bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying challenges to implementation of clinical practice guidelines for sentinel lymph node biopsy in patients with melanoma in Australia: protocol paper for a mixed methods study
Authors: Rapport Frances , Smith Andrea L , Cust Anne E , Mann Graham J , Watts Caroline G , Gyorki David E , Henderson Michael , Hong Angela M , Kelly John W , Long Georgina V , Mar Victoria J , Morton Rachael L , Saw Robyn PM , Scolyer Richard A , Spillane Andrew J , Thompson John F , Braithwaite Jeffrey 
Published: February 2020

IntroductionSentinel lymph node biopsy (SLNB) is a diagnostic procedure developed in the 1990s. It is currently used to stage patients with primary cutaneous melanoma, provide prognostic information and guide management. The Australian Clinical Practice Guidelines state that SLNB should be considered for patients with cutaneous melanoma >1 mm in thickness (or >0.8 mm with high-risk pathology features). Until recently, sentinel lymph node (SLN) status was used to identify patients who might benefit from a completion lymph node dissection, a procedure that is no longer routinely recommended. SLN status is now also being used to identify patients who might benefit from systemic adjuvant therapies such as anti-programmed cell death 1 (PD1) checkpoint inhibitor immunotherapy or BRAF-directed molecular targeted therapy, treatments that have significantly improved relapse-free survival for patients with resected stage III melanoma and improved overall survival of patients with unresectable stage III and stage IV melanoma. Australian and international data indicate that approximately half of eligible patients receive an SLNB.Methods and analysisThis mixed-methods study seeks to understand the structural, contextual and cultural factors affecting implementation of the SLNB guidelines. Data collection will include: (1) cross-sectional questionnaires and semistructured interviews with general practitioners and dermatologists; (2) semistructured interviews with other healthcare professionals involved in the diagnosis and early definitive care of melanoma patients and key stakeholders including researchers, representatives of professional colleges, training organisations and consumer melanoma groups; and (3) documentary analysis of documents from government, health services and non-government organisations. Descriptive analyses and multivariable regression models will be used to examine factors related to SLNB practices and attitudes. Qualitative data will be analysed using thematic analysis.Ethics and disseminationEthics approval has been granted by the University of Sydney. Results will be disseminated through publications and presentations to clinicians, patients, policymakers and researchers and will inform the development of strategies for implementing SLNB guidelines in Australia.
Magnitude and determinants of road traffic accidents in Northern Ethiopia: a cross-sectional study
Authors: Woldu Awtachew Berhe , Desta Abraham Aregay , Woldearegay Tewolde Wubayehu 
Published: February 2020

ObjectiveThis study aimed to assess the magnitude and determinants of road traffic accidents (RTAs) in Mekelle city, Northern Ethiopia.MethodsA cross-sectional study was done using a simple random sampling technique.SettingThe study was done in Mekelle city from February to June 2015.ParticipantsThe study was done among drivers settled in Mekelle city.Main outcome measuresThe main outcome measure was occurrence of RTA within 2 years. A binary logistic regression was used to identify factors associated with RTA.ResultsThe magnitude of RTA was found to be 23.17%. According to the drivers’ perceived cause of the accident, 22 (38.60%) of the accident was due to violation of traffic rules and regulations. The majority of the victims were pedestrians, 19 (33.33%). Drivers who were driving a governmental vehicle were 4.16 (adjusted OR (AOR) 4.16; 95% CI 1.48 to 11.70) times more likely to have RTA compared with those who drive private vehicles. Drivers who used alcohol were 2.29 (AOR 2.29; 95% CI 1.08 to 4.85) times more likely to have RTA compared with those drivers who did not consume alcohol.ConclusionMagnitude of reported road traffic accident was high. Violation of traffic laws, lack of vehicle maintenance and lack of general safety awareness on pedestrians were the dominant reported causes of RTAs. Driving a governmental vehicle and alcohol consumption were the factors associated with RTA. Monitoring blood alcohol level of drivers and regular awareness to the drivers should be in place. Holistic study should be done to identify the causes of RTAs.
Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis
Authors: Namasivayam Amrita , Lovell Sarah , Namutamba Sarah , Schluter Philip J 
Published: February 2020

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.
Tunnelled peritoneal drainage catheter placement for the palliative management of refractory ascites in patients with liver cirrhosis
Authors: Corrigan Margaret , Thomas Rhodri , McDonagh Joanne , Speakman John , Abbas Nadir , Bardell Sara , Thompson Fiona , Holt Andrew , Jones Robert , Willis Andrew , Karkhanis Salil , Rajoriya Neil 
Published: February 2020

ObjectiveRefractory ascites is an established indication for liver transplantation. While transplantation is regarded as the definitive therapy for this condition, many patients are unsuitable due to comorbidity or frailty. Alternatives such as transjugular intrahepatic portosystemic shunt (TIPSS) and large-volume paracentesis can lead to complications, including encephalopathy, circulatory and renal dysfunction, and protein–calorie deficiency that may accelerate sarcopenia. Cost and complication rates limit therapies such as alfapump. While there are data to support the use of indwelling catheters in the management of patients with malignant ascites, there is limited evidence to support their routine use in the context of end-stage liver cirrhosis. Here we describe our centres’ experience using indwelling tunnelled ascitic drains over a 6-year period.MethodsA retrospective review of data (January 2012–May 2018) was undertaken for all patients with refractory ascites who underwent a tunnelled ascitic drain. Demographics, disease aetiology, procedure data and follow-up data were obtained through interrogation of electronic records and reports.ResultsTwenty-five drains were placed. All procedures were technically successful with no immediate complications. Six patients were readmitted following their index admission with abdominal pain and suspected infected ascites (although only two had a positive ascitic fluid culture). There were three cases of abdominal wall cellulitis and three of leakage around the tunnel site; all managed conservatively.ConclusionIndwelling drains appear an effective strategy for palliative management of select patients with liver cirrhosis complicated by refractory ascites who are not amenable to undergo TIPSS or transplantation. While complications can occur, these are most usually minor and can be managed on an outpatient basis.
Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017
Authors: Haagsma Juanita A , Olij Branko F , Majdan Marek , van Beeck Ed F , Vos Theo , Castle Chris D , Dingels Zachary V , Fox Jack T , Hamilton Erin B , Liu Zichen , Roberts Nicholas L S , Sylte Dillon O , Aremu Olatunde , Bärnighausen Till Winfried , Borzì Antonio M , Briggs Andrew M , Carrero Juan J , Cooper Cyrus , El-Khatib Ziad , Ellingsen Christian Lycke , Fereshtehnejad Seyed-Mohammad , Filip Irina , Fischer Florian , Haro Josep Maria , Jonas Jost B , Kiadaliri Aliasghar A , Koyanagi Ai , Lunevicius Raimundas , Meretoja Tuomo J , Mohammed Shafiu , Pathak Ashish , Radfar Amir , Rawaf Salman , Rawaf David Laith , Riera Lidia Sanchez , Shiue Ivy , Vasankari Tommi Juhani , James Spencer L , Polinder Suzanne 
Published: February 2020

IntroductionFalls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period.MethodsWe performed a secondary database descriptive study using the GBD 2017 results on age-standardised fall-related injury in older adults aged 70 years and older in 22 countries from 1990 to 2017.ResultsIn 2017, in the Western European region, 13 840 per 100 000 (uncertainty interval (UI) 11 837–16 113) older adults sought medical treatment for fall-related injury, ranging from 7594 per 100 000 (UI 6326–9032) in Greece to 19 796 per 100 000 (UI 15 536–24 233) in Norway. Since 1990, fall-related injury DALY rates showed little change for the whole region, but patterns varied widely between countries. Some countries (eg, Belgium and Netherlands) have lost their favourable positions due to an increasing fall-related injury burden of disease since 1990.ConclusionsFrom 1990 to 2017, there was considerable variation in fall-related injury incidence, mortality, DALY rates and its composites in the 22 countries in the Western European region. It may be useful to assess which fall prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population.
Defining the medical coverage of ballistic protection to the pelvis and thigh
Authors: Lewis Eluned , Fryer R N , Breeze J 
Published: February 2020

IntroductionPelvis, lower limb and associated genital injury caused by explosive devices was responsible for mortality and considerable long-term morbidity for the UK Armed Forces during combat operations in Afghanistan, resulting in the issue of a pelvic protection system in 2010. The aim of this current research was to determine the medical coverage of the pelvis and thigh and to define the vertical dimensions of ballistic protective material for future pelvic protection (PP).MethodCT scans from 120 male UK Armed Forces personnel were analysed to identify the anthropometric landmarks and vertical boundaries of coverage for the pelvis and thigh. Pelvic height was the vertical distance between the upper border of the iliac crest in the midaxillary plane to the most inferior point of the ischial tuberosity of the pelvis. Upper thigh height was proposed as a 100 mm fixed distance below the ischial tuberosities, enabling a tourniquet to be reproducibly applied. These distances were compared with the ballistic component of the five sizes of tier 1 PP using a paired t-test.ResultsThe vertical components of coverage measured using CT scans were all significantly less (p<0.01) compared with all five sizes of tier 1 PP; for example, the ballistic component of the smallest size of tier 1 PP measured 410 mm, which was larger than the 99th percentile male, which measured 346 mm on CT scans.ConclusionsWhile all sizes of tier 1 PP provide coverage to the pelvis and upper thigh structures, there is an opportunity to optimise future PP. For example, comparing the large size of tier 1 PP to the 50th percentile male demonstrated an opportunity to reduce the ballistic protective component by 31%. Reducing the quantity of material used will improve heat dissipation and user comfort and reduce material mass and acquisition costs.
Cosmological evolution of two-scalar fields cosmology in the Jordan frame
Authors: Giacomini Alex , Leon Genly , Paliathanasis Andronikos , Pan Supriya 
Published: February 2020

AbstractIn the present article we study the cosmological evolution of a two-scalar field gravitational theory defined in the Jordan frame. Specifically, we assume one of the scalar fields to be minimally coupled to gravity, while the second field which is the Brans-Dicke scalar field is nonminimally coupled to gravity and also coupled to the other scalar field. In the Einstein frame this theory reduces to a two-scalar field theory where the two fields can interact only in the potential term, which means that the quintom theory is recovered. The cosmological evolution is studied by analyzing the equilibrium points of the field equations in the Jordan frame. We find that the theory can describe the cosmological evolution in large scales, while inflationary solutions are also provided.
The light CP-even MSSM Higgs mass including N$$^\mathbf {3}$$LO+N$$^\mathbf {3}$$LL QCD corrections
Authors: Harlander R. V. , Klappert J. , Voigt A. 
Published: February 2020

AbstractWe present a calculation of the light neutral CP-even Higgs boson pole mass in the real $$\text {MSSM}$$MSSM which combines state-of-the-art EFT and fixed-order results, including the three-loop fixed-order QCD corrections as well as the resummation of logarithmic terms in the ratio of the weak to the SUSY scale up to fourth logarithmic order. This hybrid calculation should be valid for arbitrary SUSY scales above the weak scale. Comparison to the pure fixed-order and EFT results provides an estimate of their individual validity range.
Reuse Distance-based Victim Cache for Effective Utilisation of Hybrid Main Memory System
Authors: Nath Arijit , Agarwal Sukarn , Kapoor Hemangee K. 
Published: February 2020

Hybrid main memories comprising DRAM and Non-volatile memories (NVM) are projected as potential replacements of the traditional DRAM-based memories. However, traditional cache management policies designed for improving the hit rate lack awareness of the comparative latency of read-write for NVM blocks where the write latency is more than the read latency. Therefore, developing cache management techniques that reduce costly write-backs of the NVM blocks, yet maintain a fair hit rate in the cache, is of paramount importance.
We propose two techniques based on the use of a small victim cache associated with the last-level cache that helps in retaining on the chip critical DRAM and NVM blocks. Victim cache being a scarce resource, we intend to keep only performance-critical blocks in the victim cache by exploiting the idea of reuse distance. The first technique, Victim Cache Replacement Policy, works on the replacement policy of the victim cache by preferential eviction of DRAM blocks over NVM blocks. However, the second technique, Prioritized Partitioning of victim cache, logically partitions the victim cache, giving a smaller share to the DRAM blocks and a relatively larger share to the NVM blocks. Experimental evaluation on full-system simulator shows significant improvement in system performance and reduction in the number of write-backs to the NVM partition of the main memory compared to the baseline and existing technique. Additionally, NVM reads and DRAM miss rate are also improved, leading to further performance enhancement.
Sulforaphane prevents right ventricular injury and reduces pulmonary vascular remodeling in pulmonary arterial hypertension
Authors: Kang Yin , Zhang Guangyan , Huang Emma C. , Huang Jiapeng , Cai Jun , Cai Lu , Wang Sheng , Keller Bradley B. 
Published: February 2020

Right ventricular (RV) dysfunction is the main determinant of mortality in patients with pulmonary arterial hypertension (PAH) and while inflammation is pathogenic in PAH, there is limited information on the role of RV inflammation in PAH. Sulforaphane (SFN), a potent Nrf2 activator, has significant anti-inflammatory effects and facilitates cardiac protection in preclinical diabetic models. Therefore, we hypothesized that SFN might play a comparable role in reducing RV and pulmonary inflammation and injury in a murine PAH model. We induced PAH using SU5416 and 10% hypoxia (SuHx) for 4 wk in male mice randomized to SFN at a daily dose of 0.5 mg/kg 5 days per week for 4 wk or to vehicle control. Transthoracic echocardiography was performed to characterize chamber-specific ventricular function during PAH induction. At 4 wk, we measured RV pressure and relevant measures of histology and protein and gene expression. SuHx induced progressive RV, but not LV, diastolic and systolic dysfunction, and RV and pulmonary remodeling, fibrosis, and inflammation. SFN prevented SuHx-induced RV dysfunction and remodeling, reduced RV inflammation and fibrosis, upregulated Nrf2 expression and its downstream gene NQO1, and reduced the inflammatory mediator leucine-rich repeat and pyrin domain-containing 3 (NLRP3). SFN also reduced SuHx-induced pulmonary vascular remodeling, inflammation, and fibrosis. SFN alone had no effect on the heart or lungs. Thus, SuHx-induced RV and pulmonary dysfunction, inflammation, and fibrosis can be attenuated or prevented by SFN, supporting the rationale for further studies to investigate SFN and the role of Nrf2 and NLRP3 pathways in preclinical and clinical PAH studies. NEW & NOTEWORTHY Pulmonary arterial hypertension (PAH) in this murine model (SU5416 + hypoxia) is associated with early changes in right ventricular (RV) diastolic and systolic function. RV and lung injury in the SU5416 + hypoxia model are associated with markers for fibrosis, inflammation, and oxidative stress. Sulforaphane (SFN) alone for 4 wk has no effect on the murine heart or lungs. Sulforaphane (SFN) attenuates or prevents the RV and lung injury in the SUF5416 + hypoxia model of PAH, suggesting that Nrf2 may be a candidate target for strategies to prevent or reverse PAH.
Systemic and regional hemodynamic response to activation of the exercise pressor reflex in patients with peripheral artery disease
Authors: Kim Danielle Jin-Kwang , Kuroki Marcos , Cui Jian , Gao Zhaohui , Luck J. Carter , Pai Sam , Miller Amanda , Sinoway Lawrence 
Published: February 2020

Patients with peripheral artery disease (PAD) have an accentuated exercise pressor reflex (EPR) during exercise of the affected limb. The underlying hemodynamic changes responsible for this, and its effect on blood flow to the exercising extremity, are unclear. We tested the hypothesis that the exaggerated EPR in PAD is mediated by an increase in total peripheral resistance (TPR), which augments redistribution of blood flow to the exercising limb. Twelve patients with PAD and 12 age- and sex-matched subjects without PAD performed dynamic plantar flexion (PF) using the most symptomatic leg at progressive workloads of 2–12 kg (increased by 1 kg/min until onset of fatigue). We measured heart rate, beat-by-beat blood pressure, femoral blood flow velocity (FBV), and muscle oxygen saturation ([Formula: see text]) continuously during the exercise. Femoral blood flow (FBF) was calculated from FBV and baseline femoral artery diameter. Stroke volume (SV), cardiac output (CO), and TPR were derived from the blood pressure tracings. Mean arterial blood pressure and TPR were significantly augmented in PAD compared with control during PF. FBF increased during exercise to an equal extent in both groups. However, [Formula: see text] of the exercising limb remained significantly lower in PAD compared with control. We conclude that the exaggerated pressor response in PAD is mediated by an abnormal TPR response, which augments redistribution of blood flow to the exercising extremity, leading to an equal rise in FBF compared with controls. However, this increase in FBF is not sufficient to normalize the SmO2 response during exercise in patients with PAD. NEW & NOTEWORTHY In this study, peripheral artery disease (PAD) patients and healthy control subjects performed graded, dynamic plantar flexion exercise. Data from this study suggest that previously reported exaggerated exercise pressor reflex in patients with PAD is driven by greater vasoconstriction in nonexercising vascular territories which also results in a redistribution of blood flow to the exercising extremity. However, this rise in femoral blood flow does not fully correct the oxygen deficit due to changes in other mechanisms that require further investigation.
An fMRI Study of Affective Congruence across Visual and Auditory Modalities
Authors: Gao Chuanji , Weber Christine E. , Wedell Douglas H. , Shinkareva Svetlana V. 
Published: February 2020

Abstract
Evaluating multisensory emotional content is a part of normal day-to-day interactions. We used fMRI to examine brain areas sensitive to congruence of audiovisual valence and their overlap with areas sensitive to valence. Twenty-one participants watched audiovisual clips with either congruent or incongruent valence across visual and auditory modalities. We showed that affective congruence versus incongruence across visual and auditory modalities is identifiable on a trial-by-trial basis across participants. Representations of affective congruence were widely distributed with some overlap with the areas sensitive to valence. Regions of overlap included bilateral superior temporal cortex and right pregenual anterior cingulate. The overlap between the regions identified here and in the emotion congruence literature lends support to the idea that valence may be a key determinant of affective congruence processing across a variety of discrete emotions.