bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for a mixed-method study to inform the feasibility of undertaking a large-scale multicentre study comparing the clinical and patient-reported outcomes of oncoplastic breast conservation as an alternative to mastectomy with or without immediate breast reconstruction in women unsuitable for standard breast-conserving surgery (the ANTHEM Feasibility Study)
Authors: Davies Charlotte , Holcombe Christopher , Skillman Joanna , Whisker Lisa , Hollingworth William , Conefrey Carmel , Mills Nicola , White Paul , Comins Charles , Macmillan Douglas , Fairbrother Patricia , Potter Shelley 
Published: April 2021

IntroductionApproximately 40% of the 55 000 women diagnosed with breast cancer each year in the UK undergo mastectomy because they are considered unsuitable for standard breast-conserving surgery (BCS) due to tumour size or multiple tumour foci. Mastectomy can significantly impact women’s quality of life, and only one in four women currently undergo immediate breast reconstruction (IBR).Level 2 oncoplastic breast-conserving surgery (OPBCS) combines removing the cancer with a range of plastic surgical volume replacement (eg, local perforator flaps) and volume displacement techniques (eg, therapeutic mammaplasty) that can extend the role of BCS and may allow some women not suitable for standard BCS to avoid mastectomy. High-quality research to determine whether OPBCS offers a safe and effective alternative to mastectomy±IBR is currently lacking. Preliminary work is needed to ensure a future large-scale study is feasible and well designed and addresses questions important to patients and the National Health Service.Methods and analysisMixed methods will be used to inform feasibility and design of a future large-scale study comparing the clinical effectiveness and cost-effectiveness of OPBCS and mastectomy±IBR. It will have four parts: (1) a National Practice Questionnaire to determine current practice and provision of oncoplastic breast and reconstructive surgery in the UK; (2) a pilot multicentre prospective cohort study to explore the proportion of patients choosing OPBCS versus mastectomy, the proportion in OPBCS is successful and clinical and patient-reported outcomes of different techniques at 3 and 12 months postsurgery; (3) a qualitative interview study to explore patients’ attitudes to different procedures, rationale for decision-making and perceptions of outcomes; and (4) design of the future study.All centres offering OPBCS and mastectomy in the UK will be invited to participate. Recruitment is planned to commence winter 2020 and continue for 12 months.Ethics and disseminationThe study has ethical approval from the Wales Research Ethics Committee 6 National Research Ethics Service (REC Ref 20/WA/0225). Results will be presented at national and international meetings and published in peer-reviewed journals. We will work with patients to develop lay summaries and share these through patient groups and breast cancer charities.Trial registration numberISRCTN18238549.
Response of annual canarygrass (Phalaris canariensis L.) to nitrogen fertilizer and fungicide applications
Authors: May William E. , Train Joseph C. , Greidanus Lindsey 
Published: April 2021

Annual canarygrass (Phalaris canariensis L.) is a specialty crop grown in Canada and the harvested grain is primarily used to feed wild and domesticated bird species. A field experiment was conducted at 5 locations in both 2012 and 2013 to study the response of annual canarygrass development and grain yield to the combined effects of fungicide (propiconazole + trifloxystrobin) and nitrogen (N) fertilizer, and to determine the minimum number of site years required to detect these effects. The experimental design was a split plot with fungicide application (none or fungicide) as the main plot and N application rate as the sub plot (10, 20, 30, 50, 70, 90 kg N·ha−1). There was a linear increase of 14.5% in grain yield as the rate of N fertilizer increased. The fungicide application increased the grain yield 8.5% by increasing kernel density from 15 197 kernels m−2 to 16 288 kernels m−2. There was no interaction between the N rate and fungicide application. The application of a fungicide did not increase the responsiveness of annual canarygrass to N fertilizer. The lack of an interaction between N and fungicide application indicates that these two practices can be managed independently by annual canarygrass producers. To optimize grain yield producers should apply 50 kg N·ha−1 and apply a fungicide to increase grain yield especially in regions where septoria leaf mottle is prevalent. The number of site years needed to consistently detect the impact of N and fungicide on the grain yield were 4 and 5 site years, respectively.
Gravitational waves in Brans–Dicke theory with a cosmological constant
Authors: Özer Hatice , Delice Özgür 
Published: April 2021

AbstractWeak field gravitational wave solutions are investigated in Brans–Dicke (BD) theory in the presence of a cosmological constant. In this setting the background geometry is not flat but asymptotically de-Sitter. We investigate the linearised field equations, and their gravitational wave solutions in a certain gauge choice. We will show that this theory leads to massless scalar waves as in original BD theory and in contrast to massive BD theory. The effects of these waves on free particles and their polarization properties are studied extensively and effects of the cosmological constant is analyzed in these phenomena in detail. The energy flux of these waves are also discussed in this background. By analyzing this flux, we obtain a critical distance where the waves cannot propagate further, which extends Cosmic no Hair Conjecture (CNC) to BD theory with a cosmological constant.
GW170817 event rules out general relativity in favor of vector gravity
Authors: Svidzinsky Anatoly A. , Hilborn Robert C. 
Published: April 2021

AbstractThe observation of gravitational waves by the three LIGO-Virgo interferometers allows the examination of the polarization of gravitational waves. Here, we analyze the binary neutron star event GW170817, whose source location and distance are determined precisely by concurrent electromagnetic observations. We apply a signal accumulation procedure to the LIGO-Virgo strain data and find that the measured LIGO-Livingston signal is substantially reduced in certain frequency intervals due to real-time noise subtraction. We obtain ratios of the signals detected by the three interferometers excluding these “depleted” regions from the data analysis. We find that the signal ratios are inconsistent with the tensor polarization predictions of general relativity and Einstein’s theory is ruled out at 99% confidence level. Moreover, we find that the signal ratios and distance to the source are consistent with the vector theory of gravity (Phys Scr 92:125001, 2017) and that vector GW polarization is favored over tensor polarization and scalar polarization with exponentially large Bayes factors. If, however, we erroneously include in the data analysis the frequency regions in which the Livingston signal is depleted by noise filtering, we reproduce the result of the LIGO-Virgo collaboration favoring tensor GW polarization over vector polarization with an exponentially large Bayes factor.
Examining the Effect of Interruptions at Different Breakpoints and Frequencies Within a Task
Authors: Powers Sarah A. , Scerbo Mark W. 
Published: April 2021

Objective The purpose was to explore how event segmentation theory (EST) can be used to determine optimal moments for an interruption relying on hierarchical task analysis (HTA) to identify coarse and fine event boundaries. Background Research on the effects of interruptions shows that they can be either disruptive or beneficial, depending on which aspects of an interruption are manipulated. Two important aspects that contribute to these conflicting results concern when and how often interruptions occur. Method Undergraduates completed a trip planning task divided into three subtasks. The within-subjects factor was interruption timing with three levels: none, coarse breakpoints, and fine breakpoints. The between-subjects factor was interruption frequency with two levels: one and three. The dependent measures included resumption lag, number of errors, mental workload, and frustration. Results Participants took longer to resume the primary task and reported higher mental workload when interruptions occurred at fine breakpoints. The effect of interruptions at coarse breakpoints was similar to completing the task without interruption. Interruption frequency had no effect on performance; however, participants spent significantly longer attending to interruptions in the initial task, and within a task, the first and second interruptions were attended to significantly longer than the third interruption. Conclusion The disruptiveness of an interruption is tied to the point within the task hierarchy where it occurs. Application The performance cost associated with interruptions must be considered within the task structure. Interruptions occurring at coarse breakpoints may not be disruptive or have a negative effect on mental workload.
Psychosocial functionality in depressive workers: A study on associated factors
Authors: de Almeida Prado Juliana , Santos Jair Lício Ferreira 
Published: April 2021

Background: Major Depressive Disorder (MDD) has been shown a high prevalence and debilitating mental health. Most of the burden comes from reduced work functioning and frequent or long-term absenteeism. Aims: Describe psychosocial functionality in sample of workers with MDD and observe associated factors with sick-leave. Methods: Cross-sectional study. Participants were 172 formal workers with MDD according to Mini International Neuropsychiatric Interview. They were classified as active ( n = 76) or in sick leave ( n = 96). Functionality Assessment Short Test (FAST) was used and the variables were: personal, clinical, and occupational characteristics. Descriptive, bivariate and hierarchical multivariate analyses were conducted; significant with p < .05. Results: Most of the sample was female and <50. Workers in sick leave were older, less physically active, and presented worse scores in global and in each domain of functionality (FAST). High autonomy at working process, perceived stressing work, do not enjoy the work and low resilience to work adversities were significantly associated with sick leave ( p < .05). Regarding clinical characteristics of MDD, severity, clinical comorbidity and recidivate subtype were associated with sick leave outcome ( p < .05). Conclusion: Sick leave is an important indicator of global functionality. Effective strategies to reduce MDD burden ought to involve some perspectives: (1) Diagnosis and efficient treatment; (2) Promotion and monitoring of functionality and rehabilitation programs; (3) Subject-centered actions that help workers cope with adversities, mitigate stress, and increase satisfaction at work.
Impaired olfactory neural circuit in patients with SLE at early stages
Authors: Chen Chen , Kong Wei , Liang Jun , Lu Jiaming , Chen Dajie , Sun Yi , Zhang Xin , Qing Zhao , Feng Xuebing , Sun Lingyun , Zhang Bing 
Published: April 2021

Objective To investigate the changes of olfactory function and odor-induced brain activation in patients with systemic lupus erythematosus (SLE) at early stages compared with healthy controls. Materials and Methods Olfactory function and odor-induced brain activation in 12 SLE patients at early stages and 12 age, gender and education matched healthy controls were evaluated using olfactory behavior test and odor-induced task-functional magnetic resonance imaging (task-fMRI). Results No significant differences in olfactory behavior scores (including olfactory threshold, olfactory identification, and olfactory memory) were found in the patients with SLE at early stages compared with the healthy controls, while significantly decreased odor-induced activations in olfactory-related brain regions were observed in the patients. In the SLE group, the patients with better performance in the olfactory threshold test had significantly lower levels of anti-dsDNA antibody. Conclusion The current study demonstrated that significant alterations in odor-induced brain activations occurred prior to measurable olfactory decline in SLE at early stages, which provided a new method for early diagnosis of olfactory dysfunction in SLE.
Psychosocial Correlates of Meeting National Guidelines for Muscle-Strengthening Activities in Latinas
Authors: Benitez Tanya J. , Lopez Nanette , Haughton Jessica , Marcus Bess H. , Sallis James F. , Crespo Noe , Perez Lilian G. , Arredondo Elva M. 
Published: April 2021

Background Performing regular muscle-strengthening activity has numerous health benefits, including improvements in blood pressure, hemoglobin A1c, and lean body mass. Despite the disproportionate prevalence of lifestyle-related chronic disease in Latinas (diabetes, hypertension, obesity), most do not report meeting the national guidelines for muscle-strengthening activity. Existing physical activity (PA) research in Latinas has focused almost exclusively on aerobic PA. Our study examined Latinas’ sociodemographic and psychosocial correlates of meeting muscle-strengthening PA guidelines that can inform future PA interventions. Method A cross-sectional study of participants ( N = 436) enrolled in a randomized controlled trial promoting PA and cancer screening in Latinas was conducted, and t tests examined the associations between sociodemographic and psychosocial factors with self-reported muscle-strengthening activities. Hierarchical regression was conducted in separate blocks guided by the socioecological model (sociodemographic, individual, and interpersonal factors) to examine the independent contribution of each block to the outcome of meeting national guidelines for muscle-strengthening PA. Results Participants who met the national PA guidelines of ≥2 days/week of muscle-strengthening activities reported significantly higher social support for PA ( p < .001), greater use of behavioral strategies for PA ( p < .001), and lower barriers to PA ( p < .03) than those who did not meet the guidelines. Hierarchical binary logistic regression indicated behavioral strategies for PA was the only significant correlate of meeting the national guidelines for muscle-strengthening PA (odds ratio = 1.39, 95% confidence interval [1.18, 1.65], p < .001). Discussion/Conclusion Results support a hypothesis that instructing Latinas to use behavior change strategies could help them increase muscle-strengthening PA.
Urgent and non-emergent telehealth care for seniors: Findings from a multi-site impact study
Authors: Bernstein Paul , Ko Kelly J , Israni Juhi , Cronin Alexandria O , Kurliand Michael M , Shi Jiaxiao M , Chung Joanie , Borgo Lina , Reed Amanda , Kosten Larissa , Chang Anna Marie , Sites Frank D , Funahashi Tadashi , Agha Zia 
Published: April 2021

Introduction The global pandemic has raised awareness of the need for alternative ways to deliver care, notably telehealth. Prior to this study, research has been mixed on its effectiveness and impact on downstream utilization, especially for seniors. Our multi-institution study of more than 300,000 telehealth visits for seniors evaluates the clinical outcomes and healthcare utilization for urgent and non-emergent symptoms. Methods We conducted a retrospective cohort study from November 2015 to March 2019, leveraging different models of telehealth from three health systems, comparing them to in-person visits for urgent and non-emergent needs of seniors based on International Classification of Diseases, 10th edition diagnoses. The study population was adults aged 60 years or older who had access to telehealth and were affiliated with and resided in the geographic region of the healthcare organization providing telehealth. The primary outcomes of interest were visit resolution and episodes of care for those that required follow-up. Results In total, 313,516 telehealth visits were analysed across three healthcare organizations. Telehealth encounters were successful in resolving urgent and non-emergent needs in 84.0–86.7% of cases. When visits required follow-up, over 95% were resolved in less than three visits for both telehealth and in-person cohorts. Discussion While in-person visits have traditionally been the gold standard, our results suggest that when deployed within the confines of a patient’s existing primary care and health system provider, telehealth can be an effective alternative to in-person care for urgent and non-emergent needs of seniors without increasing downstream utilization.
Osteopathic medicine for fibromyalgia: a sham-controlled randomized clinical trial
Authors: Coste Joël , Medkour Terkia , Maigne Jean-Yves , Pérez Marc , Laroche Françoise , Perrot Serge 
Published: April 2021

Background: Patients with fibromyalgia (FM) frequently resort to osteopathic or chiropractic treatment, despite very weak supporting evidence. We aimed to assess the efficacy of osteopathic manipulation in FM in a properly controlled and powered randomized clinical trial. Methods: Patients were randomized to osteopathic or sham treatment. Treatment was administered by experienced physical medicine physicians, and consisted of six sessions per patient, over 6 weeks. Treatment credibility and expectancy were repeatedly evaluated. Patients completed standardized questionnaires at baseline, during treatment, and at 6, 12, 24, and 52 weeks after randomization. The primary outcome was pain intensity (100-mm visual analog scale) during the treatment period. Secondary outcomes included fatigue, functioning, and health-related quality of life. We performed primarily intention-to-treat analyses adjusted for credibility, using multiple imputation for missing data. Results: In total, 101 patients (94% women) were included. Osteopathic treatment did not significantly decrease pain relative to sham treatment (mean difference during treatment: −2.2 mm; 95% confidence interval, −9.1 to 4.6 mm). No significant differences were observed for secondary outcomes. No serious adverse events were observed, despite a likely rebound in pain and altered functioning at week 12 in patients treated by osteopathy. Patient expectancy was predictive of pain during treatment, with a decrease of 12.9 mm (4.4–21.5 mm) per 10 points on the 0–30 scale. Treatment credibility and expectancy were also predictive of several secondary outcomes. Conclusion: Osteopathy conferred no benefit over sham treatment for pain, fatigue, functioning, and quality of life in patients with FM. These findings do not support the use of osteopathy to treat these patients. More attention should be paid to the expectancy of patients in FM management.
Pulmonary arterial hypertension in pregnancy—a systematic review of outcomes in the modern era
Authors: Low Ting‐Ting , Guron Nita , Ducas Robin , Yamamura Kenichiro , Charla Pradeepkumar , Granton John , Silversides Candice K 
Published: April 2021

Pregnancy is hazardous with pulmonary arterial hypertension, but maternal mortality may have fallen in recent years. We sought to systematically evaluate pulmonary arterial hypertension and pregnancy‐related outcomes in the last decade. We searched for articles describing outcomes in pregnancy cohorts published between 2008 and 2018. A total of 3658 titles were screened and 13 studies included for analysis. Pooled incidences and percentages of maternal and perinatal outcomes were calculated. Results showed that out of 272 pregnancies, 214 pregnancies advanced beyond 20 gestational weeks. The mean maternal age was 28 ± 2 years, mean pulmonary artery systolic pressure on echocardiogram was 76 ± 19 mmHg. Etiologies include idiopathic pulmonary arterial hypertension (22%), congenital heart disease (64%), and others (15%). Majority (74%) had good functional class I/II. Only 48% of women received pulmonary arterial hypertension‐specific therapy. Premature deliveries occur in 58% of pregnancies at mean of 34 ± 1 weeks, most (76%) had Cesarean section. Maternal mortality rate was 12% overall (n = 26); even higher for idiopathic pulmonary arterial hypertension etiology alone (20%). Reported causes of death included right heart failure, cardiac arrest, pulmonary arterial hypertension crises, pre‐eclampsia, and sepsis; 61% of maternal deaths occur at 0–4 days postpartum. Stillbirth rate was 3% and neonatal mortality rate was 1%. In conclusion, pulmonary arterial hypertension in pregnancy continues to be perilous with high maternal mortality rate. Continued prospective studies are needed.
Leaching of nanoparticles from nano-enabled products for the protection of cultural heritage surfaces: a review
Authors: Brunelli Andrea , Calgaro Loris , Semenzin Elena , Cazzagon Virginia , Giubilato Elisa , Marcomini Antonio , Badetti Elena 
Published: April 2021

AbstractThe development of highly innovative techniques and technologies to enhance performance and technical sustainability of materials used in the field of cultural heritage conservation is providing conservators with innovative nanocomposites materials, including protective coatings, by merging the performances of engineered nanoparticles (NPs) with conventional chemicals. However, the human health and environmental risks that may potentially arise from these new materials are still largely unknown, requiring an adequate assessment and management along their entire life cycle. Concerns could emerge due to the leaching of the material containing NPs or of the NPs alone, especially during their use (exposure of the treated object to, e.g., heavy or acid rain) and disposal (when the wasted product is processed in, e.g., waste water treatment plants). To date, no standard leaching test methods have been specifically developed for nano-enabled products, with the consequent lack of data on the NPs potential exposure also in the field of cultural heritage. Therefore, an extensive review over the last 10 years by querying to the Scopus database “nanoparticles”, “leaching” and “coatings” has been herein reported to clearly highlight (i) the standard test methods used or adapted to estimate the NPs leaching from nano-based coatings; (ii) the available studies in which the NPs leaching from nano-based coatings was estimated without following any specific standard test method; (iii) the works focusing on other nanocomposite materials performances than leaching, in which standard test methods were applied, potentially useful to indirectly estimate NPs leaching. All the information gathered by this bibliographic search have been used to identify the most promising leaching tests for NPs estimation to be applied in the field of cultural heritage, especially for both large, e.g., building façades, and small, e.g., bronze works of art, surface areas from which the leaching of nano-based materials could be significant in terms of human health and ecological risks, based also on the (eco)toxicity of the leachate. The derived information can thus ultimately support effective risk management of innovative nano-enabled products, including the implementation of Safe by Design approaches.