bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leading improvement at scale in healthcare: Sir John Oldham
Authors: Oldham John 
Published: July 2021

BackgroundWhen I became senior partner at my general practice I undertook a part time MBA at Manchester Business School in the late 90s to learn the things medical school hadn’t taught me; organizational design and behaviour, finance, strategic management and human resources (as it was then called). My dissertation was on quality methods in other industries that could be applied in healthcare.JourneyWe tried out total quality management methods in my practice and began to demonstrably improve care, services and the use of resources. I titled this in presentations in the early noughties the Quality Trinity, which morphed into the now widely adopted triple aim. The practice won awards and I became a sessional advisor to the Dept of Health. I was invited to Boston by Don Berwick and saw the collaborative method of improvement. When a new Government came to power pledging to improve quality I designed a means of using the collaborative for large scale change. This opened a parallel career in quality improvement for the next 20 years, though I continued to be a practicing GP for the majority of that.ReflectionsWhen I started there was literature on total quality management in other industries but very little in healthcare, and nothing on large scale change. The methods challenged orthodoxy about how you changed healthcare delivery and met resistance, even hostility. Much that was suspect is now embraced, techniques that were unheard of are now common and the literature is expanding. This article gives experiential insight into large scale change gathered in my career that I hope may help others now charged with these tasks.
Effect of pulmonary rehabilitation on exhaled nitric oxide in patients with chronic obstructive pulmonary disease
Authors: Clini E , Bianchi L , Foglio K , Porta R , Vitacca M , Ambrosino N 
Published: July 2021

BACKGROUNDIn patients with mild to moderate chronic obstructive pulmonary disease (COPD) the exercise induced increase in exhaled nitric oxide (eNO) parallels that observed in normal untrained subjects. There is no information on the effects of the level of exercise tolerance on eNO in these patients. The aim of this study was to evaluate the effect of a pulmonary rehabilitation programme including exercise training on eNO in patients with COPD.METHODSIn 14 consecutive male patients with stable COPD of mean (SD) age 64 (9) years and forced expiratory volume in one second (FEV1) 55 (14)% predicted, fractional eNO concentration (Feno), peak work rate (Wpeak) and oxygen uptake (V˙o2peak) were assessed at baseline (T–1), at the end of a 1 month run in period (T0), and after an 8 week outpatient multidisciplinary pulmonary rehabilitation programme (T1) including cycloergometer training.RESULTSFenodid not significantly differ at T–1 and T0 (mean (SE) 4.3 (0.6) and 4.4 (0.6) ppb, respectively), whereas it rose significantly at T1 to 6.4 (0.7) ppb (p<0.02). Compared with T0, both Wpeak andV˙o2 were significantly (p<0.05) increased at T1 (mean (SE) Wpeak from 89 (5.6) W to 109 (6.9) W);V˙o2peak from 1.27 (0.1) l/min to 1.48 (0.1) l/min). A significant correlation was found between baseline FEV1 and the change in Feno following the rehabilitation programme (r=–0.71; p<0.05) and between changes in Feno and Wpeak from T0 to T1(r=0.60; p<0.05).CONCLUSIONSPulmonary rehabilitation in patients with mild to moderate COPD is associated with an increase in exhaled nitric oxide.
Long term effects of non-invasive mechanical ventilation on pulmonary haemodynamics in patients with chronic respiratory failure
Authors: Schönhofer B , Barchfeld T , Wenzel M , Köhler D 
Published: July 2021

BACKGROUNDIt is not known whether long term nocturnal mechanical ventilation (NMV) reduces pulmonary hypertension in patients with chronic respiratory failure (CRF).METHODSPulmonary haemodynamics, spirometric values, and gas exchange were studied in 33 patients requiring NMV due to CRF (20 with thoracic restriction, 13 with chronic obstructive pulmonary disease (COPD)) at baseline and after 1 year of NMV given in the volume cycled mode. Patients with COPD also received supplemental oxygen.RESULTSLong term NMV improved gas exchange while lung function remained unchanged. Mean pulmonary artery pressure at rest before NMV was higher in patients with thoracic restriction than in those with COPD (33 (10) mm Hgv 25 (6) mm Hg). After 1 year of NMV mean pulmonary artery pressure decreased in patients with thoracic restriction to 25 (6) mm Hg (mean change –8.5 mm Hg (95% CI –12.6 to –4.3), p<0.01) but did not change significantly in patients with COPD (mean change 2.2 mm Hg (95% CI –0.3 to 4.8)).CONCLUSIONSLong term NMV in CRF improves pulmonary haemodynamics in patients with thoracic restriction but not in patients with COPD.
The usefulness of competitive PCR: airway gene expression of IL-5, IL-4, IL-4δ2, IL-2, and IFNγ in asthma
Authors: Glare E M , Divjak M , Bailey M J , Walters E H 
Published: July 2021

BACKGROUNDAsthma has been described as an eosinophilic bronchitis driven by interleukin(IL)-4 and IL-5. The quantification of cytokine mRNA levels in airway samples has been confounded by housekeeping gene expression which differs between and within asthmatics and controls.METHODSThe usefulness of competitive reverse transcriptase-polymerase chain reaction (RT-PCR) that is independent of housekeeping gene expression for quantitating the mRNA for interferon (IFN)γ, IL-2, IL-5, IL-4 and its receptor antagonist encoding splicing variant IL-4δ2 was determined in a cross sectional study of 45 normal control subjects and 111 with asthma.RESULTSAtopic controls and atopic asthmatic subjects expressed more IL-5 than non-atopic controls (p<0.02) in bronchoalveolar lavage (BAL) cells, but not in biopsy specimens. IL-5 mRNA expression in BAL cells from asthmatic subjects using inhaled corticosteroids (ICS) was significantly lower than those not receiving ICS (p=0.04). IL-2 mRNA levels differed with steroid use in biopsy specimens but not in BAL cells. IFNγ, IL-4, and IL-4δ2 mRNA levels did not differ between any groups and were not affected by steroid use. IL-4 and IL-4δ2 mRNA levels were positively correlated (p<0.0001), suggesting coordinated transcription.CONCLUSIONSWhile the signal differentiation of competitive PCR in asthma may rival that of in situ hybridisation and immunohistochemistry, the method is expensive and wasteful of material.
Localisation of transforming growth factor β1 and β3 mRNA transcripts in normal and fibrotic human lung
Authors: Coker R K , Laurent G J , Jeffery P K , du Bois R M , Black C M , McAnulty R J 
Published: July 2021

BACKGROUNDTransforming growth factor β1 is implicated in the pathogenesis of lung fibrosis. It promotes extracellular matrix accumulation by increasing procollagen synthesis and reducing degradation. TGFβ1 gene and protein expression increase in experimental lung fibrosis, and TGFβ1 antibodies attenuate fibrosis in mice. The role of other TGFβ isoforms is unclear. This study aimed to localise TGFβ1 and TGFβ3 gene expression in fibrotic human lung and compare it with that in normal human lung.METHODSLung tissue from patients with cryptogenic fibrosing alveolitis and fibrosis associated with systemic sclerosis was examined by in situ hybridisation. Macroscopically normal lung from carcinoma resections was used as control tissue. Digoxigenin labelled riboprobes were synthesised from TGFβ isoform specific cDNA templates.RESULTSThe digoxigenin labelled riboprobes were sensitive and permitted precise cellular localisation of mRNA transcripts. TGFβ1 and TGFβ3 mRNA transcripts were widespread in normal lung and localised to alveolar macrophages and bronchiolar epithelium. TGFβ1 but not TGFβ3 mRNA was detected in mesenchymal and endothelial cells. In fibrotic lung tissue mRNA transcripts for both isoforms were also detected in metaplastic type II cells. TGFβ1 gene expression was enhanced in some patients. TGFβ3 was expressed in fibrotic lung but was not consistently altered compared with controls.CONCLUSIONTGFβ1mRNA transcripts were localised in normal and fibrotic human lung and TGFβ3 gene expression in human lung fibrosis was shown for the first time. The results suggest that TGFβ1 may play the predominant role in pathogenesis. It is suggested that TGFβ1 should be the primary target of anticytokine treatments for pulmonary fibrosis.
Efficient emulator for solving three-nucleon continuum Faddeev equations with chiral three-nucleon force comprising any number of contact terms
Authors: Witała H. , Golak J. , Skibiński R. 
Published: July 2021

AbstractWe demonstrate a computational scheme which drastically decreases the required time to get theoretical predictions based on chiral two- and three-nucleon forces for observables in three-nucleon continuum. For a three-nucleon force containing N short-range terms all workload is reduced to solving N+1 Faddeev-type integral equations. That done, computation of observables for any combination of strengths of the contact terms is done in a flash. We demonstrate on example of the elastic nucleon-deuteron scattering observables the high precision of the proposed emulator and its capability to reproduce exact results.
Uso do assento de segurança infantil no banco traseiro de automóveis: análise em escolas de Fortaleza
Authors: Lucena Alexandre Sá Pinto da Nóbrega , Felinto Armando Nicodemos Lucena , Bessa Amanda Pires , Silva Filho Artur Henrique Soares da , Gomes Crícia Maria Lima Pontes Ferreira , Rocha Yuri Damasceno da 
Published: July 2021

Objetivo: Avaliar o uso do assento de segurança infantil, bem como o conhecimento da resolução do CONTRAN nº 277, de 2008, pelos pais e responsáveis de alunos de determinadas escolas na cidade de Fortaleza – CE. Métodos: Os autores estudaram de forma observacional e transversal os aspectos da utilização do assento de segurança infantil, servindo-se da aplicação de questionários acompanhados de termo de consentimento, esclarecendo aos participantes os motivos da pesquisa. Foram distribuídos questionários aos responsáveis pelos alunos de determinadas escolas de Fortaleza, dentre os quais um montante de 156 questionários foram devidamente preenchidos e utilizados na avaliação dos resultados da pesquisa. Resultados: De acordo com a análise dos 156 questionários respondidos no estudo, todos (100%) os participantes sabem da existência de dispositivos de segurança para transporte de crianças em automóveis. Noventa e um por cento conhecem a resolução do CONTRAN nº 277 de 2008, que regula o uso desses mecanismos. Dentre os participantes, 65,4% sempre fazem uso dos assentos, ao passo que 28,9% os utilizam apenas algumas vezes e em certas ocasiões. Para 26,9% e 14,1% dos entrevistados, o preço e o tamanho, respectivamente, poderiam ser diminuídos para melhorar a adesão dos usuários aos dispositivos de retenção infantil. Conclusão: Dentre os participantes da pesquisa, 94,3% fazem uso constante ou ocasionalmente do assento de segurança infantil. O preço e o tamanho do dispositivo são os itens que mais desfavorecem o seu uso.
Prognostic Value of Phase Analysis for Predicting Adverse Cardiac Events Beyond Conventional Single-Photon Emission Computed Tomography Variables: Results From the REFINE SPECT Registry
Authors: Kuronuma Keiichiro , Miller Robert J.H. , Otaki Yuka , Van Kriekinge Serge D. , Diniz Marcio A. , Sharir Tali , Hu Lien-Hsin , Gransar Heidi , Liang Joanna X. , Parekh Tejas , Kavanagh Paul B. , Einstein Andrew J. , Fish Mathews B. , Ruddy Terrence D. , Kaufmann Philipp A. , Sinusas Albert J. , Miller Edward J. , Bateman Timothy M. , Dorbala Sharmila , Di Carli Marcelo , Tamarappoo Balaji K. , Dey Damini , Berman Daniel S. , Slomka Piotr J. 
Published: July 2021

Background:
Phase analysis of single-photon emission computed tomography myocardial perfusion imaging provides dyssynchrony information which correlates well with assessments by echocardiography, but the independent prognostic significance is not well defined. This study assessed the independent prognostic value of single-photon emission computed tomography-myocardial perfusion imaging phase analysis in the largest multinational registry to date across all modalities.

Methods:
From the REFINE SPECT (Registry of Fast Myocardial Perfusion Imaging With Next Generation SPECT), a total of 19 210 patients were included (mean age 63.8±12.0 years and 56% males). Poststress total perfusion deficit, left ventricular ejection fraction, and phase variables (phase entropy, bandwidth, and SD) were obtained automatically. Cox proportional hazards analyses were performed to assess associations with major adverse cardiac events (MACE).

Results:

During a follow-up of 4.5±1.7 years, 2673 (13.9%) patients experienced MACE. Annualized MACE rates increased with phase variables and were ≈4-fold higher between the second and highest decile group for entropy (1.7% versus 6.7%). Optimal phase variable cutoff values stratified MACE risk in patients with normal and abnormal total perfusion deficit and left ventricular ejection fraction. Only entropy was independently associated with MACE. The addition of phase entropy significantly improved the discriminatory power for MACE prediction when added to the model with total perfusion deficit and left ventricular ejection fraction (
P
<0.0001).

Conclusions:
In a largest to date imaging study, widely representative, international cohort, phase variables were independently associated with MACE and improved risk stratification for MACE beyond the prediction by perfusion and left ventricular ejection fraction assessment alone. Phase analysis can be obtained fully automatically, without additional radiation exposure or cost to improve MACE risk prediction and, therefore, should be routinely reported for single-photon emission computed tomography-myocardial perfusion imaging studies.
Diverse Deep Neural Networks All Predict Human Inferior Temporal Cortex Well, After Training and Fitting
Authors: Storrs Katherine R. , Kietzmann Tim C. , Walther Alexander , Mehrer Johannes , Kriegeskorte Nikolaus 
Published: July 2021

Abstract
Deep neural networks (DNNs) trained on object recognition provide the best current models of high-level visual cortex. What remains unclear is how strongly experimental choices, such as network architecture, training, and fitting to brain data, contribute to the observed similarities. Here, we compare a diverse set of nine DNN architectures on their ability to explain the representational geometry of 62 object images in human inferior temporal cortex (hIT), as measured with fMRI. We compare untrained networks to their task-trained counterparts and assess the effect of cross-validated fitting to hIT, by taking a weighted combination of the principal components of features within each layer and, subsequently, a weighted combination of layers. For each combination of training and fitting, we test all models for their correlation with the hIT representational dissimilarity matrix, using independent images and subjects. Trained models outperform untrained models (accounting for 57% more of the explainable variance), suggesting that structured visual features are important for explaining hIT. Model fitting further improves the alignment of DNN and hIT representations (by 124%), suggesting that the relative prevalence of different features in hIT does not readily emerge from the Imagenet object-recognition task used to train the networks. The same models can also explain the disparate representations in primary visual cortex (V1), where stronger weights are given to earlier layers. In each region, all architectures achieved equivalently high performance once trained and fitted. The models' shared properties—deep feedforward hierarchies of spatially restricted nonlinear filters—seem more important than their differences, when modeling human visual representations.
Sensory Attenuation of the Auditory P2 Differentiates Self- from Partner-Produced Sounds during Joint Action
Authors: Bolt Nicole K. , Loehr Janeen D. 
Published: July 2021

Abstract
Successful human interaction relies on people's ability to differentiate between the sensory consequences of their own and others' actions. Research in solo action contexts has identified sensory attenuation, that is, the selective perceptual or neural dampening of the sensory consequences of self-produced actions, as a potential marker of the distinction between self- and externally produced sensory consequences. However, very little research has examined whether sensory attenuation distinguishes self- from partner-produced sensory consequences in joint action contexts. The current study examined whether sensory attenuation of the auditory N1 or P2 ERPs distinguishes self- from partner-produced tones when pairs of people coordinate their actions to produce tone sequences that match a metronome pace. We did not find evidence of auditory N1 attenuation for either self- or partner-produced tones. Instead, the auditory P2 was attenuated for self-produced tones compared to partner-produced tones within the joint action. These findings indicate that self-specific attenuation of the auditory P2 differentiates the sensory consequences of one's own from others' actions during joint action. These findings also corroborate recent evidence that N1 attenuation may be driven by general rather than action-specific processes and support a recently proposed functional dissociation between auditory N1 and P2 attenuation.
Harmonic Amplitude Summation for Frequency-tagging Analysis
Authors: Retter Talia L. , Rossion Bruno , Schiltz Christine 
Published: July 2021

Abstract
In the approach of frequency tagging, stimuli that are presented periodically generate periodic responses of the brain. Following a transformation into the frequency domain, the brain's response is often evident at the frequency of stimulation, F, and its higher harmonics (2F, 3F, etc.). This approach is increasingly used in neuroscience, as it affords objective measures to characterize brain function. However, whether these specific harmonic frequency responses should be combined for analysis—and if so, how—remains an outstanding issue. In most studies, higher harmonic responses have not been described or were described only individually; in other studies, harmonics have been combined with various approaches, for example, averaging and root-mean-square summation. A rationale for these approaches in the context of frequency-based analysis principles and an understanding of how they relate to the brain's response amplitudes in the time domain have been missing. Here, with these elements addressed, the summation of (baseline-corrected) harmonic amplitude is recommended.
scite: A smart citation index that displays the context of citations and classifies their intent using deep learning
Authors: Nicholson Josh M. , Mordaunt Milo , Lopez Patrice , Uppala Ashish , Rosati Domenic , Rodrigues Neves P. , Grabitz Peter , Rife Sean C. 
Published: July 2021

Abstract
Citation indices are tools used by the academic community for research and research evaluation that aggregate scientific literature output and measure impact by collating citation counts. Citation indices help measure the interconnections between scientific papers but fall short because they fail to communicate contextual information about a citation. The use of citations in research evaluation without consideration of context can be problematic because a citation that presents contrasting evidence to a paper is treated the same as a citation that presents supporting evidence. To solve this problem, we have used machine learning, traditional document ingestion methods, and a network of researchers to develop a “smart citation index” called scite, which categorizes citations based on context. Scite shows how a citation was used by displaying the surrounding textual context from the citing paper and a classification from our deep learning model that indicates whether the statement provides supporting or contrasting evidence for a referenced work, or simply mentions it. Scite has been developed by analyzing over 25 million full-text scientific articles and currently has a database of more than 880 million classified citation statements. Here we describe how scite works and how it can be used to further research and research evaluation.
Moral Disagreement in Anglican – Roman Catholic Relations
Authors: O’Donovan Oliver 
Published: July 2021

Abstract
The belief that the Anglican and Roman Catholic churches were divided by moral disagreements came to prominence in the early 1980s and affected the direction of ecumenical dialogue. But no moral disagreements go back to the Reformation era, and the perception of moral difference has undergone many changes since that time, especially reflecting differences of social and political setting. A moral agreement or disagreement is difficult to chart with precision. It is not embodied in a formulation of moral doctrine, since moral reason functions on two planes, that of evaluative description and that of deliberation and decision. Disagreement is phenomenologically present as offence, which has its own dynamic of expansion. Addressing offence, a task involving lay, theological and episcopal contributions, is the primary way in which moral agreement has to be sought and defended.
Tensions in Anglican – Roman Catholic Dialogue Doctrinal and Moral Absolutes 1980–2020
Authors: Sedgwick Peter 
Published: July 2021

Abstract
The article surveys Anglican – Roman Catholic ecumenical relationships from 1980–2020. It examines the belief in doctrinal and moral absolutes in official statements of the cdf, and the impact this had on documents from arcic. This was different from statements from the pcpcu, especially in relationship to wcc texts. The article concludes by looking at the changes since the election of Pope Francis, and whether ecumenical relationships will be different in the future.
Natural Law in the Teaching of Christian Ethics
Authors: Gill Robin 
Published: July 2021

Abstract
This article looks at the ways that Thomas Aquinas’ classic and highly influential understanding of natural law ethics has been criticised by students coming from a number of different faith traditions. It suggests that the way that natural law ethics was deployed in Pope Paul vi’s encyclical Humanae Vitae has not typically been found to be persuasive even among Roman Catholic students. It then looks at the way that Lisa Sowle Cahill takes on board these criticisms and offers a more persuasive account of modified natural law ethics.
Educating youth ministers in the Anglican Diocese of Sydney; John Kidson and the Youthworkers Course
Authors: Lukabyo Ruth 
Published: July 2021

Abstract
This study is a historical analysis of the education of youth ministers in the Anglican diocese of Sydney in the 1970s and 1980s. John Kidson ran the Youthworkers Course with the goal of educating professional, specialised youth ministers that could evangelise young people who were influenced by the counter-culture and increasingly disengaged from the church. Kidson used a distinctive educational model that emphasised relational outreach, transformative community, praxis, and the importance of the Bible. His goal was only partially met. He trained youth ministers that were able to communicate with and evangelise non-churched youth, but there were small numbers being trained, and few remained in youth ministry in the long-term. The Youthworkers Course and its strengths and weaknesses can be used as a case study for churches and colleges today as they consider the best way to educate youth ministers.