bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the Oxford Pandemic Attitude Scale-COVID-19 (OPAS-C): an internet-based cross-sectional study in the UK and USA
Authors: Kantor Bella Nichole , Kantor Jonathan 
Published: July 2021

ObjectivesTo develop and validate the Oxford Pandemic Attitude Scale-COVID-19 (OPAS-C), a multidimensional scale that addresses seven domains over 20 items including stress, fear, loneliness, sense of community, belief that the pandemic is a hoax or exaggerated, the use of and attitude to non-pharmaceutical interventions and vaccine hesitancy, in a single measure.DesignCross-sectional validation study.SettingInternet based with respondents in the USA and UK.ParticipantsGeneral community respondents using the Prolific Academic platform.Main outcome measuresExploratory factor analyses with promax oblique rotation and confirmatory factor analysis including goodness of fit indices: root mean square error of approximation (RMSEA), standardised root mean square residual (SRMR) and comparative fit index (CFI). Reliability as internal consistency using Cronbach’s alpha. Convergent and discriminant validity using Pearson correlation coefficients.ResultsThe sample included 351 respondents in the USA and the factorial structure was confirmed using a separate set of 348 respondents in the UK. The OPAS-C had excellent goodness of fit characteristics, with an RMSEA of 0.047 (90% CI 0.037 to 0.056), SRMR of 0.043 and CFI of 0.962. Reliability was excellent, demonstrating Cronbach’s alpha of 0.87 in both the US and UK samples. Convergent validity showed correlation coefficients of 0.54 and 0.49 in the US and UK samples, respectively. Discriminant validity demonstrated correlations of 0.21 and 0.26 in the US and UK samples, respectively.ConclusionsThe OPAS-C represents the first validated scale that addresses mental health measures and public health-relevant responses to COVID-19, and may be a useful measure for use in future longitudinal and cross-sectional studies. Further international validation beyond the USA and UK may be helpful.
Electronic Health Records, Interoperability and Patient Safety in Health Systems of High-income Countries: A Systematic Review Protocol
Authors: Li Edmond , Clarke Jonathan , Neves Ana Luisa , Ashrafian Hutan , Darzi Ara 
Published: July 2021

IntroductionThe availability and routine use of electronic health records (EHRs) have become commonplace in healthcare systems of many high-income countries. While there is an ever-growing body of literature pertaining to their use, evidence surrounding the importance of EHR interoperability and its impact on patient safety remains less clear. There is, therefore, a need and opportunity to evaluate the evidence available regarding this relationship so as to better inform health informatics development and policies in the years to come. This systematic review aims to evaluate the impact of EHR interoperability on patient safety in health systems of high-income countries.Methods and analysisA systematic literature review will be conducted via a computerised search through four databases: PubMed, Embase, Health Management Information Consortium and PsycInfo for relevant articles published between 2010 and 2020. Outcomes of interest will include impact on patient safety and the broader effects on health systems. Quality of the randomised quantitative studies will be assessed using Cochrane Risk of Bias Tool. Non-randomised papers will be evaluated with the Risk of Bias In Non-Randomised Studies—of Interventions tool. Drummond’s Checklist will be used for publications pertaining to economic evaluation. The National Institute for Health and Care Excellence quality appraisal checklist will be used to assess qualitative studies. A narrative synthesis will be conducted for included studies, and the body of evidence will be summarised in a summary of findings table.Ethics and disseminationThis review will summarise published studies with non-identifiable data and, thus, does not require ethical approval. Findings will be disseminated through preprints, open access peer-reviewed publications, and conference presentations.PROSPERO registration numberCRD42020209285.
EXperienceS and aTtitudes towards Agitated behaviours in Traumatic brain injury in the Intensive Care unit patients (EXSTATIC): a protocol for an interprofessional mixed-method study
Authors: Saavedra-Mitjans Mar , David Pierre-Marie , Frenette Anne-Julie , Arbour Caroline , Perreault Marc , Williams Virginie , Bernard Francis , Williamson David 
Published: July 2021

IntroductionAgitation and violent behaviours are common conditions developed by patients with acute traumatic brain injury (TBI) in intensive care units (ICUs). Healthcare professionals caring for these patients have various tools to manage these behaviours, but lack of a formal protocol to assess and manage them makes caring for these patients a challenge. Moreover, safety may often be compromised for both ICU professionals and patients encountering such situations. The EXperienceS and aTtitudes towards Agitated behaviours in Traumatic brain injury in the Intensive Care unit patients (EXSTATIC) study aims to explore the experiences and attitudes of ICU nurses and other ICU healthcare professionals on the management of agitated behaviours in patients with acute TBI.Methods and analysisEXSTATIC is a multicenter mixed methods convergent study exploring experiences and attitudes of ICU healthcare professionals caring of agitated patients with TBI. The study includes three qualitative methods (observation, semistructured interviews and focus groups) and one quantitative method (retrospective cohort). The integration of the different methods will be done using sequential steps of the research and by the integration of results for each step. Qualitative data will be evaluated following a thematic analysis derived from a grounded theory approach. Quantitative data will be analysed using descriptive statistics. Qualitative and quantitative results will be combined in a convergent interactive interpretative design. Gender and race perspective will be integrated in collection, analysis and interpretation of data.Ethics and disseminationThis study has been approved by the Centre intégré universitaire de santé et de services sociaux du nord de l’île de Montréal (CIUSSS-NÎM) Research Ethics Board. The findings will be disseminated locally with ICU staff and health managers, international peer-reviewed journals, a PhD dissertation, and national and international conferences. The knowledge derived from this study is key in the development of clinical protocols to manage agitation and related behaviours in patients with TBI and designing further interventional studies targeting this specific problematic.Trial registration numberNCT04741399.
Cohort profile: SCREEN-RA: design, methods and perspectives of a Swiss cohort study of first-degree relatives of patients with rheumatoid arthritis
Authors: Gilbert Benoit Thomas P , Lamacchia Céline , Mongin Denis , Lauper Kim , Trunk Eric , Studer Olivia , Courvoisier Delphine S , Rubbert-Roth Andrea , Kyburz Diego , Moeller Burkhard , Finckh Axel 
Published: July 2021

PurposeRheumatoid arthritis (RA) is an insidious autoimmune disease, with an immunological onset years before diagnosis. Early interventions in preclinical stages could prevent or minimise the progression towards irreversible joint damage. The SCREEN-RA cohort (Evaluation of a SCREENing strategy for Rheumatoid Arthritis) aims to characterise the preclinical stages of the disease, to identify environmental risk factors, and to discover or validate novel biomarkers predictive for RA development.ParticipantsSCREEN-RA includes an at-risk population for RA, namely first-degree relatives of patients with established RA.Findings to dateThe cohort started in 2009 is composed of mostly asymptomatic healthy individuals (total n=1458, 7262 person-years), with a mean age of 44 years at enrolment, 74% female and 91% Caucasian ethnicity. During the study period, 16 participants have developed RA. All participants provide baseline serum, DNA and RNA samples, and in a subset, stool samples and oral examination are performed for microbiota assessment. At enrolment, 10% of participants had asymptomatic autoimmunity associated with RA (n=147), 10% presented ‘clinically suspect arthralgias’ (n=143) and 3% reported arthralgias in conjunction with autoimmunity or high genetic risk (n=51). Studies with this cohort have uncovered risk factors for RA development, such as female hormonal factors, poor oral health or intestinal dysbiosis.Future plansFuture directions include immunological and ‘multiomics’ approaches to discover new biological markers of progression towards RA, as well as testing preventive interventions in ‘high-risk’ population.
Risk of 30-day hospital readmission associated with medical conditions and drug regimens of polymedicated, older inpatients discharged home: a registry-based cohort study
Authors: Pereira Filipa , Verloo Henk , Taushanov Zhivko , Di Giovanni Saviana , Meyer-Massetti Carla , von Gunten Armin , Martins Maria Manuela , Wernli Boris 
Published: July 2021

ObjectivesThe present study analysed 4 years of a hospital register (2015–2018) to determine the risk of 30-day hospital readmission associated with the medical conditions and drug regimens of polymedicated, older inpatients discharged home.DesignRegistry-based cohort study.SettingValais Hospital—a public general hospital centre in the French-speaking part of Switzerland.ParticipantsWe explored the electronic records of 20 422 inpatient stays by polymedicated, home-dwelling older adults held in the hospital’s patient register. We identified 13 802 hospital stays by older adults who returned home involving 8878 separate patients over 64 years old.Outcome measuresSociodemographic characteristics, medical conditions and drug regimen data associated with risk of readmission within 30 days of discharge.ResultsThe overall 30-day hospital readmission rate was 7.8%. Adjusted multivariate analyses revealed increased risk of hospital readmission for patients with longer hospital length of stay (OR=1.014 per additional day; 95% CI 1.006 to 1.021), impaired mobility (OR=1.218; 95% CI 1.039 to 1.427), multimorbidity (OR=1.419 per additional International Classification of Diseases, 10th Revision condition; 95% CI 1.282 to 1.572), tumorous disease (OR=2.538; 95% CI 2.089 to 3.082), polypharmacy (OR=1.043 per additional drug prescribed; 95% CI 1.028 to 1.058), and certain specific drugs, including antiemetics and antinauseants (OR=3.216 per additional drug unit taken; 95% CI 1.842 to 5.617), antihypertensives (OR=1.771; 95% CI 1.287 to 2.438), drugs for functional gastrointestinal disorders (OR=1.424; 95% CI 1.166 to 1.739), systemic hormonal preparations (OR=1.207; 95% CI 1.052 to 1.385) and vitamins (OR=1.201; 95% CI 1.049 to 1.374), as well as concurrent use of beta-blocking agents and drugs for acid-related disorders (OR=1.367; 95% CI 1.046 to 1.788).ConclusionsThirty-day hospital readmission risk was associated with longer hospital length of stay, health disorders, polypharmacy and drug regimens. The drug regimen patterns increasing the risk of hospital readmission were very heterogeneous. Further research is needed to explore hospital readmissions caused solely by specific drugs and drug–drug interactions.
‘Do not attempt cardiopulmonary resuscitation’ (DNACPR)—difficulty in discussions with older medical inpatients and their families: a survey of hospital doctors
Authors: Walker Jane , Burke Katy , Magill Nicholas , van Niekerk Maike , Wanat Marta , Hobbs Harriet , Rocroi Isabelle , Frost Chris , Sharpe Michael 
Published: July 2021

ObjectivesTo determine, for doctors looking after older medical inpatients: (1) how difficult they find discussions about ‘do not attempt cardiopulmonary resuscitation’ (DNACPR); (2) whether difficulty is associated with doctors’ personal and professional characteristics; (3) how frequently DNACPR discussions are made more difficult by practical issues and by doctors’ uncertainties.MethodsSurvey of hospital doctors working on the acute medical wards of a UK NHS teaching hospital.Results171/200 (86%) of eligible doctors participated. 165 had experience of DNACPR discussions with older inpatients and/or their families and were included in our analysis. ‘Difficulty’ (defined as finding discussions ‘fairly difficult’ or ‘difficult’) was experienced by 52/165 (32%) for discussions with patients and 60/165 (36%) for discussions with families. Doctors with specific training in DNACPR discussions were less likely to have difficulty in discussions with patients. Older, more experienced doctors were less likely to have difficulty in discussions with families. Lack of time and place, and uncertainty about prognosis were the most frequently reported causes of difficulty.ConclusionsMany doctors have difficulty in DNACPR discussions. Training needs to include managing discussions with families, as well as with patients, and doctors need time and space to deliver this important part of their job.
Impact of the COVID-19 pandemic on emergency medical service response to out-of-hospital cardiac arrests in Taiwan: a retrospective observational study
Authors: Yu Jiun-Hao , Liu Chien-Yu , Chen Wei-Kung , Yu Shao-Hua , Huang Fen-Wei , Yang Ming-Tzu , Chen Chih-Yu , Shih Hong-Mo 
Published: July 2021

BackgroundEmergency medical service (EMS) personnel have high COVID-19 risk during resuscitation. The resuscitation protocol for patients with out-of-hospital cardiac arrest (OHCA) was modified in response to the COVID-19 pandemic. However, how the adjustments in the EMS system affected patients with OHCA remains unclear.MethodsWe analysed data from the Taichung OHCA registry system. We compared OHCA outcomes and rescue records for 622 cases during the COVID-19 outbreak period (1 February to 30 April 2020) with those recorded for 570 cases during the same period in 2019.ResultsThe two periods did not differ significantly with respect to patient age, patient sex, the presence of witnesses or OHCA location. Bystander cardiopulmonary resuscitation and defibrillation with automated external defibrillators were more common in 2020 (52.81% vs 65.76%, p<0.001%, and 23.51% vs 31.67%, p=0.001, respectively). The EMS response time was longer during the COVID-19 pandemic (445.8±210.2 s in 2020 vs 389.7±201.8 s in 2019, p<0.001). The rate of prehospital return of spontaneous circulation was lower in 2020 (6.49% vs 2.57%, p=0.001); 2019 and 2020 had similar rates of survival discharge (5.96% vs 4.98%). However, significantly fewer cases had favourable neurological function in 2020 (4.21% vs 2.09%, p=0.035).ConclusionEMS response time for patients with OHCA was prolonged during the COVID-19 pandemic. Early advanced life support by EMS personnel remains crucial for patients with OHCA.
Reverse translation approach generates a signature of penetrating fibrosis in Crohn’s disease that is associated with anti-TNF response
Authors: Xiong Shanshan , Whitehurst Charles E , Li Li , Heo Gyu Seong , Lai Chin-Wen , Jain Umang , Muegge Brian D , Espenschied Scott T , Musich Ryan J , Chen Minhu , Liu Yongjian , Liu Ta-Chiang , Stappenbeck Thaddeus S 
Published: July 2021

ObjectiveFibrosis is a common feature of Crohn’s disease (CD) which can involve the mesenteric fat. However, the molecular signature of this process remains unclear. Our goal was to define the transcriptional signature of mesenteric fibrosis in CD subjects and to model mesenteric fibrosis in mice to improve our understanding of CD pathogenesis.DesignWe performed histological and transcriptional analysis of fibrosis in CD samples. We modelled a CD-like fibrosis phenotype by performing repeated colonic biopsies in mice and analysed the model by histology, type I collagen-targeted positron emission tomography (PET) and global gene expression. We generated a gene set list of essential features of mesenteric fibrosis and compared it to mucosal biopsy datasets from inflammatory bowel disease patients to identify a refined gene set that correlated with clinical outcomes.ResultsMesenteric fibrosis in CD was interconnected to areas of fibrosis in all layers of the intestine, defined as penetrating fibrosis. We found a transcriptional signature of differentially expressed genes enriched in areas of the mesenteric fat of CD subjects with high levels of fibrosis. Mice subjected to repeated colonic biopsies showed penetrating fibrosis as shown by histology, PET imaging and transcriptional analysis. Finally, we composed a composite 24-gene set list that was linked to inflammatory fibroblasts and correlated with treatment response.ConclusionWe linked histopathological and molecular features of CD penetrating fibrosis to a mouse model of repeated biopsy injuries. This experimental system provides an innovative approach for functional investigations of underlying profibrotic mechanisms and therapeutic concepts in CD.
Effects of non-surgical treatment of chronic periodontitis on insulin resistance and glucose tolerance in subjects without diabetes (PARODIA 2 study)
Authors: Nana Nana Arnel Redon , Tsobgny Tsague Nadia-Flore , Lontchi-Yimagou Eric , Bengondo Messanga Charles , Tankeu Aurel , Katte Jean-Claude , Balti Vounsia Eric , Dehayem Mesmin , Sobngwi Eugene 
Published: July 2021

This study aimed to assess the effects of non-surgical periodontal treatment (NSPT) of chronic periodontitis on insulin sensitivity, glucose tolerance, and serum C reactive protein (CRP) level in individuals without diabetes. Twenty individuals without diabetes with chronic periodontitis underwent NSPT, which consisted of complete scaling, polishing, root planing, and irrigation of the periodontal pockets with a 10% povidone-iodine solution. Periodontal indices (plaque index, gingival bleeding index, pocket depth, and clinical attachment loss), insulin sensitivity using the Short Insulin Tolerance Test index (KITT), glucose tolerance derived from oral glucose tolerance test, and serum CRP level were measured before and 3 months after the intervention. This study was carried out at the National Obesity Center of Yaoundé Central Hospital, Cameroon. After 3 months, we observed significant improvement in periodontal parameters (all p<0.001) and insulin sensitivity (3.72 (2.99–4.17) %/min before treatment vs 4.04 (3.67–4.78) %/min after treatment, p=0.001) and significant decrease in serum CRP level (2.35 (1.46–4.18) mg/L before vs 1.53 (1.03–2.12) mg/L after, p=0.033). There was a trend toward improvement in glucose tolerance, although not statistically significant after the intervention. This study suggests that NSPT of chronic periodontitis in individuals without diabetes is associated with increased insulin sensitivity and decreased serum CRP levels. Trial registration number NCT02830113.
Ethical issues in two parallel trials of personalised criteria for implantation of implantable cardioverter defibrillators for primary prevention: the PROFID project—a position paper
Authors: Willems Dick , Bak Marieke , Tan Hanno , Lindinger Georg , Kocar Ayca , Seperhi Shamloo Alireza , Schmidt Georg , Hindricks Gerhard , Dagres Nikolaos 
Published: July 2021

AimTo discuss ethical issues related to a complex study (PROFID) involving the development of a new, partly artificial intelligence-based, prediction model to enable personalised decision-making about the implantation of an implantable cardioverter defibrillator (ICD) in postmyocardial infarction patients, and a parallel non-inferiority and superiority trial to test decision-making informed by that model.MethodThe position expressed in this paper is based on an analysis of the PROFID trials using concepts from high-profile publications in the ethical literature.ResultsWe identify ethical issues related to the testing of the model in the treatment setting, and to both the superiority and the non-inferiority trial. We underline the need for ethical-empirical studies about these issues, also among patients, as a parallel to the actual trials. The number of ethics committees involved is an organisational, but also an ethical challenge.ConclusionThe PROFID trials, and probably other studies of similar scale and complexity, raise questions that deserve dedicated parallel ethics and social science research, but do not constitute a generic obstacle. A harmonisation procedure, comparable to the Voluntary Harmonization Procedure (VHP) for medication trials, could be needed for this type of trials.
Ecological responses to elevated water temperatures across invasive populations of the round goby (Neogobius melanostomus) in the Great Lakes basin
Authors: Reid Heather Bauer , Ricciardi Anthony 
Published: July 2021

Climate warming is expected to alter the distribution, abundance, and impact of non-native species in aquatic ecosystems. In laboratory experiments, we measured the maximum feeding rate and critical thermal maximum (CTmax) of an invasive Eurasian fish, the round goby (Neogobius melanostomus), acclimated to a range of temperatures (18–28 °C) reflecting current and projected future thermal conditions for the nearshore Great Lakes. Fish were collected from four distinct populations along a latitudinal gradient from the western basin of Lake Erie to Hamilton Harbour (Lake Ontario) and the upper St. Lawrence River. Thermal tolerance increased with acclimation temperature for populations in Lakes Erie and Ontario. However, the St. Lawrence River populations had lower acclimation capacity and exhibited an unexpected decline in CTmax at the highest acclimation temperature. Maximum feeding rates peaked at 18–24 °C and declined with temperatures above 24 °C. Northern populations in the basin appear poorly adapted to elevated temperatures such that their performance and impact could be reduced by climate warming. Thermal response data from latitudinally distributed populations are needed to inform invasive species risk assessment.
Competitive Caching with Machine Learned Advice
Authors: Lykouris Thodoris , Vassilvitskii Sergei 
Published: July 2021

Traditional online algorithms encapsulate decision making under uncertainty, and give ways to hedge against all possible future events, while guaranteeing a nearly optimal solution, as compared to an offline optimum. On the other hand, machine learning algorithms are in the business of extrapolating patterns found in the data to predict the future, and usually come with strong guarantees on the expected generalization error.
In this work, we develop a framework for augmenting online algorithms with a machine learned predictor to achieve competitive ratios that provably improve upon unconditional worst-case lower bounds when the predictor has low error. Our approach treats the predictor as a complete black box and is not dependent on its inner workings or the exact distribution of its errors.

We apply this framework to the traditional caching problem—creating an eviction strategy for a cache of size
k
. We demonstrate that naively following the oracle’s recommendations may lead to very poor performance, even when the average error is quite low. Instead, we show how to modify the Marker algorithm to take into account the predictions and prove that this combined approach achieves a competitive ratio that both (i) decreases as the predictor’s error decreases and (ii) is always capped by
O
(log
k
), which can be achieved without any assistance from the predictor. We complement our results with an empirical evaluation of our algorithm on real-world datasets and show that it performs well empirically even when using simple off-the-shelf predictions.