bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antithrombotic management of patients with acute coronary syndrome and atrial fibrillation undergoing coronary stenting: a prospective, observational, nationwide study
Authors: De Luca Leonardo , Rubboli Andrea , Bolognese Leonardo , Gonzini Lucio , Urbinati Stefano , Murrone Adriano , Scotto di Uccio Fortunato , Ferrari Fabio , Lucà Fabiana , Caldarola Pasquale , Lucci Donata , Gabrielli Domenico , Di Lenarda Andrea , Gulizia Michele Massimo 
Published: December 2020

ObjectiveThe aim of the study was to assess current management of patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) undergoing coronary stenting.DesignNon-interventional, prospective, nationwide study.Setting76 private or public cardiology centres in Italy.ParticipantsPatients with ACS with concomitant AF undergoing percutaneous coronary intervention (PCI).Primary and secondary outcome measuresTo obtain accurate and up-to-date information on pharmacological management of patients with AF admitted for an ACS and undergoing PCI with stent implantation.ResultsOver a 12-month period, 598 consecutive patients were enrolled: 48.8% with AF at hospital admission and 51.2% developing AF during hospitalisation. At discharge, a triple antithrombotic therapy (TAT) was prescribed in 64.8%, dual antiplatelet therapy (DAPT) in 25.7% and dual antithrombotic therapy (DAT) in 8.8% of patients. Among patients with AF at admission, TAT and DAT were more frequently prescribed compared with patients with new-onset AF (76.3% vs 53.8% and 12.5% vs 5.3%, respectively; both p<0.0001), while a DAPT was less often used (11.2% vs 39.5%; p<0.0001). At multivariable analysis, a major bleeding event (OR: 5.40; 95% CI: 2.42 to 12.05; p<0.0001) and malignancy (OR: 5.11; 95% CI: 1.77 to 14.78; p=0.003) resulted the most important independent predictors of DAT prescription.ConclusionsIn this contemporary registry of patients with ACS with AF treated with coronary stents, TAT still resulted as the antithrombotic strategy of choice, DAT was reserved for high bleeding risk and DAPT was mainly prescribed in those developing AF during hospitalisation.Trial registration numberNCT03656523.
Using qualitative and co-design methods to inform the development of an intervention to support and improve physical activity in childhood cancer survivors: a study protocol for BEing Active after ChildhOod caNcer (BEACON)
Authors: Brown Morven C , Araújo-Soares Vera , Skinner Roderick , Glaser Adam W , Sarwar Naseem , Saxton John M , Montague Kyle , Hall Jamie , Burns Olivia , Sharp Linda 
Published: December 2020

IntroductionChildhood cancer survivors (CCSs) treated with cardiotoxic cancer treatments are at increased risk of developing cardiometabolic complications. This risk is further exacerbated by poor health behaviours. In particular, CCSs are less active than non-cancer comparators. Existing interventions aiming to improve physical activity (PA) levels in CCSs are methodologically weak. The aim of this study is to rigorously and systematically develop an evidence-based and theoretically-informed intervention to promote, support, improve and sustain PA levels in CCSs, with the long-term goal of reducing CCSs’ cardiovascular morbidity and mortality.Methods and analysisThe BEing Active after ChildhOod caNcer (BEACON) study involves two workpackages at two National Health Service sites in England, UK.Participants will be CCSs and their parents, and healthcare professionals (HCPs) involved in their care.Workpackage one (WP1) will use qualitative methods to explore and understand the barriers and facilitators to PA in CCSs. Two sets of semistructured interviews will be conducted with (1) CCSs (aged 10–24 years) and (2) parents of CCSs. WP2 will use co-design methods to bring together stakeholders (CCSs; their parents; HCPs; researchers) to develop a prototype intervention. Where possible, all data will be audio recorded and transcribed.Data from WP1 will be analysed using a thematic approach. Analysis of WP2 data will involve content analysis, and analysis of formative output and procedures.Ethics and disseminationThe study was approved by North East-Tyne & Wear South Research Ethics Committee (REC ref: 18/NE/0274). Research findings will be disseminated primarily via national and international conferences and publication in peer-reviewed journals. Patient and public involvement will inform further dissemination activities.
Identifying the commonly used antibiotics for self-medication in urban Mozambique: a qualitative study
Authors: Torres Neusa F , Solomon Vernon P , Middleton Lyn E 
Published: December 2020

ObjectivesThe study aimed at identifying the commonly used non-prescribed antibiotics (NPAs) and the main health conditions leading to the practices of self-medication with antibiotics (SMAs) in Maputo city, Mozambique.DesignCross-sectional qualitative study based on individual and group interviews.SettingThe study was conducted in nine pharmacies of three socioeconomic areas of Maputo city, from October 2018 to March 2019.ParticipantsThe study included 32 pharmacy clients and 17 pharmacists. The pharmacy clients included men 10 (31%) and women 22 (69%) ranging from 19 to 67 years while the pharmacists included men 6 (35,3%) and women 11 (64,7%) with ages ranging from 24 to 47 years.FindingsThe majority of the pharmacy clients 30 (93.75%) admitted frequent use of NPAs, 15 (88.2%) out of the 17 pharmacists admitted dispensing NPAs. While the majority of the participants (16) mentioned the use of amoxicillin, also known as ‘two colours medicine’, 14 mentioned the use of cotrimoxazole and seven mentioned amoxicillin with clavulanic acid. Two to five participants also used tetracycline, ciprofloxacin, azithromycin, doxycycline, erythromycin, metronidazole and phenoxymethylpenicillin. The above mentioned NPAs were used to treat self-perceived sore throat, fever, pain, cough, vaginal discharge, eye problems, the common influenza, urinary infections, respiratory tract infections, wounds and toothaches.ConclusionsAntibiotics are perceived as essential medical resources to manage health and illnesses. While taking an active role in their health-disease process, participants commonly used amoxicillin, ‘two colours’, cotrimoxazole and amoxicillin with clavulanic acid to manage their health and that of their families. In this sense, the practices of SMAs were perceived as part of the self-care process and not necessarily as misuse of antibiotics. A wideunderstanding of health-seeking beliefs and behaviours regarding the utilisation of antibiotics is needed to inform public health experts, health policymakers and other stake-holders in designing and implementing public health education and health promotion programsat all levels in Mozambique.
Transition from child to adult health services for young people with cerebral palsy in Ireland: a mixed-methods study protocol
Authors: Ryan Jennifer M , Fortune Jennifer , Walsh Aisling , Norris Meriel , Kerr C , Hensey Owen , Kroll Thilo , Lavelle Grace , Owens Mary , Byrne M , Walsh Michael 
Published: December 2020

IntroductionThe transition from child to adult health services is a challenging and complex process for young people with cerebral palsy (CP). Poorly managed transition is associated with deterioration in health, increased hospitalisations and reduced quality of life. While international research identifies key practices that can improve the experience and outcomes of transition, there is a paucity of data in the Irish context. This research study aims to gain an insight into the experience of transition for young people with CP in Ireland.Methods and analysisA convergent parallel mixed-methods design will be used to collect, analyse and interpret quantitative and qualitative data. Participants will be young people aged 16–22 years with CP, their parent(s)/carer(s) and service providers. Quantitative and qualitative data will be collected through questionnaires and interviews, respectively. Quantitative data will be reported using descriptive statistics. Where sufficient data are collected, we will examine associations between the experience of transition practices and sociodemographic and CP-related factors, respectively, using appropriate regression models. Associations between service provider characteristics and provision of key transition practices may also be explored using appropriate regression models. Qualitative data will be analysed using the Framework Method. A coding matrix based on key transitional practices identified from the literature will be used to identify convergence and divergence across study components at the integration stage.Ethics and disseminationThe study has been approved by the RCSI University of Medicine and Health Sciences Research Ethics Committee (REC201911010). Results will be presented to non-academic stakeholders through a variety of knowledge translation activities. Results will be published in open access, peer-reviewed journals and presented at national and international scientific conferences.
TriMaster: randomised double-blind crossover study of a DPP4 inhibitor, SGLT2 inhibitor and thiazolidinedione as second-line or third-line therapy in patients with type 2 diabetes who have suboptimal glycaemic control on metformin treatment with or without a sulfonylurea—a MASTERMIND study protocol
Authors: Angwin Catherine , Jenkinson Caroline , Jones Angus , Jennison Christopher , Henley William , Farmer Andrew , Sattar Naveed , Holman Rury R , Pearson Ewan , Shields Beverley , Hattersley Andrew 
Published: December 2020

IntroductionPharmaceutical treatment options for patients with type 2 diabetes mellitus (T2DM) have increased to include multiple classes of oral glucose-lowering agents but without accompanying guidance on which of these may most benefit individual patients. Clinicians lack information for treatment intensification after first-line metformin therapy. Stratifying patients by simple clinical characteristics may improve care by targeting treatment options to those in whom they are most effective. This academically designed and run three-way crossover trial aims to test a stratification approach using three standard oral glucose-lowering agents.Methods and analysisTriMaster is a randomised, double-blind, crossover trial taking place at up to 25 clinical sites across England, Scotland and Wales. 520 patients with T2DM treated with either metformin alone, or metformin and a sulfonylurea who have glycated haemoglobin (HbA1c) >58 mmol/mol will be randomised to receive 16 weeks each of a dipeptidyl peptidase‐4 inhibitor, sodium-glucose co-transporter-2 inhibitor and thiazolidinedione in random order. Participants will be assessed at the end of each treatment period, providing clinical and biochemical data, and their experience of side effects. Participant preference will be assessed on completion of all three treatments. The primary endpoint is HbA1c after 4 months of therapy (allowing a range of 12–18 weeks for analysis). Secondary endpoints include participant-reported preference between the three treatments, tolerability and prevalence of side effects.Ethical approvalThis study was approved by National Health Service Health Research Authority Research Ethics Committee South Central—Oxford A, study 16/SC/0147. Written informed consent will be obtained from all participants. Results will be submitted to a peer-reviewed journal and presented at relevant scientific meetings. A lay summary of results will be made available to all participants.Trial registration numbers12039221; 2015-002790-38 and NCT02653209.
Duration of palliative care involvement and cancer care aggressiveness near the end of life
Authors: Monier Pierre Antoine , Chrusciel Jan , Ecarnot Fiona , Bruera Eduardo , Sanchez Stephane , Barbaret Cecile 
Published: December 2020

ObjectivesPrevious studies have found an association between aggressive cancer care and lower quality end of life. Despite international recommendations, late or very late referral to palliative care seems frequent. This study aimed to evaluate the association between the duration of involvement of a palliative care team (PCT), and aggressive cancer care, and to identify factors associated with aggressive cancer care.MethodsWe performed an observational retrospective study in a single academic teaching hospital. In total, 561 inpatients with solid tumours or haematological malignancies were included. Patients followed by a PCT for at least 1 month before death were classified in the palliative care group. Aggressive cancer care was defined as: hospitalisations and/or a new line of chemotherapy within the last month of life, location of death, the use of chemotherapy in the last 2 weeks and hospice admissions within the last 3 days of life.ResultsAmong the 561 patients, 241 (43%) were referred to the PCT; 89 (16%) were followed by the PCT for a month or more before death. In the last 2 weeks of life, 124 (22%) patients received chemotherapy, 110 (20%) died in an acute care unit. At least one criterion of aggressive cancer care was found in 395 patients overall (71%). Aggressive cancer care was significantly less frequent when the PCT referral occurred >1 month before death (p<0.0001).ConclusionMore studies are needed to understand reasons for late referrals despite international recommendations encouraging integrative palliative care.Ethics approvalThe study was approved by the Grenoble Teaching Hospital ethics committee, and by the CNIL (French national commission for data privacy; Commission Nationale de l’Informatique et des Libertés) under the number 1987785 v 0. Due to ethical and legal restrictions, data are only available on request.
Systematic review to examine the methods used to adapt evidence-based psychological treatments for adults diagnosed with a mental illness
Authors: Harvey Allison G. , Lammers Hannah S. , Dolsen Emily A , Mullin Alice C. , Hilmoe Heather E. , Tran Melanie , Portnova Vera , Tuck Alison B. , Mallidi Ajitha , Fang Anya , Byrnes Caitlin , Kao Esther , Lee Colin 
Published: December 2020

QuestionThe context for the implementation of evidence-based psychological treatments (EBPTs) often differs from the context in which the treatment was developed, which necessitates adaptations. In this systematic review we build on, and add to, prior approaches by examining the method used to guide such adaptations. In particular, we sought to elucidate the extent to which an empirical process is used.Study selection and analysisWe focused on publications describing adaptations made to EBPTs for adults diagnosed with a mental illness. We searched PubMed, PsycINFO, Embase and Web of Science from database inception to July 2018. Two raters independently coded the articles for the method used to conduct the adaptation, the reason for and nature of the adaptation, and who made the adaptation.FindingsThe search produced 20 194 citations, which yielded 152 articles after screening. The most commonly used methods for planned adaptations were literature review (57.7%), clinical intuition (47.0%) and theory (38.9%). The use of data from stakeholder interviews ranked fourth (21.5%) and the use of other types of data (eg, pilot study, experiment, survey, interview) ranked last at fifth (12.1%). Few publications reporting ad hoc adaptations were identified (n=3).ConclusionsThis review highlights a need to (a) educate providers and researchers to carefully consider the methods used for the treatment adaptation process, and to use empirical methods where possible and where appropriate, (b) improve the quality of reporting of stakeholder interviews and (c) develop reporting standards that articulate optimal methods for conducting treatment adaptations.
Liver dysfunction in COVID-19: a useful prognostic marker of severe disease?
Authors: Lok James , Gess Markus 
Published: December 2020

BackgroundCOVID-19 is a global pandemic caused by the novel coronavirus SARS-CoV-2. Risk factors and prognostic markers of severe disease remain to be fully determined, although some studies have suggested a correlation between abnormal liver function and adverse outcomes. Further studies are needed to investigate this further.MethodsThis retrospective study enrolled patients with a confirmed diagnosis of COVID-19 who were admitted to Kingston Hospital in the UK. Data collected included age, sex, ethnicity, comorbidity profile, biochemical markers of liver function and the acute phase response, and overall outcome.ResultsBetween 16 March 2020 and 30 April 2020, a total of 343 patients were admitted to the acute medical team at Kingston Hospital. Excluding those with a history of liver disease, 299 patients had liver function tests performed with abnormalities demonstrated in 44.8% of individuals. Derangement of liver function was associated with greater need for ventilatory support (p<0.001), admission to high dependency unit or intensive care (p<0.001) and increased length of hospital stay (p<0.001). Of note, liver dysfunction was more common in those of non-white ethnicity (p=0.007) and correlated with higher levels of C reactive protein (p=0.01) and ferritin (p<0.001).ConclusionAbnormal liver function is associated with a negative outcome among those hospitalised with COVID-19. The cause for this association is unclear, but correlation between abnormal liver function and higher serum levels of acute phase proteins suggest that dysregulation of the immune system in response to SARS-CoV-2 may be contributory.
Dietary beliefs and recommendations in inflammatory bowel disease: a national survey of healthcare professionals in the UK
Authors: Crooks Benjamin , McLaughlin John , Limdi Jimmy 
Published: December 2020

BackgroundThe role of diet in inflammatory bowel disease (IBD) remains incompletely understood. Knowledge around the actual dietary advice healthcare professionals provide to individuals with IBD is scarce. Our objective was to describe the dietary beliefs of healthcare professionals and dietary recommendations made to people with IBD.MethodologyAn online survey regarding IBD-related dietary beliefs and advice provided to patients was distributed to gastroenterologists, dietitians and IBD nurses in the UK.ResultsTwo-hundred and twenty-three eligible healthcare professionals participated: 107 (48%) believed that diet was involved in IBD development. The most frequently implicated dietary components were processed foods (78%), additives/preservatives (71%), sweet/sugary foods (36%), red meat (36%) and fatty foods (31%). Views were broadly consistent across professions, however, gastroenterologists were significantly more likely to believe red meat and additives/preservatives initiated IBD. One hundred and thirteen participants (53%) believed that diet could trigger disease relapse and 128 (61%) recommended limiting specific foodstuffs to reduce this risk, most commonly high fibre foods. Forty-six (23%) considered recommending a low Fermentable Oligo-, Di- and Monosaccharides and Polyols diet to reduce relapse risk. IBD nurses and healthcare professionals with <5 years experience were most likely to recommend this. Dietitians felt most comfortable providing dietary advice for functional gastrointestinal symptoms in quiescent IBD.ConclusionDietary advice in IBD is inconsistent reflecting uncertainty among healthcare professionals. While some consensus exists regarding dietary components implicated in IBD development and relapse, dietary recommendations varied. Future research is required to disentangle these complex relationships, alongside better training and education.
Improving Flow-through Electrode Performance Using Computational Design of Architected Porosity
Authors: Beck Victor A , Watts Seth E , Wong Jonathan M , Tortorelli Dan A , Baker Sarah E , Duoss Eric B , Worsley Marcus A. 
Published: December 2020

Electrochemical systems such as fuel cells, flow batteries, and electrochemical reactors are prevalent in industry, but few tools for their numerical design and optimization exist. Controlling fluid flow, active species distribution, and mass transport in the electrode has a dramatic impact on power and efficiency. However, this control is often limited to changing a quasi-two-dimensional flowfield and selecting bulk properties of a monolithic porous material electrode like carbon felt or paper. This can lead to non-uniform reaction rates, underutilized regions of the flow cell, and can limit the ultimate performance of the devices. To address these limitations, we propose using electrodes composed of a micro-architected variable porosity medium. As a specific example, we enable variable porosity by leveraging advances in the additive manufacture of microscale iso-truss lattices. We employ physics-based homogenization of the governing microscopic, continuum transport equations to develop a descriptive model and enable the design of this variable porosity electrode. Our tool is used to generate optimized architectures which are predicted to outperform monolithic electrodes when used in a standard flow-through configuration. We conclude by demonstrating how the optimal porosity distribution changes to retain the performance benefits as the electrode is scaled beyond benchtop-experiments
LLNL-ABS- 810799
This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.
Lithium Ion Battery Life Analysis in Railway Application
Authors: Hyun Jung Eun 
Published: December 2020

It is well-known that the life of battery is influenced by the temperature, current rate/ pattern, depth of discharge, and chemistry of cell. Capacity and power fade over cycling and storage of lithium ion batteries are still major barriers as their calendar life is 3-5 years whereas target automotive and stationary applications require 10-20years of life time. Battery lifetime is highly dependent on application conditions. In railway application the power pattern is usually similar and repeated, and needs at least 5 years-life warrant. Understanding the relationship between the operating conditions and aging behavior of the batteries is an important task to increase the lifespan. However, it is not easy to quantify the effect of each condition on aging behavior as the aging of batteries involves multiple closely interrelated factors. Accelerated degradation testing with associated modeling and data analysis can effectively be used to predict failure-time distributions. The behaviors of lithium ion cells and aging mechanisms are strongly dependent to the battery cell chemistry and technology so should be chosen in the right application. The lithium ion battery in railway is operated during the whole day time in the mainly outside, and needs high power, high energy characteristics like PHEV and should store the regenerative breaking energy from the traction driving motor.
In this study by using an accelerated method the life of railway application battery is evaluated. This study attempts to quantify the strength of the stress factors and the relationship between aging behavior and operating conditions. The accelerating factor is a temperature and depth of discharge, current pattern to understand the effect on life.