bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Ebola infection prevention and control in primary healthcare facilities in Sierra Leone: a single-group pretest post-test, mixed-methods study
Authors: Ratnayake Ruwan , Ho Lara S , Ansumana Rashid , Brown Hannah , Borchert Matthias , Miller Laura , Kratz Thomas , McMahon Shannon A , Sahr Foday 
Published: December 2016

BackgroundAccomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops.MethodsWe conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015. Quantitative methods administered to HCWs at baseline and follow-up included a survey on attitudes and self-efficacy towards IPC, and structured observations of behaviours. The intervention involved a workshop for HCWs to develop improvement plans for their facility. We analysed the changes between rounds in survey responses and behaviours. We used interviews to explore attitudes and self-efficacy throughout the study period.ResultsHCWs described IPC as ‘life-saving’ and personal protective equipment (PPE) as uncomfortable for providers and frightening for patients. At baseline, self-efficacy was high (median=4/strongly agree). Responses reflecting unfavourable attitudes were low for glove use (median=1/strongly disagree, IQR, 1–2) and PPE use with ill family members (median=1, IQR, 1–2), and mixed for PPE use with ill HCWs (median=2/disagree, IQR, 1–4). Observations demonstrated consistent glove reuse and poor HCW handwashing. The maintenance of distance (RR 1.09, 95% CI 1.02 to 1.16) and patient handwashing (RR 1.19, 95% CI 1.3 to 1.25) improved to >90%.ConclusionsWe found favourable attitudes towards IPC and gaps in practice. Risk perceptions of HCWs and tendencies to ration PPE where chronic supply chain issues normally lead to PPE stock-outs may affect practice. As Sierra Leone's Ebola Recovery Strategy aims to make all facilities IPC compliant, socio-behavioural improvements and a secure supply chain are essential.
Translation and validation of the Cancer-Related Fatigue Scale in Greek in a sample of patients with advanced prostate cancer
Authors: Charalambous Andreas , Kaite Charis , Constantinou Marianna , Kouta Christiana 
Published: December 2016

ObjectiveTo translate and validate the Cancer-Related Fatigue (CRF) Scale in the Greek language.DesignA cross-sectional descriptive design was used in order to translate and validate the CRF Scale in Greek. Factor analyses were performed to understand the psychometric properties of the scale and to establish construct, criterion and convergent validity.SettingOutpatients' oncology clinics of two public hospitals in Cyprus.Participants148 patients with advanced prostate cancer undergoing chemotherapy.ResultsThe Cancer Fatigue Scale (CFS) had good stability (test–retest reliability r=0.79, p<0.001) and good internal consistency (Cronbach's α coefficient for all 15 items α=0.916). Furthermore, the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO value) was found to be 0.743 and considered to be satisfactory (>0.5). The correlations between the CFS physical scale (CFS-FS scale) and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 physical subscales were found to be significant (r=−0.715). The same occurred between CFS cognitive and EORTC cognitive subscale (r=−0.579). Overall, the criterion validity was verified. The same occurs for the convergent validity of the CFS since all correlations with the Global Health Status (q29–q30) were found to be significant.ConclusionsThis is the first validation study of the CRF Scale in Greek and warrant of its use in the assessment of prostate cancer patient's related fatigue. However, further testing and validation is needed in the early stages of the disease and in patients in later chemotherapy cycles.
Physical activity as intervention for age-related loss of muscle mass and function: protocol for a randomised controlled trial (the LISA study)
Authors: Eriksen Christian Skou , Garde Ellen , Reislev Nina Linde , Wimmelmann Cathrine Lawaetz , Bieler Theresa , Ziegler Andreas Kraag , Gylling Anne Theil , Dideriksen Kasper Juel , Siebner Hartwig Roman , Mortensen Erik Lykke , Kjaer Michael 
Published: December 2016

IntroductionPhysical and cognitive function decline with age, accelerating during the 6th decade. Loss of muscle power (force×velocity product) is a dominant physical determinant for loss of functional ability, especially if the lower extremities are affected. Muscle strength training is known to maintain or even improve muscle power as well as physical function in older adults, but the optimal type of training for beneficial long-term training effects over several years is unknown. Moreover, the impact of muscle strength training on cognitive function and brain structure remains speculative. The primary aim of this randomised controlled trial is to compare the efficacy of two different 1 year strength training regimens on immediate and long-lasting improvements in muscle power in retirement-age individuals. Secondary aims are to evaluate the effect on muscle strength, muscle mass, physical and cognitive function, mental well-being, health-related quality of life and brain morphology.Methods and analysisThe study includes 450 home-dwelling men and women (62–70 years). Participants are randomly allocated to (1) 1 year of supervised, centre-based heavy resistance training, (2) home-based moderate intensity resistance training or (3) habitual physical activity (control). Changes in primary (leg extensor power) and secondary outcomes are analysed according to the intention to treat principle and per protocol at 1, 2, 4, 7 and 10 years.Ethics and disseminationThe study is expected to generate new insights into training-induced promotion of functional ability and independency after retirement and will help to formulate national recommendations regarding physical activity schemes for the growing population of older individuals in western societies. Results will be published in scientific peer-reviewed journals, in PhD theses and at public meetings. The study is approved by the Regional Ethical Committee (Capital Region, Copenhagen, Denmark, number H-3-2014-017).Trial registration numberNCT02123641.
HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge
Authors: Lowthian Judy A , Lennox Alyse , Curtis Andrea , Dale Jeremy , Browning Colette , Smit De Villiers , Wilson Gillian , O'Brien Debra , Rosewarne Cate , Boyd Lee , Garner Cath , Cameron Peter 
Published: December 2016

IntroductionOlder people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. TheHOW R U?study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers.Methods and analysisA multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in level of loneliness (UCLA-3 item Loneliness Scale), mood (Geriatric Depression Scale-5 item) and health-related quality of life (EQ-5D-5L and EQ-VAS) will also be measured postintervention (3 months).Ethics and disseminationResearch ethics and governance committee approval has been granted for this study by each participating centre (reference: 432/15 and 12-09-11-15). Study findings will inform the design and conduct of a future multicentre randomised controlled trial of a postdischarge volunteer-peer telephone support programme to improve social isolation, loneliness or depressive symptoms in older patients. Results will be disseminated through peer-reviewed journal publication, and conference and seminar presentation.Trial registration numberACTRN12615000715572, Pre-results.
‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study
Authors: Rich Antonia , Viney Rowena , Needleman Sarah , Griffin Ann , Woolf Katherine 
Published: December 2016

ObjectivesInvestigate the work–life balance of doctors in training in the UK from the perspectives of trainers and trainees.DesignQualitative semistructured focus groups and interviews with trainees and trainers.SettingPostgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training.Participants96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation.ResultsPostgraduate training was characterised by work–life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work–life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work–life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems.ConclusionsA lack of work–life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work–life balance of trainees.
Urban–rural differences in cancer-directed surgery and survival of patients with non-small cell lung cancer
Authors: Thomas Audrey Alforque , Pearce Alison , O'Neill Ciaran , Molcho Michal , Sharp Linda 
Published: December 2016

BackgroundLung cancer is the leading cause of cancer death worldwide. Clinically appropriate cancer-directed surgery is an influential and significant prognostic factor. In a population-based study, we determined how urban/rural residence was related to surgery receipt for patients with non-small cell lung cancer. We assessed the relationship between relative survival and patients' area of residence, taking into account surgery receipt and area socioeconomic level.MethodsWe extracted data from the National Cancer Registry Ireland on patients with non-small cell lung cancer diagnosed during 1994–2011 and linked to area-level data on socioeconomic indicators and urban/rural categories. We calculated ORs for receipt of cancer-directed surgery using logistic regression with postestimation of adjusted proportions. Relative survival estimates with follow-up to 31 December 2012 were calculated for all cases and stratified by surgery receipt, adjusting for clinical variables, area socioeconomic level and other sociodemographic characteristics.Results15 031 people diagnosed with non-small cell lung cancer were included in the analysis. On the basis of the multiple logistic regression model, a significantly larger proportion of urban patients (adjusted proportion 23%) as compared with rural patients (adjusted proportion 21%) received surgery (p<0.001). In multivariate analysis, rural residence was significantly related to a decrease in excess mortality for all cases (HR 0.90, 95% CI 0.87 to 0.94, p<0.001) and for non-surgical cases (HR 0.88, 95% CI 0.85 to 0.92, p<0.001).ConclusionsThe findings point to the need for targeted policies addressing access to treatment for rural patients with non-small cell lung cancer.
A Low-Phase Noise ADPLL Based on a PRBS-Dithered DDS Enhancement Circuit
Authors: Ameur Noura Ben 
Published: December 2016

This paper aims to design an all-digital phase-locked loop (ADPLL) intended for professional digital audio data conversion applications. The method used for designing is based on an analogy between analog PLL and ADPLL. Managing a low-jitter effect, a comparative study between discrete voltage-controlled oscillator (DVCO) and direct digital synthesis (DDS) based on a pseudorandom binary sequence (PRBS) generator is performed. The features of the design in this work are high-precision and low harmonic distortion DDS which is combined with ADPLL. For model-based design validation, a rapid register transfer level (RTL) with VHSIC hardware description language (VHDL) is practiced and the dynamic performance result indicates a significant improvement in total harmonic distortion (THD) ([Formula: see text][Formula: see text]dB) and a better resolution of 18.97[Formula: see text]bits for audio applications based on the aid of phase dithering DDS enhancement circuit.
The furthest end of the Earth: the role of geological research in Antarctic exploration, 1895–1922
Authors: Clary Renee M. , Sharpe Tom 
Published: December 2016

Abstract
Following the 1895 Sixth International Geographical Congress declaration that Antarctica was the greatest goal in exploration, an intensive period of Antarctic Exploration (1895–1922) was ushered in with multiple expeditions to the South Polar regions. These often included geological exploration in their scientific programmes. During this period, evidence for the geological links between the Antarctic Peninsula and the Andes was gathered, the outline stratigraphy of the Transantarctic Mountains deciphered and the first studies of Antarctica's palaeontology undertaken, in addition to the attainment of the Geographical South Pole.
Metabolomic Characterization of Hepatocellular Carcinoma in Patients with Liver Cirrhosis for Biomarker Discovery
Authors: Di Poto Cristina , Ferrarini Alessia , Zhao Yi , Varghese Rency S. , Tu Chao , Zuo Yiming , Wang Minkun , Nezami Ranjbar Mohammad R. , Luo Yue , Zhang Chi , Desai Chirag S. , Shetty Kirti , Tadesse Mahlet G. , Ressom Habtom W. 
Published: December 2016

AbstractBackground: Metabolomics plays an important role in providing insight into the etiology and mechanisms of hepatocellular carcinoma (HCC). This is accomplished by a comprehensive analysis of patterns involved in metabolic alterations in human specimens. This study compares the levels of plasma metabolites in HCC cases versus cirrhotic patients and evaluates the ability of candidate metabolites in distinguishing the two groups. Also, it investigates the combined use of metabolites and clinical covariates for detection of HCC in patients with liver cirrhosis.Methods: Untargeted analysis of metabolites in plasma from 128 subjects (63 HCC cases and 65 cirrhotic controls) was conducted using gas chromatography coupled to mass spectrometry (GC-MS). This was followed by targeted evaluation of selected metabolites. LASSO regression was used to select a set of metabolites and clinical covariates that are associated with HCC. The performance of candidate biomarkers in distinguishing HCC from cirrhosis was evaluated through a leave-one-out cross-validation based on area under the receiver operating characteristics (ROC) curve.Results: We identified 11 metabolites and three clinical covariates that differentiated HCC cases from cirrhotic controls. Combining these features in a panel for disease classification using support vector machines (SVM) yielded better area under the ROC curve compared with alpha-fetoprotein (AFP).Conclusions: This study demonstrates the combination of metabolites and clinical covariates as an effective approach for early detection of HCC in patients with liver cirrhosis.Impact: Further investigation of these findings may improve understanding of HCC pathophysiology and possible implication of the metabolites in HCC prevention and diagnosis. Cancer Epidemiol Biomarkers Prev; 26(5); 675–83. ©2016 AACR.
Long-term Exposure to Fine Particulate Matter and Breast Cancer Incidence in the Danish Nurse Cohort Study
Authors: Andersen Zorana Jovanovic , Ravnskjær Line , Andersen Klaus Kaae , Loft Steffen , Brandt Jørgen , Becker Thomas , Ketzel Matthias , Hertel Ole , Lynge Elsebeth , Bräuner Elvira Vaclavik 
Published: December 2016

Abstract
Background: An association between air pollution and breast cancer risk has been suggested, but evidence is sparse and inconclusive.
Methods: We included 22,877 female nurses from the Danish Nurse Cohort who were recruited in 1993 or 1999 and followed them for incidence of breast cancer (N = 1,145) until 2013 in the Danish Cancer Register. We estimated annual mean concentrations of particulate matter with diameter &lt;2.5 μg/m3 (PM2.5) and &lt;10 μg/m3 (PM10), and nitrogen dioxide (NO2) at nurses' residences since 1990 using an atmospheric chemistry transport model. We examined the association between the 3-year running mean of each pollutant and breast cancer incidence using a time-varying Cox regression.
Results: We found no association between breast cancer and PM2.5 (HR, 0.99; 95% confidence interval, 0.94–1.10 per interquartile range of 3.3 μg/m3), PM10 (1.02; 0.94–1.10 per 2.9 μg/m3), or NO2 (0.99; 0.93–1.05 per 7.4 μg/m3).
Conclusions: Air pollution is not associated with breast cancer risk.
Impact: Exposure to air pollution in adulthood does not increase the risk of breast cancer, but more data on the effects of early exposure, before first birth, are needed. Cancer Epidemiol Biomarkers Prev; 26(3); 428–30. ©2016 AACR.
Assessment of MISR Cloud Motion Vectors (CMVs) Relative to GOES and MODIS Atmospheric Motion Vectors (AMVs)
Authors: Mueller Kevin J. , Wu Dong L. , Horváth Ákos , Jovanovic Veljko M. , Muller Jan-Peter , Di Girolamo Larry , Garay Michael J. , Diner David J. , Moroney Catherine M. , Wanzong Steve 
Published: December 2016

AbstractCloud motion vector (CMV) winds retrieved from the Multiangle Imaging SpectroRadiometer (MISR) instrument on the polar-orbiting Terra satellite from 2003 to 2008 are compared with collocated atmospheric motion vectors (AMVs) retrieved from Geostationary Operational Environmental Satellite (GOES) imagery over the tropics and midlatitudes and from Moderate Resolution Imaging Spectroradiometer (MODIS) imagery near the poles. MISR imagery from multiple view angles is exploited to jointly retrieve stereoscopic cloud heights and motions, showing advantages over the AMV heights assigned by radiometric means, particularly at low heights (<3 km) that account for over 95% of MISR CMV sampling. MISR–GOES wind differences exhibit a standard deviation ranging with increasing height from 3.3 to 4.5 m s−1 for a high-quality [quality indicator (QI) ≥ 80] subset where height differences are <1.5 km. Much of the observed difference can be attributed to the less accurately retrieved component of CMV motion along the direction of satellite motion. MISR CMV retrieval is subject to correlation between error in retrieval of this along-track component and of height. This manifests as along-track bias varying with height to magnitudes as large as 2.5 m s−1. The cross-track component of MISR CMVs shows small (<0.5 m s−1) bias and standard deviation of differences (1.7 m s−1) relative to GOES AMVs. Larger differences relative to MODIS are attributed to the tracking of cloud features at heights lower than MODIS in multilayer cloud scenes.
Skill and Skill Prediction of Cloud-Track Advection-Only Forecasting under a Cumulus-Dominated Regime
Authors: Srikrishnan Vivek , Young George S. , Brownson Jeffrey R. S. 
Published: December 2016

AbstractThe intermittency of solar power production is dependent on the evolution and advection of the nearby cloud field. A key problem related to solar energy integration is the improvement of 1-h-ahead forecasts to reduce the impact of intermittency on power systems operations. Many solar forecasts explicitly or implicitly assume Taylor’s hypothesis. While such advection-only forecasts can be presumed to be valid across sufficiently short time scales, it is not clear how rapidly the skill of such a forecast decays with increased lead time. As the goal is to improve the quality of 1-h-ahead forecasts, this work focuses on quantifying the skill of cloud-track wind-based cumulus-dominated cloud field forecasts with respect to lead time. No explicit connection is drawn to the quality of solar forecasts because of the importance of separating two potential sources of error: cloud field forecasting and radiative transfer estimation. It is found that the cumulus field forecast skill begins to asymptotically approach a minimum at lead times of beyond 30 min, suggesting that advection-only forecasts in a cumulus-dominated environment should not be relied upon for 1-h-ahead point forecasts used by radiative transfer methods to estimate solar power production. A first attempt at forming a probabilistic forecast that can quantify this increasing uncertainty when using advection-only methods is presented.
Improving Coastal Storm Evacuation Messages
Authors: Cuite Cara L. , Shwom Rachael L. , Hallman William K. , Morss Rebecca E. , Demuth Julie L. 
Published: December 2016

AbstractEvacuation before severe coastal storms is a critical tool for keeping coastal residents safe. Effective messaging of evacuations could help save lives, but there is little evidence-based guidance on the advantages or disadvantages of specific messaging. Ideally, evacuation messages would convince those most at risk to evacuate and those who do not need to evacuate to stay in their homes. Using an online survey of 1716 coastal residents in Connecticut, New Jersey, and New York, this study randomly assigned respondents to message conditions in each of two hypothetical storm scenarios. Results from the first scenario indicate that those who saw mandatory evacuation messages had higher evacuation intentions than those who saw advisory messages, and both of those messages resulted in slightly higher evacuation intentions than voluntary evacuation messages. However, voluntary messages resulted in lower evacuation intentions for those that did not live in evacuation zones compared to those who did live in evacuation zones, which may help reduce shadow evacuation. In the second scenario, identifying an evacuation area by the municipality name or the individual’s street name resulted in similar evacuation intentions across all participants. Messages identifying an evacuation area by “flood zone” or “flood-prone area” resulted in equally high evacuation intentions for those who believe they live in a flood zone, but these messages suppressed evacuation intentions for those who do not believe they live in a flood zone. This indicates that such messages could also be an effective approach for reducing shadow evacuation. Implications for risk communicators and emergency managers are discussed.