bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transformación del paisaje cultural de Santa Fe de Antioquia: impactos del paisaje regional, en el urbano y el cotidiano
Authors: Patiño Zuluaga Evelyn , Montoya Arenas Catalina , Escobar Ocampo Lina María , González Escobar Luis Fernando 
Published: August 2018

Las escasas investigaciones registradas en nuestro país sobre el paisaje cultural han adolecido, en buena medida, de establecer vínculos teórico-prácticos entre los procesos históricos, estéticos y simbólicos, contrastados con agentes transformadores del modelo económico (discurso de la competitividad, la industria turística y la presión inmobiliaria). A partir del levantamiento de nuevos mapas que combinan la lectura y análisis de la cartografía, la coreografía y la narrativa histórica-literaria-pictórica con un análisis multivariado y multitemporal, este artículo profundizará en el paisaje regional de Santa Fe de Antioquia como aquel que teje lazos históricos y funcionales en diversas escalas y temporalidades, sus implicaciones espaciales en el paisaje urbano y un análisis físico-perceptual de las transformaciones acaecidas en un sector del centro histórico declarado y su área de influencia (sector del paisaje cotidiano). Diversos proyectos de infraestructura nacional desarrollados en las inmediaciones del municipio, que solo cruzan por él o que hacen uso de cierta condición geoestratégica del mismo, plantean posibilidades, y a la vez retos y grandes conflictos con las condiciones del paisaje cultural, el cual actualmente es partícipe de una supra-estructura de desarrollo territorial de tres futuras áreas metropolitanas contiguas, y que para este caso ya revelan desequilibrios espaciales en el modelo de ocupación que estos agentes promueven. De esta interacción surgen efectos espaciales que pueden ser leídos tanto en la estructura territorial, centrada de manera fundamental en el reparto de cargas poblacionales, en el modelo de ocupación del centro histórico y del contexto no monumental, así como sus imbricaciones en el hábitat doméstico.
‘Van Herick Plus’: a modified grading scheme for the assessment of peripheral anterior chamber depth and angle
Authors: Sihota Ramanjit , Kamble Neha , Sharma Ajay K , Bhari Anju , Gupta Amisha , Midha Neha , Selvan Harathy , Dada Tanuj , Gupta Viney , Pandey Ravindra M 
Published: August 2018

AimTo evaluate the accuracy of a new, modified grading scheme involving a short vertical slit beam, at the inferior angle for peripheral anterior chamber depth (PAC) and angle estimation and its correlation with anterior segment optical coherence tomography (ASOCT).MethodsA cross-sectional study of consecutive phakic patients, above 40 years of age, was performed. Using a short, vertical slit beam not reaching the pupil, the inferior angle at the sclerolimbal junction was evaluated, photographed and assessed by a ratio of peripheral anterior chamber depth to peripheral corneal thickness (PAC:PCT) and iridocorneal angle (ICA) on ImageJ software. The inferior angle at the same meridian was also recorded on ASOCT.ResultsBased on the PAC:PCT ratio, the subjects were divided into four groups: I (<1/4), II (1/4-1/2), III (>1/2–1) and IV (>1). The clinically assessed angle by short vertical slit beam correlated well with ASOCT values, trabecular-iris angle (TIA) (r=0.918; p<0.001) and scleral spur angle (r=0.903, p<0.001). The mean difference between ICA and TIA on ASOCT was 0.7970; 95% limits of agreement:−5.7670 to 7.3610 (±1.96 SD). For angles graded narrow on ASOCT (TIA <200), using a cut-off of peripheral PAC:PCT <1/4, the area under the curve was 0.918 with a sensitivity of 85.2% and a specificity of 88.2%. There was good agreement between ImageJ parameters with those assessed subjectively on photograph of the slit beam examination by a glaucoma fellow (weighted kappa=0.74) as compared with a general ophthalmologist, where there was moderate agreement (weighted kappa=0.57).ConclusionA short, vertical slit lamp beam evaluation at the inferior angle is an easy and relatively accurate method for both peripheral anterior chamber depth and angle assessment. It correlated well with ASOCT and can be used as a more reliable screening tool to identify eyes with possibly occludable angles.
Defining and measuring health equity effects in research on task shifting interventions in high-income countries: a systematic review protocol
Authors: Orkin Aaron M , McArthur Allison , McDonald André , Mew Emma J , Martiniuk Alexandra , Buchman Daniel Z , Kouyoumdjian Fiona , Rachlis Beth , Strike Carol , Upshur Ross 
Published: August 2018

IntroductionTask shifting interventions are intended to both deliver clinically effective treatments to reduce disease burden and address health inequities or population vulnerability. Little is known about how health equity and population vulnerability are defined and measured in research focused on task shifting. This systematic review will address the following questions: Among task shifting interventions in high-income settings that have been studied using randomised controlled trials or variants, how are health inequity or population vulnerability identified and defined? What methods and indicators are used to describe, characterise and measure the population’s baseline status and the intervention’s impacts on inequity and vulnerability?Methods and analysisStudies were identified through database searches (MEDLINE, Embase, CINAHL, PsycINFO and Web of Science). Eligible studies will be randomised controlled trials published since 2004, conducted in high-income countries, concerning task shifting interventions to treat any disease, in any population that may face health disadvantage as defined by the PROGRESS-Plus framework (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, social capital, socioeconomic position, age, disability, sexual orientation, other vulnerable groups). We will conduct independent and duplicate title and abstract screening, then identify related papers from the same programme of research through further database and manual searching. From each programme of research, we will extract study details, and definitions and measures of health equity or population vulnerability based on the PROGRESS-Plus framework. Two investigators will assess the quality of reporting and measurement related to health equity and vulnerability using a scale developed for this study. A narrative synthesis will highlight similarities and differences between the gathered studies and offer critical analyses and implications.Ethics and disseminationThis review does not involve primary data collection, does not constitute research on human subjects and is not subject to additional institutional ethics review or informed consent procedures. Dissemination will include open-access peer-reviewed publication and academic conference presentations.PROSPERO Registration Number CRD42017049959.
Vitamin D status among adolescents in Kuwait: a cross-sectional study
Authors: Al-Taiar Abdullah , Rahman Abdur , Al-Sabah Reem , Shaban Lemia , Al-Harbi Anwar 
Published: August 2018

ObjectivesIn Kuwait, as in many Arab states in the Gulf region, there are limited data on the prevalence of vitamin D deficiency among healthy adolescents. This study aimed to estimate the prevalence of vitamin D deficiency in a nationally representative sample of adolescents and investigate factors associated with vitamin D status.MethodsA cross-sectional study was conducted on 1416 adolescents aged 11–16 years, who were randomly selected from middle schools in all governorates of Kuwait. Data were collected from parents through self-administered questionnaire and from adolescents through face-to-face interview. Vitamin D was measured using liquid chromatography-tandem mass spectrometry. Logistic regression was used to investigate the independent factors associated with vitamin D status.ResultsThe prevalence of vitamin D deficiency was 81.21% (95% CI 71.61% to 90.81%), while severe deficiency was 39.48%. Only 3.60% of adolescents were vitamin D-sufficient. The prevalence of vitamin D deficiency was significantly higher among girls compared with boys (91.69% vs 70.32%; p<0.001). There was a significant inverse correlation between vitamin D and parathyroid hormone (Spearman correlation=−0.35; p<0.001). In the final model, gender, age, governorate, parental education, body mass index, vitamin D supplement and the number of times adolescents walk to schools per week were all significantly related to vitamin D deficiency.ConclusionHigh prevalence of vitamin D deficiency was noted among adolescents in Kuwait despite the abundant sunshine, which may reflect strong sun avoidance behaviour. Adequate outdoor daytime activities should be encouraged especially for girls. We call for locally tailored guidelines for vitamin D supplement in which girls should have a higher dose compared with boys.
Randomised controlled feasibility trial of the Active Communication Education programme plus hearing aid provision versus hearing aid provision alone (ACE to HEAR): a study protocol
Authors: Thyer Nicholas J , Watson Jude , Jackson Cath , Hickson Louise , Maynard Christina , Forster Anne , Clark Laura , Bell Kerry , Fairhurst Caroline , Cocks Kim , Gardner Rob , Iley Kate , Gailey Lorraine 
Published: August 2018

IntroductionUp to 30% of hearing aids fitted to new adult clients are reported to be of low benefit and used intermittently or not at all. Evidence suggests that additional interventions paired with service-delivery redesign may help improve hearing aid use and benefit. The range of interventions available is limited. In particular, the efficacy of interventions like the Active Communication Education (ACE) programme that focus on improving communication success with hearing-impaired people and significant others, has not previously been assessed. We propose that improved communication outcomes associated with the ACE intervention, lead to an increased perception of hearing aid value and more realistic expectations associated with hearing aid use and ownership, which are reported to be key barriers and facilitators for successful hearing aid use. This study will assess the feasibility of delivering ACE and undertaking a definitive randomised controlled trial to evaluate whether ACE would be a cost-effective and acceptable way of increasing quality of life through improving communication and hearing aid use in a public health service such as the National Health Service.Methods and analysisThis will be a randomised controlled, open feasibility trial with embedded economic and process evaluations delivered in audiology departments in two UK cities. We aim to recruit 84 patients (and up to 84 significant others) aged 18 years and over, who report moderate or less than moderate benefit from their new hearing aid. The feasibility of a large-scale study and the acceptability of the ACE intervention will be measured by recruitment rates, treatment retention, follow-up rates and qualitative interviews.Ethics and disseminationEthical approval granted by South East Coast-Surrey Research Ethics Committee (16/LO/2012). Dissemination of results will be via peer-reviewed research publications both online and in print, conference presentations, posters, patient forums and Trust bulletins.Trial registration numberISRCTN28090877.
Cutting care clusters: the creation of an inverse pharmacy care law? An area-level analysis exploring the clustering of community pharmacies in England
Authors: Todd Adam , Thomson Katie , Kasim Adetayo , Bambra Clare 
Published: August 2018

ObjectivesTo (1) explore the clustering of community pharmacies in England and (2) determine the relationship between community pharmacy clustering, urbanity and deprivation.DesignAn area-level analysis spatial study.SettingEngland.Primary and secondary outcome measuresCommunity pharmacy clustering determined as a community pharmacy located within 10 min walking distance to another community pharmacy.ParticipantsAddresses and postal codes of each community pharmacy in England were used in the analysis. Each pharmacy postal code was assigned to a lower layer super output area, which was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score).Results75% of community pharmacies in England were located in a ‘cluster’ (within 10 min walking distance of another pharmacy): 19% of community pharmacies were in a cluster of two, while 56% of community pharmacies were in clusters of three or more. There was a linear relationship between community pharmacy clustering and social deprivation—with clustering more prevalent in areas of higher deprivation: for community pharmacies located in areas of lowest deprivation (decile 1), there was a significantly lower risk of clustering compared with community pharmacies located in areas of highest deprivation (relative risk 0.12 (95% CI 0.10 to 0.16)).ConclusionsClustering of community pharmacies in England is common, although there is a positive trend between community pharmacy clustering and social deprivation, whereby clustering is more significant in areas of high deprivation. Arrangements for future community pharmacy funding should not solely focus on distance from one pharmacy to another as means of determining funding allocation, as this could penalise community pharmacies in our most deprived communities, and potentially have a negative effect on other healthcare providers, such as general practitioner and accident and emergency services.
Protocol for the mixed-methods development of a concussion-specific health-related quality of life outcome measure based on the international classification of functioning, disability and health
Authors: van Ierssel Jacqueline , Sveistrup Heidi , Marshall Shawn 
Published: August 2018

IntroductionRecovery from concussion has traditionally been evaluated by patient-reported symptoms, objective measures such as loss of consciousness, specific dimensions such as depression or fatigue, cognitive status, employment status, level of physical activity and the more complex construct of disability. Increasingly, patient-reported outcome measures of health-related quality of life (HRQOL) are being emphasised as an important end point in patient care, clinical trial and health policy decisions. Currently, no standardised concussion-specific HRQOL outcome measure exists. The process for developing a concussion-specific HRQOL outcome measure based on the international classification of functioning, disability and health is outlined.Methods and analysisA multistage, patient-centred approach to developing the outcome measure will integrate evidence from systematic reviews, qualitative research and cognitive interviewing into a self-report questionnaire to guide clinical decision-making. The psychometric properties of the questionnaire will be evaluated to assess the inter-rater reliability and construct validity of the measure in individuals with persistent post-concussion symptoms. To date, the systematic review and the clinical expert interviews within the preparatory phase have been completed and work is progressing on the subsequent phases. It is anticipated that the outcome measure will be ready for psychometric testing in September 2018.Ethics and disseminationEthical approval was granted by the Ottawa Health Science Network Research Ethics Board (Protocol #20170720-01H) on 31 October 2017 to conduct the patient and clinical expert interviews. Ethical approval for psychometric testing of the outcome measure will be sought by the Ottawa Health Science Network Research Ethics Board in Phase II, after the development of the final HRQOL questionnaire. Results will be disseminated through peer-reviewed journals and professional conferences.PROSPERO registrationPhase I systematic review registration number CRD42017075588 (15 June 2017). Phase II systematic review registration number CRD42017075588 (27 September 2017).
How do people with dementia use the ambulance service? A retrospective study in England: the HOMEWARD project
Authors: Voss Sarah , Brandling Janet , Taylor Hazel , Black Sarah , Buswell Marina , Cheston Richard , Cullum Sarah , Foster Theresa , Kirby Kim , Prothero Larissa , Purdy Sarah , Solway Chris , Benger Jonathan Richard 
Published: August 2018

ObjectivesAn increasing number of older people are calling ambulances and presenting to accident and emergency departments. The presence of comorbidities and dementia can make managing these patients more challenging and hospital admission more likely, resulting in poorer outcomes for patients. However, we do not know how many of these patients are conveyed to hospital by ambulance. This study aims to determine: how often ambulances are called to older people; how often comorbidities including dementia are recorded; the reason for the call; provisional diagnosis; the amount of time ambulance clinicians spend on scene; the frequency with which these patients are transported to hospital.MethodsWe conducted a retrospective cross-sectional study of ambulance patient care records (PCRs) from calls to patients aged 65 years and over. Data were collected from two ambulance services in England during 24 or 48 hours periods in January 2017 and July 2017. The records were examined by two researchers using a standard template and the data were extracted from 3037 PCRs using a coding structure.ResultsResults were reported as percentages and means with 95% CIs. Dementia was recorded in 421 (13.9%) of PCRs. Patients with dementia were significantly less likely to be conveyed to hospital following an emergency call than those without dementia. The call cycle times were similar for patients regardless of whether or not they had dementia. Calls to people with dementia were more likely to be due to injury following a fall. In the overall sample, one or more comorbidities were reported on the PCR in over 80% of cases.ConclusionRates of hospital conveyance for older people may be related to comorbidities, frailty and complex needs, rather than dementia. Further research is needed to understand the way in which ambulance clinicians make conveyance decisions at scene.
Micropools of reliable area MT neurons explain rapid motion detection
Authors: Krause Bryan M. , Ghose Geoffrey M. 
Published: August 2018

Many models of perceptually based decisions postulate that actions are initiated when accumulated sensory signals reach a threshold level of activity. These models have received considerable neurophysiological support from recordings of individual neurons while animals are engaged in motion discrimination tasks. These experiments have found that the activity of neurons in a particular visual area strongly associated with motion processing (MT), when pooled over hundreds of milliseconds, is sufficient to explain behavioral timing and performance. However, this level of pooling may be problematic for urgent perceptual decisions in which rapid detection dictates temporally precise integration. In this paper, we explore the physiological basis of one such task in which macaques detected brief (~70 ms) transients of coherent motion within ~240 ms. We find that a simple linear summation model based on realistic stimulus responses of as few as 40 correlated neurons can predict the reliability and timing of rapid motion detection. The model naturally reproduces a distinctive physiological relationship observed in rapid detection tasks in which the individual neurons with the most reliable stimulus responses are also the most predictive of impending behavioral choices. Remarkably, we observed this relationship across our simulated neuronal populations even when all neurons within the pool were weighted equally with respect to readout. These results demonstrate that small numbers of reliable sensory neurons can dominate perceptual judgments without any explicit reliability based weighting and are sufficient to explain the accuracy, latency, and temporal precision of rapid detection. NEW & NOTEWORTHY Computational and psychophysical models suggest that performance in many perceptual tasks may be based on the preferential sampling of reliable neurons. Recent studies of MT neurons during rapid motion detection, in which only those neurons with the most reliable sensory responses were strongly predictive of the animals’ decisions, seemingly support this notion. Here we show that a simple threshold model without explicit reliability biases can explain both the behavioral accuracy and precision of these detections and the distribution of sensory- and choice-related signals across neurons.
Proportion of U.S. Trends in Breast Cancer Incidence Attributable to Long-term Changes in Risk Factor Distributions
Authors: Pfeiffer Ruth M. , Webb-Vargas Yenny , Wheeler William , Gail Mitchell H. 
Published: August 2018

Abstract
Background: U.S. breast cancer incidence has been changing, as have distributions of risk factors, including body mass index (BMI), age at menarche, age at first live birth, and number of live births.
Methods: Using data for U.S. women from large nationally representative surveys, we estimated risk factor distributions from 1980 to 2008. To estimate ecologic associations with breast cancer incidence, we fitted Poisson models to age- and calendar year–specific incidence data from the NCI's Surveillance, Epidemiology and End Results registries from 1980 to 2011. We then assessed the proportion of incidence attributable to specific risk factors by comparing incidence from models that only included age and calendar period as predictors with models that additionally included age- and cohort-specific categorized mean risk factors. Analyses were stratified by age and race.
Results: Ecologic associations usually agreed with previous findings from analytic epidemiology. From 1980 to 2011, compared with the risk factor reference level, increased BMI was associated with 7.6% decreased incidence in women ages 40 to 44 and 2.6% increased incidence for women ages 55 to 59. Fewer births were associated with 22.2% and 3.99% increased incidence in women ages 40 to 44 and 55 to 59 years, respectively. Changes in age at menarche and age at first live birth in parous women did not significantly impact population incidence from 1980 to 2011.
Conclusions: Changes in BMI and number of births since 1980 significantly impacted U.S. breast cancer incidence.
Impact: Quantifying long-term impact of risk factor trends on incidence is important to understand the future breast cancer burden and inform prevention efforts. Cancer Epidemiol Biomarkers Prev; 27(10); 1214–22. ©2018 AACR.