bluuebunny/crossref_metadata_2025_split huggingface dataset:
Was the risk of death among the population of teachers and other school workers in England and Wales due to COVID-19 and all causes higher than other occupations during the pandemic in 2020? An ecological study using routinely collected data on deaths from the Office for National Statistics
Authors: Lewis Sarah J , Dack Kyle , Relton Caroline L , Munafo Marcus R , Davey Smith George 
Published: November 2021

ObjectivesTo estimate occupation risk from COVID-19 among teachers and others working in schools using publicly available data on mortality in England and Wales.DesignAnalysis of national death registration data from the Office for National Statistics.SettingEngland and Wales, 8 March–28 December 2020, during the COVID-19 pandemic.ParticipantsThe total working age population in England and Wales plus those still working aged over 65 years.Primary and secondary outcomesDeath with COVID-19 as a primary outcome and death from all causes as a secondary outcome.ResultsAcross occupational groups, there was a strong correlation between COVID-19 mortality and both non-COVID-19 and all-cause mortality. The absolute mortality rates for deaths with COVID-19 were low among those working in schools (from 10 per 100 000 in female primary school teachers to 39 per 100 000 male secondary school teachers) relative to many other occupations (range: 9–50 per 100 000 in women; 10–143 per 100 000 in men). There was weak evidence that secondary school teachers had slightly higher risks of dying with COVID-19 compared with the average for all working-aged people, but stronger evidence of a higher risk compared with the average for all professionals; primary school teachers had a lower risk. All-cause mortality was also higher among all teachers compared with all professionals. Teaching and lunchtime assistants were not at higher risk of death from COVID-19 compared with all working-aged people.ConclusionThere was weak evidence that COVID-19 mortality risk for secondary school teachers was above expectation, but in general school staff had COVID-19 mortality risks which were proportionate to their non-COVID-19 mortality risk.
Codeveloping a multibehavioural mobile phone app to enhance social and emotional well-being and reduce health risks among Aboriginal and Torres Strait Islander women during preconception and pregnancy: a three-phased mixed-methods study
Authors: Kennedy Michelle , Kumar Ratika , Ryan Nicole M , Bennett Jessica , La Hera Fuentes Gina , Gould Gillian Sandra 
Published: November 2021

ObjectiveDescribe the development and pretest of a prototype multibehavioural change app MAMA-EMPOWER.DesignMixed-methods study reporting three phases: (1) contextual enquiry included stakeholder engagement and qualitative interviews with Aboriginal women, (2) value specification included user-workshop with an Aboriginal researcher, community members and experts, (3) codesign with Aboriginal researchers and community members, followed by a pretest of the app with Aboriginal women, and feedback from qualitative interviews and the user-Mobile Application Rating Scale (U-MARS) survey tool.SettingsAboriginal women and communities in urban and regional New South Wales, Australia.ParticipantsPhase 1: interviews, 8 Aboriginal women. Phase 2: workshop, 6 Aboriginal women. Phase 3: app trial, 16 Aboriginal women. U-MARS, 5 Aboriginal women.ResultsPhase 1 interviews revealed three themes: current app use, desired app characteristics and implementation. Phase 2 workshop provided guidance for the user experience. Phase 3 app trial assessed all content areas. The highest ratings were for information (mean score of 3.80 out of 5, SD=0.77) and aesthetics (mean score of 3.87 with SD of 0.74), while functionality, engagement and subjective quality had lower scores. Qualitative interviews revealed the acceptability of the app, however, functionality was problematic.ConclusionsDeveloping a mobile phone app, particularly in an Aboriginal community setting, requires extensive consultation, negotiation and design work. Using a strong theoretical foundation of behavioural change technique’s coupled with the consultative approach has added rigour to this process. Using phone apps to implement behavioural interventions in Aboriginal community settings remains a new area for investigation. In the next iteration of the app, we aim to find better ways to personalise the content to women’s needs, then ensure full functionality before conducting a larger trial. We predict the process of development will be of interest to other health researchers and practitioners.
Is subjectively perceived treatment urgency of patients in emergency departments associated with self-reported health literacy and the willingness to use the GP as coordinator of treatment? Results from the multicentre, cross-sectional, observational study PiNo Bund
Authors: Schäfer Ingmar , Menzel Agata , Oltrogge Jan Hendrik , Slagman Anna , Möckel Martin , Lühmann Dagmar , Scherer Martin 
Published: November 2021

ObjectivesAim of this study was to analyse if subjectively perceived treatment urgency of patients in emergency departments is associated with self-reported health literacy and the willingness to use the general practitioner (GP) as coordinator of treatment.DesignA multicentre, cross-sectional, observational study.SettingEmergency departments in five hospitals. Each hospital was visited 14 times representing two 8-hour shifts on each day of the week. Calendar dates were randomly assigned.ParticipantsAll patients of legal age registered at the emergency department or hospital reception desk. Exclusion criteria included immediate or very urgent need of treatment, high level of symptom burden and severe functional impairments in terms of hearing, vision and speech. We conducted standardised personal interviews. Additionally, clinical data were extracted from patient records.Primary and secondary outcome measuresOur target variable was subjectively perceived treatment urgency. Predictor variables included age, sex, education, health-related quality of life (EuroQol Five-Dimension Scale, value set UK), anxiety and depression (Hospital Anxiety and Depression Scale), somatic symptoms (Patient Health Questionnaire, 15 items version), self-reported health literacy (European Health Literacy Questionnaire, 16 questions version) and the commitment to the GP (Fragebogen zur Intensität der Hausarztbindung, ‘F-HaBi’). Data were analysed by multilevel, multivariable linear regression adjusted for random effects at the hospital level.ResultsOur sample comprised 276 patients with a mean age of 50.1 years and 51.8% women. A low treatment urgency (defined as 0–5 points on a Numerical Rating Scale) was reported by 111 patients (40.2%). In the final model, lower subjective treatment urgency was associated with male sex (β=0.84; 95% CI 0.11/1.57, p=0.024), higher health-related quality of life (−2.27 to –3.39/−1.15, p<0.001), lower somatic symptoms score (0.09, 0.004/0.17, p=0.040), higher anxiety score (−0.13 to –0.24/−0.01, p=0.027) and lower commitment to the GP (0.08, 0.01/0.14, p=0.029).ConclusionsA lower level of subjectively perceived treatment urgency was predicted by a lower willingness to use the GP as coordinator of treatment. Self-reported health literacy did not predict the patients’ urgency rating.
Rhesus isoimmunisation in unsensitised RhD-negative individuals seeking abortion at less than 12 weeks’ gestation: a systematic review
Authors: Chan Michelle C , Gill Roopan Kaur , Kim Caron Rahn 
Published: November 2021

AimThe aim of this review was to systematically review the outcome of routine anti-D administration among unsensitised rhesus (RhD)-negative individuals who have an abortion. This review is registered with Prospero.MethodsA search for all published and ongoing studies, without restrictions on language or publication status, was performed using the following databases from their inception: EBM Reviews Ovid - Cochrane Central Register of Controlled Trials, MEDLINE Ovid (Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily), Embase.com, Popline and Google Scholar. Study types included: randomised controlled trials, controlled trials, cohort and case–control studies from 1971 onwards. The population included women who undergo an abortion (induced, incomplete, spontaneous or septic abortion), medical or surgical <12 weeks, and isoimmunisation in a subsequent pregnancy. The primary outcomes were: (1) development of a positive Kleihauer–Betke test and (2) development of Rh alloimmunisation in a subsequent pregnancy.ResultsA total of 2652 studies were screened with 105 accessed for full-text review. Two studies have been included with high bias appreciated. Both studies found few women to be sensitised in forming antibodies after an abortion. The limited studies available and heterogeneity prevent the conduction of a meta-analysis.ConclusionsRh immunoglobulin has well-documented safety. However, it is not without risks and costs, is a possible barrier to delivering efficient services, and may have limited availability in some countries. The evidence base and quality of studies are currently limited. There is unclear benefit from the recommendation for Rh testing and immunoglobulin administration in early pregnancy. More research is needed as clinical practice guidelines are varied, based on expert opinions and moving away from testing and administration at time of abortion.ImplicationsThere is limited evidence surrounding medical benefit of Rh testing and immunoglobulin administration in early pregnancy. Further research is needed to define alloimmunisation and immunoglobulin benefit to update standards of care. Additionally, other factors should be considered in forming clinical policies and guidelines such as costs, feasibility and impact on access to care for patients.
2021 DORIS definition of remission in SLE: final recommendations from an international task force
Authors: van Vollenhoven Ronald F , Bertsias George , Doria Andrea , Isenberg David , Morand Eric , Petri Michelle A , Pons-Estel Bernardo A , Rahman Anisur , Ugarte-Gil Manuel Francisco , Voskuyl Alexandre , Arnaud Laurent , Bruce Ian N , Cervera Ricard , Costedoat-Chalumeau Nathalie , Gordon Caroline , Houssiau Frédéric A , Mosca Marta , Schneider Matthias , Ward Michael M , Alarcon Graciela , Aringer Martin , Askanase Anca D , Bae Sang-Cheol , Bootsma Hendrika , Boumpas Dimitrios T , Brunner Hermine , Clarke Ann Elaine , Coney Cindy , Czirják László , Dörner Thomas , Faria Raquel , Fischer Rebecca , Fritsch-Stork Ruth , Inanc Murat , Jacobsen Søren , Jayne David , Kuhn Annegret , van Leeuw Bernadette , Limper Maarten , Mariette Xavier , Navarra Sandra , Nikpour Mandana , Olesinska Marzena Helena , Pons-Estel Guillermo , Romero-Diaz Juanita , Rubio Blanca , Schoenfeld Yehuda , Bonfá Eloisa , Smolen Josef , Teng Y K Onno , Tincani Angela , Tsang-A-Sjoe Michel , Vasconcelos Carlos , Voss Anne , Werth Victoria P , Zakharhova Elena , Aranow Cynthia 
Published: November 2021

ObjectiveTo achieve consensus on a definition of remission in SLE (DORIS).BackgroundRemission is the stated goal for both patient and caregiver, but consensus on a definition of remission has been lacking. Previously, an international task force consisting of patient representatives and medical specialists published a framework for such a definition, without reaching a final recommendation.MethodsSeveral systematic literature reviews were performed and specific research questions examined in suitably chosen data sets. The findings were discussed, reformulated as recommendations and voted on.ResultsBased on data from the literature and several SLE-specific data sets, a set of recommendations was endorsed. Ultimately, the DORIS Task Force recommended a single definition of remission in SLE, based on clinical systemic lupus erythematosus disease activitiy index (SLEDAI)=0, Evaluator’s Global Assessment <0.5 (0–3), prednisolone 5 mg/day or less, and stable antimalarials, immunosuppressives, and biologics.ConclusionThe 2021 DORIS definition of remission in SLE is recommended for use in clinical care, education, and research including clinical trials and observational studies.
Seasonal regulation of river discharge by the cascade reservoirs in the Lancang River and its effect on downstream freshwater and estuarine saltwater intrusion
Authors: Zhu Jianrong , Qiu Wei , Tang Chuanmin , Cheng Xinyue 
Published: November 2021

Abstract
This study assesses the seasonal regulation of river discharge by hydropower dam-induced cascade reservoirs in the Lancang River and its effect on downstream freshwater and estuarine saltwater intrusion. There are eight main reservoirs in the Lancang River, with a total regulation capacity of 25.67 billion m3, which regulates river discharge by conserving water in the flood season and releasing water in the dry season. River discharge during the dry season from 1960 to 2009 accounted for 21% of the annual discharge before the cascade reservoirs were constructed and increased to 33% from 2010 to 2015 after the cascade reservoirs were constructed at the Jinghong hydrological station, which is the lowermost station in the Lancang River. During the 2016 extreme drought in the lower Mekong River basin, the river discharge increased by 550, 367, 1283, 969, and 524 m3/s in January, February, March, April, and May, respectively, regulated by the cascade reservoirs at the Jinghong hydrological station. Considering runoff, tides, wind, and continental shelf currents, a high-resolution three-dimensional numerical model was used to simulate the effect of regulation of river discharge by the cascade reservoirs in the Lancang River on the saltwater intrusion in the Mekong River Delta (MRD). The simulation results show that the seasonal regulation of river discharge by the cascade reservoirs in the Lancang River weakens estuarine saltwater intrusion during the dry season, especially in the sand bar areas, which is much more significant in the extreme dry season of 2016. The seasonal regulation of river discharge by the reservoirs in the Lancang River makes the seasonal distribution of downstream river discharge more uniform, favoring downstream freshwater utilization and alleviating flood disasters and saltwater intrusion in the MRD.
Thermal transitions in metastable Cu – 68.5 at. % Co alloy
Authors: Jegede Oluwatoyin E. , Haque Nafisul , Mullis Andrew M. , Cochrane Robert F. 
Published: November 2021

The arc melted and drop tube processed Cu – 68.5 at. % Co alloy was subjected to differential thermal analysis (DTA). The liquidus temperature determined from the DTA curves of the arc melt sample (1664 K) was found to be close to the phase diagram estimate of 1662 K. In contrast, as a result of liquid phase separation in the drop-tube samples, the values obtained in the powders were much lower, mainly because the compositions of the demixed phases varied from those of the parent melt. The liquidus temperature of the 850+ μm powder was 1632 K, whereas that of the <38 μm sieve powder was 1616 K. This variance was due to the asymmetric nature of the metastable phase diagram of the system.
Interpretable Aspect-Aware Capsule Network for Peer Review Based Citation Count Prediction
Authors: Li Siqing , Li Yaliang , Zhao Wayne Xin , Ding Bolin , Wen Ji-Rong 
Published: November 2021

Citation count prediction is an important task for estimating the future impact of research papers. Most of the existing works utilize the information extracted from the paper itself. In this article, we focus on how to utilize another kind of useful data signal (i.e., peer review text) to improve both the performance and interpretability of the prediction models.
Specially, we propose a novel aspect-aware capsule network for citation count prediction based on review text. It contains two major capsule layers, namely the feature capsule layer and the aspect capsule layer, with two different routing approaches, respectively. Feature capsules encode the local semantics from review sentences as the input of aspect capsule layer, whereas aspect capsules aim to capture high-level semantic features that will be served as final representations for prediction. Besides the predictive capacity, we also enhance the model interpretability with two strategies. First, we use the topic distribution of the review text to guide the learning of aspect capsules so that each aspect capsule can represent a specific aspect in the review. Then, we use the learned aspect capsules to generate readable text for explaining the predicted citation count. Extensive experiments on two real-world datasets have demonstrated the effectiveness of the proposed model in both performance and interpretability.
Lower Semicontinuity in

L

1

of a Class of Functionals Defined on
B
V
with Carathéodory Integrands
Authors: Wunderli T. 
Published: November 2021

We prove lower semicontinuity in

L

1

Ω

for a class of functionals

G
:
B
V

Ω

⟶
ℝ

of the form

G

u

=

∫

Ω

g

x

,

∇

u

d
x
+

∫

Ω

ψ

x

d

D

s

u

where

g
:
Ω
×

ℝ

N

⟶
ℝ

,

Ω
⊂

ℝ

N

is open and bounded,

g

·
,
p

∈

L

1

Ω

for each

p
,

satisfies the linear growth condition

lim

p

⟶

∞

g

x
,
p

/

p

=
ψ

x

∈
C

Ω

∩

L

∞

Ω

,

and is convex in

p

depending only on

p

for a.e.

x
.

Here, we recall for

u
∈
B
V

Ω

; the gradient measure

D
u
=
∇
u

d
x
+
d

D

s

u

x

is decomposed into mutually singular measures

∇
u

d
x

and

d

D

s

u

x

. As an example, we use this to prove that

∫

Ω

ψ

x

α

2

x

+

∇
u

2

d
x
+

∫

Ω

ψ

x

d

D

s

u

is lower semicontinuous in

L

1

Ω

for any bounded continuous

ψ

and any

α
∈

L

1

Ω

.

Under minor addtional assumptions on

g

, we then have the existence of minimizers of functionals to variational problems of the form

G

u

+

u
−

u

0

L

1

for the given

u

0

∈

L

1

Ω

,

due to the compactness of

B
V

Ω

in

L

1

Ω

.
C3aR Signaling Inhibits NK-cell Infiltration into the Tumor Microenvironment in Mouse Models
Authors: Nandagopal Saravanan , Li Caiyun G. , Xu Yu , Sodji Quaovi H. , Graves Edward E. , Giaccia Amato J. 
Published: November 2021

AbstractMany solid tumors have low levels of cytotoxic CD56dim natural killer (NK) cells, suggesting that CD56dim NK-cell exclusion from the tumor microenvironment (TME) contributes to the decreased response rate of immunotherapy. Complement component 3a (C3a) is known for its tumor-promoting and immunosuppressive roles in solid tumors. Previous reports have implicated the involvement of the C3a receptor (C3aR) in immune cell trafficking into the TME. C3aR is predominantly expressed on the surface of activated cytotoxic NK cells, but a specific role for C3aR in NK-cell biology has not been investigated. Because solid tumors generate elevated C3a and have decreased NK-cell infiltration, we hypothesized that C3aR might play a role in cytotoxic NK-cell recruitment into the TME. Our results indicate that blocking C3aR signaling in NK cells increased NK-cell infiltration into the TME in mouse models and led to tumor regression. Because the critical lymphocyte trafficking integrin LFA-1 orchestrates the migration of activated NK cells, we wanted to gain insight into the interaction between C3aR signaling and LFA-1. Our results demonstrated that direct interaction between C3aR and LFA-1, which led to a high-affinity LFA-1 conformation, decreased NK-cell infiltration into the TME. We propose that approaches to enhance cytotoxic NK-cell infiltration into the TME, through either disrupting C3a and C3aR interaction or inhibiting the formation of high-affinity LFA-1, represent a new strategy to improve the efficiency of immunotherapy for cancer treatment.
Influence of Monitoring Strategy on Assessment of Ablation Success and Postablation Atrial Fibrillation Burden Assessment: Implications for Practice and Clinical Trial Design
Authors: Aguilar Martin , Macle Laurent , Deyell Marc W. , Yao Robert , Hawkins Nathaniel M. , Khairy Paul , Andrade Jason G. 
Published: November 2021

Background:
Various noninvasive intermittent rhythm monitoring strategies have been used to assess arrhythmia recurrences in trials evaluating pharmacological and invasive therapeutic interventions for atrial fibrillation (AF). We determined whether a frequency and duration of noninvasive rhythm monitoring could be identified that accurately detects arrhythmia recurrences and approximates the AF burden derived from continuous monitoring using an implantable cardiac monitor (ICM).

Methods:
The rhythm history of 346 patients enrolled in the CIRCA-DOSE trial (Cryoballoon Versus Contact-Force Irrigated Radiofrequency Catheter Ablation) was reconstructed. Using computer simulations, we evaluated event-free survival, sensitivity, negative predictive value, and AF burden of a range of noninvasive monitoring strategies, including those used in contemporary AF ablation trials.

Results:

A total of 126 290 monitoring days were included in the analysis. At 12 months, 164 patients experienced atrial arrhythmia recurrence as documented by the ICM (1-year event-free survival, 52.6%). Most noninvasive monitoring strategies used in AF ablation trials had poor sensitivity for detecting arrhythmia recurrence. Sensitivity increased with the intensity of monitoring, with serial (3) short-duration monitors (24-/48-hour ECG monitors) missing a substantial proportion of recurrences (sensitivity, 15.8% [95% CI, 8.9%–20.7%] and 24.5% [95% CI, 16.2%–30.6%], respectively). Serial (3) longer-term monitors (14-day ECG monitors) more closely approximated the gold standard ICM (sensitivity, 64.6% [95% CI, 53.6%–74.3%]). AF burden derived from short-duration monitors significantly overestimated the true AF burden in patients with recurrences. Increasing monitoring duration resulted in improved correlation and concordance between noninvasive estimates of the invasive AF burden (
R
2
= 0.85 and interclass correlation coefficient = 0.91 for serial [3] 14-day ECG monitors versus ICM).

Conclusions:
The observed rate of postablation atrial tachyarrhythmia recurrence is highly dependent on the arrhythmia monitoring strategy employed. Between-trial discrepancies in outcomes may reflect different monitoring protocols. On the basis of measures of agreement, serial long-term (7–14 day) intermittent monitors accumulating at least 28 days of annual monitoring provide estimates of AF burden comparable with ICM. However, ICMs outperform intermittent monitoring for arrhythmia detection, and should be considered the gold standard for clinical trials.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01913522.