bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in socioeconomic inequalities in five major risk factors for cardiovascular disease in the Korean population: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, 2001–2014
Authors: Kim Yoon Jung , Lee Ji Sung , Park Juri , Choi Dong Seop , Kim Doo Man , Lee Kee-Hyoung , Kim Ho Yeon , Kim Sin Gon , Lee Juneyoung 
Published: December 2018

ObjectivesTo examine trends in socioeconomic inequalities in major cardiovascular disease (CVD) risk factors among the Korean population.DesignCross-sectional study.SettingA nationally representative population survey database.ParticipantsA total of 42 725 Koreans, aged 25–64 years, who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) II (2001) to VI (2013–2014).Main outcome measuresTrends in socioeconomic inequalities in five major CVD risk factors (smoking, obesity, diabetes, hypertension and hypercholesterolaemia).ResultsGender differences were noted in the time trends in socioeconomic inequalities in smoking, obesity, diabetes and hypertension. Among men, low socioeconomic status (SES) was associated with higher prevalence of smoking, but not with obesity, diabetes or hypertension. The magnitudes of socioeconomic inequalities in smoking, obesity and diabetes remained unchanged, and the magnitude of the inequality in hypertension decreased over time. However, among women, low SES was associated with higher prevalence of smoking, obesity, diabetes and hypertension. Time trends towards increasing socioeconomic inequalities, measured by income, in smoking, obesity and diabetes were found in women. Unlike the other CVD risk factors, hypercholesterolaemia was not associated with socioeconomic inequality.ConclusionsSES had a stronger impact on major CVD risk factors among Korean women than men. Moreover, socioeconomic inequalities in smoking, obesity and diabetes worsened among Korean women over time. Public policies to prevent smoking, obesity and diabetes in women with lower SES are needed to address inequalities.
Understanding how and why audits work: protocol for a realist review of audit programmes to improve hospital care
Authors: Hut-Mossel Lisanne , Welker Gera , Ahaus Kees , Gans Rijk 
Published: December 2018

IntroductionMany types of audits are commonly used in hospital care to promote quality improvements. However, the evidence on the effectiveness of audits is mixed. The objectives of this proposed realist review are (1) to understand how and why audits might, or might not, work in terms of delivering the intended outcome of improved quality of hospital care and (2) to examine under what circumstances audits could potentially be effective. This protocol will provide the rationale for using a realist review approach and outline the method.Methods and analysisThis review will be conducted using an iterative four-stage approach. The first and second steps have already been executed. The first step was to develop an initial programme theory based on the literature that explains how audits are supposed to work. Second, a systematic literature search was conducted using relevant databases. Third, data will be extracted and coded for concepts relating to context, outcomes and their interrelatedness. Finally, the data will be synthesised in a five-step process: (1) organising the extracted data into evidence tables, (2) theming, (3) formulating chains of inference from the identified themes, (4) linking the chains of inference and formulating CMO configurations and (5) refining the initial programme theory. The reporting of the review will follow the ‘Realist and Meta-Review Evidence Synthesis: Evolving Standards’ (RAMESES) publication standards.Ethics and disseminationThis review does not require formal ethical approval. A better understanding of how and why these audits work, and how context impacts their effectiveness, will inform stakeholders in deciding how to tailor and implement audits within their local context. We will use a range of dissemination strategies to ensure that findings from this realist review are broadly disseminated to academic and non-academic audiences.PROSPERO registration numberCRD42016039882.
Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study
Authors: Rocks Stephen , Stepney Melissa , Glogowska Margaret , Fazel Mina , Tsiachristas Apostolos 
Published: December 2018

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.
Behind the wheel safety in palliative care: a literature review
Authors: Howard Mark , Ramsenthaler Christina 
Published: December 2018

BackgroundDriving is a complex activity that requires physical abilities and adequate executive and cognitive functioning. There is concern among specialist palliative care services about patients continuing to drive despite having progressive incurable illnesses, comorbidities and medications to manage their symptoms.ObjectivesTo determine the quality of literature available about driving that would apply to palliative care patients, specifically in relation to road test or simulated driving scores and neurocognitive testing.MethodA literature search based on systematic principles was conducted on the Ovid Medline, PsycINFO, Embase and CINAHL database up to 14 October 2018. Patient populations with life-limiting illness such as cancer, cardiorespiratory and neurological diagnoses were included.Results37,546 articles were screened. 14 articles satisfied the search criteria. Six studies focused on patients with multiple sclerosis (MS). Four studies investigated driving ability in patients with Huntington’s disease. The remaining four articles studied heart failure, chronic obstructive pulmonary disease (COPD), interstitial lung disease and patients with cancer. In the road test studies, 19%–47% of patients with MS and Huntington’s failed the behind-the-wheel assessment. The simulated driving scores in seven studies demonstrated statistically significant differences in errors made between study participants and controls. Divided attention was found in seven studies to be associated with poorer road-test or simulated driving ability.ConclusionsThis review highlights the scarcity of studies available for patients who would be known to palliative care services. For most patient groups, a battery of neurocognitive tests combined with a road-test or simulated driving assessment is still considered the best practice in determining driving safety.
Increased IP-10 production by blood–nerve barrier in multifocal acquired demyelinating sensory and motor neuropathy and multifocal motor neuropathy
Authors: Shimizu Fumitaka , Oishi Mariko , Sawai Setsu , Beppu Minako , Misawa Sonoko , Matsui Naoko , Miyashiro Ai , Maeda Toshihiko , Takeshita Yukio , Nishihara Hideaki , Sano Yasuteru , Sato Ryota , Kaji Ryuji , Kuwabara Satoshi , Kanda Takashi 
Published: December 2018

ObjectiveDysfunction of the blood–nerve barrier (BNB) plays important roles in chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). The aim of the present study was to identify the candidate cytokines/chemokines that cause the breakdown of the BNB using sera from patients with CIDP and MMN.MethodsWe determined the levels of 27 cytokines and chemokines in human peripheral nerve microvascular endothelial cells (PnMECs) after exposure to sera obtained from patients with CIDP variants (typical CIDP and multifocal acquired demyelinating sensory and motor neuropathy [MADSAM]), MMN and amyotrophic lateral sclerosis (ALS), and healthy controls (HC), using a multiplexed fluorescent bead-based immunoassay system.ResultsThe induced protein (IP)10 level in the cells in both the MADSAM and MMN groups was markedly increased in comparison with the typical CIDP, ALS and HC groups. The other cytokines, including granulocyte colony-stimulating factor,vascular endothelial growth factor (VEGF) and interleukin-7, were also significantly upregulated in the MADSAM group. The increase of IP-10 produced by PnMECs was correlated with the presence of conduction block in both the MADSAM and MMN groups.ConclusionThe autocrine secretion of IP-10 induced by patient sera in PnMECs was markedly upregulated in both the MADSAM and MMN groups. The overproduction of IP-10 by PnMECs leads to the focal breakdown of the BNB and may help to mediate the transfer of pathogenic T cells across the BNB, thereby resulting in the appearance of conduction block in electrophysiological studies of patients with MADSAM and MMN.
Abatacept in combination with methotrexate in Japanese biologic-naive patients with active rheumatoid arthritis: a randomised placebo-controlled phase IV study
Authors: Matsubara Tsukasa , Inoue Hiroshi , Nakajima Toshihiro , Tanimura Kazuhide , Sagawa Akira , Sato Yukio , Osano Kei , Nagano Shuji , Ueki Yukitaka , Hanyu Tadamasa , Hashizume Koichi , Amano Norihito , Tanaka Yoshiya , Takeuchi Tsutomu 
Published: December 2018

ObjectivesTo evaluate efficacy and safety of abatacept+methotrexate (MTX) in biologic-naive, anticitrullinated protein antibody (ACPA)-positive Japanese patients with active rheumatoid arthritis (RA) and early erosion versus placebo+MTX.MethodsIn this phase IV, multicentre, double-blind study (NCT01758198), patients were randomised (1:1) to receive intravenous abatacept (~10 mg/kg) or placebo, plus MTX (≥6 mg/week). Primary efficacy objectives were to compare American College of Rheumatology 20 (ACR20) response rates at week 16 and mean change from baseline in van der Heijde-modified total Sharp score (vdH-mTSS) at week 24 between abatacept+MTX and placebo+MTX groups.ResultsOverall, 203 and 202 patients received abatacept+MTX and placebo+MTX, respectively. At week 16, ACR20 response rates were higher in the abatacept (75.4%) versus placebo group (27.7%; p<0.001). Mean change from baseline in vdH-mTSS at week 24 was 0.84 in the abatacept and 1.26 in the placebo group (p=0.017). Radiographic non-progression rates (change in vdH-mTSS≤smallest detectable change (1.9)) were 88.1% and 75.4% in abatacept and placebo groups, respectively. Adjusted mean change from baseline in Disease Activity Score 28 (C-reactive protein) (DAS28 (CRP)) at week 16 demonstrated a numerically greater reduction in the abatacept versus placebo group. Proportions of patients with DAS28 (CRP), Simplified Disease Activity Index and Clinical Disease Activity Index remission up to week 52 were higher in the abatacept versus placebo group. The abatacept safety profile was consistent with previous observations.ConclusionsCompared with MTX alone, abatacept+MTX improved clinical symptoms and inhibited structural damage progression in ACPA-positive, Japanese patients with RA, early erosion and inadequate response to MTX.
Brotli
Authors: Alakuijala Jyrki , Farruggia Andrea , Ferragina Paolo , Kliuchnikov Eugene , Obryk Robert , Szabadka Zoltan , Vandevenne Lode 
Published: December 2018

Brotli is an open source general-purpose data compressor introduced by Google in late 2013 and now adopted in most known browsers and Web servers. It is publicly available on GitHub and its data format was submitted as RFC 7932 in July 2016. Brotli is based on the Lempel-Ziv compression scheme and planned as a generic replacement of Gzip and ZLib. The main goal in its design was to compress data on the Internet, which meant optimizing the resources used at decoding time, while achieving maximal compression density.
This article is intended to provide the first thorough, systematic description of the Brotli format as well as a detailed computational and experimental analysis of the main algorithmic blocks underlying the current encoder implementation, together with a comparison against compressors of different families constituting the state-of-the-art either in practice or in theory. This treatment will allow us to raise a set of new algorithmic and software engineering problems that deserve further attention from the scientific community.
Binary Sketches for Secondary Filtering
Authors: Mic Vladimir , Novak David , Zezula Pavel 
Published: December 2018

This article addresses the problem of matching the most similar data objects to a given query object. We adopt a generic model of similarity that involves the domain of objects and metric distance functions only. We examine the case of a large dataset in a complex data space, which makes this problem inherently difficult. Many indexing and searching approaches have been proposed, but they have often failed to efficiently prune complex search spaces and access large portions of the dataset when evaluating queries. We propose an approach to enhancing the existing search techniques to significantly reduce the number of accessed data objects while preserving the quality of the search results. In particular, we extend each data object with its
sketch
, a short binary string in Hamming space. These sketches approximate the similarity relationships in the original search space, and we use them to filter out non-relevant objects not pruned by the original search technique. We provide a probabilistic model to tune the parameters of the sketch-based filtering separately for each query object. Experiments conducted with different similarity search techniques and real-life datasets demonstrate that the secondary filtering can speed-up similarity search several times.
Reflex response to airway occlusion in human inspiratory muscles when recruited for breathing and posture
Authors: Luu Billy L. , McBain Rachel A. , Taylor Janet L. , Gandevia Simon C. , Butler Jane E. 
Published: December 2018

Briefly occluding the airway during inspiration produces a short-latency reflex inhibition in human inspiratory muscles. This occlusion reflex seems specific to respiratory muscles; however, it is not known whether the reflex inhibition has a uniform effect across a motoneuron pool when a muscle is recruited concurrently for breathing and posture. In this study, participants were seated and breathed through a mouthpiece that occluded inspiratory airflow for 250 ms at a volume threshold of 0.2 liters. The reflex response was measured in the scalene and sternocleidomastoid muscles during 1) a control condition with the head supported in space and the muscles recruited for breathing only, 2) a postural condition with the head unsupported and the neck flexors recruited for both breathing and to maintain head posture, and 3) a large-breath condition with the head supported and the volume threshold raised to between 0.8 and 1.0 liters to increase inspiratory muscle activity. When normalized to its preocclusion mean, the reflex response in the scalene muscles was not significantly different between the large-breath and control conditions, whereas concomitant recruitment of these muscles for posture control reduced the reflex response by half compared with the control condition. A reflex response occurred in sternocleidomastoid when it contracted phasically as an accessory muscle for inspiration during the large-breath condition. These results indicate that the occlusion reflex does not produce a uniform effect across the motoneuron pool and that afferent inputs for this reflex most likely act via intersegmental networks of premotoneurons rather than at a motoneuronal level. NEW & NOTEWORTHY In this study, we investigated the effect of nonrespiratory activity on the reflex response to brief sudden airway occlusions in human inspiratory muscles. We show that the reflex inhibition in the scalene muscles was not uniform across the motoneuron pool when the muscle was recruited concurrently for breathing and postural control. The reflex had a larger effect on respiratory-driven motoneurons than those recruited to maintain head posture.
Stroke Outcomes With Vorapaxar Versus Placebo in Patients With Acute Coronary Syndromes: Insights From the TRACER Trial
Authors: Ungar Leo , Clare Robert M. , Rodriguez Fatima , Kolls Bradley J. , Armstrong Paul W. , Aylward Philip , Held Claes , Moliterno David J. , Strony John , Van de Werf Frans , Wallentin Lars , White Harvey D. , Tricoci Pierluigi , Harrington Robert A. , Mahaffey Kenneth W. , Melloni Chiara 
Published: December 2018

Background
Vorapaxar, a protease‐activated receptor‐1 antagonist, is approved for secondary prevention of cardiovascular events but is associated with increased intracranial hemorrhage.

Methods and Results

TRACER
(Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) was a trial of vorapaxar versus placebo among patients with acute coronary syndrome. Strokes were adjudicated by a central events committee. Of 12 944 patients, 199 (1.5%) had ≥1 stroke during the study period (median follow‐up, 477 days). Four patients had a single stroke of unknown type; 195 patients had ≥1 stroke classified as hemorrhagic or nonhemorrhagic (165 nonhemorrhagic, 28 hemorrhagic, and 2 both). Strokes occurred in 96 of 6473 patients (1.5%) assigned vorapaxar and 103 of 6471 patients (1.6%) assigned placebo. Kaplan‐Meier incidence of stroke for vorapaxar versus placebo was higher for hemorrhagic stroke (0.45% versus 0.14% [hazard ratio, 2.74; 95% confidence interval, 1.22–6.15]), lower but not significantly different for nonhemorrhagic stroke (1.53% versus 1.98% at 2 years [hazard ratio, 0.79; 95% confidence interval, 0.58–1.07]), and similar for stroke overall (1.93% versus 2.13% at 2 years [hazard ratio, 0.94; 95% confidence interval, 0.71–1.24]).

Conclusions
Stroke occurred in <2% of patients. Vorapaxar‐assigned patients had increased hemorrhagic stroke but a nonsignificant trend toward lower nonhemorrhagic stroke. Overall stroke frequency was similar with vorapaxar versus placebo.
The Effect of Land Surface Heterogeneity and Background Wind on Shallow Cumulus Clouds and the Transition to Deeper Convection
Authors: Lee Jungmin M. , Zhang Yunyan , Klein Stephen A. 
Published: December 2018

Abstract
Idealized large-eddy simulations (LESs) with prescribed heterogeneous land surface heat fluxes are performed to study the impact of the heterogeneity length scale and background wind speed on the development of shallow cumulus and the subsequent transition to congestus/deep convection. We study the impact of land surface heterogeneity in an atmosphere that favors shallow convection but is also conditionally unstable with respect to deeper convection. We find that before the convection transition, larger and thicker shallow cumulus clouds are attached to moisture pools near the PBL top over patches with low evaporative fraction (referred to as “DRY”). This feature is attributable to a surface-induced secondary circulation whose development depends on the heterogeneity size and the background wind speed. With large patches (≥5 km) under zero ambient wind, the secondary mesoscale circulation promotes the vertical transport of moisture forming a moisture pool over DRY patches, while with smaller patches, no such circulation develops. The influence of the background wind on the secondary circulation is strong such that any wind stronger than 2 m s−1 effectively eliminates the impact of surface heterogeneity on the PBL and brings no secondary circulation. This is because the triggered secondary circulation is not strong enough to withstand the imposed background wind. Based on these, we propose two criteria for the convection transition, namely, that the heterogeneity length scale is greater than 5 km and that the background wind speed is less than Uc0, where Uc0 is the near-surface cross-patch wind speed of the secondary circulation under zero background wind for a given patch size and is about 1.5 m s−1 in our cases.
Role of Moisture Transport and Recycling in Characterizing Droughts: Perspectives from Two Recent U.S. Droughts and the CFSv2 System
Authors: Roy Tirthankar , Martinez J. Alejandro , Herrera-Estrada Julio E. , Zhang Yu , Dominguez Francina , Berg Alexis , Ek Mike , Wood Eric F. 
Published: December 2018

AbstractWe investigate the role of moisture transport and recycling in characterizing two recent drought events in Texas (2011) and the Upper Midwest (2012) by analyzing the precipitation, evapotranspiration, precipitable water, and soil moisture data from the Climate Forecast System version 2 (CFSv2) analysis. Next, we evaluate the CFSv2 forecasts in terms of their ability to capture different drought signals as reflected in the analysis data. Precipitation from both sources is partitioned into recycled and advected components using a moisture accounting–based precipitation recycling model. All four variables reflected drought signals through their anomalously low values, while precipitation and evapotranspiration had the strongest signals. Drought in Texas was dominated by the differences in moisture transport, whereas in the Upper Midwest, the absence of strong precipitation-generating mechanisms was a crucial factor. Reduced advection from the tropical and midlatitude Atlantic contributed to the drought in Texas. The Upper Midwest experienced reduced contributions from recycling, terrestrial sources, the midlatitude Pacific, and the tropical Atlantic. In both cases, long-range moisture transport from oceanic sources was reduced during the corresponding drought years. June and August in Texas and July and August in the Upper Midwest were the driest months, and in both cases, drought was alleviated by the end of August. Moisture from terrestrial sources most likely contributed to alleviating drought intensity in such conditions, even with negative anomalies. The forecasts showed noticeable differences as compared to the analysis for multiple variables in both regions, which could be attributed to several factors as discussed in this paper.