bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satisfaction with life and associated factors among elderly people living in two cities in northwest Ethiopia: a community-based cross-sectional study
Authors: Mekonnen Habtamu Sewunet , Lindgren Helena , Geda Biftu , Azale Telake , Erlandsson Kerstin 
Published: September 2022

ObjectiveThis study aimed to determine the level of life satisfaction and identify associated factors among elderly people living in two cities in northwest Ethiopia.DesignCommunity-based cross-sectional study.SettingTwo cities in northwest Ethiopia (Gondar and Bahir Dar).Participants816 elderly people age 60 years and above living in Gondar and Bahir Dar, northwest Ethiopia. Systematic random sampling was used to select study participants.Main outcome measureLevel of life satisfaction. Considering the mean and SD, three levels of satisfaction appeared to suffice as the basis for analysis and discussion: 23.5–34.4 dissatisfied, 34.5–56.5 averagely satisfied and 56.6–67.5 satisfied. Multivariable ordinal regression analysis was done to control the confounders. Since the outcome variable has an ordinal category, ordinal regression analysis is appropriate. A p≤0.05 and AOR (adjusted OR) with a 95% CI were considered to determine the statistically significant variables and strength of the association.ResultsThe mean age of the respondents was 68.2 years with an SD±7.2. The level of life satisfaction was: dissatisfied 17.2%, moderately satisfied 63.8% and well satisfied 19.0%. Overall, 45.8% (95% CI 42.2% to 49.2%) of the participants had a score equal to or above the mean. Regarding associated factors; retired current occupation (AOR=2.23, 95% CI 1.09 to 4.55), good self-rated health status (AOR=2.54, 95% CI 1.29 to 4.99), having no chronic disease (AOR=1.48, 95% CI 1.03 to 2.11), somewhat-good (AOR=2.15, 95% CI 1.12 to 4.13) and good (AOR=4.51, 95% CI 2.40 to 8.45) self-perception on ageing life, moderate functional impairment on daily living activities (AOR=5.43, 95% CI 1.81 to 16.24), high sense of coherence (AOR=3.80, 95% CI 2.04 to 7.08), house rent as a source of finance (AOR=2.60, 95% CI 1.49 to 4.52) and high perceived social support (AOR=2.13, 95% CI 1.44 to 3.16) had statistically significant association with the life satisfaction.ConclusionThe life satisfaction level in our study group was lower than in some more highly developed countries. To improve the level of life satisfaction in Ethiopia, a holistic programme of nursing care for elderly people, particularly as concerns about their health and psychosocial conditions is crucial in both community and clinical settings.
Hypofractionated versus conventional intensity-modulated radiation irradiation (HARVEST-adjuvant): study protocol for a randomised non-inferior multicentre phase III trial
Authors: Xie Jinrong , Xu Feifei , Zhao Yutian , Cai Gang , Lin Xiao , Zhu Qiwei , Lin Qing , Yao Yuan , Xu Cheng , Cai Rong , Wang Shubei , Tang Xiaolu , Chen Chuying , Zheng Siyue , Chen Mei , Chen Min , Qian Xiaofang , Shen Chunhong , Li Jian , Xu Haoping , Xu Fei , Han Yimin , Li Min , Ou Dan , Shen Kun Wei , Qi Wei-Xiang , Cao Lu , Huang Xiaobo , Chen Jiayi 
Published: September 2022

IntroductionShort course regimen has become the major trend in the field of adjuvant radiotherapy for patients with breast cancer. Hypofractionated radiotherapy (HF-RT) regimen of 40–42.5 Gy in 15–16 fractions has been established as a preferred option for whole breast irradiation. However, few evidences of hypofractionated regional nodal irradiation (RNI), especially involving internal mammary nodes (IMNs), could be available during the era of intensity-modulated radiation therapy (IMRT). Against this background, we design this trial to explore the hypothesis that HF-RT regimen involving RNI (including infraclavicular, supraclavicular nodes and IMNs) will be non-inferior to a standard schedule by using IMRT technique.Methods and analysisThis is an open-label randomised, non-inferior, multicentre phase III trial. Patients with breast cancer with an indication for RNI after breast conserving surgery or mastectomy are randomised at a ratio of 1:1 into the following two groups: hypofractionated regimen of 2.67 Gy for 16 fractions or conventional regimen of 2 Gy for 25 fractions. The dose was prescribed to ipsilateral chest wall or whole breast and RNI (including infraclavicular, supraclavicular nodes and IMNs, lower axilla if indicated). The trial plans to enrol a total of 801 patients and all patients will be treated using IMRT technique. The primary endpoint is 5-year locoregional recurrence. The secondary endpoints include 5-year distant metastasis free survival, invasive recurrence-free survival, overall survival, accumulative acute radiation-induced toxicity and accumulative late radiation-induced toxicity, cosmetic outcomes and quality of life.Ethics and disseminationThe study has been approved by the Ethical Committee of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine (version 2018-95-3) and approvals from ethical committee of each participating centre have also been obtained. Research findings will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03829553.
Nomograms for predicting overall and cancer-specific survival of patients with chromophobe renal cell carcinoma after nephrectomy: a retrospective SEER-based study
Authors: Zheng Jianyi , Li Shijie , Zhao Yiqiao , Tao Zijia , Li Lei , Li Zeyu , Li Mingyang , Chen Xiaonan 
Published: September 2022

ObjectiveWe aimed to construct and validate nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with chromophobe renal cell carcinoma (chRCC) after nephrectomy.DesignThis study is a retrospective cohort study.Setting and participantsThere were 2810 patients with chRCC from Surveillance, Epidemiology and End Results database diagnosed between 2010 and 2015 included in the study who were randomly divided into a training cohort (n=1970) and a validation cohort (n=840). Another single-centre external validation cohort containing 124 patients from our hospital was also involved in our study.Primary and secondary outcome measuresOS and CSS.ResultsNomograms for OS and CSS include four and five variables, respectively, from the result of least absolute shrinkage and selection operator regression analyses. Nomograms reveal the accurate discrimination by the area under the curve of receiver operating characteristic (ROC) curves and C-indexes, with a C-index value of 0.777 (95% CI 0.728 to 0.826), 0.810 (95% CI 0.747 to 0.873) and 0.863 (95% CI 0.773 to 0.953) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for OS; and a C-index value of 0.884 (95% CI 0.829 to 0.939), 0.868 (95% CI 0.772 to 0.964) and 0.862 (95% CI 0.760 to 0.964) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for CSS. It was also proven that there was a high degree of conformance between the predicted and observation results by calibration plots. In addition, the comparison of ROC curves and C-indexes between nomograms and seventh tumour, node and metastasis stage demonstrated that nomograms were better in accuracy and efficacy ability.ConclusionsWe successfully constructed two accurate and effective nomograms to predict OS and CSS for patients with chRCC after nephrectomy, which can help clinical doctors choose individual treatment strategies for chRCC patients.
Treatment patterns for oral anticoagulants in older patients with atrial fibrillation: a retrospective, cross-sectional, nationwide study from Denmark
Authors: Rasmussen Peter Vibe , Sakthivel Tharsika , Dalgaard Frederik , Gislason Gunnar Hilmar , Pallisgaard Jannik Langtved , Hansen Morten Lock 
Published: September 2022

ObjectivesAtrial fibrillation (AF) is a predominant risk factor of ischaemic stroke and treatment with oral anticoagulants (OACs) is recommended in all patients with risk factors. This study sought to examine treatment patterns of OACs in older patients with AF.DesignRetrospective, cross-sectional study.SettingDanish nationwide administrative and clinical registers and databases.ParticipantsA total of 40 027 patients,>75 years of age, after their first hospital contact due to AF between 2010 and 2018.Primary and secondary outcomes measuresThe primary event of interest was claimed prescriptions for OACs within 180 days after first hospital contact due to AF. Proportions of patients treated with OACs were estimated and clinical factors associated with the probability of receiving OAC treatment were identified using adjusted logistic regression models.ResultsA total of 40 027 patients were included with a slight majority of women (54%). The median age was 81 years (IQR 78–86). We found that an overall 32 235 patients (81%) were prescribed an OAC after their first hospital contact due to AF with a marked increase in the proportion of patients treated from 2010 to 2018. Factors related to a decreased probability of receiving treatment were bleeding risk factors such as a history of haemorrhagic stroke (OR 0.21, 95% CI 0.16 to 0.27), any bleeding (OR 0.58, 95% CI 0.53 to 0.62) as well as markers of frailty such as osteoporosis (OR 0.78, 95% CI 0.71 to 0.85).ConclusionIn this large nationwide study, we found that in older patients with AF, the overall rates of OAC prescription were generally high (~80%) and increasing during the last decade. Factors associated with not receiving guideline recommended OAC treatment were generally related to bleeding risk factors or frailty.
Multicentre single-arm phase II trial evaluating the safety and effiCacy of Panitumumab and iRinOtecan in NeoRAS Wild-type mEtaStatic colorectal cancer patientS (C-PROWESS trial): study protocol
Authors: Osumi Hiroki , Ishizuka Naoki , Takashima Atsuo , Kumekawa Yosuke , Nakano Daisuke , Shiozawa Manabu , Denda Tadamichi , Sawada Ryoichi , Ouchi Kota , Wakatsuki Takeru , Narikazu Boku , Kato Ken , Yamaguchi Kensei , Shinozaki Eiji 
Published: September 2022

IntroductionA new concept of ‘NeoRAS wild-type (WT)’, which means conversion of RAS status from RAS mutant to RAS WT after treatment, has been reported. Previous observational and proof-of-concept studies have demonstrated the efficacy of epidermal growth factor receptor inhibitors in patients with NeoRAS WT metastatic colorectal cancer (mCRC). Moreover, posthoc biomarker analyses of these studies have suggested that not only the RAS status in the circulating tumour DNA (ctDNA) but also other gene mutational status may be useful as biomarkers of epidermal growth factor receptor inhibitors for NeoRAS WT mCRC.Methods and analysisThis trial is a multicentre, single-arm, phase II trial to assess the efficacy and safety of panitumumab plus irinotecan therapy for patients with NeoRAS mCRC. The key eligibility criteria include RAS mutant mCRC initially proven in tumour tissue refractory or intolerant to fluoropyrimidine, oxaliplatin and irinotecan; RAS WT in ctDNA (defined as plasma mutant allele frequencies of all RAS ≤0.1%) within 28 days before enrolment and Eastern Cooperative Oncology Group performance status ≤2. The primary endpoint is the response rate. The target sample size is 30 patients. Biomarker analyses are planned to be performed using next-generation sequencing-based ctDNA analysis.Ethics and disseminationThis study was approved by the certified review board of National Cancer Center Hospital. The main results of the trial will be presented in international meetings and in medical journals.Trial registration numbers031210565.
Improving access to Hackney Integrated Learning Disability Service
Authors: Omrani Osama , Spiers Jessica , Prior David , Haberland Kirsty , Kabir Anwar , Sinclair Candace , Woods Tom , Hall Ian , Checkley Laura 
Published: September 2022

AimsImproving access to Hackney Integrated Learning Disability Service (ILDS) using quality improvement (QI) methodology by reducing the time taken to complete eligibility assessment by 50% by April 2021, while improving service user and staff experience.BackgroundReferrals to ILDS require assessment of eligibility. It was noted that there was significant waiting time between referral and eligibility assessment, exacerbated by the COVID-19 pandemic. Quality Network for Community Learning Disability Services guidelines suggest waiting times for those accessing adult learning disability (LD) community services be locally agreed, although there is limited literature on this topic.MethodsAll staff members across the multidisciplinary team were invited to participate in the QI project. We defined outcome measures as days from referral to allocation of eligibility assessment to staff member and to completion of eligibility assessment, comparing referrals received before and after start of the project. The key change ideas tested using Plan-Do-Study-Act cycles were: (1) eligibility screening checklist, (2) eligibility assessments drop-in sessions for staff, (3) formal training for ILDS staff, (4) eligibility screening allocation system, (5) template letters for eligibility decisions, (6) new ILDS referral form, (7) workshops for local general practitioners.ResultsTime taken to eligibility assessment allocation decreased from median of 184 (mean=183.5±109.8) to 13 days (mean=19.9±26.4) (93% reduction). Time to completion of eligibility assessment decreased from a median of 271 (mean=296.0±133.8) to 63 days (mean=75.7±34.8) (77% reduction). We received positive feedback from staff and service users regarding the new eligibility process.ConclusionsWe report waiting times for accessing our community adult LD services and effective strategies for reducing this. We recommend similar services use a QI methodology to reduce waiting times and improve the experience of staff and service users.
Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations
Authors: Braybrook Debbie , Bristowe Katherine , Timmins Liadh , Roach Anna , Day Elizabeth , Clift Paul , Rose Ruth , Marshall Steve , Johnson Katherine , Sleeman Katherine E , Harding Richard 
Published: September 2022

BackgroundHealthcare organisations have legal and ethical duties to reduce inequalities in access to healthcare services and related outcomes. However, lesbian, gay, bisexual and/or transgender (LGBT+) people continue to experience and anticipate discrimination in health and social care. Skilled communication is vital for quality person-centred care, but there is inconsistent provision of evidence-based clinician education on health needs and experiences of LGBT+ people to support this. This study aimed to identify key stakeholders’ experiences, preferences and best practices for communication regarding sexual orientation, gender identity and gender history in order to reduce inequalities in healthcare.MethodsSemistructured qualitative interviews with LGBT+ patients with serious illness, significant others and clinicians, recruited via UK-wide LGBT+ groups, two hospitals and one hospice in England. We analysed the interview data using reflexive thematic analysis.Results74 stakeholders participated: 34 LGBT+ patients with serious illness, 13 significant others and 27 multiprofessional clinicians. Participants described key communication strategies to promote inclusive practice across three domains: (1) ‘Creating positive first impressions and building rapport’ were central to relationship building and enacted through routine use of inclusive language, avoiding potentially negative non-verbal signals and echoing terminology used by patients and caregivers; (2) ‘Enhancing care by actively exploring and explaining the relevance of sexual orientation and gender identity’, participants described the benefits of clinicians initiating these discussions, pursuing topics guided by the patient’s response or expressed preferences for disclosure. Active involvement of significant others was encouraged to demonstrate recognition of the relationship; these individual level actions are underpinned by a foundation of (3) ‘visible and consistent LGBT+ inclusiveness in care systems’. Although participants expressed hesitance talking about LGBT+ identities with individuals from some sociocultural and religious backgrounds, there was widespread support for institutions to adopt a standardised, LGBT+ inclusive, visibly supportive approach.ConclusionsPerson-centred care can be enhanced by incorporating discussions about sexual orientation and gender identity into routine clinical practice. Inclusive language and sensitive exploration of relationships and identities are core activities. Institutions need to support clinicians through provision of adequate training, resources, inclusive monitoring systems, policies and structures. Ten inclusive communication recommendations are made based on the data.
Occupational health screening during Gurkha Central Selection: a retrospective cohort study
Authors: Wong Andrew Ka Ho , Paton M , Dalbahadur P , Williams A M , Semakula F , Sweeney C , Smith M , Parsons I T 
Published: September 2022

ObjectiveThe selection process to the British Army’s Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection is free, fair and transparent. The aim of this study was to retrospectively review reasons for potential recruits (PRs) to be deemed medically unsuitable or deferred suitability on medical grounds for selection to the Brigade of Gurkhas.MethodsA retrospective review was conducted by extracted data from published post-exercise reports for the past four years to ascertain numbers of PRs deemed medically fit, medically unsuitable or deferred suitability on medical grounds. The International Classification of Disease version 11 (ICD-11) codes were retrospectively assigned to code medical reasons for non-progression. Rates of medical non-progression were compared by year.ResultsA total of 3154 PRs were analysed between 2018 and 2021. There was no significant difference between PRs deemed medically fit and those deemed medically suitable or deferred on medical grounds over the study period (p=0.351). There was a significant difference in the ratio of PRs deferred on medical grounds and those deemed medically unsuitable over the study period (p<0.05).ConclusionSelection to the Gurkhas is extremely competitive. These data demonstrate that, overall, reasons for medical deferral or unsuitability have remained constant despite the impact of a global pandemic. These data reinforce the central tenant of Gurkha selection; that it continues to be free, fair, and transparent.
Motives, frequency, predictors and outcomes of MRA discontinuation in a real-world heart failure population
Authors: Jonsson Holmdahl Anna , Wessberg Gustav , Norberg Helena , Söderström Adrian , Valham Fredrik , Bergdahl Ellinor , Lindmark Krister 
Published: September 2022

IntroductionMineralocorticoid receptor antagonists (MRAs) reduce mortality and morbidity in patients with heart failure and reduced ejection fraction (HFrEF), but are largely underused. We evaluated the frequency, motives, predictors and outcomes of MRA discontinuation in a real-world heart failure population.Methods and resultsThis was a single-centre, retrospective cohort study where medical record-based data were collected on patients with HFrEF between 2010 and 2018. In the final analysis, 572 patients were included that comprised the continued MRA group (n=275) and the discontinued MRA group (n=297). Patients that discontinued MRA were older, had a higher comorbidity index and a lower index estimated glomerular filtration rate (eGFR). Predictors of MRA discontinuations were increased S-potassium, lower eGFR, lower systolic blood pressure, higher frequency of comorbidities and a higher left ventricular ejection fraction. The most common reason for MRA discontinuation was renal dysfunction (n=97, 33%) with 59% of these having an eGFR <30 mL/min/1.73m2, and elevated S-potassium (n=71, 24%) with 32% of these having an S-potassium >5.5 mmol/L. Discontinuation of MRA increased the adjusted risk of all-cause mortality (HR 1.48; 95% CI 1.07 to 2.05; p=0.019).ConclusionsHalf of all patients with HFrEF initiated on MRA discontinued the treatment. A substantial number of patients discontinued MRA without meeting the guideline-recommended levels of eGFR and S-potassium where mild to moderate hyperkalaemia seems to be the most decisive predictor. Further, MRA discontinuation was associated with increased adjusted risk of all-cause mortality.
Energy extraction via magnetic reconnection in Lorentz breaking Kerr–Sen and Kiselev black holes
Authors: Carleo Amodio , Lambiase Gaetano , Mastrototaro Leonardo 
Published: September 2022

AbstractBlack holes can accumulate a large amount of energy, responsible for highly energetic astrophysical phenomena. Although the Blandford–Znajek is considered to date the leading mechanism for powering jets and GRBs, recently fast magnetic reconnection (MR) of the magnetic field was proposed as a new way to extract energy. In this paper, we investigate this phenomena in a bumblebee Kerr–Sen BH, which differentiates from standard Kerr solution via a Lorentz symmetry breaking parameter $$\ell $$
ℓ
and an electric charge one b. We find that the presence of the charge parameter strongly changes the simple Kerr case, making this extraction mechanism possible even for not extremely rotating black holes ($$a\sim 0.7$$

a
∼
0.7

). We also show that, under appropriate circumstances, MR is more efficient compared to the Blandford–Znajek mechanism. We finally compare these results with dark energy (quintessence) black-hole solutions. In this case, we find that a Kerr black hole is indistinguishable from a rotational Kiselev one, whatever the energy-matter that surrounds it (including ordinary matter, such as dust and radiation).
Resummed Higgs boson cross section at next-to SV to $${\mathrm{NNLO}}+ {\overline{\mathrm{NNLL}}}$$
Authors: Ajjath A. H. , Mukherjee Pooja , Ravindran V. , Sankar Aparna , Tiwari Surabhi 
Published: September 2022

AbstractWe present the resummed predictions for inclusive cross section for the production of Higgs boson at next-to-next-to leading logarithmic ($${\overline{\mathrm{NNLL}}}$$

NNLL
¯

) accuracy taking into account both soft-virtual ($$\mathrm{SV}$$
SV
) and next-to SV ($$\mathrm{NSV}$$
NSV
) threshold logarithms. We derive the N-dependent coefficients and the N-independent constants in Mellin-N space for our study. Using the minimal prescription we perform the inverse Mellin transformation and match it with the corresponding fixed order results. We report in detail the numerical impact of N-independent part of resummed result and explore the ambiguity involved in exponentiating them. By studying the K factors at different logarithmic accuracy, we find that the perturbative expansion shows better convergence improving the reliability of the prediction at $${\mathrm{NNLO}} + {\overline{\mathrm{NNLL}}}$$

NNLO
+

NNLL
¯

accuracy. For instance, the cross-section at $${\mathrm{NNLO}} + {\overline{\mathrm{NNLL}}}$$

NNLO
+

NNLL
¯

accuracy reduces by $$3.15\%$$

3.15
%

as compared to the $$\mathrm{NNLO}$$
NNLO
result for the central scale $$\mu _R = \mu _F = m_H/2$$

μ
R

=

μ
F

=

m
H

/
2

at 13 TeV LHC. We also observe that the resummed $$\mathrm{SV} + \mathrm{NSV}$$

SV
+
NSV

result improves the renormalisation scale uncertainty at every order in perturbation theory. The uncertainty from the renormalisation scale $$\mu _R$$

μ
R

ranges between $$(+8.85\% ,-10.12\%)$$

(
+
8.85
%
,
-
10.12
%
)

at $$\mathrm{NNLO}$$
NNLO
whereas it goes down to $$(+6.54\% , - 8.32\%)$$

(
+
6.54
%
,
-
8.32
%
)

at $${\mathrm{NNLO}} + {\overline{\mathrm{NNLL}}}$$

NNLO
+

NNLL
¯

accuracy. However, the factorisation scale uncertainty is worsened by the inclusion of these NSV logarithms hinting the importance of resummation beyond $$\mathrm{NSV}$$
NSV
terms. We also present our predictions for $$\mathrm{SV} + \mathrm{NSV}$$

SV
+
NSV

resummed result at different collider energies.