bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introducing the Needs in Recovery Assessment (NiRA) into clinical practice: protocol for a pilot study investigating the formal and systematic assessment of clinical and social needs experienced by service users at a tertiary, metropolitan mental health service
Authors: Davies Ellen L. , Gordon Andrea L. , Hooper Kenneth J. , Laing Robert E. , Lynch Elizabeth A. , Pelentsov Lemuel J. , Esterman Adrian J. , Harvey Gillian 
Published: September 2021

Abstract
Background
The Needs in Recovery Assessment (NiRA) is a newly developed needs assessment tool, designed to identify the needs of people recovering from mental illness. This tool has been evaluated outside of the clinical context for validity and reliability. The aim of this study is to introduce the NiRA into clinical practice and to evaluate the value of the NiRA as an adjunct to service delivery from the perspectives of stakeholders and to evaluate the barriers and facilitators of embedding the NiRA in a mental health service.

Methods
The establishment of the NiRA in a tertiary mental health unit over a 6-month period will be evaluated using a multi-methods approach. Quantitative data will be collected using the NiRA itself and the Recovery Self-Assessment (RSA). Face-to-face interviews with service users and clinicians will be conducted following the initial completion of the NiRA, with a follow-up interview for service users on discharge from the service. Regular informal follow-up with clinicians throughout the study will support the introduction of the NiRA. Descriptive statistics will be used to analyse quantitative data, and descriptive qualitative methods will be used to analyse data from interviews.

Discussion
Aligning mental health services with recovery-oriented frameworks of care is imperative. The NiRA is a tool that has been designed in accordance with recovery principles and may assist services to be more recovery-oriented. If the NiRA is able to achieve the aims and objectives of this project, a larger implementation study will be conducted.
Trial registration
Australian and New Zealand Clinical Trial Registry (ANZCTR), ACTRN12621000316808
Stress, anxiety, and depression in patients with vitiligo
Authors: Nasser Marwa Abd El Malk , Raggi El Tahlawi Samar Mohamed , Abdelfatah Zahra Abbas , Soltan Mohamed Ramadan 
Published: September 2021

AbstractBackgroundVitiligo has a significant effect on patients’ quality of life; they feel stigmatized and disturbed by their condition. A lot of vitiligo patients, according to reports, suffer from psychological disturbances. The aim of the study is to find the relation between vitiligo and stress, anxiety, and depression and to measure how vitiligo affects the quality of life index. This study included 50 vitiligo patients and 50 matched healthy control groups. All patients were assessed by the Depression Anxiety Stress Scale (DASS) to determine the severity of anxiety, depression, and stress symptoms and the Dermatology Life Quality Index (DLQI) scale to evaluate their quality of life while the control group underwent only the Depression Anxiety Stress Scale.ResultsThe prevalence of stress was 76% (n=38), anxiety was 78% (n=39), and depression was 80% (n=40); the difference was statistically significant between patient group and control group regarding stress, anxiety, and depression. Gender had a significant relationship with stress, anxiety, and depression (p < 0.05) (female affected more than male). Also, there was a statistically significant relation between the degree of vitiligo and anxiety (p < 0.05). Vitiligo has a moderate to very severe effect on the quality of life index. There was a statistically significant positive correlation between stress and feeling of embarrassment from vitiligo and clothes choice.ConclusionVitiligo is a psychcutaneous disease that does not only affect the patient’s physical status, but also his mental and psychological status.
Two-Stage Approaches to Accounting for Patient Heterogeneity in Machine Learning Risk Prediction Models in Oncology
Authors: Oh Eun Jeong , Parikh Ravi B. , Chivers Corey , Chen Jinbo 
Published: September 2021

PURPOSEMachine learning models developed from electronic health records data have been increasingly used to predict risk of mortality for general oncology patients. But these models may have suboptimal performance because of patient heterogeneity. The objective of this work is to develop a new modeling approach to predicting short-term mortality that accounts for heterogeneity across multiple subgroups in the presence of a large number of electronic health record predictors.METHODSWe proposed a two-stage approach to addressing heterogeneity among oncology patients of different cancer types for predicting their risk of mortality. Structured data were extracted from the University of Pennsylvania Health System for 20,723 patients of 11 cancer types, where 1,340 (6.5%) patients were deceased. We first modeled the overall risk for all patients without differentiating cancer types, as is done in the current practice. We then developed cancer type–specific models using the overall risk score as a predictor along with preselected type-specific predictors. The overall and type-specific models were compared with respect to discrimination using the area under the precision-recall curve (AUPRC) and calibration using the calibration slope. We also proposed metrics that characterize the degree of risk heterogeneity by comparing risk predictors in the overall and type-specific models.RESULTSThe two-stage modeling resulted in improved calibration and discrimination across all 11 cancer types. The improvement in AUPRC was significant for hematologic malignancies including leukemia, lymphoma, and myeloma. For instance, the AUPRC increased from 0.358 to 0.519 (∆ = 0.161; 95% CI, 0.102 to 0.224) and from 0.299 to 0.354 (∆ = 0.055; 95% CI, 0.009 to 0.107) for leukemia and lymphoma, respectively. For all 11 cancer types, the two-stage approach generated well-calibrated risks. A high degree of heterogeneity between type-specific and overall risk predictors was observed for most cancer types.CONCLUSIONOur two-stage modeling approach that accounts for cancer type–specific risk heterogeneity has improved calibration and discrimination than a model agnostic to cancer types.
Carbonaceous Materials: The Beauty of Simplicity
Authors: López-Salas Nieves , Antonietti Markus 
Published: September 2021

Abstract
The current mandates of a sustainable society and circular economy lead to the request that materials chemistry, but also chemistry as such, become significantly redesigned. Changes include the commonplace as the glassware we use, the minimization of wastes and side products or replacement strategies in the materials choice, among others. In this context, “carbons” are very versatile and already have found their place in a myriad of applications for a “carbon-neutral” society. They already take key enabling positions for sensors and biomaterials preparation, as energy conversion and storage electrodes, or as effluent remediation sorbents. Herein, we describe how carbon chemistry can be again re-designed to outperform benchmark materials in a number of fields, especially in energy storage, (electro)catalysis, as sorbents, but also in a new chemistry of the confined state.
Synthesis and Conformational Characteristics of Calix[4]arene Oligomers
Authors: Morie Masayuki , Sekiya Ryo , Haino Takeharu 
Published: September 2021

Abstract
Lower- and/or upper-rim functionalization of calix[4]arene realized a variety of calix[4]arene systems. Compared to these monomeric calix[4]arenes, covalently linked calix[4]arene oligomers have not been studied well. Calix[4]arene oligomers can be utilized as building blocks of supramolecular complexes as well as for the synthesis of calix[4]arene polymers. This background motivated us to develop synthetic procedures for calix[4]arene oligomers and to conduct conformational analysis of these oligomers. We produce oligomers ranging from the monomer to the pentamer. The coupling of the pentamer with 2,3-dibenzyloxy-1,4-benzenedicarboxylic acid can access a decamer and oligomers. NMR measurements, X-ray crystal structure analysis, and computational studies demonstrate that calix[4]arene oligomers can regulate their length by changing the conformations of the calix[4]arene cores.
Physical Activity Changes during the Spring 2020 COVID-19 Shutdown in the United States
Authors: Mel Astrid E. , Stenson Mary C. 
Published: September 2021

ABSTRACT

Introduction/Purpose
The purpose of this study was to examine how and why physical activity (PA) changed during the COVID-19 pandemic, from early March to June 2020 in the United States.

Methods
A survey was distributed on social media. US adult residents were asked about their PA habits before and during the spring shutdown, such as average days of exercise, minutes per session and session intensity, and likelihood of maintaining pandemic PA habits for 1 yr.

Results
A total of 873 individuals completed the survey. The sample was 85.3% female (n = 745) with an average age of 38.7 ± 12.9 yr. More than half (89.3%) of the participants were non-Hispanic White, 89.9% reported an income greater than $45,000, and 87.6% earned a bachelor’s degree or higher. The proportion of participants who reported meeting or exceeding the guidelines of 150 min of moderate-to-vigorous PA per week was 52.7%. The proportion of participants not meeting the PA guidelines decreased by 7.8% during the shutdown. The proportion of participants exceeding the PA guidelines increased by 11.3%. PA days per week significantly increased during the shutdown (3.75 ± 1.9 to 4.27 ± 2.1 d, P < 0.001), whereas minutes per session remained consistent (1.87 ± 0.95 to 1.93 ± 0.98 min, P = 0.10; 1, 1–30 min; 2, 31–60 min). Average intensity of exercise sessions significantly decreased (2.81 ± 1.16 to 2.62 ± 1.14, P = 0.001). Participants reported decreased fitness center access and more outdoor walking. Overall, 73.4% of the participants indicated they were likely to maintain shutdown PA habits for 1 yr. Almost all (93.8%) of those who increased their PA during the shutdown reported they were likely to maintain their habit for 1 yr. Participants who did not change were more likely to report they would maintain PA levels for 1 yr compared with those who decreased PA levels during the shutdown.

Conclusions
Generally, US adults increased PA during the COVID-19 shutdown. This study provides insight into how routine disruption may affect PA habits.
From Mad Men to Maths Men: Concentration and Buyer Power in Online Advertising
Authors: Decarolis Francesco , Rovigatti Gabriele 
Published: September 2021

This paper analyzes the impact of intermediary concentration on the allocation of revenue in online platforms. We study sponsored search documenting how advertisers increasingly bid through a handful of specialized intermediaries. This enhances automated bidding and data pooling, but lessens competition whenever the intermediary represents competing advertisers. Using data on nearly 40 million Google keyword auctions, we first apply machine learning algorithms to cluster keywords into thematic groups serving as relevant markets. Using an instrumental variable strategy, we estimate a decline in the platform’s revenue of approximately 11 percent due to the average rise in concentration associated with intermediary merger and acquisition activity. (JEL C45, D44, G34, L13, L81, M37)
Patient doses in endovascular and hybrid revascularization of aortoiliac segment
Authors: Stanev Stefan , Kostova-Lefterova Desislava , Dineva Svetla 
Published: September 2021

Objectives: Constantly increasing number of procedures performed – endovascular or hybrid in patients with aortoiliac occlusive disease during the last decades finds its explanation in the lower morbidity and mortality rates, compared to bypass surgery. The purpose of the current survey was to estimate patients’ radiation exposure in aortoiliac segment after endovascular or hybrid revascularization and to study the main factors which have direct contribution. Methods: A retrospective study of 285 procedures conducted with the help of a mobile C-arm system in 223 patients was performed. Procedures were grouped according to criteria such as: type of intervention, vascular access, level of complexity and operating team. Different analyses were performed within the groups and dose values. Results: The median values of kerma–air product (KAP), the number of series and the peak skin dose (PSD) significantly increase with the increasing number of vascular accesses: for one access (16.68 Gy.cm2, 6 and 336 mGy), for two (56.93 Gy.cm2, 11 and 545 mGy), and for three (102.28 Gy.cm2, 15 and 781 mGy). Significant dependence was observed in the case of single access site between the type of access and the dose values: hybrid and retrograde common femoral artery/superficial femoral artery (CFA/SFA) endovascular accesses, 10.06 Gy.cm2/301 mGy and 13.23 Gy.cm2/318 mGy respectively, in contrast with the contralateral CFA and left brachial access, 33 Gy.cm2/421 mGy and 38.33 Gy.cm2/448 mGy respectively. Conclusion: The results demonstrate that the most important factors increasing the dose values are number and type of vascular accesses, followed by the combination and number of implanted stents with the complexity of the procedure. The PSD values for a single procedure were between 2 and 12 times lower than those IAEA proposed as trigger levels for radiation-induced erythema. This study shows that trigger levels were not reached even for patients with repeated procedures in the same segment in 1-year period. Advances in knowledge: The study gives important understanding and clarity on the growing awareness for dose-modifying factors during endovascular and hybrid revascularization of aortoiliac segment.
A retrospective review of MRI features associated with metastasis-free survival in women with breast cancer: focusing on skin thickening and skin enhancement
Authors: Mberu Valentine , McFarlane Jennifer , Macaskill E Jane , Evans Andrew 
Published: September 2021

Objectives: To identify associations between MRI-detected skin thickening and enhancement and metastasis-free survival (MFS) given recent reports of skin thickening on ultrasound being a poorer prognostic indicator. Methods: Interrogation of a prospectively collected database of ultrasound-visible breast lesions showed 214 lesions with pre-treatment MRIs available for analysis in a single centre. Data on MFS was prospectively collected. Retrospective MRI review was performed blinded to outcome. Imaging factors recorded were presence of skin thickening and enhancement, non-mass-enhancement (NME) and abnormal nodes, mass characteristics, perilesional oedema and background parenchymal enhancement. Statistical analysis used chi-squared test, Kaplan-Meier survival curves, the Log-rank test and receiver-operator characteristic (ROC) curves. Results: During a median follow-up period of 5.6 years, 21 (10%) of 212 patients developed distant metastases. Skin thickening [24 of 30 (80%) vs 169 of 184 (92%), p = 0.043] and skin enhancement [15 of 20 (75%) vs 178 of 194 (92%), p = 0.016] were associated with poorer MFS. Large index lesion size [p < 0.001, AUC 0.823], large sum of masses [p < 0.001, AUC 0.813], increasing total lesion extent including NME [p < 0.001, AUC 0.749] and abnormal axillary nodes [55 of 66 (83%) vs 138 of 148 (93%), p = 0.024] were also associated with poorer MFS. Conclusions: Skin thickening and enhancement on breast MRI are associated with poorer MFS. These findings should be taken into account when managing patients with invasive breast cancer. Advances in knowledge: Skin enhancement on breast MRI at diagnosis is associated with metastases development. Skin thickening on breast MRI is associated with future metastatic disease.
Eco-geographic patterns of child malnutrition in India and its association with cereal cultivation: An analysis using demographic health survey and agriculture datasets
Authors: Sanjeev Rama Krishna , Nuggehalli Srinivas Prashanth , Krishnan Bindu , Basappa Yogish Channa , Dinesh Akshay S. , Ulahannan Sabu K. 
Published: September 2021

Background: High prevalence of maternal malnutrition, low birth-weight and child malnutrition in India contribute substantially to the global malnutrition burden. Rural India has disproportionately higher levels of child malnutrition. Stunting and wasting are the primary determinants of child malnutrition and their district-level distribution shows clustering in different geographies and regions. Cereals, particularly millets, constitute the bulk of protein intake among the poor, especially in rural areas in India where high prevalence of wasting persists. Methods: The last round of National Family Health Survey (NFHS4) has disaggregated data by district, enabling a more fine-scale characterisation of the prevalence of markers of malnutrition. We used data from NFHS4 and agricultural statistics datasets to analyse relationship of prevalence of malnutrition at the district level and area under cereal cultivation. We analysed malnutrition through data on under-5 stunting and wasting by district. Results: Stunting and wasting patterns across districts show a distinct geographical and age distribution; districts with higher wasting showed relatively higher prevalence before six months of age. Wasting prevalence at district level was associated with higher cultivation of millets, with a stronger association seen for jowar and other millets (Kodo millet, little millet, proso millet, barnyard millet and foxtail millet). District level stunting was associated with higher district level cultivation of all crops (except other millets). The analysis was limited by lack of fine-scale data on prevalence of low birth-weight and type of cereal consumed. Conclusions: Better cereal cultivation and consumption data will be needed to confirm causal pathways contributing to potential ecogeographic patterns. The cultivation of other millets has a strong association with prevalence of wasting. State-of-the-art studies that improve our understanding of bio-availability of amino acids and other nutrients from the prevalent dietary matrices of rural poor communities will be needed to confirm causal pathways contributing to potential eco-geographic patterns.
Parent priorities for research and communication concerning childhood outcomes following preterm birth
Authors: Ginnell Lorna , Boardman James P. , Reynolds Rebecca M. , Fletcher-Watson Sue 
Published: September 2021

Background: Children born preterm (before 37 weeks of gestation) are at risk for several adverse childhood outcomes. Parent priorities for research into these outcomes, and preferences for receiving information about these risks, have not previously been established. Here we report the results of an online survey designed to understand parent priorities for research and their preferences for receiving information about childhood outcomes. Methods: An online survey was circulated through social media and was completed by 148 parents of preterm children between the ages of 0 and 12 years from around the United Kingdom (UK). Survey questions were in the form of rating scale, multiple choice, ranking or open-ended free text questions. Descriptive analysis was applied to the quantitative data. Illustrative quotes were extracted from the qualitative free text data and a subset of these questions were analysed using framework analysis. Results: Parent priorities for research centre around identification of factors which can protect against or improve adverse cognitive or developmental outcomes. The majority of parents would prefer for communication to begin within the first year of the child’s life. Parents reported a knowledge gap among health visitors, early years educators and schools. Conclusions: In order to align with parent preferences, research should prioritise identification of protective factors and the development of effective interventions to improve outcomes. Training for health visitors and educational professionals could improve the experiences of families and children.
Tools for analysis and conditional deletion of subsets of sensory neurons
Authors: Santana-Varela Sonia , Bogdanov Yury D. , Gossage Samuel J. , Okorokov Andrei L. , Li Shengnan , de Clauser Larissa , Alves-Simoes Marta , Sexton Jane E. , Iseppon Federico , Luiz Ana P. , Zhao Jing , Wood John N. , Cox James J. 
Published: September 2021

Background: Somatosensation depends on primary sensory neurons of the trigeminal and dorsal root ganglia (DRG). Transcriptional profiling of mouse DRG sensory neurons has defined at least 18 distinct neuronal cell types. Using an advillin promoter, we have generated a transgenic mouse line that only expresses diphtheria toxin A (DTA) in sensory neurons in the presence of Cre recombinase. This has allowed us to ablate specific neuronal subsets within the DRG using a range of established and novel Cre lines that encompass all sets of sensory neurons. Methods: A floxed-tdTomato-stop-DTA bacterial artificial chromosome (BAC) transgenic reporter line (AdvDTA) under the control of the mouse advillin DRG promoter was generated. The line was first validated using a Nav1.8Cre and then crossed to CGRPCreER (Calca), ThCreERT2, Tmem45bCre, Tmem233Cre, Ntng1Cre and TrkBCreER (Ntrk2) lines. Pain behavioural assays included Hargreaves’, hot plate, Randall-Selitto, cold plantar, partial sciatic nerve ligation and formalin tests. Results: Motor activity, as assessed by the rotarod test, was normal for all lines tested. Noxious mechanosensation was significantly reduced when either Nav1.8 positive neurons or Tmem45b positive neurons were ablated whilst acute heat pain was unaffected. In contrast, noxious mechanosensation was normal following ablation of CGRP-positive neurons but acute heat pain thresholds were significantly elevated and a reduction in nocifensive responses was observed in the second phase of the formalin test. Ablation of TrkB-positive neurons led to significant deficits in mechanical hypersensitivity in the partial sciatic nerve ligation neuropathic pain model. Conclusions: Ablation of specific DRG neuronal subsets using the AdvDTA line will be a useful resource for further functional characterization of somatosensory processing, neuro-immune interactions and chronic pain disorders.