bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis outcomes in solid organ transplant recipients
Authors: Gotur Deepa B. , Masud Faisal N. , Ezeana Chika F. , Nisar Tariq , Paranilam Jaya , Chen Shenyi , Puppala Mamta , Wong Stephen T. C. , Zimmerman Janice L. 
Published: November 2019

AbstractBackgroundWe present data on a cohort of patients diagnosed with sepsis over a 10‐year period comparing outcomes in solid organ transplant (SOT) and non–solid organ transplant (non–SOT) recipients.MethodsThis is a retrospective single‐center study of patients with diagnosis of sepsis from 1/1/06 to 6/30/16. Cases and controls were matched by year of sepsis diagnosis with propensity score matching. Conditional logistic regression and repeated measurement models were performed for binary outcomes. Trends over time for in‐hospital mortality were determined using the Cochran‐Armitage test. A gamma‐distributed model was performed on the continuous variables.ResultsOverall, there were 18 632 admission encounters with a discharge diagnosis of sepsis in 14 780 unique patients. Of those admissions, 1689 were SOT recipients. After 1:1 matching by year, there were three thousand three hundred and forty patients (1670 cases; 1670 controls) diagnosed with sepsis. There was a decreasing trend for in‐hospital mortality for sepsis over time in SOT patients and non–SOT patients (P < .05) due to early sepsis recognition and improved standard of care. Despite higher comorbidities in the SOT group, conditional logistic regression showed that in‐hospital mortality for sepsis in SOT patients was similar compared with non–SOT patients (odds ratio [OR] =1.14 [95% confidence interval {CI}, 0.95‐1.37], P = .161). However, heart and lung SOT subgroups had higher odds of dying compared with the non–SOT group (OR = 1.83 [95% CI, 1.30‐2.57], P < .001 and OR = 1.77 [95% CI, 1.34‐2.34], P < .001). On average, SOT patients had 2 days longer hospital length of stay compared with non–SOT admissions (17.00 ± 19.54 vs 15.23 ± 17.07, P < .05). Additionally, SOT patients had higher odds of hospital readmission within 30 days (OR = 1.25 [95% CI, 1.06‐1.51], P = .020), and higher odds for DIC compared with non–SOT patients (OR = 1.76 [95% CI, 1.10‐2.86], P = .021).ConclusionSepsis in solid organ transplants and non–solid organ transplant patients have similar mortality; however, the subset of heart and lung transplant recipients with sepsis has a higher rate of mortality compared with the non–solid organ transplant recipients. SOT with sepsis as a group has a higher hospital readmission rate compared with non–transplant sepsis patients.
Metapragmatic comments and orthographic performances of a New York accent on YouTube
Authors: Cutler Cecelia 
Published: November 2019

AbstractThis paper adopts a metapragmatic approach (Urban, 2006) to analyze responses to YouTube videos on ‘how to talk like a New Yorker’ in a corpus of YouTube comments (N = 2,649). The analysis illustrates how linguistic features associated with this way of talking are experienced and negotiated by locals and non‐locals in their metapragmatic comments and performances of the accent and how they come to be socially recognized as indexical of a certain set of speaker attributes (Agha, 2005; Bolander, 2016). Analyzing user‐generated reactions to linguistic variation complements traditional variationist work by illustrating how people experience sociolinguistic difference (Leone‐Pizzighella & Rymes, 2017; Rymes, 2014). It also shows how digital sharing and commenting practices expose shifts in language ideologies that mirror the changing status of American English within the Inner Circle.
Using an Activity Based on Constructivism To Help Students Develop a More Integrated Understanding of Cell Signaling Pathways
Authors: MacDonald Laura , Segarra Verónica A. , Solem Amanda 
Published: November 2019

In subjects like cell biology, genetics, and immunology, a solid understanding of signal transduction is key to mastering new content. Often times students’ approach to learning signal transduction pathways relies heavily on memorization. In this paper, we describe a modular method to introduce students to signal transduction. In this method, students are first presented with the discreet building blocks or molecules that comprise signaling pathways (such as the vocabulary terms signal molecule, receptor, effector and target) and asked to integrate the knowledge by building (“do it yourself” or DIY) their own signaling pathway. Students are then given the opportunity to learn about each other’s pathways to identify ways in which they overlap and diverge. Ultimately, students are given the task to search the literature to identify a real-world example that mimics or is very similar to the pathway they came up with and note similarities and differences. We find this is a way to foster students integrating signal transduction knowledge.
Lithosphere thickness controls continental basalt compositions: An illustration using Cenozoic basalts from eastern China
Authors: Guo Pengyuan , Niu Yaoling , Sun Pu , Gong Hongmei , Wang Xiaohong 
Published: November 2019

Abstract
Recent studies demonstrate that lithosphere thickness variation exerts the primary control on global seafloor basalt compositions. If the mechanism of such control, i.e., the lid effect, is indeed at work, lithosphere thickness variation must also influence basaltic compositions in continental settings. To test this hypothesis, we chose to study Cenozoic basalts in eastern continental China over a distance of ∼260 km along a southeast-to-northwest traverse with a steep topographic gradient (∼500 to ∼1500 m above sea level) mirrored with a steep lithospheric thickness gradient (∼80 to ∼120 km). The basalts erupted on the thinned lithosphere to the east are characterized by lower pressure (e.g., higher Si72, lower Mg72, Fe72, and [Sm/Yb]N; subscript “72” refers to corresponding oxides corrected for fractionation effect to Mg# = 72; N—primitive mantle normalized) and higher extent (e.g., low Ti72, P72, K72, Rb, Ba, Th, and ratios of more- to less-incompatible elements such as [La/Sm]N, Ba/Zr, and Zr/Yb) of melting than basalts erupted on the thickened lithosphere to the west. Importantly, these geochemical parameters all show significant correlations with both lithosphere thickness and topographic elevation. These first-order observations are a straightforward manifestation of the lid effect. Lithospheric contamination and mantle-source compositional variation can indeed contribute to the compositional variability of these continental basalts, but these latter effects are averaged out and are overshadowed by the lid effect. This finding emphasizes the importance of evaluating the lid effect before interpreting the petrogenesis of continental basalts and mantle dynamics. Our results also indicate that the continental surface elevation is isostatically balanced above a mantle depth that is deeper than the lithosphere-asthenosphere boundary.
Motivating factors on performance of primary care workers in China: a systematic review and meta-analysis
Authors: Li Huiwen , Yuan Beibei , Wang Dan , Meng Qingyue 
Published: November 2019

ObjectiveAlthough China has made remarkable progress in strengthening its primary healthcare system, lack of well-performed primary health workforce is still the bottleneck of deepening the reform. The objective of this review is to understand the current profile of Chinese primary care workers (PCWs) and their motivating factors of performance and propose targeted policy suggestions on improving their work performance.DesignSystematic review.MethodsA systematic search of PubMed and MEDLINE was conducted to identify articles published from January 1, 2000, to June 2, 2018. Quality assessment and data extraction for the studies closely relevant to performance of PCWs in China were conducted by two reviewers independently. A preliminary framework containing different levels of factors influencing PCWs’ motivation based on existence, growth and relatedness (ERG) theory guided the synthesis analysis. In addition, we used a random-eﬀects model to pool individual studies on job satisfaction and estimate the overall job satisfaction of PCWs.ResultsA total of 36 articles were included; 16 (23 882 participants) in the meta-analysis. Regarding the individual level of motivation, 3 overarching themes and 12 subthemes were developed. The subthemes of financial incentives, career advancement and work itself were frequently mentioned and have more influences on PCWs’ performance. Moreover, the healthcare system reform policies have inevitable and complex impacts on different levels of human needs, and then influences on the motivation and performance of PCWs. Meta-analysis showed that the overall job satisfaction score among PCWs was 3.30, just reaching a satisfied rating and varied in different regions.ConclusionsThis study suggests low work satisfaction among PCWs in China, with financial incentives and career advancement being two most important motivating factors. Eﬀorts to improve the work performance in PCWs should give priority to these motivating factors and systematically take into account the health policy’s impacts on performance of PCWs.
At the grassroots of home and community-based aged care: strategies for successful consumer engagement
Authors: Brett Lindsey , Siette Joyce , Nguyen Amy , Jorgensen Mikaela , Miao Melissa , Westbrook Johanna , Lee Winifred , Gow Edwina , Hourihan Fleur , Georgiou Andrew 
Published: November 2019

Objectives(1) To describe the processes used to plan and conduct a stakeholder forum in aged care as a means of informing future uptake of consumer participatory research. (2) To discuss how capturing and drawing on stakeholders’ experiences of aged care can generate new research ideas and inform the delivery of more person-centred aged care services.Key principles of consumer engagementA stakeholder forum was conducted as part of Ageing Well, a 2-year project evaluating the value and impact of social participation and quality of life tools as part of routine community aged care assessments at a large Australian provider. The forum was codesigned with community aged care clients and care coordinators and aimed to coproduce implementation strategies with a targeted representation of stakeholders. The stakeholder forum was developed using five key principles of consumer engagement activities: purposeful, inclusive, timely, transparent and respectful. The forum fostered an environment of mutual respect and collective inquiry to encourage contributions from all participants. This article outlines practical guidance on using a consumer engagement framework and the lessons learnt.DiscussionThe stakeholder forum facilitated an understanding of consumers’ needs and existing gaps in aged care services and the circumstances that can enable or hinder the delivery and implementation of these services. This collective information can guide future research and policy at institutional, regional and national committees that relate to aged care.Trial registration numberACTRN12617001212347
Observational cohort study to investigate the unmet need and time waiting for referral for specialist opinion in adult asthma in England (UNTWIST asthma)
Authors: Blakey John D , Gayle Alicia , Slater Mariel G , Jones Gareth H , Baldwin Michael 
Published: November 2019

ObjectivesThis study aimed to estimate how many patients with asthma in England met the referral eligibility criteria using national asthma guidelines, identify what proportion were referred and determine the average waiting time to referral.DesignThis is an observational cohort study.Setting/Data sourcesRoutinely collected healthcare data were provided by Clinical Practice Research Datalink records and Hospital Episode Statistics records from January 2007 to December 2015.ParticipantsPatients with asthma aged 18–80 years participated in this study.Main outcome measuresEligibility for referral by the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) 2016 guidelines, determined after a 3-month pharmacological therapy exposure assessment, was classed by either ‘high-dose therapies’, ‘continuous or frequent use of oral steroids’ or ‘incident eligibility’ during follow-up (continuous oral corticosteroids for more than 3 months, or ≥800 µg/day inhaled corticosteroids/long-acting β2-agonist (or three controllers) and ≥2 asthma attacks/year).ResultsFrom the final cohort (n=23293), 19837 patients were eligible for specialist referral during follow-up based on the BTS/SIGN guideline recommendations. Among eligible patients without any previously recorded referral, 4% were referred during follow-up, with a median waiting time of 880 days (IQR=1428 days) between eligibility and referral.ConclusionsA large number of patients with asthma were eligible for specialist referral, of which a small proportion were referred, and many experienced a long waiting time before referral. The results indicate a major unmet need in asthma referral, which is a potential source of preventable harm and are likely to have implications regarding how services are organised to address this unmet need.
Does obesity modify the epidemiological association between hyperuricemia and the prevalence of hypertension among Northern Chinese community-dwelling people? A Chinese population-based study
Authors: Tian Simiao , Liu Yazhuo , Xu Yang , Feng Ao 
Published: November 2019

ObjectivesHyperuricemia and obesity both play a role in the development of hypertension. However, limited evidence is available for the combined effect of hyperuricemia and obesity on the prevalence of hypertension in the Chinese population. We aimed to assess the separate and combined effects of these two risk factors on the risk of hypertension.MethodsWe conducted a cross-sectional study in an area of Dalian city, Liaoning Province, China, from September 2015 to November 2016; 8700 adult residents were invited to participate in this study. Hyperuricemia was defined as serum uric acid ≥ 416 μmol/L in men and ≥ 357 μmol/L in women according to the guidelines. Individuals were categorised into four groups: the control group (body mass index (BMI) §amp;lt; 25 without hyperuricemia, the reference group), the obesity group (BMI ≥ 25 without hyperuricemia), the hyperuricemia group (BMI §amp;lt; 25 with hyperuricemia) and the obese-hyperuricemia group (BMI ≥ 25 with hyperuricemia). A multivariable logistic model was used to investigate individual and combined effects of hyperuricemia and obesity on the risk of hypertension.ResultsOf the 8331 individuals included, 44.3% were obese, 13.6% suffered from hyperuricemia, and 7.8% were both obese and hyperuricemic. The hypertension prevalence was the highest in the obese-hyperuricemia group (55.5% (95% CI 51.6% to 59.2%)), followed by that in the obesity (44.3% (42.6% to 46.1%)) and that in the hyperuricemia groups (33.5% (29.5% to 37.9%)). After adjusting for confounders, the obese-hyperuricemia group had a nearly threefold increased risk of hypertension compared with their healthy counterparts (OR 2.98 (2.48 to 3.57)). This pattern was also observed in the obesity group with a higher risk of hypertension (OR 2.18 (1.96 to 2.42)) compared with the control group, whereas the risk of hypertension was not elevated significantly in the hyperuricemia group (OR 1.14 (0.92 to 1.42)).ConclusionOur study provided the first evidence that obese Chinese individuals with hyperuricemia had a significantly increased risk of hypertension compared with their healthy counterparts. This combined effect on the risk of hypertension is much stronger than the individual effect of either factor.
Cohort profile: the MCC-Spain follow-up on colorectal, breast and prostate cancers: study design and initial results
Authors: Alonso-Molero Jessica , Molina Antonio J , Jiménez-Moleón Jose Juan , Pérez-Gómez Beatriz , Martin Vicente , Moreno Victor , Amiano Pilar , Ardanaz Eva , de Sanjose Silvia , Salcedo Inmaculada , Fernandez-Tardon Guillermo , Alguacil Juan , Salas Dolores , Marcos-Gragera Rafael , Chirlaque Maria Dolores , Aragonés Nuria , Castaño-Vinyals Gemma , Pollán Marina , Kogevinas Manolis , Llorca Javier 
Published: November 2019

PurposeSince 2016, the multicase-control study in Spain (MCC-Spain) has focused towards the identification of factors associated with cancer prognosis. Inception cohorts of patients with colorectal, breast and prostate cancers were assembled using the incident cases originally recruited.Participants2140 new cases of colorectal cancer, 1732 of breast cancer and 1112 of prostate cancer were initially recruited in 12 Spanish provinces; all cancers were incident and pathologically confirmed. Follow-up was obtained for 2097 (98%), 1685 (97%) and 1055 (94.9%) patients, respectively.Findings to dateInformation gathered at recruitment included sociodemographic factors, medical history, lifestyle and environmental exposures. Biological samples were obtained, and 80% of patients were genotyped using a commercial exome array. The follow-up was performed by (1) reviewing medical records; (2) interviewing the patients by phone on quality of life; and (3) verifying vital status and cause of death in the Spanish National Death Index. Ninety-seven per cent of recruited patients were successfully followed up in 2017 or 2018; patient-years of follow-up were 30 914. Most colorectal cancers (52%) were at clinical stage II or lower at recruitment; 819 patients died in the follow-up and the 5-year survival was better for women (74.4%) than men (70.0%). 71% of breast cancers were diagnosed at stages I or II; 206 women with breast cancer died in the follow-up and the 5-year survival was 90.7%. 49% of prostate cancers were diagnosed at stage II and 32% at stage III; 119 patients with prostate cancer died in the follow-up and the 5-year survival was 93.7%.Future plansMCC-Spain has built three prospective cohorts on highly frequent cancers across Spain, allowing to investigate socioeconomic, clinical, lifestyle, environmental and genetic variables as putative prognosis factors determining survival of patients of the three cancers and the inter-relationship of these factors.
Identifying and prioritising unanswered research questions for people with hyperacusis: James Lind Alliance Hyperacusis Priority Setting Partnership
Authors: Fackrell Kathryn , Stratmann Linda , Kennedy Veronica , MacDonald Carol , Hodgson Hilary , Wray Nic , Farrell Carolyn , Meadows Mike , Sheldrake Jacqueline , Byrom Peter , Baguley David M , Kentish Rosie , Chapman Sarah , Marriage Josephine , Phillips John , Pollard Tracey , Henshaw Helen , Gronlund Toto A , Hoare Derek J 
Published: November 2019

ObjectiveTo determine research priorities in hyperacusis that key stakeholders agree are the most important.Design/settingA priority setting partnership using two international surveys, and a UK prioritisation workshop, adhering to the six-staged methodology outlined by the James Lind Alliance.ParticipantsPeople with lived experience of hyperacusis, parents/carers, family and friends, educational professionals and healthcare professionals who support and/or treat adults and children who experience hyperacusis, including but not limited to surgeons, audiologists, psychologists and hearing therapists.MethodsThe priority setting partnership was conducted from August 2017 to July 2018. An international identification survey asked respondents to submit any questions/uncertainties about hyperacusis. Uncertainties were categorised, refined and rephrased into representative indicative questions using thematic analysis techniques. These questions were verified as ‘unanswered’ through searches of current evidence. A second international survey asked respondents to vote for their top 10 priority questions. A shortlist of questions that represented votes from all stakeholder groups was prioritised into a top 10 at the final prioritisation workshop (UK).ResultsIn the identification survey, 312 respondents submitted 2730 uncertainties. Of those uncertainties, 593 were removed as out of scope, and the remaining were refined into 85 indicative questions. None of the indicative questions had already been answered in research. The second survey collected votes from 327 respondents, which resulted in a shortlist of 28 representative questions for the final workshop. Consensus was reached on the top 10 priorities for future research, including identifying causes and underlying mechanisms, effective management and training for healthcare professionals.ConclusionsThese priorities were identified and shaped by people with lived experience, parents/carers and healthcare professionals, and as such are an essential resource for directing future research in hyperacusis. Researchers and funders should focus on addressing these priorities.
Multifaceted intervention to Reduce Antimicrobial Prescribing in Care Homes: a process evaluation of a UK-based non-randomised feasibility study
Authors: Potter Rachel , Campbell Anne , Ellard David R , Shaw Catherine , Gardner Evie , Agus Ashley , O’Reilly Dermot , Underwood Martin , Loeb Mark , Stafford Bob , Tunney Michael , Hughes Carmel 
Published: November 2019

ObjectivesTo explore the facilitators and obstacles to the development and implementation of the Reduce Antimicrobial Prescribing in Care Homes intervention.DesignWe used a mixed-methods approach. We conducted focus groups with care home staff and relatives of residents, and interviews with general practitioners (GPs) and home managers, completed observational visits and collected demographic data, training attendance records and data on the use of a decision-making algorithm. We used normalisation process theory to inform topic guides and interpretation of the data.SettingSix care homes, three in Northern Ireland and three in the West Midlands, England.InterventionA decision-making algorithm for urinary tract, respiratory tract and skin and soft-tissue infections, plus small group interactive training for care home staff.ResultsWe ran 21 training sessions across the six homes and trained 35/42 (83%) of nurses and 101/219 (46%) of all care staff. Care home staff reported using the decision-making algorithm 81 times. Postimplementation, staff reported being more knowledgeable about antimicrobial resistance but were unsure if the intervention would change how GPs prescribed antimicrobials. The pressures of everyday work in some homes meant that engagement was challenging at times. Staff felt that some of the symptoms included in decision-making algorithm, despite being evidence based, were not easy to detect in residents with dementia or urinary incontinence. Some staff did not use the decision-making algorithm, noting that their own knowledge of the resident was more important.ConclusionWe delivered a training package to a substantial number of key staff in care homes. A decision-making algorithm for common infections in care homes empowered staff but was challenging to operationalise at times. A future study should consider the findings from the process evaluation to help ensure the successful implementation on a larger scale.