bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between health behaviours and cardiometabolic dysregulation: a population-based survey among healthy adults in Hong Kong
Authors: Yu Esther Yee Tak , Yeung Caitlin Hon Ning , Wan Eric Yuk Fai , Tang Eric Ho Man , Wong Carlos King Ho , Cheung Bernard Man Yung , Lam Cindy Lo Kuen 
Published: July 2021

ObjectiveTo explore the association between cardiometabolic dysregulation, an integral component of allostatic load, and health risk behaviours (HRBs) of the Hong Kong healthy adult population.DesignSecondary analysis of cross-sectional anonymous data.SettingData on sociodemographics, self-reported health status, HRBs and biomarkers were extracted from the Hong Kong Population Health Survey 2014/2015.ParticipantsOne thousand five hundred and fifty-one participants aged 18–64 years without self-reported diagnoses of hypertension, diabetes mellitus, hyperlipidaemia, cardiovascular disease, cognitive impairment or cancer.Primary outcome measuresCardiometabolic dysregulation index (CMDI), ranging from 0 to 6, was calculated by counting the number of biomarkers including systolic blood pressure, diastolic blood pressure, waist to hip ratio, glycated haemoglobin, total cholesterol to high-density lipoprotein cholesterol ratio, and triglycerides that were above the respective normal level suggested by international guidelines and literature. HRBs including smoking, dietary habits and sleeping hours were collected by self-report questionnaire. Alcohol consumption was assessed by the 10-item Alcohol Use Disorders Identification Test, while physical activity level was measured using the Global Physical Activity Questionnaire. A composite HRB score, ranging from 0 to 5, was calculated as the cumulative number of HRBs. The effect of HRB on CMDI was evaluated by negative binomial regression with adjustment for socioeconomic status, health awareness and comorbidities of the participants.ResultsThe mean CMDI of the studied population was 1.6; 29.5% had a CMDI of 0, whereas 1.5% had a CMDI of 6. Significant difference was observed in mean CMDI between gender and different age groups. Sleeping less than 6 hours (incidence rate ratio (IRR)=1.26, p<0.001), smoking (IRR=1.15, p=0.027), insufficient physical activity (IRR=1.12, p=0.007) and higher composite HRB score (IRR=1.12, 95% CI 1.06 to 1.18) were significantly associated with higher CMDI.ConclusionSmoking, physical inactivity and inadequate sleep—an essential yet often overlooked health behaviour—were associated with higher CMDI in the Hong Kong healthy adult population.
Trends in cardiovascular disease in Scottish military veterans: a retrospective cohort study
Authors: Bergman Beverly P , Mackay Daniel F , Pell Jill P 
Published: July 2021

ObjectivesTo examine the risk of cardiovascular disease (CVD) in Scottish military veterans in comparison with people who had never served in long-term follow-up to 2017, and to compare the findings with our earlier study to 2012 to assess trends.DesignRetrospective cohort study with up to 37 years follow-up.SettingPseudo-anonymised extract of computerised Scottish National Health Service records and national vital records.Participants78 000 veterans and 253 000 people with no record of service matched for age, sex and area of residence.Outcome measuresRisk of first occurrence of acute myocardial infarction, peripheral arterial disease and stroke in veterans compared with non-veterans, overall and by sex and birth cohort.ResultsA first episode of CVD was recorded in 5.7% of veterans and 4.8% of non-veterans overall, Cox proportional HR 1.16, 95% CIs 1.12 to 1.20, p=0.001. The difference was only significant for men, and for veterans born before 1960, and was highest in veterans with the shortest service. In all categories, the difference in risk was less than at the end of 2012.ConclusionsThe excess burden of CVD in veterans which was evident at the end of 2012 has reduced in the following 5 years from 23% to 16% overall. The increased risk continues to affect only those veterans born prior to 1960, suggesting that improvements in military health promotion since 1978, when veterans born from 1960 joined the armed forces, have had an important and ongoing beneficial effect on the long-term health of veterans.
Changing relationships: how does patient involvement transform professional identity? An ethnographic study
Authors: Codsi Marie-Pierre , Karazivan Philippe , Rouly Ghislaine , Leclaire Marie , Boivin Antoine 
Published: July 2021

ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.
Cost savings associated with nutritional support in medical inpatients: an economic model based on data from a systematic review of randomised trials
Authors: Schuetz Philipp , Sulo Suela , Walzer Stefan , Vollmer Lutz , Brunton Cory , Kaegi-Braun Nina , Stanga Zeno , Mueller Beat , Gomes Filomena 
Published: July 2021

Background and aimsNutritional support improves clinical outcomes during hospitalisation as well as after discharge. Recently, a systematic review of 27 randomised, controlled trials showed that nutritional support was associated with lower rates of hospital readmissions and improved survival. In the present economic modelling study, we sought to determine whether in-hospital nutritional support would also return economic benefits.MethodsThe current economic model applied cost estimates to the outcome results from our recent systematic review of hospitalised patients. In the underlying meta-analysis, a total of 27 trials (n=6803 patients) were included. To calculate the economic impact of nutritional support, a Markov model was developed using transitions between relevant health states. Costs were estimated accounting for length of stay in a general hospital ward, hospital-acquired infections, readmissions and nutritional support. Six-month mortality was also considered. The estimated daily per-patient cost for in-hospital nutrition was US$6.23.ResultsOverall costs of care within the model timeframe of 6 months averaged US$63 227 per patient in the intervention group versus US$66 045 in the control group, which corresponds to per patient cost savings of US$2818. These cost savings were mainly due to reduced infection rate and shorter lengths of stay. We also calculated the costs to prevent a hospital-acquired infection and a non-elective readmission, that is, US$820 and US$733, respectively. The incremental cost per life-day gained was −US$1149 with 2.53 additional days. The sensitivity analyses for cost per quality-adjusted life day provided support for the original findings.ConclusionsFor medical inpatients who are malnourished or at nutritional risk, our findings showed that in-hospital nutritional support is a cost-effective way to reduce risk for readmissions, lower the frequency of hospital-associated infections, and improve survival rates.
Protocol for development of a reporting guideline (TRIPOD-AI) and risk of bias tool (PROBAST-AI) for diagnostic and prognostic prediction model studies based on artificial intelligence
Authors: Collins Gary S , Dhiman Paula , Andaur Navarro Constanza L , Ma Jie , Hooft Lotty , Reitsma Johannes B , Logullo Patricia , Beam Andrew L , Peng Lily , Van Calster Ben , van Smeden Maarten , Riley Richard D , Moons Karel GM 
Published: July 2021

IntroductionThe Transparent Reporting of a multivariable prediction model of Individual Prognosis Or Diagnosis (TRIPOD) statement and the Prediction model Risk Of Bias ASsessment Tool (PROBAST) were both published to improve the reporting and critical appraisal of prediction model studies for diagnosis and prognosis. This paper describes the processes and methods that will be used to develop an extension to the TRIPOD statement (TRIPOD-artificial intelligence, AI) and the PROBAST (PROBAST-AI) tool for prediction model studies that applied machine learning techniques.Methods and analysisTRIPOD-AI and PROBAST-AI will be developed following published guidance from the EQUATOR Network, and will comprise five stages. Stage 1 will comprise two systematic reviews (across all medical fields and specifically in oncology) to examine the quality of reporting in published machine-learning-based prediction model studies. In stage 2, we will consult a diverse group of key stakeholders using a Delphi process to identify items to be considered for inclusion in TRIPOD-AI and PROBAST-AI. Stage 3 will be virtual consensus meetings to consolidate and prioritise key items to be included in TRIPOD-AI and PROBAST-AI. Stage 4 will involve developing the TRIPOD-AI checklist and the PROBAST-AI tool, and writing the accompanying explanation and elaboration papers. In the final stage, stage 5, we will disseminate TRIPOD-AI and PROBAST-AI via journals, conferences, blogs, websites (including TRIPOD, PROBAST and EQUATOR Network) and social media. TRIPOD-AI will provide researchers working on prediction model studies based on machine learning with a reporting guideline that can help them report key details that readers need to evaluate the study quality and interpret its findings, potentially reducing research waste. We anticipate PROBAST-AI will help researchers, clinicians, systematic reviewers and policymakers critically appraise the design, conduct and analysis of machine learning based prediction model studies, with a robust standardised tool for bias evaluation.Ethics and disseminationEthical approval has been granted by the Central University Research Ethics Committee, University of Oxford on 10-December-2020 (R73034/RE001). Findings from this study will be disseminated through peer-review publications.PROSPERO registration numberCRD42019140361 and CRD42019161764.
Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women
Authors: Wang Hanyu , Frasco Eric , Shang Jie , Chen Minne , Xin Tong , Tang Kun 
Published: July 2021

ObjectivesThis study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.DesignCross-sectional data from a Chinese population-based study were analysed.SettingPopulation from 10 (5 rural and 5 urban) areas in China.ParticipantsAround 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.OutcomeMDD was assessed using the Composite International Diagnostic Inventory.ResultsThe odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.ConclusionsPeople in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.
ACTonDiabetes—a guided psychological internet intervention based on Acceptance and Commitment Therapy (ACT) for adults living with type 1 or 2 diabetes: results of a randomised controlled feasibility trial
Authors: Bendig Eileen , Bauereiss Natalie , Schmitt Andreas , Albus Patrick , Baumeister Harald 
Published: July 2021

ObjectivesThis two-group randomised controlled trial evaluates the feasibility of an Acceptance and Commitment Therapy (ACT)-based internet intervention for diabetes distress in people with diabetes type 1 or type 2. Participants were assigned to a guided self-help intervention (EG) or waitlist control group (CG).SettingRecruitment took place following an open recruitment strategy including different diabetes centres, self-help groups and social media platforms.ParticipantsEligibility criteria comprised being 18 years of age or older, self-reported diagnosis of type 1 or type 2 diabetes, internet access, sufficient German language skills and written informed consent.InterventionACTonDiabetes is an internet-based and mobile-based intervention and comprises an introduction and seven modules (one module per week, processing time about 45–60 min). Intervention contents are based on ACT.Primary and secondary outcome measuresParticipants were assessed before and 8 weeks after randomisation. Primary outcome was feasibility (trial recruitment, acceptability). Potential group differences in diabetes distress and other outcomes at follow-up were analysed using linear regression models with baseline values as predictors. All analyses were based on an intention-to-treat principle, potential negative effects were analysed on per-protocol basis.ResultsFrom October 2017 to April 2018, N=42 people with diabetes consented and were randomised (EG n=21, CG n=21). Forty-three per cent of the EG completed all treatment modules within 8 weeks. Across modules, formative user feedback revealed that contents could be optimised regarding comprehensibility (34%), individualisation (20%) and text amount (21%). Overall, 57% of participants dropped out prior to full treatment completion. There were reductions of diabetes distress in the EG (d=0.65, p=0.042).ConclusionsModifications of the intervention content according to the user feedback will be performed to further improve acceptability. Mechanisms to foster intervention adherence should be considered for lowering the attrition rate. ACTonDiabetes is feasible for the implementation in a confirmatory trial.Trial registration numberWHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS) (DRKS00013193).
Portable light therapy in the treatment of unipolar non-seasonal major depressive disorder: study protocol for the LUMIDEP randomised controlled trial
Authors: Cosker Eve , Moulard Marie , Schmitt Samuel , Angioi-Duprez Karine , Baumann Cédric , Laprévote Vincent , Schwan Raymund , Schwitzer Thomas 
Published: July 2021

IntroductionMajor depressive disorder (MDD) affects more than 264 million people worldwide and is associated with an impaired quality of life as well as a higher risk of mortality. Current routine treatments demonstrate limited effectiveness. Light therapy (LT) on its own or in combination with antidepressant treatments could be an effective treatment, but the use of conventional LT devices use is restrictive. Portable LT devices allow patients to continue with their day-to-day activities and therefore encourage better treatment compliance. They have not been evaluated in MDD.Methods and analysisThe study is a single-centre, double-blind, randomised controlled trial assessing the efficacy of LT delivered via a portable device in addition to usual care (medical care and drug treatment) for inpatients and outpatients with unipolar non-seasonal MDD. Over the course of 8 weeks, patients use the device daily for 30 min at medium intensity as soon as possible after waking up and preferably between 07:00 and 09:00. All patients continue their usual care with their referring physician. N=50 patients with MDD are included. The primary outcome measure is depressive symptom severity assessed using the Montgomery-Åsberg Depression Rating Scale between baseline and the eighth week. Secondary outcome measures are sleep quality assessed using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale and anxiety level assessed on the Hamilton Anxiety Rating Scale, between baseline and week 8. Further parameters relating to cognitive function are measured at baseline and after the intervention. An ancillary study aims to evaluate the impact of MDD on the retina and to follow its progression. Main limitations include risk of discontinuation or non-adherence and bias in patient selection.Ethics and disseminationThe study protocol was approved by Ile de France X’s Ethics Committee (protocol number 34–2018). Findings will be published in peer-reviewed journals.Trial registration numberNCT03685942.
Exploration play statistics in the Southern North Sea region of The Netherlands and UK
Authors: Quirk David G. , Archer Stuart G. 
Published: July 2021

Abstract

This paper presents the historical results of onshore and offshore petroleum exploration in the Anglo-Dutch Basin of the Southern North Sea. A total recoverable resource of 220 Tcfe has been discovered within a contiguous area of 85 000 km
2
. 73% of the resource occurs in The Netherlands. The resource is predominantly gas (207 Tcf), sourced from Upper Carboniferous coals, although the youngest play is oil, sourced from Lower Jurassic shales.

There are five plays, partitioned by late Permian-age (Zechstein) salt. In terms of discovered resource they are ranked: (1) Rotliegend aeolian–fluvial sandstones (443 gas discoveries, 417 Bcfe average size); (2) Triassic fluvial sandstones (101 gas discoveries, 140 Bcfe average); (3) Lower Cretaceous paralic–shallow-marine sandstones (61 oil discoveries, 29 MMboe average); (4) Westphalian fluvial sandstones (70 gas discoveries, 88 Bcfe average); and (5) Zechstein carbonates (51 gas discoveries, 83 Bcfe average). Although the main Rotliegend fairway is mature, there are probably discoveries yet to be made in the Westphalian and Zechstein plays, and possibly within the Triassic and Lower Cretaceous plays. There is also potential to extend the Rotliegend play beyond where it is proven: for example, along the northern margin of the basin and towards its centre.
Changing hazard awareness over two decades: the case of Furnas, São Miguel (Azores)
Authors: Lotteri Alessandra , Speake Janet , Kennedy Victoria , Wallenstein Nicolau , Coutinho Rui , Chester David , Duncan Angus , Dibben Christopher , Ferreira Francisco 
Published: July 2021

Abstract

Furnas (
c.
1500 inhabitants) lies within the caldera of Furnas volcano on the island of São Miguel (Azores) and has the potential to expose its inhabitants to multiple hazards (e.g. landslides, earthquakes, volcanic eruptions and degassing). The present population has never experienced a volcanic eruption or a major earthquake, although the catalogue records six eruptions, sub-Plinian in style, over the last 2 kyr. Today, the area experiences strong fumarolic activity. In the case of an eruption, early evacuation would be necessary to prevent inhabitants from being trapped within the caldera. An awareness of potential threats and knowledge of what to do in the case of an emergency would assist in evacuation. In this paper, inhabitants’ awareness of volcanic and seismic threats in 2017 is compared with that revealed in a similar study completed more than two decades ago. It is concluded that whereas awareness of earthquakes and the dangers posed by volcanic gas discharge has increased, knowledge of the threat of volcanic eruptions and the need to prepare for possible evacuation has not. Research suggests that the changing awareness is related to effective collaboration that has developed between the regional government, through its civil protection authorities and scientists, and the people of Furnas.
Integrated Hardware Garbage Collection
Authors: García Andrés Amaya , May David , Nutting Ed 
Published: July 2021

Garbage collected programming languages, such as Python and C#, have accelerated software development. These modern languages increase productivity and software reliability as they provide high-level data representation and control structures. Modern languages are widely used in software development for mobile, desktop, and server devices, but their adoption is limited in real-time embedded systems.
There is clear interest in supporting modern languages in embedded devices as emerging markets, like the Internet of Things, demand ever smarter and more reliable products. Multiple commercial and open-source projects, such as Zerynth and MicroPython, are attempting to provide support. But these projects rely on software garbage collectors that impose high overheads and introduce unpredictable pauses, preventing their use in many embedded applications. These limitations arise from the unsuitability of conventional processors for performing efficient, predictable garbage collection.
We propose the Integrated Hardware Garbage Collector (IHGC); a garbage collector tightly coupled with the processor that runs continuously in the background. Further, we introduce a static analysis technique to guarantee that real-time programs are never paused by the collector. Our design allocates a memory cycle to the collector when the processor is not using the memory. The IHGC achieves this by careful division of collection work into single-memory-access steps that are interleaved with the processor’s memory accesses. As a result, our collector eliminates run-time overheads and enables real-time program analysis.
The principles behind the IHGC can be used in conjunction with existing architectures. For example, we simulated the IHGC alongside the ARMv6-M architecture. Compared to a conventional processor, our experiments indicate that the IHGC offers 1.5–7 times better performance for programs that rely on garbage collection. The IHGC delivers the benefits of garbage-collected languages with real-time performance but without the complexity and overheads inherent in software collectors.