bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the introduction of rotavirus vaccination on paediatric hospital admissions, Lothian, Scotland: a retrospective observational study
Authors: Forrest Ruth , Jones Laura , Willocks Lorna , Hardie Alison , Templeton Kate 
Published: November 2016

ObjectiveRotavirus (RV) vaccination was introduced into the UK vaccination schedule in July 2013. This retrospective observational study assessed, in a UK setting, the impact of the vaccination programme on the number of RV gastroenteritis (RVGE) admissions, the complications of RVGE in hospitalised children, and the impact on hospital-acquired RVGE.DesignOver a 3 year period, 1-year before and 2 years after the introduction of the vaccine, children under 13 years of age in Lothian region with RV+ve stool sample by PCR were identified, retrospectively, and admission data (length of stay, complications) and vaccination status analysed. Viral strain (vaccine/wild type) was typed using PCR-based methods in vaccinated children.ResultsVaccination uptake in the first 2 years of the programme was 93–94%. In the 2 years following vaccine introduction, the annual number of confirmed RVGE admissions fell by 84.7% (95% CI 75.4 to 91.0), from 131 to 20, bed days reduced by 91.1% (86.9 to 94.1), from 325 to 29, and suspected hospital-acquired infections reduced by 95.7% (73.5–99.5), from 23 to 1. The reduction in admissions was seen across all age groups despite the vaccination only being administered to infants. Despite the reduction in incidence, complication rates in children admitted with RVGE remained unchanged across the three study years. A frequent incidental finding was RV vaccine strain in the stools of vaccinated children, up to 43 days after last immunisation. There has been no concurrent increase in rate of intussusception in the region.ConclusionsThese results provide encouraging initial evidence of the public health benefit, including to the unimmunised population, of the RV vaccination programme in the UK.
Dementia and Imagination: a mixed-methods protocol for arts and science research
Authors: Windle Gill , Newman Andrew , Burholt Vanessa , Woods Bob , O'Brien Dave , Baber Michael , Hounsome Barry , Parkinson Clive , Tischler Victoria 
Published: November 2016

IntroductionDementia and Imagination is a multidisciplinary research collaboration bringing together arts and science to address current evidence limitations around the benefits of visual art activities in dementia care. The research questions ask: Can art improve quality of life and well-being? If it does make a difference, how does it do this—and why? Does it have wider social and community benefits?Methods and analysisThis mixed-methods study recruits participants from residential care homes, National Health Service (NHS) wards and communities in England and Wales. A visual art intervention is developed and delivered as 1×2-hour weekly group session for 3 months in care and community settings to N=100 people living with dementia. Quantitative and qualitative data are collected at 3 time points to examine the impact on their quality of life, and the perceptions of those who care for them (N=100 family and professional carers). Repeated-measures systematic observations of well-being are obtained during the intervention (intervention vs control condition). The health economics component conducts a social return on investment evaluation of the intervention. Qualitative data are collected at 3 time points (n=35 carers/staff and n=35 people living with dementia) to explore changes in social connectedness. Self-reported outcomes of the intervention delivery are obtained (n=100). Focus groups with intervention participants (n=40) explore perceptions of impact. Social network analysis of quantitative and qualitative data from arts and healthcare professionals (N=100) examines changes in perceptions and practice.Ethics and disseminationThe study is approved by North Wales Research Ethics Committee—West. A range of activities will share the research findings, including international and national academic conferences, quarterly newsletters and the project website. Public engagement projects will target a broad range of stakeholders. Policy and practice summaries will be developed. The visual art intervention protocol will be developed as a freely available practitioners guide.
Therapy discontinuation or substitution in patients with cardiovascular disease, switching among different products of the same off-patent active substance: a ‘real-world’ retrospective cohort study
Authors: Degli Esposti Luca , Sangiorgi Diego , Buda Stefano , Degli Esposti Ezio , Scaglione Francesco 
Published: November 2016

ObjectiveThe present study investigated the effects of switching to different products of the same off-patent active substance (brand name or generic) on therapy discontinuation or substitution with another molecule of the same class, in patients with cardiovascular disease treated with statins and antihypertensives in a ‘real-world’ setting.DesignA retrospective cohort study in a ‘real-world’ setting.SettingAnalysis of data performed by integrating administrative databases that included approximately two million individuals who are assisted by the National Health System from three Local Health Units located in three different regions of Italy.ParticipantsAll patients aged ≥18 years with at least one prescription of simvastatin, ramipril or amlodipine in the period 1 January to 31 December 2010 were included and followed up for 2 years.Main outcome measuresPrescription refills occurring during follow-up were evaluated. Frequency of discontinuation of therapy or substitution with another molecule of the same class (eg, from simvastatin to a different statin) during follow-up was identified.ResultsDuring follow-up, therapy discontinuation or substitution was found to be more frequent in patients switching to a different product of the same active substance compared with non-switching patients (11.5% vs 10.8% and 22.2% vs 20.8% (p=0.002), respectively, in the simvastatin group; 4.0% vs 3.5% and 24.6% vs 22.7% (p<0.001), respectively, in the amlodipine group). In the ramipril group, 8% of patients undertook a therapy substitution to another molecule; no trend towards a lower percentage of substitution was observed in the non-switching group, while 18% of patients discontinued treatment, with a significant difference in favour of patients not switching. These findings were partially confirmed by multivariate analysis.ConclusionsSwitches among products of the same active substance are quite common in patients with cardiovascular disease. Our study suggests that switching may expose patients to a higher risk of therapy discontinuation or substitution.
Protocol for the economic evaluation of a community-based intervention to improve growth among children under two in rural India (CARING trial)
Authors: Skordis-Worrall Jolene , Sinha Rajesh , Kumar Ojha Amit , Sarangi Soumendra , Nair Nirmala , Tripathy Prasanta , Sachdev H S , Bhattacharyya Sanghita , Gope Rajkumar , Rath Shibanand , Rath Suchitra , Srivastava Aradhana , Batura Neha , Pulkki-Brännström Anni-Maria , Costello Anthony , Copas Andrew , Saville Naomi , Prost Audrey , Haghparast-Bidgoli Hassan 
Published: November 2016

IntroductionUndernutrition affects ∼165 million children globally and contributes up to 45% of all child deaths. India has the highest proportion of global undernutrition-related morbidity and mortality. This protocol describes the planned economic evaluation of a community-based intervention to improve growth in children under 2 years of age in two rural districts of eastern India. The intervention is being evaluated through a cluster-randomised controlled trial (cRCT, the CARING trial).Methods and analysisA cost-effectiveness and cost–utility analysis nested within a cRCT will be conducted from a societal perspective, measuring programme, provider, household and societal costs. Programme costs will be collected prospectively from project accounts using a standardised tool. These will be supplemented with time sheets and key informant interviews to inform the allocation of joint costs. Direct and indirect costs incurred by providers will be collected using key informant interviews and time use surveys. Direct and indirect household costs will be collected prospectively, using time use and consumption surveys. Incremental cost-effectiveness ratios (ICERs) will be calculated for the primary outcome measure, that is, cases of stunting prevented, and other outcomes such as cases of wasting prevented, cases of infant mortality averted, life years saved and disability-adjusted life years (DALYs) averted. Sensitivity analyses will be conducted to assess the robustness of results.Ethics and disseminationThere is a shortage of robust evidence regarding the cost-effectiveness of strategies to improve early child growth. As this economic evaluation is nested within a large scale, cRCT, it will contribute to understanding the fiscal space for investment in early child growth, and the relative (in)efficiency of prioritising resources to this intervention over others to prevent stunting in this and other comparable contexts. The protocol has all necessary ethical approvals and the findings will be disseminated within academia and the wider policy sphere.Trial registration numberISRCTN51505201; pre-results.
‘I'll be in a safe place’: a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care
Authors: Henson Lesley A , Higginson Irene J , Daveson Barbara A , Ellis-Smith Clare , Koffman Jonathan , Morgan Myfanwy , Gao Wei 
Published: November 2016

ObjectiveTo explore the decisions of people with advanced cancer and their caregivers to seek emergency department (ED) care, and understand the issues that influence the decision-making process.DesignCross-sectional qualitative study incorporating semistructured patient and caregiver interviews.MethodsBetween December 2014 and July 2015, semistructured interviews were conducted with 18 people with advanced cancer, all of whom had recently attended the ED of a large university teaching hospital located in south-east London; and six of their caregivers. Interviews were audio recorded, transcribed verbatim and analysed using a constant comparative approach. Padgett and Brodsky's modified version of the ‘Behavioral Model of Health Services Use’ was used as a framework to guide the study.ResultsIssues influencing the decision-making process included: (1) disease-related anxiety—those with greater anxiety related to their cancer diagnosis interpreted their symptoms as more severe and/or requiring immediate attention; (2) prior patterns of health-seeking behaviour—at times of crisis participants defaulted to previously used services; (3) feelings of safety and familiarity with the hospital setting—many felt reassured by the presence of healthcare professionals and monitoring of their condition; and, (4) difficulties accessing community healthcare services—especially urgently and/or out-of-hours.ConclusionsThese data provide healthcare professionals and policymakers with a greater understanding of how systems of care may be developed to help reduce ED visits by people with advanced cancer. In particular, our findings suggest that the number of ED visits could be reduced with greater end-of-life symptom support and education, earlier collaboration between oncology and palliative care, and with increased access to community healthcare services.
Goblet Cell Ratio in Combination with Differentiation and Stem Cell Markers in Barrett Esophagus Allow Distinction of Patients with and without Esophageal Adenocarcinoma
Authors: Schellnegger Raphael , Quante Anne , Rospleszcz Susanne , Schernhammer Martina , Höhl Bettina , Tobiasch Moritz , Pastula Agnieszka , Brandtner Anna , Abrams Julian A. , Strauch Konstantin , Schmid Roland M. , Vieth Michael , Wang Timothy C. , Quante Michael 
Published: November 2016

Abstract
The increasing incidence of esophageal adenocarcinoma (EAC) is mirrored by the increasing prevalence of Barrett esophagus, a precursor lesion resulting in a large number of individuals “at risk” for this lethal malignancy. Among patients with Barrett esophagus, only about 0.3% annually will develop EAC. Because large numbers of patients are followed in endoscopic surveillance, there is a need for risk prediction among a growing population of patients with Barrett esophagus. We identified four potential biomarkers from an inflammation (IL1β)-dependent mouse model of Barrett esophagus and tested them in 189 patients with Barrett esophagus with and without high-grade dysplasia (HGD)/early cancer (T1). The primary goal was to distinguish patients with Barrett esophagus with no evidence of dysplasia from those with dysplasia. Increasing stem cell marker LGR5 and niche cell marker DCLK1 and decreasing differentiation marker (secretory mucus cells, TFF2+ cells) correlated with elevated tumor score in the mouse. Having outlined the origin of those markers in the Barrett esophagus mouse model, we showed the applicability for human Barrett esophagus. We compared 94 patients with nondysplastic Barrett esophagus tissue with 95 patients with Barrett esophagus and HGD or early cancer. Low levels of TFF2 (AUC 87.2%) provided the best discrimination between nondysplastic Barrett esophagus and Barrett esophagus with cancer, followed by high levels of DCLK1 (AUC 83.4%), low goblet cell ratio (AUC 79.4%), and high LGR5 (AUC 71.4%). The goblet cell ratio, rather than the presence of goblet cells per se, was found to be an important discriminator. These findings may be useful in developing future risk prediction models for patients with Barrett esophagus and ultimately to improve EAC surveillance. Cancer Prev Res; 10(1); 55–66. ©2016 AACR.
A New Snow Density Parameterization for Land Data Initialization
Authors: Dawson Nicholas , Broxton Patrick , Zeng Xubin 
Published: November 2016

Abstract
Snow initialization is crucial for weather and seasonal prediction, but the National Centers for Environmental Prediction (NCEP) operational models have been found to produce too little snow water equivalent, partly because they assume a constant and unrealistically low snow density for the snowpack. One possible solution is to use the snow density formulation from the Noah land model used in NCEP operational forecast models. While this solution is better than the constant density assumption, the seasonal evolution of snow density in Noah is still found to be unrealistic, through the evaluation of both the offline Noah model output and the Noah snow density formulation itself. A physically based snow density parameterization is then developed, which performs considerably better than the Noah parameterization based on the measurements from the SNOTEL network over the western United States and Alaska. It also performs better than the snow density schemes used in three other models. This parameterization could be easily implemented in NCEP operational snow initialization. With the consideration of up to 10 snow layers, this parameterization can also be applied to multilayer snowpack initiation or to estimate snow water equivalent from in situ and airborne snow depth measurements.
An Ice-Phase Microphysics Forward Model and Preliminary Results of Polarimetric Radar Data Assimilation
Authors: Li Xuanli , Mecikalski John R. , Posselt Derek 
Published: November 2016

AbstractIn this study, an ice-phase microphysics forward model has been developed for the Weather Research and Forecasting (WRF) Model three-dimensional variational data assimilation (WRF 3D-Var) system. Radar forward operators for reflectivity and the polarimetric variable, specific differential phase (KDP), have been built into the ice-phase WRF 3D-Var package to allow modifications in liquid (cloud water and rain) and solid water (cloud ice and snow) fields through data assimilation. Experiments have been conducted to assimilate reflectivity and radial velocity observations collected by the Weather Surveillance Radar-1988 Doppler (WSR-88D) in Hytop, Alabama, for a mesoscale convective system (MCS) on 15 March 2008. Numerical results have been examined to assess the impact of the WSR-88D data using the ice-phase WRF 3D-Var radar data assimilation package. The main goals are to first demonstrate radar data assimilation with an ice-phase microphysics forward model and second to improve understanding on how to enhance the utilization of radar data in numerical weather prediction. Results showed that the assimilation of reflectivity and radial velocity data using the ice-phase system provided significant improvement especially in the mid- to upper troposphere. The improved initial conditions led to apparent improvement in the short-term precipitation forecast of the MCS. An additional experiment has been conducted to explore the assimilation of KDP data collected by the Advanced Radar for Meteorological and Operational Research (ARMOR). Results showed that KDP data have been successfully assimilated using the ice-phase 3D-Var package. A positive impact of the KDP data has been found on rainwater in the lower troposphere and snow in the mid- to upper troposphere.
A Technique for Verification of Convection-Permitting NWP Model Deterministic Forecasts of Lightning Activity
Authors: Wilkinson Jonathan M. 
Published: November 2016

Abstract
This manuscript introduces a new technique for evaluating lightning forecasts from convection-permitting models. In recent years, numerical weather prediction models at the convection-permitting scales (horizontal grid resolutions of 1–5 km) have been able to produce realistic-looking forecasts of lightning activity when compared with observations. However, it is challenging to assess what value these forecasts add above standard large-scale indices. Examining this problem, it is found that existing skill scores and neighborhood verification methods are unable to cope with both the double-penalty effect and the model’s variable frequency bias. A displacement distance and a quasi-symmetric distance score are introduced based on the distance between the model and the observations, the latter showing any improvement the forecast has over a completely “hedged” forecast. This can be combined with a domain-improved contingency table and comparisons between modeled and observed lightning flashes to evaluate the forecast performance in three important dimensions: coverage, distance, and intensity. The verification metric is illustrated with a single case, which shows that the convective-scale U.K. variable resolution model (UKV) delivers improved forecasts compared with the large-scale indices in both coverage and distance. Additionally, a month-long analysis is performed, which reveals that the coverage of lightning is in good agreement with the observations; lightning is displaced by the model by a distance on the order of 50–75 km, but the model overpredicts the lightning intensity by at least a factor of 6 after observational detection efficiencies have been considered.
Tourist Demand Reactions: Symmetric or Asymmetric across the Business Cycle?
Authors: Bronner Fred , de Hoog Robert 
Published: November 2016

Economizing and spending priorities on different types of vacations are investigated during two periods: an economic downturn and returning prosperity. Two nation-wide samples of vacationers are used: one during a downturn, the other one at the start of the recovery period. Through comparing the results, conclusions can be drawn about symmetric or asymmetric tourist demand across the business cycle. The main summer holiday has an asymmetric profile: being fairly crisis-resistant during a recession and showing considerable growth during an expansion. This does not apply to short vacations and day trips, each having a symmetric profile: during a recession they experience substantial reductions and during expansion comparable growth. So when talking about tourist demand in general, one cannot say that it is symmetric or asymmetric across the business cycle: it depends on the type of vacation. Differences in tourist demand are best explained by the role of Quality-of-Life for vacationers.
Subcutaneous Infusion of Fluids for Hydration or Nutrition: A Review
Authors: Caccialanza Riccardo , Constans Thierry , Cotogni Paolo , Zaloga Gary P. , Pontes‐Arruda Alessandro 
Published: November 2016

AbstractSubcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small‐gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route. Of note, subcutaneous infusion offers several advantages over intravenous infusion, including ease of application, low cost, and the lack of potential serious complications, particularly infections. Subcutaneous infusion may be particularly suited for patients with mild to moderate dehydration or malnutrition when oral/enteral intake is insufficient; when placement of an intravenous catheter is not possible, tolerated, or desirable; at risk of dehydration when oral intake is not tolerated; as a bridging technique in case of difficult intravenous access or catheter‐related bloodstream infection while infection control treatment is being attempted; and in multiple settings (eg, emergency department, hospital, outpatient clinic, nursing home, long‐term care, hospice, and home).
Nepantla, Cross-cultural Encounters, and Literature: Latin America, India, Japan
Authors: Palencia-Roth Michael 
Published: November 2016

AbstractThis essay briefly explores the phenomenon of nepantla in three representative cross-cultural encounters, in both initial and later phases: Spain-Latin America, England-India, and the West-Japan. Nepantla is a mode of in-betweenness rooted in the historical encounter between cultures and leading to mediation of various kinds. For Latin America, the essay focuses on Columbus, the Cortés-Moctezuma encounter, the Aztec-Franciscan dialogues of 1524, Gabriel García Márquez, and Mario Vargas Llosa. For India, the essay comments on the East India Company, English education in India, Lord Macaulay, Dean Mahomet, Rabindranath Tagore, Salman Rushdie, V.S. Naipaul, and a number of other writers from the early, mid and late twentieth century. For Japan, the essay considers, first, Japanese reactions to missionary activities in the sixteenth century, then the opening up of Japan in the nineteenth century, the Meiji Restoration and its literature, and in particular authors like Fukuzawa, Sōseki, Endō, Kawabata, and Ōe. The essay argues, finally, that nepantla is a useful and dynamic approach to intercultural encounters that complements approaches indicated by terms like colonialism, imperialism, contact zones, hybridity or métissage, liminality, de-colonization, or post-coloniality.