bluuebunny/crossref_metadata_2025_split huggingface dataset:
Processes of care and outcomes for homeless patients hospitalised for cardiovascular conditions at safety-net versus non-safety-net hospitals: cross-sectional study
Authors: Miyawaki Atsushi , Khullar Dhruv , Tsugawa Yusuke 
Published: April 2021

ObjectivesEvidence suggests that homeless patients experience worse quality of care and poorer health outcomes across a range of medical conditions. It remains unclear, however, whether differences in care delivery at safety-net versus non-safety-net hospitals explain these disparities. We aimed to investigate whether homeless versus non-homeless adults hospitalised for cardiovascular conditions (acute myocardial infarction (AMI) and stroke) experience differences in care delivery and health outcomes at safety-net versus non-safety-net hospitals.DesignCross-sectional study.SettingData including all hospital admissions in four states (Florida, Massachusetts, Maryland, and New York) in 2014.ParticipantsWe analysed 167 105 adults aged 18 years or older hospitalised for cardiovascular conditions (age mean=64.5 years; 75 361 (45.1%) women; 2123 (1.3%) homeless hospitalisations) discharged from 348 hospitals.Outcome measuresRisk-adjusted diagnostic and therapeutic procedure and in-hospital mortality, after adjusting for patient characteristics and state and quarter fixed effects.ResultsAt safety-net hospitals, homeless adults hospitalised for AMI were less likely to receive coronary angiogram (adjusted OR (aOR), 0.42; 95% CI, 0.36 to 0.50; p<0.001), percutaneous coronary intervention (aOR, 0.52; 95% CI, 0.44 to 0.62; p<0.001) and coronary artery bypass graft (aOR, 0.43; 95% CI, 0.26 to 0.71; p<0.01) compared with non-homeless adults. Homeless patients treated for strokes at safety-net hospitals were less likely to receive cerebral arteriography (aOR, 0.23; 95% CI, 0.16 to 0.34; p<0.001), but were as likely to receive thrombolysis therapy. At non-safety-net hospitals, we found no evidence that the probability of receiving these procedures differed between homeless and non-homeless adults hospitalised for AMI or stroke. Finally, there were no differences in in-hospital mortality rates for homeless versus non-homeless patients at either safety-net or non-safety-net hospitals.ConclusionDisparities in receipt of diagnostic and therapeutic procedures for homeless patients with cardiovascular conditions were observed only at safety-net hospitals. However, we found no evidence that these differences influenced in-hospital mortality markedly.
Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study
Authors: Shum Leona K , Chan Herbert , Erdelyi Shannon , Pei Lulu X , Brubacher Jeffrey R 
Published: April 2021

IntroductionRoad trauma (RT) is a major public health problem affecting physical and mental health, and may result in prolonged absenteeism from work or study. It is important for healthcare providers to know which RT survivors are at risk of a poor outcome, and policy-makers should know the associated costs. Unfortunately, outcome after RT is poorly understood, especially for RT survivors who are treated and released from an emergency department (ED) without the need for hospital admission. Currently, there is almost no research on risk factors for a poor outcome among RT survivors. This study will use current Canadian data to address these knowledge gaps.Methods and analysisWe will follow an inception cohort of 1500 RT survivors (16 years and older) who visited a participating ED within 24 hours of the accident. Baseline interviews determine pre-existing health and functional status, and other potential risk factors for a poor outcome. Follow-up interviews at 2, 4, 6, and 12 months (key stages of recovery) use standardised health-related quality of life tools to determine physical and mental health outcome, functional recovery, and healthcare resource use and lost productivity costs.Ethics and disseminationTheRoad Trauma Outcome Studyis approved by our institutional Research Ethics Board. This study aims to provide healthcare providers with knowledge on how quickly RT survivors recover from their injuries and who may be more likely to have a poor outcome. We anticipate that this information will be used to improve management of all road users following RT. Healthcare resource use and lost productivity costs will be collected to provide a better cost estimate of the effects of RT. This information can be used by policy-makers to make informed decisions on RT prevention programmes.
Efficacy of vision-based treatments for children and teens with amblyopia: a systematic review and meta-analysis of randomised controlled trials
Authors: Brin Taylor Adrian , Chow Amy , Carter Caitlin , Oremus Mark , Bobier William , Thompson Benjamin 
Published: April 2021

ObjectiveTo identify differences in efficacy between vision-based treatments for improving visual acuity (VA) of the amblyopic eye in persons aged 4–17 years old.Data sourcesOvid Embase, PubMed (Medline), the Cochrane Library, Vision Cite and Scopus were systematically searched from 1975 to 17 June 2020.MethodsTwo independent reviewers screened search results for randomised controlled trials of vision-based amblyopia treatments that specified change in amblyopic eye VA (logMAR) as the primary outcome measure. Quality was assessed via risk of bias and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations).ResultsOf the 3346 studies identified, 36 were included in a narrative synthesis. A random effects meta-analysis (five studies) compared the efficacy of binocular treatments versus patching: mean difference −0.03 logMAR; 95% CI 0.01 to 0.04 (p<0.001), favouring patching. An exploratory study-level regression (18 studies) showed no statistically significant differences between vision-based treatments and a reference group of 2–5 hours of patching. Age, sample size and pre-randomisation optical treatment were not statistically significantly associated with changes in amblyopic eye acuity. A network meta-analysis (26 studies) comparing vision-based treatments to patching 2–5 hours found one statistically significant comparison, namely, the favouring of a combination of two treatment arms comparing combination and binocular treatments, against patching 2–5 hours: standard mean difference: 2.63; 95% CI 1.18 to 4.09. However, this result was an indirect comparison calculated from a single study. A linear regression analysis (17 studies) found a significant relationship between adherence and effect size, but the model did not completely fit the data: regression coefficient 0.022; 95% CI 0.004 to 0.040 (p=0.02).ConclusionWe found no clinically relevant differences in treatment efficacy between the treatments included in this review. Adherence to the prescribed hours of treatment varied considerably and may have had an effect on treatment success.
Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis
Authors: Pelton Matt , Ciarletta Matt , Wisnousky Holly , Lazzara Nicholas , Manglani Monica , Ba Djibril M , Chinchillli Vernon M , Du Ping , Ssentongo Anna E , Ssentongo Paddy 
Published: April 2021

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.
Impact of lockdown on key workers: findings from the COVID-19 survey in four UK national longitudinal studies
Authors: Topriceanu Constantin-Cristian , Wong Andrew , Moon James C , Hughes Alun D , Chaturvedi Nishi , Conti Gabriella , Bann David , Patalay Praveetha , Captur Gabriella 
Published: April 2021

BackgroundKey workers played a pivotal role during the national lockdown in the UK’s response to the COVID-19 pandemic. Although protective measures have been taken, the impact of the pandemic on key workers is yet to be fully elucidated.MethodsParticipants were from four longitudinal age-homogeneous British cohorts (born in 2001, 1990, 1970 and 1958). A web-based survey provided outcome data during the first UK national lockdown (May 2020) on COVID-19 infection status, changes in financial situation, trust in government, conflict with people around, household composition, psychological distress, alcohol consumption, smoking and sleep duration. Generalised linear models with logit link assessed the association between being a key worker and the above outcomes. Adjustment was made for cohort design, non-response, sex, ethnicity, adult socioeconomic position (SEP), childhood SEP, the presence of a chronic illness and receipt of a shielding letter. Meta-analyses were performed across the cohorts.Findings13 736 participants were included. During lockdown, being a key worker was associated with increased chances of being infected with COVID-19 (OR 1.43, 95% CI 1.22 to 1.68) and experiencing conflict with people around (OR 1.19, 95% CI 1.03 to 1.37). However, key workers were less likely to be worse off financially (OR 0.32, 95% CI 0.24 to 0.65), to consume more alcohol (OR 0.88, 95% CI 0.79 to 0.98) or to smoke more (OR 0.60, 95% CI 0.44 to 0.80) during lockdown. Interestingly, being a key worker was not associated with psychological distress (OR 0.95, 95% CI 0.85 to 1.05).InterpretationBeing a key worker during the first UK COVID-19 lockdown was a double-edged sword, with both benefits and downsides. The UK government had the basic duty to protect its key workers from SARS-CoV-2 infection, but it may have failed to do so, and there is an urgent need to rectify this in light of the ongoing third wave.
Intratumoral OH2, an oncolytic herpes simplex virus 2, in patients with advanced solid tumors: a multicenter, phase I/II clinical trial
Authors: Zhang Bo , Huang Jing , Tang Jialin , Hu Sheng , Luo Suxia , Luo Zhiguo , Zhou Fuxiang , Tan Shiyun , Ying Jieer , Chang Qing , Zhang Rui , Geng Chengyun , Wu Dawei , Gu Xiangyong , Liu Binlei 
Published: April 2021

BackgroundOH2 is a genetically engineered oncolytic herpes simplex virus type 2 designed to selectively amplify in tumor cells and express granulocyte-macrophage colony-stimulating factor to enhance antitumor immune responses. We investigated the safety, tolerability and antitumor activity of OH2 as single agent or in combination with HX008, an anti-programmed cell death protein 1 antibody, in patients with advanced solid tumors.MethodsIn this multicenter, phase I/II trial, we enrolled patients with standard treatment-refractory advanced solid tumors who have injectable lesions. In phase I, patients received intratumoral injection of OH2 at escalating doses (106, 107 and 108CCID50/mL) as single agent or with fixed-dose HX008. The recommended doses were then expanded in phase II. Primary endpoints were safety and tolerability defined by the maximum-tolerated dose and dose-limiting toxicities (DLTs) in phase I, and antitumor activity assessed per Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) and immune-RECIST in phase II.ResultsBetween April 17, 2019 and September 22, 2020, 54 patients with metastatic cancers were enrolled. Forty patients were treated with single agent OH2, and 14 with OH2 plus HX008. No DLTs were reported with single agent OH2 in phase I. Four patients, having metastatic mismatch repair-proficient rectal cancer or metastatic esophageal cancer, achieved immune-partial response, with two from the single agent cohort and two from the combination cohort. The duration of response were 11.25+ and 14.03+ months for the two responders treated with single agent OH2, and 1.38+ and 2.56+ months for the two responders in the combination cohort. The most common treatment-related adverse event (TRAE) with single agent OH2 was fever (n=18, 45.0%). All TRAEs were of grade 1–2, except one case of grade 3 fever in the 108CCID50/mL group. No treatment-related serious AEs occurred. Single agent OH2 induced alterations in the tumor microenvironment, with clear increases in CD3+ and CD8+ cell density and programmed death-ligand 1 expression in the patients’ post-treatment biopsies relative to baseline.ConclusionsIntratumoral injection of OH2 was well-tolerated, and demonstrated durable antitumor activity in patients with metastatic esophageal and rectal cancer. Further clinical development of OH2 as single agent or with immune checkpoint inhibitors in selected tumor types is warranted.
How to best handle vaccine decliners: scientific facts and psychological approach
Authors: Xantus Gabor Zoltan , Burke Derek , Kanizsai Peter 
Published: April 2021

AbstractThere is currently no curative drug therapy for COVID-19. The spread of the virus seems relentless despite the unprecedented epidemiological measures. Prevention remains the only feasible option to stop the pandemic; without population-level vaccination, we are unlikely to regain the quality of social life and the unrestricted economy/commerce we enjoyed before. Anti-vaxxers and conspiracy theorists are seemingly oblivious to the detrimental effect of COVID-19 both at an individual and societal level. These groups have (and probably will) continue to attempt to undermine efforts to eradicate the virus despite the fact that the major reduction in morbidity/and mortality of infectious diseases of the past century was achieved through the development of vaccines and improved hygiene. Conspiracy theories are directly associated with reduced vaccine uptake and unfortunately neither anti-vaxxers nor vaccine hesitants cannot be persuaded (debunked) with logical arguments; hence, prescribers must not only be aware of the truth underlying the dense web of misinformation but must fully understand the psychological aspects as well to be able to efficiently counsel about the potential benefits and harms. Such knowledge is pivotal to help the lay public to make informed decisions about SARS CoV-2 in general and vaccination in particular; as the COVID-19 situation can probably be best controlled with mass inoculation and novel immune therapies. The lessons learnt regarding the importance of efficient communication and the adherence to the proven epidemiological measures hopefully would be leaving us better prepared for the future if challenged by novel communicable diseases of pandemic potential.
Analysis of wedding appeals on cigarette packs in China
Authors: Trimble Deana G , Yu Lingwei , Welding Kevin , Clegg Smith Katherine , Cohen Joanna E 
Published: April 2021

IntroductionExchanging or gifting cigarettes is a common practice in Chinese culture, often occurring during weddings to connote celebrations and happiness. We examined Chinese cigarette packs for wedding terminology and imagery to assess the extent to which packs are marketed for such occasions.MethodsCigarette packs were collected from Beijing, Guangzhou, Shanghai, Kunming and Chengdu in February 2017 using a systematic protocol designed to capture unique packs. Packs were coded by two independent coders for text and imagery of traditional Chinese wedding symbols, such as double happiness, dragon and phoenix, and other culturally specific phrases and images associated with weddings in China.ResultsFrom the sample of 738 unique cigarette packs, 68 (9.2%) contained either lexical and/or imagery appeals for wedding gifting. Of these 68 packs, 65 contained both lexical and imagery appeals, 1 pack had only a lexical appeal and 2 packs only included an imagery appeal. The most common appeal was ‘double happiness’ found on 56 packs (82.4%) for both lexical and imagery, followed by ‘dragon and phoenix’ found lexically on 12 packs (17.6%), and through imagery on 15 packs (22.1%).ConclusionsChinese tobacco manufacturers take full advantage of the cigarette gifting and sharing culture demonstrated by packs with imagery and terminology specific to weddings. With only a 35% text health warning label, manufacturers have much real estate to make packs attractive for gifting on such occasions. Implementing plain packaging policies may be effective in decreasing gifting attractiveness for cigarette packs.
40Ar/39Ar dating of Paleoproterozoic shear zones in the Ellesmere–Devon crystalline terrane, Nunavut, Canadian Arctic
Authors: Caswell Brandon , Gilotti Jane A. , Webb Laura E. , McClelland William C. , Kośmińska Karolina , Piepjohn Karsten , von Gosen Werner 
Published: April 2021

Paleoproterozoic gneisses of the Ellesmere–Devon crystalline terrane on southeastern Ellesmere Island are deformed by metre-scale, east-striking mylonite zones. The shear zones commonly offset pegmatitic dikes and represent the last episode of ductile deformation. Samples were dated by the 40Ar/39Ar step-heating method to put an upper limit on the time of deformation. Biotite from one tonalitic protolith and five shear zones give geologically meaningful results. Clusters of unoriented biotite grains pseudomorph granulite-facies orthopyroxene in some of the weakly deformed gneisses, whereas the shape-preferred orientation of biotite defines the mylonitic fabric. The intrusive age of the tonalitic protolith is 1958 ± 12 Ma, based on previous U–Pb dating of zircon. 40Ar/39Ar analysis of biotite from the same sample gave a plateau age of 1929 ± 23 Ma, which is interpreted as cooling from regional granulite facies metamorphism. Three nearby samples of mylonitic tonalite have 40Ar/39Ar ages in the range of ≈1870–1840 Ma. Biotite from two granitic mylonites over 80 km away return high-resolution Ar spectra in the same range, implying that widespread ductile shearing occurred at ≈1870–1840 Ma, or ≈90 million years after cooling from regional metamorphism. Although the 2.0–1.9 Ga gneisses of southeastern Ellesmere Island correlate with the Inglefield Mobile Belt in North-West Greenland and the Thelon Tectonic Zone, the late shear zones are superimposed on that juvenile arc long after the 1.97 Ga Thelon orogeny.
Evaluation of selected cider apple (Malus domesticaBorkh.) cultivars grown in Ontario. II. Juice attributes
Authors: Plotkowski Derek J. , Cline John A. 
Published: April 2021

Twenty-eight apple cultivars were selected for their potential for hard cider production in Ontario; their juice characteristics were measured in 2017 and 2018, beginning two years after planting in 2015. After being harvested and pressed, each juice sample underwent analyses to determine soluble solids concentration (SSC), titratable acidity (TA), pH, yeast assimilable nitrogen (YAN), and polyphenolic concentration. Soluble solids concentration ranged from 10.6 °Brix in Brown’s Apple to 18.3 °Brix in Ashmead’s Kernel. Titratable acidity ranged from 31 as mg malic acid per 100 mL juice in Sweet Alford to 191 as mg malic acid per 100 mL juice in Bramley’s Seedling. The pH ranged from 2.88 in Breakwell to 4.76 in Sweet Alford. Yeast assimilable nitrogen concentration ranged from 60 mg YAN·L−1juice in Medaille d’Or to 256 mg YAN·L−1juice in Bulmer’s Norman. Polyphenols in juice ranged from 131 μg gallic acid equivalents (gae)·mL−1juice in Tolman Sweet to 1042 μg gae·mL−1juice in Stoke Red. Firmness ranged from 6.3 kg in Yarlington Mill to 11.7 kg in GoldRush. The relationships between these variables were also analyzed, showing a connection between acidity and juicing efficiency as well as a relationship between polyphenol concentration and fruit weight. Exploratory analyses indicated that juice attributes can be used to distinguish between cultivars and their origins. Cider producers can use these data to determine what to expect in juice from these cultivars.
Rye cover crop improves vegetable crop nitrogen use efficiency and yield in a short season growing region
Authors: Farzadfar Soudeh , Knight J. Diane , Congreves Kate A. 
Published: April 2021

Cover crops have the potential to immobilize nitrogen (N) that would otherwise be lost before or after the main crop production, leading to improved N management. However, information on how cover crops influence N management in intensive vegetable cropping systems is scarce. This study aimed to determine how an overwintering rye cover crop impacts crop yield and N cycling, for three common prairie vegetable crops. From 2017 to 2019, a broccoli – sweet corn – root crop sequence was tested (in which all crops of rotation were present each year), with each crop type receiving five N fertilizer treatments, ranging from 0 to 300 kg N·ha−1. After harvest each year, sub-plots were established with vs. without a rye cover crop, and the effect on vegetable yield, soil inorganic N, and N use efficiency (NUE) was followed into the subsequent growing season. In most cases, the cover crop increased vegetable crop productivity and N content in the subsequent growing season. The cover crop also lowered soil inorganic N levels at vegetable planting but increased levels at harvest. Vegetable crop NUE indices were frequently improved with vs. without the cover crop. As for the N fertilizer response, increasing N fertilizer rate did not continually increase vegetable crop productivity and N content. Higher N fertilizer rates increased soil inorganic N levels at vegetable planting and harvest, and often lowered vegetable crop NUE indices. These results demonstrate the importance of adjusting soil N levels to better align with crop needs — and that including a rye cover crop in the vegetable rotation is one method of doing so.