bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modern-like elevation and climate in Tibet since the mid-Miocene (ca. 15 Ma)
Authors: Xu Qiang , Li Shun , Bai Yan 
Published: February 2022

Abstract
When the modern-like geomorphology and climate pattern of the Himalaya-Tibetan Plateau were established still remains unclear. In this study, we apply paired stable isotope compositions of carbonate (δ18Oc) and leaf waxderived n-alkanes (δ2Halk) from the upper Gazhacun Formation in the Namling Basin to reconstruct the middle Miocene elevation and climate of southern Tibet. Depositional age of the upper Gazhacun Formation has been precisely constrained to between 15.5 Ma and 15.1 Ma by zircon U-Pb ages of dacite interlayers. Paired carbonate derived δ18Ow values (–17.9 ± 1.3‰ to –18.3 ± 1.3‰) and leaf-wax derived δ2Hw values (–131.5 ± 20‰ to –145.7 ± 20‰) plot on or very close to the global meteoric water line suggesting that these samples experienced little evaporation enrichment and isotopic alternation. Based on these two independent proxies, paleoelevation estimates for the Namling Basin are consistently between 4.6+0.7/-0.8 km and 5.2+0.7/-0.8 km, supporting a high elevation for southern Tibet in the mid-Miocene. Integrated with published paleoelevation estimates for the Himalaya, central and northern Tibet in literature, a near-present elevation across the whole Himalaya-Tibetan Plateau has already been established since the middle Miocene (ca. 15 Ma). Besides, stable isotopic values across the Himalaya-Tibetan Plateau show that the δ2Hw values gradually increase northward from the Himalaya to northeastern Tibet, quite similar to that of the present day. This pattern suggests that during the middle Miocene, the Himalaya-Gangdese system may have blocked southerly monsoonal moisture from reaching northern Tibet. Westerlies or local recycling of moisture might be the dominant moisture sources across northern Tibet, with enriched δ18Ow and δ2Hw precipitation values that could lead to erroneous paleoelevation estimates over central and northern Tibet.
Early Paleozoic Cascadia-type active-margin evolution of the Dunhuang block (NW China): Geochemical and geochronological constraints
Authors: Soldner Jérémie , Yuan Chao , Schulmann Karel , Jiang Yingde , Štípská Pavla , Zhang Yunying , Huang Zongying , Wang Xinyu 
Published: February 2022

Abstract
Origins of early Paleozoic metabasites (granulites and amphibolites) and their host metasedimentary rocks in the Dunhuang block, NW China, are addressed by new geochronological and geochemical data. The metabasites show back-arc basalt–like geochemical features, marked by high Zr/Nb ratios and Zr-Hf troughs, but they can be classified into two groups based on their dissimilar protolith ages and distinct Nd signatures. Most group I metabasaltic rocks were emplaced before 455 Ma and possess high Ba/Nb ratios (11.46–224), low (Nb/La)PM (0.10–0.71), and negative whole-rock εNd(t) values (−12.7 to −2.7), whereas group II rocks have protolith ages around 445 Ma, low Ba/Nb ratios (0.70–22.93), low (Nb/La)PM (0.78–1.51), and less evolved whole-rock Nd isotopic features (εNd[t]: −2.0 to +2.7). It is proposed that group I metabasites originated from an enriched lithospheric mantle, while group II metabasites were derived from the depleted asthenospheric mantle. The metasedimentary rocks received detritus mainly from the neighboring Cambrian magmatic arc, and they are compositionally similar to active-margin sediments. Metamorphic zircon U-Pb ages ranging 462–422 Ma from the investigated rocks together with prominent magmatism further suggest high-grade metamorphism prevailing during the Late Ordovician–early Silurian. Based on these data, a Cascadia-type evolution is proposed involving an Ordovician–early Silurian suprasubduction stretching of the Cambrian active continental margin, which culminated with mantle upwelling. Recent paleogeographic reconstructions support the evolution and assembly of interior Proto–Tethys-Ran oceanic and continental plates, including the Dunhuang block, between 510 and 440 Ma, followed by Panthalassan subduction beneath the Tarim–North China continental assemblage at 440–430 Ma.
Sertraline hydrochloride for reducing impulsive behaviour in male, repeat-violent offenders (ReINVEST): protocol for a phase IV, double-blind, placebo-controlled, randomised clinical trial
Authors: Butler Tony , Schofield Peter W , Knight Lee , Ton Bianca , Greenberg David , Scott Rodney J , Grant Luke , Keech Anthony C , Gebski Val , Jones Jocelyn , Ellis Andrew , Weatherburn Donald , Wilhelm Kay , Jones Alison , Churchill Alison , Allnutt Stephen , Mitchell Philip B , Chappell Duncan , D'Este Catherine , Villa Dominic , Carr Vaughan 
Published: February 2022

IntroductionConsiderable evidence supports an association between poor impulse control (impulsivity) and violent crime. Furthermore, impulsivity and aggression has been associated with reduced levels of serotonergic activity in the brain. Selective serotonin reuptake inhibitors (SSRIs) are a class of anti­depressants that aim to regulate brain serotonin concentrations. Several small studies in psychiatric populations have administered SSRIs to impulsive­–aggressive individuals, resulting in reduced impulsivity, anger, aggression and depression. However, no clinical trial has been undertaken in a criminal justice population. This protocol describes the design and implementation of the first systematic study of the potential benefits of SSRIs in impulsive­­–violent offenders who are at high risk of reoffending.Methods and analysisA randomised, double-blinded, multicentre trial to test the clinical efficacy of an SSRI, sertraline hydrochloride, compared with placebo on recidivism and behavioural measures (including impulsivity, anger, aggression, depression and self-reported offending) over 12 months. 460 participants with histories of violence and screening positive for impulsivity are recruited at several local courts and correctional service offices in New South Wales, Australia.Ethics and disseminationResults will be submitted for publication in a peer-reviewed journal. Possible implications of the effectiveness of this pharmacological intervention include economic benefits of reducing prison costs and societal benefits of improving safety. This study has received ethical approval from the University of New South Wales, Aboriginal Health & Medical Research Council, Corrective Services NSW and the NSW Justice Health and Forensic Mental Health Network.Trial registration numberACTRN12613000442707.
Prepectoral versus subpectoral
implant-based breast reconstruction after
skin-sparing mastectomy or nipple-sparing
mastectomy (OPBC-02/ PREPEC): a pragmatic,
multicentre, randomised, superiority trial
Authors: Kappos Elisabeth A , Schulz Alexandra , Regan Meredith M , Moffa Giusi , Harder Yves , Ribi Karin , Potter Shelley , Pusic Andrea L , Fehr Mathias K , Hemkens Lars G , Holzbach Thomas , Farhadi Jian , Simonson Colin , Knauer Michael , Verstappen Ralph , Bucher Heiner C , Zwahlen Daniel , Zimmermann Frank , Schwenkglenks Matthias , Mucklow Rosine , Shaw Jane , Bjelic-Radisic Vesna , Chiorescu Amelia , Chun Yoon S , Farah Subrina , Xiaosong Chen , Nigard Linda , Kuemmel Sherko , Reitsamer Roland , Hauschild Maik , Fulco Ilario , Tausch Christoph , Fischer Thomas , Sarlos Dimitri , Constantinescu Mihai A , Lupatsch Judith E , Fitzal Florian , Heil Joerg , Matrai Zoltan , de Boniface Jana , Kurzeder Christian , Haug Martin , Weber Walter P 
Published: February 2022

Introduction
The emphasis on aesthetic outcomes and
quality of life (QoL) has motivated surgeons to
develop skin-sparing or nipple-sparing mastectomy
(SSM/ NSM) for breast cancer treatment or
prevention. During the same operation, a so-called
immediate breast reconstruction is performed. The
breast can be reconstructed by positioning of a
breast implant above (prepectoral) or below
(subpectoral) the pectoralis major muscle or by
using the patients’ own tissue (autologous
reconstruction). The optimal positioning of the
implant prepectoral or subpectoral is currently
not clear. Subpectoral implant-based breast
reconstruction (IBBR) is still standard care in
many countries, but prepectoral IBBR is
increasingly performed. This heterogeneity in
breast reconstruction practice is calling for
randomised clinical trials (RCTs) to guide
treatment decisions.

Methods and analysis
International, pragmatic, multicentre,
randomised, superiority trial. The primary
objective of this trial is to test whether
prepectoral IBBR provides better QoL with respect
to long-term (24 months) physical well-being
(chest) compared with subpectoral IBBR for
patients undergoing SSM or NSM for prevention or
treatment of breast cancer. Secondary objectives
will compare prepectoral versus subpectoral IBBR
in terms of safety, QoL and patient satisfaction,
aesthetic outcomes and burden on patients. Total
number of patients to be included: 372 (186 per
arm).

Ethics and dissemination
This study will be conducted in compliance
with the Declaration of Helsinki. Ethical approval
has been obtained for the lead investigator’s site
by the Ethics Committee ‘Ethikkommission Nordwest-
und Zentralschweiz‘ (2020–00256, 26 March 2020).
The results of this study will be published in a
peer-reviewed medical journal, independent of the
results, following the Consolidated Standards of
Reporting Trials standards for RCTs and good
publication practice. Metadata describing the
type, size and content of the datasets will be
shared along with the study protocol and case
report forms on public repositories adhering to
the FAIR (Findability, Accessibility,
Interoperability, and Reuse) principles.

Trial registration number
NCT04293146.
Assessment of equity in healthcare financing and benefits distribution in Tanzania: a cross-sectional study protocol
Authors: Binyaruka Peter , Kuwawenaruwa August , Ally Mariam , Piatti Moritz , Mtei Gemini 
Published: February 2022

IntroductionAchieving universal health coverage goal by ensuring access to quality health service without financial hardship is a policy target in many countries. Thus, routine assessments of financial risk protection, and equity in financing and service delivery are required in order to track country progress towards realising this universal coverage target. This study aims to undertake a system-wide assessment of equity in health financing and benefits distribution as well as catastrophic and impoverishing health spending by using the recent national survey data in Tanzania. We aim for updated analyses and compare with previous assessments for trend analyses.Methods and analysisWe will use cross-sectional data from the national Household Budget Survey 2017/2018 covering 9463 households and 45 935 individuals cross all 26 regions of mainland Tanzania. These data include information on service utilisation, healthcare payments and consumption expenditure. To assess the distribution of healthcare benefits (and in relation to healthcare need) across population subgroups, we will employ a benefit incidence analysis across public and private health providers. The distributions of healthcare benefits across population subgroups will be summarised by concentration indices. The distribution of healthcare financing burdens in relation to household ability-to-pay across population subgroups will be assessed through a financing incidence analysis. Financing incidence analysis will focus on domestic sources (tax revenues, insurance contributions and out-of-pocket payments). Kakwani indices will be used to summarise the distributions of financing burdens according to households’ ability to pay. We will further estimate two measures of financial risk protection (ie, catastrophic health expenditure and impoverishing effect of healthcare payments).Ethics and disseminationWe will involve secondary data analysis that does not require ethical approval. The results of this study will be disseminated through stakeholder meetings, peer-reviewed journal articles, policy briefs, local and international conferences and through social media platforms.
Effect of profit status in facilities on the mortality of patients on long-term haemodialysis: a nationwide cohort study
Authors: Liu Sheng-Yu , Cheng Chung-Yi , Wu Mei-Yi , Zheng Cai-Mei , Hsu Chih-Cheng , Wu Mai-Szu , Lin Yen-Chung 
Published: February 2022

ObjectivesOver the past two decades, debates on whether the profit status of dialysis facilities influences patient prognosis have been popular in the USA. Taiwan is one of the regions with the highest rate per capita of kidney replacement therapy worldwide, but no similar research has been conducted to date. This is the first study to address this issue.DesignThis was a nationwide retrospective cohort study based on the Taiwan Renal Registry Data System.SettingPatients were categorised into two groups based on the profit status (for-profit, not-for-profit (NFP)) of dialysis facilities, with 31 350 patients in each group. The patients were followed up from 2005 to 2012.ParticipantsPatients with uraemia who underwent long-term haemodialysis in private dialysis facilities and public facilities were excluded.Primary and secondary outcome measuresSurvival analyses were performed to compare prognosis between the two groups. Adjustments to patients’ basic profile, and facilities’ geographical distribution, level, and length of ownership were carried out to minimise possible confounding effects.ResultsAnalysis revealed that NFP dialysis facilities had better outcomes (HR=0.91, 95% CI (0.89 to 0.93)). A favourable effect remains with the adjustment of the facilities’ level, geographical distribution (HR=0.89, 95% CI (0.86 to 0.93)) or length of ownership (HR=0.95, 95% CI (0.89 to 0.95)). Survival analysis based on the geographical distribution and level of facilities was also conducted, which showed better prognosis in medical centres in the six municipalities, whereas worse prognosis was found in local hospitals not located in these municipalities.ConclusionOur findings suggest that in contemporary settings in Taiwan, treatment at NFP dialysis facilities was associated with a better prognosis. The results should be interpreted with caution since the possibility of residual confounding effects and uncertainty of casual relations exist due to the nature of observational studies.
Impact of night shifts on sleeping patterns, psychosocial and physical
well-being among healthcare professionals: a cross-sectional study in a
tertiary hospital in Saudi Arabia
Authors: Qanash Sultan , Alwafi Hassan , Barasheed Shaima , Bashnaini Shahad , Andergiri Rahaf , Yaghmour Loujain , Murad Weam , Shabrawishi Mohammed , Naser Abdallah Y , Alsywid Basim 
Published: February 2022

Background
Shift work and night shifts are very common in healthcare
organisations worldwide. However, healthcare professionals doing shift
work and night shifts are exposed to several stressors with
psychological, social, physical and sleeping consequences. This study
aimed to evaluate the effect of night shifts on the psychosocial,
physical well-being and sleeping patterns of healthcare professionals in
Saudi Arabia.

Methods
We conducted an observational cross-sectional study from July to
September 2019 at King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Convenience sampling technique was used to recruit healthcare providers
to participate in the study. The outcomes measured included the effect
of working hours of healthcare workers on psychosocial and physical
health, substance use, and sleep quality and patterns. Pearson’s
χ2 test was used to compare proportions, and
Student’s t-test/Analysis of variance (ANOVA) was used to examine the
mean differences among different demographic groups.

Results
A total of 352 healthcare providers were involved in the study, of
whom only 272 were night shift workers. The mean level of job
satisfaction was higher among day shift workers than night shift
workers: the mean scores were 3.82 (SD=0.93) and 3.48 (SD=1.04),
respectively, p=0.007. Moreover, social life was more adversely affected
among night shift workers compared with day shift workers: 3.95
(SD=1.11) and 3.61 (SD=1.25), respectively, p<0.030. Likewise, family
life was more adversely affected among night shift workers than day
shift workers, with a mean of 3.92 (SD=1.10) and 3.50 (SD=1.21),
respectively, p<0.006. Around 71% of night shift workers reported
having poor-quality sleep compared with 50% of day shift workers
(p=0.001).

Conclusion
Quality of life is poor among night shift workers than day shift
workers, particularly concerning sleep and social and physical outcomes.
Further research is needed to investigate factors associated with the
quality of sleep and the psychosocial and physical well-being of
healthcare professionals working night shifts.
Remote cognitive assessment of older adults in rural areas by
telemedicine and automatic speech and video analysis: protocol for a
cross-over feasibility study
Authors: König Alexandra , Zeghari Radia , Guerchouche Rachid , Duc Tran Minh , Bremond François , Linz Nicklas , Lindsay Hali , Langel Kai , Ramakers Inez , Lemoine Pascale , Bultingaire Vincent , Robert Philippe 
Published: February 2022

Introduction
Early detection of cognitive impairments is crucial for the
successful implementation of preventive strategies. However, in rural
isolated areas or so-called ‘medical deserts’, access to diagnosis and
care is very limited. With the current pandemic crisis, now even more
than ever, remote solutions such as telemedicine platforms represent
great potential and can help to overcome this barrier. Moreover, current
advances made in voice and image analysis can help overcome the barrier
of physical distance by providing additional information on a patients’
emotional and cognitive state. Therefore, the aim of this study is to
evaluate the feasibility and reliability of a videoconference system for
remote cognitive testing empowered by automatic speech and video
analysis.

Methods and analysis
60 participants (aged 55 and older) with and without cognitive
impairment will be recruited. A complete neuropsychological assessment
including a short clinical interview will be administered in two
conditions, once by telemedicine and once by face-to-face. The order of
administration procedure will be counterbalanced so half of the sample
starts with the videoconference condition and the other half with the
face-to-face condition. Acceptability and user experience will be
assessed among participants and clinicians in a qualitative and
quantitative manner. Speech and video features will be extracted and
analysed to obtain additional information on mood and engagement levels.
In a subgroup, measurements of stress indicators such as heart rate and
skin conductance will be compared.

Ethics and dissemination
The procedures are not invasive and there are no expected risks or
burdens to participants. All participants will be informed that this is
an observational study and their consent taken prior to the experiment.
Demonstration of the effectiveness of such technology makes it possible
to diffuse its use across all rural areas (‘medical deserts’) and thus,
to improve the early diagnosis of neurodegenerative pathologies, while
providing data crucial for basic research. Results from this study will
be published in peer-reviewed journals.
Suicide after cancer diagnosis in South Korea: a population-based cohort
study
Authors: Choi Young , Park Eun-Cheol 
Published: February 2022

Objective
The present study aimed to determine whether the suicide risk
increased after a cancer diagnosis.

Design
Population-based cohort study.

Setting and participants
This study incorporated the National Health Insurance
Service-National Sample Cohort in South Korea. Of the 975 348 subjects,
39 027 with cancer and 936 321 who were cancer free participated between
2005 and 2013.

Primary outcome measure
Suicide.

Results
A total of 110 suicides (82 men, 28 women) were identified among
these 39 027 subjects with cancer during a total of 127 184
person-years; among the 936 321 cancer-free subjects, 2163 suicides were
reported during a total of 8 222 479 person-years. Cox proportional
hazards models were used to compare all-cause and suicide mortalities
after cancer diagnosis following adjustment for possible confounding
covariates. After adjusting for factors related to suicide, we
identified an elevated relative risk of suicide among patients with
cancer (HR: 1.480, 95% CI: 1.209 to 1.812). Among men, the relative risk
was substantially increased among patients with lip, oral
cavity/pharyngeal, colon and rectal, pancreatic and lung cancers when
compared with cancer-free subjects; whereas among women, the relative
risk was substantially increased among patients with colon and rectal
cancers.

Conclusion
Our study observed an increased risk of suicide among patients with
cancer that varied according to the anatomical cancer site, even after
accounting for clinical comorbidities and psychiatric illness. Our
findings indicate a need for social support and suicide prevention
strategies for patients with cancer.
COVID-19 hinterland: surveilling the self-reported impacts of the pandemic on diabetes management in the USA (cross-sectional results of the iNPHORM study)
Authors: Ratzki-Leewing Alexandria A , Ryan Bridget L , Buchenberger John D , Dickens Joseph W , Black Jason E , Harris Stewart B 
Published: February 2022

Main objectiveTo determine how and to what extent COVID-19 has affected real-world, self-reported glycaemic management in Americans with type 1 or type 2 diabetes taking insulin and/or secretagogues, with or without infection.DesignA cross-sectional substudy using data from the Investigating Novel Predictions of Hypoglycemia Occurrence using Real-world Models panel survey.SettingUSA.ParticipantsAmericans 18–90 years old with type 1 or 2 diabetes taking insulin and/or secretagogues were conveniently sampled from a probability-based internet panel.Primary outcome measureA structured, COVID-19-specific questionnaire was administered to assess the impact of the pandemic (irrespective of infection) on socioeconomic, behavioural/clinical and psychosocial aspects of glycaemic management.ResultsData from 667 respondents (type 1 diabetes: 18%; type 2 diabetes: 82%) were analysed. Almost 25% reported A1c values ≥8.1%. Rates of severe and non-severe hypoglycaemia were 0.68 (95% CI 0.5 to 0.96) and 2.75 (95% CI 2.4 to 3.1) events per person-month, respectively. Ten respondents reported a confirmed or probable COVID-19 diagnosis. Because of the pandemic, 24% of respondents experienced difficulties affording housing; 28% struggled to maintain sufficient food to avoid hypoglycaemia; and 19% and 17% reported challenges accessing diabetes therapies and testing strips, respectively. Over one-quarter reported issues retrieving antihyperglycaemics from the pharmacy and over one-third reported challenges consulting with diabetes providers. The pandemic contributed to therapeutic non-adherence (14%), drug rationing (17%) and reduced monitoring (16%). Many struggled to keep track, and in control, of hypoglycaemia (12%–15%) and lacked social support to help manage their risk (19%). Nearly half reported decreased physical activity. Few statistically significant differences were observed by diabetes type.ConclusionsCOVID-19 was found to cause substantial self-reported deficiencies in glycaemic management. Study results signal the need for decisive action to restabilise routine diabetes care in the USA.Trial registration numberNCT04219514.