature changes, and then calculates the critical temperatures, at which the minima are degenerate. is constructed with modularity, flexibility and practicality in mind. It is fast and stable, and can receive potentials provided by other packages such as . can be useful analysing cosmological phase transitions which played an important role in the very early evolution of the Universe. If they were first order they could generate detectable gravitational waves and/or trigger electroweak baryogenesis to generate the observed matter anti-matter asymmetry of the Universe. The code can be obtained from https://github.com/PhaseTracer/PhaseTracer.