bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study
Authors: Drennan Vari M , Halter Mary , Wheeler Carly , Nice Laura , Brearley Sally , Ennis James , Gabe Jonathan , Gage Heather , Levenson Ros , de Lusignan Simon , Begg Phil , Parle James 
Published: January 2019

ObjectivesTo investigate the deployment of physician associates (PAs); the factors supporting and inhibiting their employment and their contribution and impact on patients’ experience and outcomes and the organisation of services.DesignMixed methods within a case study design, using interviews, observations, work diaries and documentary analysis.SettingSix acute care hospitals in three regions of England in 2016–2017.Participants43 PAs, 77 other health professionals, 28 managers, 28 patients and relatives.ResultsA key influencing factor supporting the employment of PAs in all settings was a shortage of doctors. PAs were found to be acceptable, appropriate and safe members of the medical/surgical teams by the majority of doctors, managers and nurses. They were mainly deployed to undertake inpatient ward work in the medical/surgical team during core weekday hours. They were reported to positively contribute to: continuity within their medical/surgical team, patient experience and flow, inducting new junior doctors, supporting the medical/surgical teams’ workload, which released doctors for more complex patients and their training. The lack of regulation and attendant lack of authority to prescribe was seen as a problem in many but not all specialties. The contribution of PAs to productivity and patient outcomes was not quantifiable separately from other members of the team and wider service organisation. Patients and relatives described PAs positively but most did not understand who and what a PA was, often mistaking them for doctors.ConclusionsThis study offers new insights concerning the deployment and contribution of PAs in medical and surgical specialties in English hospitals. PAs provided a flexible addition to the secondary care workforce without drawing from existing professions. Their utility in the hospital setting is unlikely to be completely realised without the appropriate level of regulation and authority to prescribe medicines and order ionising radiation within their scope of practice.
Knowledge of the physical activity guidelines and factors associated with physical activity participation among adults in Harar town, eastern Ethiopia
Authors: Abdeta Chalchisa , Seyoum Berhanu , Teklemariam Zelalem 
Published: January 2019

ObjectivesWe assessed knowledge of the physical activity guidelines and factors associated with physical activity participation among adults in Harar town, eastern Ethiopia.DesignA cross-sectional study of 590 adults in Harar town with face-to-face interview.ResultsOnly 27% of participants had good knowledge of the physical activity guidelines. The extent of physical activity participation was 54% (95% CI 50.0% to 58.4%). Male participants (adjusted OR (AOR) 2.14; 95% CI 1.49 to 3.07), educational status of college diploma and above (AOR 2.06; 95% CI 1.09 to 3.89), sitting less than 2 hours per day (AOR 1.82; 95% CI: 1.17% to 2.83%) and good knowledge of physical activity (AOR 3.03; 95% CI 1.98 to 4.64) were associated with physical activity participation.ConclusionsThere is limited knowledge of physical activity guideline in the study area.
Prognostic value of soluble ST2 in adults with congenital heart disease
Authors: Geenen Laurie W , Baggen Vivan J M , van den Bosch Annemien E , Eindhoven Jannet A , Cuypers Judith A A E , Witsenburg Maarten , Boersma Eric , Roos-Hesselink Jolien W 
Published: January 2019

ObjectiveSoluble suppression of tumourigenicity-2 (sST2) is upregulated as response to myocardial stress and may be a potential biomarker for risk stratification in patients with adult congenital heart disease (ACHD). This study aimed to investigate the release of sST2 and its association with cardiovascular events in ACHD.MethodsIn this prospective cohort study, 602 consecutive patients with ACHD visiting the outpatient clinic were included (2011–2013). The association between sST2 and a primary composite endpoint of all-cause mortality, heart failure, hospitalisation, arrhythmia, thromboembolic events or cardiac interventions was investigated using multivariable Cox regression.ResultssST2 was measured in 590 (98%) patients (median age 33 [25–41] years, 42% women). After a median follow-up of 5.8 [IQR 5.1–6.2) years, 225 (38.5%) reached the primary endpoint. sST2 was significantly associated with the primary endpoint when adjusted for age, sex, creatinine and N  terminal pro-B type brain natriuretic peptide (NT-proBNP) (HR per twofold higher sST2: 1.28, 95% CI 1.03 to 1.58, p=0.025). This association negated when adjusted for clinical variables and NT-proBNP (HR per twofold higher sST2: 1.19, 95% CI 0.96 to 1.48, p=0.106). Stratified analysis in complex ACHD did show a significant association between sST2 and the primary endpoint when adjusted for clinical variables and NT-proBNP (HR per twofold higher sST2: 1.31, 95% CI 1.01 to 1.69, p=0.043). Sex-specific analysis showed an association between sST2 and the primary endpoint in women (HR per twofold higher sST2 1.80, 95% CI 1.30 to 2.49, p<0.001) but not in men (HR per twofold higher sST2 1.19, 95% CI 0.90 to 1.56, p=0.223).ConclusionssST2 is a promising novel biomarker in patients with ACHD, specifically in complex ACHD and women. Future research is warranted to elucidate sex-specific and diagnosis-specific differences.
Inflammation markers and risk of developing hypertension: a meta-analysis of cohort studies
Authors: Jayedi Ahmad , Rahimi Kazem , Bautista Leonelo E , Nazarzadeh Milad , Zargar Mahdieh Sadat , Shab-Bidar Sakineh 
Published: January 2019

ObjectiveTo systematically assess the association of circulating inflammation markers with the future risk of hypertension.MethodsWe did a systematic literature search of PubMed and Scopus, from database inception to July 10, 2018. Prospective and retrospective cohort studies evaluating the association of circulating C reactive protein (CRP), high-sensitive CRP (hs-CRP), interleukin 6 (IL-6) and IL-1β to the risk of developing hypertension in the general population were included. The relative risks (RRs) for the top versus bottom tertiles of circulating biomarkers were calculated using a fixed-effects/random-effects model. A potential non-linear dose-response association was tested.ResultsFourteen prospective cohort studies, two retrospective cohort studies and five nested case-control studies involving 142 640 participants and 20 676 cases were identified. The RR for the third versus first tertiles of circulating CRP was 1.23 (95% CI 1.11 to 1.35; I2=59%, n=12). The association remained unchanged after adjustment for body mass index. The RRs for other biomarkers were as follows: hs-CRP (RR 1.20, 95% CI 1.02 to 1.37; I2=74%, n=7), IL-6 (RR 1.51, 95% CI 1.30 to 1.71; I2=0%, n=5), and IL-1β (RR 1.22, 95% CI 0.92 to 1.51; I2=0%, n=3). A non-linear dose-response meta-analysis demonstrated that the risk of hypertension increased linearly with increasing circulating inflammation markers, even within the low-risk and intermediate-risk categories.ConclusionsHigher levels of circulating CRP, hs-CRP and IL-6, but not IL-1β, were associated with the risk of developing hypertension. The association persisted in subgroups of studies defined by major sources of heterogeneity.
Association between vaginal washing and detection ofLactobacillusby culture and quantitative PCR in HIV-seronegative Kenyan women: a cross-sectional analysis
Authors: Lokken Erica M , Manguro Griffins Odhiambo , Abdallah Amina , Ngacha Caroline , Shafi Juma , Kiarie James , Jaoko Walter , Srinivasan Sujatha , Fiedler Tina L , Munch Matthew M , Fredricks David N , McClelland R Scott , Balkus Jennifer E 
Published: January 2019

ObjectivesVaginal washing has been associated with reductions in cultivableLactobacillusand an increased risk of both bacterial vaginosis (BV) and HIV infection. The effect of vaginal washing on the quantity of individualLactobacillusspecies is not well characterised. This analysis tested the hypothesis that vaginal washing would be associated with a lower likelihood ofLactobacillusspp. detected by both culture and quantitative PCR (qPCR).MethodsWe conducted a cross-sectional study of 272 HIV-seronegative women enrolled in an open-cohort study in Mombasa, Kenya. Vaginal washing and sexual risk behaviours were assessed using face-to-face interviews. VaginalLactobacillusspp. were detected using cultivation and PCR methods, withL. crispatus,L. jensenii and L. inersconcentrations measured using qPCR assays targeting the 16S rRNA gene. Poisson regression with robust SEs was used to assess associations between vaginal washing andLactobacillusdetection by culture and qPCR.ResultsEighty percent (n=217) of participants reported vaginal washing in the prior week. One-fifth (n=58) of participants had BV by Nugent score. In unadjusted analysis, vaginal washing was associated with a 45% decreased likelihood ofLactobacillusspp. detection by culture (prevalence ratio (PR): 0.55, 95% CI 0.37 to 0.82). Adjusting for age and condomless sex in the prior week did not change the magnitude of the association (adjusted PR (aPR): 0.56, 95% CI (0.37 to 0.85). Vaginal washing was associated with approximately a 40% reduction inL. crispatusdetection (aPR: 0.57, 95% CI 0.36 to 0.92), but was not significantly associated withL. jensenii(aPR: 0.68, 95% CI 0.42 to 1.09) orL. inersdetection (aPR: 1.03, 95% CI 0.92 to 1.15).ConclusionsVaginal washing in the prior week was associated with a significantly reduced likelihood of detecting cultivableLactobacillusandL. crispatusby qPCR. Given associations betweenLactobacillusdetection and improved reproductive health outcomes, these results provide motivation for additional study of vaginal washing cessation interventions to improve vaginal health.
Changing causes of death for patients with chronic respiratory disease in England, 2005-2015
Authors: Gayle Alicia V , Axson Eleanor L , Bloom Chloe I , Navaratnam Vidya , Quint Jennifer K 
Published: January 2019

BackgroundChronic respiratory diseases (CRD) are common, are increasing in prevalence, and cause significant morbidity and mortality worldwide. However, we have limited knowledge on causes of death of patients with CRD in the general population.ObjectiveWe evaluated mortality rates and causes of death over time in patients with CRD.MethodsWe used linked primary care and mortality data to determine mortality rates and the most common causes of death in people with CRD (including asthma, bronchiectasis, COPD and interstitial lung diseases (ILD)) during 2005–2015 in England.ResultsWe identified 558 888 patients with CRD (451 830 asthma, 137 709 COPD, 19 374 bronchiectasis, 10 745 ILD). The age-standardised mortality rate of patients with CRD was 1607 per 100 000 persons (asthma=856, COPD=1503, ILD=2609, bronchiectasis=1463). CRD mortality was overall 54% higher than the general population. A third of patients with CRD died from respiratory-related causes. Respiratory-related mortality was constant, while cardiovascular-related mortality decreased significantly over time. COPD accounted for the majority of respiratory-related deaths (66% overall) in all patient groups except ILD.ConclusionsPatients with CRD continue to experience substantial morbidity and mortality due to respiratory diseases. Disease-modifying intervention strategies are needed to improve outcomes for patients with CRD.
Perspectives and outlook from HEP window on the universe
Authors: Hou George Wei-Shu 
Published: January 2019

This brief review grew out from the HEP concluding talk of the 25th Anniversary of the Rencontres du Vietnam, held in August 2018, at Quy Nhon. The first two-thirds gives a summary and highlights, or snapshot, of High Energy Physics at the end of Large Hadron Collider (LHC) Run 2. It can be viewed as the combined effort of the program organizers, the invited plenary speakers, and finally filtered into the present mosaic. It certainly should not be viewed as comprehensive. In the second one-third, a more personal perspective and outlook is given, including my take on the flavor anomalies, and why the next three years, the period of Long Shutdown 2 plus first year (or more) of LHC Run 3, would be bright and flavorful, with much hope for uncovering New Physics. We advocate extra Yukawa couplings as the most likely, next, New Physics to be tested, the effect of which is already written in our Matter Universe.
On the hydrodynamics of three in-line square cylinders in a uniform flow
Authors: Huang Qiao-Gao , Pan Guang 
Published: January 2019

In this paper, is the hydrodynamics of three in-line square cylinders in a uniform flow, where the gap between two neighboring square cylinders is equivalent is under investigation. The fluid dynamics around those multiple bluff bodies, including time-mean drag coefficients, time-mean lift coefficients and Strouhal numbers, are considered at the Reynolds number [Formula: see text]. Through numerically solving the nonlinear hydrodynamic problem, we show that the drag force acting on the first square cylinder is always larger than that acting on the remaining two square cylinders. From the perspective of wake structures, with keeping the increase of the gap between two neighboring square cylinders, the wake structures become much more complicated, including attachment of shear layer, interaction between shear layer and vortex, interaction between vortex and vortex, etc. Moreover, the Strouhal number of three square cylinders are approximately equaled when the dimensionless gap between two neighboring square cylinders is less than 2.
Rheological information determined from cleavage refraction in naturally deformed interlayered quartzites and phyllites
Authors: Czeck Dyanna M. , Traut Jolene T. , Hudleston Peter J. 
Published: January 2019

Abstract
Cleavage refraction angles are used to estimate effective viscosity contrasts between interlayered quartzites and phyllites within the Baraboo Syncline, Wisconsin, USA. Both types of layers contain two major phases, quartz and pyrophyllite, with minor amounts of hematite. Quartz (with minor hematite) behaves as the strong phase and pyrophyllite acts as the weak phase. Cleavage refraction directly relates to mineralogy with a linear relationship between bedding/cleavage angle and strong-phase concentration. Mineralogy exerts first-order control over effective viscosity contrasts, which are generally small, in most cases <10. Effective viscosity contrasts are consistent across the fold, so are likely not to be highly strain dependent and indicate approximate linear viscous rheology. Microstructures suggest deformation was dominated by dislocation creep in layers with high quartz concentrations and diffusive mass transfer in layers with lower quartz concentrations, and that the transition of the deformation mechanism is gradual. Thus, the rheological flow laws at the small scale may not reflect the bulk flow law at the large scale over the span of the deformation. Effective viscosity contrasts allow an evaluation of samples compared to theoretical two-phase mixtures. The analysed samples most closely resemble the Reuss bound of two-phase mixtures, regardless of the mineralogy.
Chronic alcohol exposure alters circulating insulin and ghrelin levels: role of ghrelin in hepatic steatosis
Authors: Rasineni Karuna , Thomes Paul G. , Kubik Jacy L. , Harris Edward N. , Kharbanda Kusum K. , Casey Carol A. 
Published: January 2019

Fatty liver is the earliest response of the liver to excessive ethanol consumption. Central in the development of alcoholic steatosis is increased mobilization of nonesterified free fatty acids (NEFAs) to the liver from the adipose tissue. In this study, we hypothesized that ethanol-induced increase in ghrelin by impairing insulin secretion, could be responsible for the altered lipid metabolism observed in adipose and liver tissue. Male Wistar rats were fed for 5–8 wk with control or ethanol Lieber-DeCarli diet, followed by biochemical analyses in serum and liver tissues. In addition, in vitro studies were conducted on pancreatic islets isolated from experimental rats. We found that ethanol increased serum ghrelin and decreased serum insulin levels in both fed and fasting conditions. These results were corroborated by our observations of a significant accumulation of insulin in pancreatic islets of ethanol-fed rats, indicating that its secretion was impaired. Furthermore, ethanol-induced reduction in circulating insulin was associated with lower adipose weight and increased NEFA levels observed in these rats. Additionally, we found that increased concentration of serum ghrelin was due to increased synthesis and maturation in the stomach of the ethanol-fed rats. We also report that in addition to its effect on the pancreas, ghrelin can also directly act on hepatocytes via the ghrelin receptors and promote fat accumulation. In conclusion, alcohol-induced elevation of circulating ghrelin levels impairs insulin secretion. Consequently, reduced circulating insulin levels likely contribute to increased free fatty acid mobilization from adipose tissue to liver, thereby contributing to hepatic steatosis.NEW & NOTEWORTHY Our studies are the first to report that ethanol-induced increases in ghrelin contribute to impaired insulin secretion, which results in the altered lipid metabolism observed in adipose and liver tissue in the setting of alcoholic fatty liver disease.
Sex differences in the relationship between cardiorespiratory fitness and brain function in older adulthood
Authors: Dimech Christina J. , Anderson John A. E. , Lockrow Amber W. , Spreng R. Nathan , Turner Gary R. 
Published: January 2019

We investigated sex differences in the association between a measure of physical health, cardiorespiratory fitness (CRF), and brain function using resting-state functional connectivity fMRI. We examined these sex differences in the default, frontoparietal control, and cingulo-opercular networks, assemblies of functionally connected brain regions known to be impacted by both age and fitness level. Healthy older adults ( n = 49; 29 women) were scanned to obtain measures of intrinsic connectivity within and across these 3 networks. We calculated global efficiency (a measure of network integration) and local efficiency (a measure of network specialization) using graph theoretical methods. Across all three networks combined, local efficiency was positively associated with CRF, and this was more robust in male versus female older adults. Furthermore, global efficiency was negatively associated with CRF, but only in males. Our findings suggest that in older adults, associations between brain network integrity and physical health are sex-dependent. These results underscore the importance of considering sex differences when examining associations between fitness and brain function in older adulthood. NEW & NOTEWORTHY We examined the association between cardiorespiratory fitness and resting state functional connectivity in several brain networks known to be impacted by age and fitness level. We found significant associations between fitness and measures of network integration and network specialization, but in a sex-dependent manner, highlighting the interplay between sex differences, fitness, and aging brain health. Our findings underscore the importance of considering sex differences when examining associations between fitness and brain function in older adulthood.
Elevated Platelet Count Appears to Be Causally Associated with Increased Risk of Lung Cancer: A Mendelian Randomization Analysis
Authors: Zhu Ying , Wei Yongyue , Zhang Ruyang , Dong Xuesi , Shen Sipeng , Zhao Yang , Bai Jianling , Albanes Demetrius , Caporaso Neil E. , Landi Maria Teresa , Zhu Bin , Chanock Stephen J. , Gu Fangyi , Lam Stephen , Tsao Ming-Sound , Shepherd Frances A. , Tardon Adonina , Fernández-Somoano Ana , Fernandez-Tardon Guillermo , Chen Chu , Barnett Matthew J. , Doherty Jennifer , Bojesen Stig E. , Johansson Mattias , Brennan Paul , McKay James D. , Carreras-Torres Robert , Muley Thomas , Risch Angela , Wichmann Heunz-Erich , Bickeboeller Heike , Rosenberger Albert , Rennert Gad , Saliba Walid , Arnold Susanne M. , Field John K. , Davies Michael P.A. , Marcus Michael W. , Wu Xifeng , Ye Yuanqing , Le Marchand Loic , Wilkens Lynne R. , Melander Olle , Manjer Jonas , Brunnström Hans , Hung Rayjean J. , Liu Geoffrey , Brhane Yonathan , Kachuri Linda , Andrew Angeline S. , Duell Eric J. , Kiemeney Lambertus A. , van der Heijden Erik HFM , Haugen Aage , Zienolddiny Shanbeh , Skaug Vidar , Grankvist Kjell , Johansson Mikael , Woll Penella J. , Cox Angela , Taylor Fiona , Teare Dawn M. , Lazarus Philip , Schabath Matthew B. , Aldrich Melinda C. , Houlston Richard S. , McLaughlin John , Stevens Victoria L. , Shen Hongbing , Hu Zhibin , Dai Juncheng , Amos Christopher I. , Han Younghun , Zhu Dakai , Goodman Gary E. , Chen Feng , Christiani David C. 
Published: January 2019

Abstract

Background:
Platelets are a critical element in coagulation and inflammation, and activated platelets are linked to cancer risk through diverse mechanisms. However, a causal relationship between platelets and risk of lung cancer remains unclear.

Methods:
We performed single and combined multiple instrumental variable Mendelian randomization analysis by an inverse-weighted method, in addition to a series of sensitivity analyses. Summary data for associations between SNPs and platelet count are from a recent publication that included 48,666 Caucasian Europeans, and the International Lung Cancer Consortium and Transdisciplinary Research in Cancer of the Lung data consisting of 29,266 cases and 56,450 controls to analyze associations between candidate SNPs and lung cancer risk.

Results:
Multiple instrumental variable analysis incorporating six SNPs showed a 62% increased risk of overall non–small cell lung cancer [NSCLC; OR, 1.62; 95% confidence interval (CI), 1.15–2.27; P = 0.005] and a 200% increased risk for small-cell lung cancer (OR, 3.00; 95% CI, 1.27–7.06; P = 0.01). Results showed only a trending association with NSCLC histologic subtypes, which may be due to insufficient sample size and/or weak effect size. A series of sensitivity analysis retained these findings.

Conclusions:
Our findings suggest a causal relationship between elevated platelet count and increased risk of lung cancer and provide evidence of possible antiplatelet interventions for lung cancer prevention.

Impact:
These findings provide a better understanding of lung cancer etiology and potential evidence for antiplatelet interventions for lung cancer prevention.