bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrepancies in drug histories at admission to gastrointestinal surgery, internal medicine and geriatric hospital wards in Central Norway: a cross-sectional study
Authors: Sund Janne Kutschera , Sletvold Olav , Mellingsæter Trude Cecilie , Hukari Randi , Hole Torstein , Uggen Per Einar , Vadset Petra Thiemann , Spigset Olav
Published: September 2017

Objectives

To compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission.

Design

Cross-sectional study.

Setting

Two gastrointestinal surgery wards and one geriatric ward at St Olav’s University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway.

Participants

All patients acutely admitted to these wards during a period of three months were asked to participate in the study. A total of 168 patients were included. For each patient, drug information available at admission was compared with information from drug lists obtained from the general practitioner and (if applicable) the home care services/the nursing home.

Primary and secondary outcome measures

Number of patients with one or more discrepancies in their drug history. Type and clinical impact of the discrepancies found. Selection criteria for patients that should be subject to a detailed drug history.

Results

In total, 83% had at least one discrepancy in their drug history. Omission of a drug accounted for 72% of the discrepancies, whereas a difference in dosing was the cause of the remaining 28%. 9% of the discrepancies had the potential to cause severe harm or discomfort. We found no significant differences in the number of discrepancies between hospital wards, genders, ages or levels of care.

Conclusions

This study demonstrates the importance of collecting drug information from all available sources when a patient is admitted to hospital. As we found no significant differences in discrepancies between subgroups of patients, we suggest that medication reconciliation should be performed for all patients.
Development of a questionnaire to evaluate patients’ awareness of cardiovascular disease risk in England’s National Health Service Health Check preventive cardiovascular programme
Authors: Woringer Maria , Nielsen Jessica Jones , Zibarras Lara , Evason Julie , Kassianos Angelos P , Harris Matthew , Majeed Azeem , Soljak Michael
Published: September 2017

Background

The National Health Service (NHS) Health Check is a cardiovascular disease (CVD) risk assessment and management programme in England aiming to increase CVD risk awareness among people at increased risk of CVD. There is no tool to assess the effectiveness of the programme in communicating CVD risk to patients.

Aims

The aim of this paper was to develop a questionnaire examining patients’ CVD risk awareness for use in health service research evaluations of the NHS Health Check programme.

Methods

We developed an 85-item questionnaire to determine patients’ views of their risk of CVD. The questionnaire was based on a review of the relevant literature. After review by an expert panel and focus group discussion, 22 items were dropped and 2 new items were added. The resulting 65-item questionnaire with satisfactory content validity (content validity indices≥0.80) and face validity was tested on 110 NHS Health Check attendees in primary care in a cross-sectional study between 21 May 2014 and 28 July 2014.

Results

Following analyses of data, we reduced the questionnaire from 65 to 26 items. The 26-item questionnaire constitutes four scales: Knowledge of CVD Risk and Prevention, Perceived Risk of Heart Attack/Stroke, Perceived Benefits and Intention to Change Behaviour and Healthy Eating Intentions. Perceived Risk (Cronbach’s α=0.85) and Perceived Benefits and Intention to Change Behaviour (Cronbach’s α=0.82) have satisfactory reliability (Cronbach’s α≥0.70). Healthy Eating Intentions (Cronbach’s α=0.56) is below minimum threshold for reliability but acceptable for a three-item scale.

Conclusions

The resulting questionnaire, with satisfactory reliability and validity, may be used in assessing patients’ awareness of CVD risk among NHS Health Check attendees.
Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?
Authors: Clay-Williams Robyn , Ludlow Kristiana , Testa Luke , Li Zhicheng , Braithwaite Jeffrey
Published: September 2017

Introduction

Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers.

Objectives

To determine whether there is an association between the leader’s medical background and management performance in terms of organisational performance or patient outcomes.

Methods

We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded.

Results

The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role.

Discussion and conclusion

A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that directly compared the performance of medical and non-medical managers. This is an under-researched area that requires further funding and focus.
Serum levels of chemical elements in esophageal squamous cell carcinoma in Anyang, China: a case-control study based on machine learning methods
Authors: Lin Tong , Liu Tiebing , Lin Yucheng , Zhang Chaoting , Yan Lailai , Chen Zhongxue , He Zhonghu , Wang Jingyu
Published: September 2017

Objectives

Esophageal squamous cell carcinoma (ESCC) is the predominant form of esophageal carcinoma with extremely aggressive nature and low survival rate. The risk factors for ESCC in the high-incidence areas of China remain unclear. We used machine learning methods to investigate whether there was an association between the alterations of serum levels of certain chemical elements and ESCC.

Settings

Primary healthcare unit inAnyangcity, Henan Province of China.

Participants

100 patients with ESCC and 100 healthy controls matched for age, sex and region were included.

Primary and secondary outcome measures

Primary outcome was the classification accuracy. Secondary outcome was the p Value of the t-test or rank-sum test.

Methods

Both traditional statistical methods of t-test and rank-sum test and fashionable machine learning approaches were employed.

Results

Random Forest achieves the best accuracy of 98.38% on the original feature vectors (without dimensionality reduction), and support vector machine outperforms other classifiers by yielding accuracy of 96.56% on embedding spaces (with dimensionality reduction). All six classifiers can achieve accuracies more than 90% based on the single most important element Sr. The other two elements with distinctive difference are S and P, providing accuracies around 80%. More than half of chemical elements were found to be significantly different between patients with ESCC and the controls.

Conclusions

These results suggest clear differences between patients with ESCC and controls, implying some potential promising applications in diagnosis, prognosis, pharmacy and nutrition of ESCC. However, the results should be interpreted with caution due to the retrospective design nature, limited sample size and the lack of several potential confounding factors (including obesity, nutritional status, and fruit and vegetable consumption and potential regional carcinogen contacts).
UK-based prospective cohort study to anglicise and validate the FACE-Q Skin Cancer Module in patients with facial skin cancer undergoing surgical reconstruction: the PROMISCR (Patient-Reported Outcome Measure in Skin Cancer Reconstruction) study
Authors: Dobbs Thomas , Hutchings Hayley A , Whitaker Iain S
Published: September 2017

Introduction

Skin cancer is the most common malignancy worldwide, often occurring on the face, where the cosmetic outcome of treatment is paramount. A number of skin cancer-specific patient-reported outcome measures (PROMs) exist, however none adequately consider the difference in type of reconstruction from a patient’s point of view. It is the aim of this study to ‘anglicise’ (to UK English) a recently developed US PROM for facial skin cancer (the FACE-Q Skin Cancer Module) and to validate this UK version of the PROM. The validation will also involve an assessment of the items for relevance to facial reconstruction patients. This will either validate this new measure for the use in clinical care and research of various facial reconstructive options, or provide evidence that a more specific PROM is required.

Methods and analysis

This is a prospective validation study of the FACE-Q Skin Cancer Module in a UK facial skin cancer population with a specific focus on the difference between types of reconstruction. The face and content validity of the FACE-Q questionnaire will initially be assessed by a review process involving patients, skin cancer specialists and methodologists. An assessment of whether questions are relevant and any missing questions will be made. Initial validation will then be carried out by recruiting a cohort of 100 study participants with skin cancer of the face pre-operatively. All eligible patients will be invited to complete the questionnaire preoperatively and postoperatively. Psychometric analysis will be performed to test validity, reliability and responsiveness to change. Subgroup analysis will be performed on patients undergoing different forms of reconstruction postexcision of their skin cancer.

Ethics and dissemination

This study has been approved by the West Midlands, Edgbaston Research Ethics Committee (Ref 16/WM/0445). All personal data collected will be anonymised and patient-specific data will only be reported in terms of group demographics. Identifiable data collected will include the patient name and date of birth. Other collected personal data will include their diagnosis, treatment performed, method of reconstruction and complications. A unique identifier will be applied to each patient so that pretreatment and post-treatment questionnaire results can be compared. All data acquisition and storage will be in accordance with the Data Protection Act 1998. Following completion of the study, all records will be stored in the Abertawe Bro Morgannwg University (AMBU) Health Board archive facility. Only qualified personnel working on the project will have access to the data.

The outputs from this work will be published as widely as possible in peer-review journals and it is our aim to make this open access.
Comparison of ethnic group classification using naming analysis and routinely collected data: application to cancer incidence trends in children and young people
Authors: Smith Lesley , Norman Paul , Kapetanstrataki Melpo , Fleming Sarah , Fraser Lorna K , Parslow Roger C , Feltbower Richard G
Published: September 2017

Objective

Inpatient Hospital Episode Statistics (HES) ethnicity data are available but not always collected and data quality can be unreliable. This may have implications when assessing outcomes by ethnicity. An alternative method for assigning ethnicity is using naming algorithms. We investigate if the association between ethnicity and cancer incidence varied dependent on how ethnic group was assigned.

Design

Population-based cancer registry cohort study.

Setting

Yorkshire, UK.

Participants

Cancer registrations from 1998 to 2009 in children and young people (0–29 years) from a specialist cancer register in Yorkshire, UK (n=3998) were linked to inpatient HES data to obtain recorded ethnicity. Patients’ names, recorded in the cancer register, were matched to an ethnic group using the naming algorithm software Onomap. Each source of ethnicity was categorised as white, South Asian (SA) or Other, and a further two indicators were defined based on the combined ethnicities of HES and Onomap, one prioritising HES results, the other prioritising Onomap.

Outcomes

Incidence rate ratios (IRR) between ethnic groups were compared using Poisson regression for all cancers combined, leukaemia, lymphoma and central nervous system (CNS) tumours.

Results

Depending on the indicator used, 7.1%–8.6% of the study population were classified as SA. For all cancers combined there were no statistically significant differences between white and SA groups using any indicator; however, for lymphomas significant differences were only evident using one of the ‘Combined’ indicators (IRR=1.36 (95% CI 1.08 to 1.71)), and for CNS tumours incidence was lower using three of the four indicators. For the other ethnic group the IRR for all cancers combined ranged from 0.78 (0.65 to 0.94) to 1.41 (1.23 to 1.62).

Conclusions

Using different methods of assigning ethnicity can result in different estimates of ethnic variation in cancer incidence. Combining ethnicity from multiple sources results in a more complete estimate of ethnicity than the use of one single source.
Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea
Authors: Seong Sang Cheol , Kim Yeon-Yong , Park Sue K , Khang Young Ho , Kim Hyeon Chang , Park Jong Heon , Kang Hee-Jin , Do Cheol-Ho , Song Jong-Sun , Lee Eun-Joo , Ha Seongjun , Shin Soon Ae , Jeong Seung-Lyeal
Published: September 2017

Purpose

The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker.

Participants

To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003.

Findings to date

The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women).

Future plans

This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS.
Use of glucocorticoids during pregnancy and risk of attention-deficit/hyperactivity disorder in offspring: a nationwide Danish cohort study
Authors: Laugesen Kristina , Byrjalsen Anna , Frøslev Trine , Olsen Morten S , Sørensen Henrik Toft
Published: September 2017

Objective

Prenatal exposure to excess endogenous glucocorticoid (GC) has been linked to attention-deficit/hyperactivity disorder (ADHD). We investigated whether prenatal exposure to exogenous GC is associated with ADHD.

Design

Nationwide cohort study.

Setting

A cohort of 875 996 singletons born alive between 1996 and 2009 in Denmark. Data were obtained from national registries.

Exposures

We identified children exposed prenatally to GCs, children unexposed prenatally and born to maternal former users, and children unexposed and born to maternal never users.

Main outcome measures

We compared ADHD risk in children prenatally exposed to GCs and in children of former GC users with risk in unexposed children of never users. We computed cumulative incidence at 10 years of age and adjusted HRs (aHRs). In addition, we compared exposed children with unexposed siblings in a sibling design.

Results

We identified 875 996 children, among whom 5319 were prenatally exposed to systemic GCs and 36 780 to local/inhaled GCs. Cumulative incidences of ADHD at 10 years of age were 2.65% in prenatally exposed children and 2.03% in unexposed children of never users. At the general population level, prenatal exposure was associated with ADHD compared with unexposed, with aHR of 1.43(95% CI 1.24 to 1.65) for systemic exposure and 1.23 (95% CI 1.15 to 1.31) for local/inhaled exposure. However, our former user analysis (aHR of 1.25 (95% CI 1.20 to 1.29)) and sibling design (aHR of 1.03 (95% CI 0.87 to 1.20)) indicated that these findings were due to confounding.

Conclusion

This study provides no evidence of a causal association between prenatal exposure to GCs and risk of ADHD.
A hospital-based observational cohort study exploring pain and biomarkers in patients with hand osteoarthritis in Norway: The Nor-Hand protocol
Authors: Gløersen Marthe , Mulrooney Elisabeth , Mathiessen Alexander , Hammer Hilde Berner , Slatkowsky-Christensen Barbara , Faraj Karwan , Isaksen Thore , Neogi Tuhina , Kvien Tore K , Magnusson Karin , Haugen Ida Kristin
Published: September 2017

Introduction

We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms.

Methods and analysis

The Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes.

Ethics and dissemination

The protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals.

Trial registration number

NCT03083548; Pre-results.
Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study
Authors: Wu Chung-Kuan , Wu Chia-Lin , Lin Chia-Hsun , Leu Jyh-Gang , Kor Chew-Teng , Tarng Der-Cherng
Published: September 2017

Objectives

To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients.

Design

Observational cohort study.

Setting

Single centre.

Participants

Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were aged <18 years and had Qa levels of ≥2000mL/min. A total of 378 adult chronic HD patients were eventually enrolled for the study.

Interventions

The selected patients were evaluated with Qa and cardiac index (CI). They were divided into four groups according to three Qa cut-off points (500, 1000 and 1500 mL/min).

Primary and secondary outcome measures

Short-term and long-term vascular (cardiovascular or cerebrovascular) and all-cause mortality.

Results

Qa was positively correlated with CI (r=0.48, p<0.001). A Qa level of <1000 mL/min was independently associated with 1-year all-cause mortality (adjusted OR, 6.04; 95% CI 1.64 to 22.16; p=0.007). Kaplan-Meier analysis revealed that the cumulative incidence rates of all-cause and vascular mortality were significantly higher in the patients with a Qa level of <1000 mL/min (log-rank test; all p<0.01). Furthermore, a Qa level of <1000 mL/min was independently associated with long-term all-cause mortality (adjusted HR, 1.62; 95% CI 1.11 to 2.37; p=0.013); however, the risk of vascular mortality did not significantly increase after adjustment for confounders.

Conclusions

Qa is moderately correlated with cardiac function, and a Qa level of <1000 mL/min is an independent risk factor for both short-term and long-term all-cause mortality in chronic HD patients.
Youth friendliness in mental health and addiction services: protocol for a scoping review
Authors: Hawke Lisa D , Cleverley Kristin , Settipani Cara , Rice Maureen , Henderson Joanna
Published: September 2017

Introduction

To better reach youth in need of mental health and addiction (MHA) services, there is increasing emphasis on making MHA services ‘youth friendly.’ However, it is unclear what youth friendliness means on a practical level. This scoping review explores (1) how youth friendliness in mental health services is defined in the literature, (2) what characteristics make MHA services youth friendly and (3) how youth friendliness is expected to impact service use by young people.

Methods

A search will be conducted of eight electronic bibliographic databases over the last 15 years (2002–2017) to identify literature on youth friendliness consistent with the modern youth experience. Grey literature will also be searched. The search and literature selection process will include all study designs, as well as non-research literature. Two independent raters will determine eligibility based on a review of the titles and abstracts of the identified literature, followed by full text reviews when required. Data will be extracted from the identified literature and then synthesised using qualitative and quantitative approaches. As a final step, we will conduct stakeholder consultations with youth, family members and service provider groups to validate the findings and identify any characteristics of youth friendliness that they deem important that were not reported in the findings.

Ethics and dissemination

Results will be disseminated through a peer-reviewed publication, as well as international, national and local conference presentations. Agency reports will be developed to present the findings in a user-friendly format, including a youth-friendliness checklist for youth-serving organisations. Research ethics approval has been obtained for the consultation component of this study.
Effects of kinesiotaping added to a rehabilitation programme for patients with rotator cuff tendinopathy: protocol for a single-blind, randomised controlled trial addressing symptoms, functional limitations and underlying deficits
Authors: de Oliveira Fábio Carlos Lucas , de Fontenay Benoît Pairot , Bouyer Laurent Julien , Desmeules François , Roy Jean-Sébastien
Published: September 2017

Introduction

Rotator cuff tendinopathy (RCTe) is the most frequent cause of shoulder pain, resulting in considerable losses to society and public resources. Muscle imbalance and inadequate sensorimotor control are deficits often associated with RCTe. Kinesiotaping (KT) is widely used by clinicians for rehabilitation of RCTe. While previous studies have examined the immediate effects of KT on shoulder injuries or the effects of KT as an isolated method of treatment, no published study has addressed its mid-term and long-term effects when combined with a rehabilitation programme for patients with RCTe. The primary objective of this randomised controlled trial (RCT) will be to assess the efficacy of therapeutic KT, added to a rehabilitation programme, in reducing pain and disabilities in individuals with RCTe. Secondary objectives will look at the effects of KT on the underlying factors involved in shoulder control, such as muscular activity, acromiohumeral distance (AHD) and range of motion (ROM).

Methods and analysis

A single-blind RCT will be conducted. Fifty-two participants, randomly allocated to one of two groups (KT or no-KT), will take part in a 6-week rehabilitation programme. The KT group will receive KT added to the rehabilitation programme, whereas the no-KT group will receive only the rehabilitation programme. Measurements will be taken at baseline, week 3, week 6, week 12 and 6 months. Primary outcomes will be symptoms and functional limitations assessed by the Disabilities of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include shoulder ROM, AHD at rest and at 60° of abduction, and muscle activation during arm elevation. The added effects of KT will be assessed through a two-way analysis of variance for repeated measures.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of Quebec Rehabilitation Institute of the Centre Integrated University Health and Social Services. Results will be disseminated through international publications in peer-reviewed journals, in addition to international conference presentations.

Trial registration number

Protocol was registered at ClinicalTrials.gov (NCT02881021) on 25 August 2016. The WHO Trial Registration Data Set can also be found as an online supplementary file.
Prevalence and associated factors of skin diseases in aged nursing home residents: a multicentre prevalence study
Authors: Hahnel Elisabeth , Blume-Peytavi Ulrike , Trojahn Carina , Dobos Gabor , Jahnke Irina , Kanti Vera , Richter Claudia , Lichterfeld-Kottner Andrea , Garcia Bartels Natalie , Kottner Jan
Published: September 2017

Objectives

The aim of this study was to measure the prevalence of skin diseases in aged nursing home residents and to explore possible associations with demographic and medical characteristics.

Design

Descriptive multicentre prevalence study.

Setting and participants

The study was conducted in a random sample of ten institutional long-term care facilities in the federal state of Berlin, Germany. In total, n=223 residents were included.

Results

In total, 60 dermatological diseases were diagnosed. The most frequently diagnosed skin disease was xerosis cutis (99.1%, 95% CI 97.7% to 100.0%) followed by tinea ungium (62.3%, 95% CI 56.0% to 69.1%) and seborrheic keratosis (56.5%, 95% CI 50.2% to 63.0%). Only few bivariate associations have been detected between skin diseases and demographic and medical characteristics.

Conclusion

Study results indicate that almost every resident living in residential care has at least one dermatological diagnosis. Dermatological findings range from highly prevalent xerosis and cutaneous infection up to skin cancer. Not all conditions require immediate dermatological treatment and can be managed by targeted skin care interventions. Caregivers need knowledge and diagnostic skills to make appropriate clinical decisions. It is unlikely that specialised dermatological care will be delivered widely in the growing long-term care sector.

Trial registration number

This study is registered athttps://clinicaltrials.gov/ct2/show/NCT02216526.
Study protocol for a randomised controlled trial evaluating the effect of prenatal omega-3 LCPUFA supplementation to reduce the incidence of preterm birth: the ORIP trial
Authors: Zhou Shao J , Best Karen , Gibson Robert , McPhee Andrew , Yelland Lisa , Quinlivan Julie , Makrides Maria
Published: September 2017

Introduction

Preterm birth accounts for more than 85% of all perinatal complications and deaths. Seventy-five per cent of early preterm births (EPTBs) occur spontaneously and without identifiable risk factors. The need for a broadly applicable, effective strategy for primary prevention is paramount. Secondary outcomes from the docosahexaenoic acid (DHA) to Optimise Mother Infant Outcome trial showed that maternal supplementation until delivery with omega-3 (ω-3) long chain polyunsaturated fatty acid (LCPUFA), predominantly as DHA, resulted in a 50% reduction in the incidence of EPTB and an increase in the incidence of post-term induction or post-term prelabour caesarean section due to extended gestation. We aim to determine the effectiveness of supplementing the maternal diet with ω-3 LCPUFA until 34 weeks’ gestation on the incidence of EPTB.

Methods and analysis

This is a multicentre, parallel group, randomised, blinded and controlled trial. Women less than 20 weeks’ gestation with a singleton or multiple pregnancy and able to give informed consent are eligible to participate. Women will be randomised to receive high DHA fish oil capsules or control capsules without DHA. Capsules will be taken from enrolment until 34 weeks’ gestation. The primary outcome is the incidence of EPTB, defined as delivery before 34 completed weeks’ gestation. Key secondary outcomes include length of gestation, incidence of post-term induction or prelabour caesarean section and spontaneous EPTB. The target sample size is 5540 women (2770 per group), which will provide 85% power to detect an absolute reduction in the incidence of preterm birth of 1.16% (from 2.45% to 1.29%) between the DHA and control group (two sided α=0.05). The primary analysis will be based on the intention-to-treat principle.

Trial registration number

Australia and New Zealand Clinical Trial Registry Number: 2613001142729; Pre-results.
A local quality initiative to improve follow-up times for patients with heart failure
Authors: Schofield Toni , Duero Posada Juan , Foroutan Farid , Alba Ana Carolina , McDonald Michael , Linghorne Meredith
Published: September 2017

IntroductionHeart failure is the most common cause of hospital admission in patients >65 years and around 50% of patients will be readmitted within 6 months. Inability to achieve timely outpatient follow-up may contribute to the high rates of avoidable rehospitalisation for this group of patients. Canadian guidelines recommend patients with heart failure should be seen within 14 days of discharge.

MethodsAn audit demonstrated that less than half of advanced heart failure patients were being followed up within 14 days. In an effort to improve postdischarge follow-up in our heart function clinic, we used process mapping and applied a series of iterative changes to the appointment booking system using Plan–Do–Study–Act cycles to reduce waste and standardise.

ResultsThe primary outcome measure, tracked over a period of 20 months, was percentage of patients booked within 14 days. At baseline, 37% of patients were seen within 14 days. After our series of interventions related to streamlining and standardising the appointment booking process, 77% of patients were seen within 14 days and 100% of patients were seen within 21 days.

ConclusionThe changes made to the appointment booking process were reproducible, sustainable, effective and required no additional resources or funding.
Upper Ordovician conodont biostratigraphy and revised lithostratigraphy and geological map, Akpatok Island, Ungava Bay, Nunavut
Authors: Zhang Shunxin
Published: September 2017

Stratigraphic units exposed on Akpatok Island, Ungava Bay, Nunavut, were previously recognized as Boas River and Akpatok formations; their biostratigraphic ages and correlations, in particular the stratigraphic position and age of the organic rich “Boas River” Formation, were largely based on limited data. New detailed field observations have recognized three stratigraphic units, namely the Amadjuak, Akpatok, and Foster Bay formations, in which extensive microfossil sampling recovered over 22 000 conodont elements from 66 productive samples from both outcrops and rubble at over 20 localities in four areas. Four Upper Ordovician conodont zones and one unzoned interval are established for the three redefined formations: Belodina confluens and Oulodus velicuspis Interval zones are confined to the exposed Amadjuak Formation and correlated to Edenian and Maysvillian; Amorphognathus ordovicicus – Plegagnathus dartoni Concurrent-range Zone occurs with the Akpatok Formation and correlated to lower Richmondian; Rhipidognathus symmetricus Taxon-range Zone is retained in the Foster Bay Formation and correlated to upper Richmondian; and an “Unzoned Interval” is defined between the last two zones in the lower Foster Bay Formation. The conodont Amorphognathus ordovicicus occurs in both Akpatok and lower Foster Bay formations, and it is also recovered from the bituminous, argillaceous limestone rubble, based on which the stratigraphic position of the previously named “Boas River” Formation is most likely positioned within the lower Foster Bay Formation. The biostratigraphy and lithostratigraphy are combined with geographic information systems (GIS) to establish the thicknesses of the three formations and revise the geologic map of the island.
Endoplasmic Reticulum Stress and NF-κB Pathway in Salidroside Mediated Neuroprotection: Potential of Salidroside in Neurodegenerative Diseases
Authors: Wang Chenggui , Lou Yiting , Xu Jianxiang , Feng Zhenhua , Chen Yu , Tang Qian , Wang Qingqing , Jin Haiming , Wu Yaosen , Tian Naifeng , Zhou Yifei , Xu Huazi , Zhang Xiaolei
Published: September 2017

Microglial activation leads to increased production of proinflammatory enzymes and cytokines, which is considered to play crucial role in neurodegenerative diseases, however there are only a few drugs that target microglia activation. Recent studies have indicated that the Traditional Chinese Medicine, salidroside (Sal), exerted anti-inflammatory effects. According to this evidence, our present study aims to explore the effect of the Sal (a phenylpropanoid glycoside compound which is isolated from rhodiola), on microglia activation in lipopolysaccharide (LPS)-stimulated BV-2 cells. Our results showed that Sal could significantly inhibit the excessive production of Nitric Oxide (NO) and Prostaglandin E2 (PGE2) in LPS-stimulated BV2 cells. Moreover, Sal treatment could suppress the mRNA and protein expressions of inflammatory enzymes, including Inducible Nitric Oxide Synthase (iNOS) and Cyclooxygenase-2 (COX-2). The mechanisms may be related to the inhibition of the activation of Nuclear Factor-kappaB (NF-[Formula: see text]B) and endoplasmic reticulum stress. Our study demonstrated that salidroside could inhibit lipopolysaccharide-induced microglia activation via the inhibition of the NF-[Formula: see text]B pathway and endoplasmic reticulum stress, which makes it a promising therapeutic agent for human neurodegenerative diseases.
Enterprise Architecture: What Did We Study?
Authors: Kotusev Svyatoslav
Published: September 2017

Enterprise architecture (EA) is a description of an enterprise from an integrated business and IT perspective intended to improve business and IT alignment, and is used in the majority of large companies. However, despite that EA was established as an independent discipline long ago, a commonly accepted “big picture” in EA research is still missing. As a result, the scope of the EA discipline is vague, the extent of diversity in EA publications is poorly understood and the progression of the EA research stream over time is unclear. In this paper I conduct a comprehensive EA literature review covering 1075 publications aiming to structure, clarify and consolidate the whole EA research stream. I analyze the distribution of the EA research stream by time, source, research methodology and attitude, code all the issues discussed in EA publications into 42 narrow EA-related topics and 11 broader themes, establish the conceptual relationship between them and present a picture of the EA discipline “on a page”. Moreover, I classify all EA-related topics into four categories according to their lifecycles helping future EA researchers to better understand the evolution of the EA discipline and make the maximum contribution to it.
The Influence of an Integrated View of Source’s Expertise on Knowledge Transfer
Authors: Cho Kwangsu , Han Sehee , Chung Ting-Ting Rachel , Bateman Patrick J.
Published: September 2017

Many studies focus on the effect of a source’s expertise, but little attention has been paid to what happens in the event of a misalignment between who is knowledgeable (cognitive expertise) and who is regarded as being knowledgeable (social expertise). The emphasis on expertise alignment in this study suggests the importance not of simply having a transactive memory system, but rather, of having an accurate transactive memory system in place. Using experimental data from a sample of 134 participants, the results indicate that the knowledge transfer is greater in the source’s cognitive-social expertise alignment than in the misalignment, but the source’s cognitive expertise could be a more significant criterion for the knowledge transfer in the expertise misalignment. In the view of source-recipient dynamics, knowledge transfer is greater in the low cognitive expertise gap condition than in the high cognitive expertise gap condition. The results contribute to the understanding of the role of a source’s expertise in knowledge transfer from a socio-cognitive perspective.
Messinian canyons in the Turkish western Black Sea
Authors: Sipahioğlu N. Ö. , Batı Z.
Published: September 2017

Several canyons are observed along the Turkish margin of the western Black Sea that are associated with a prominent unconformity and interpreted to be the manifestations of the sea-level fall during the Messinian salinity crisis in the Mediterranean. In this study, their morphology, geometry and fill characteristics, as well as downslope evolution, are compared and contrasted using four 3D seismic surveys and some 2D regional seismic lines.

Two types of canyon morphologies are observed in the study area: (1) shelf incising and (2) blind. Located in the western part of the study area and deeply incised into a wide shelf, the Karaburun Canyon extends roughly in a SW–NE direction. The fill of the canyon is almost absent on the shelf, where the canyon base is downlapped by a series of Pliocene clinoforms. A thin fill appears on the upper slope, which gets thicker towards the lower slope. The eastern part of the study area is dominated by a series of blind canyons (Boğaziçi canyons). They are typically confined to the continental rise, with their heads hardly reaching the lower slope. Their fill is entirely characterized by mass-transport complexes (MTCs).

It is concluded that during the Messinian lowstand, the sediments within the Karaburun Canyon bypassed the wide shelf and were funnelled down to the continental rise and abyssal plain through the slope, which was followed by progradation of the basin margin during the relative sea-level rise in the Pliocene. A minimal imprint by tectonics in that particular area might have helped establish more stable conditions for the development of a relatively mature sediment dispersal system extending from the hinterland down to the basin centre. In this area, the shelf-slope morphology was dominantly shaped by the depositional geometries of the sedimentary packages. Being fully confined to the continental rise, the Boğaziçi canyons are situated in an area where shelf-slope morphology is governed by the Late Cretaceous volcanic arc. Parallel with the coastline, these volcanic edifices have created fairly steep dips; thus, leading to the development of an unstable basin margin and favouring MTC deposition at least since the Early–Middle Miocene. The width and relief of the canyons display a decreasing trend from west to east, which may be attributed to their relative distance from a possible drainage system in the vicinity of the Bosporus that might have acted as the major sediment supplier during this period.
Modeling and Optimizing of Producing Recycled PET from Fabrics Waste via Falling Film-Rotating Disk Combined Reactor
Authors: Qin Dan , Wang Chaosheng , Wang Huaping , Chen Ye , Ji Peng , Xi Zhenhao
Published: September 2017

Recycling and reusing of poly (ethylene terephthalate) (PET) fabrics waste are essential for reducing serious waste of resources and environmental pollution caused by low utilization rate. The liquid-phase polymerization method has advantages of short process flow, low energy consumption, and low production cost. However, unlike prepolymer, the material characteristics of PET fabrics waste (complex composition, high intrinsic viscosity, and large quality fluctuations) make its recycling a technique challenge. In this study, the falling film-rotating disk combined reactor is proposed, and the continuous liquid-phase polymerization is modeled by optimizing and correcting existing models for the final stage of PET polymerization to improve the product quality in plant production. Through modeling and simulation, the weight analysis of indexes closely related to the product quality (intrinsic viscosity, carboxyl end group concentration, and diethylene glycol content) was investigated to optimize the production process in order to obtain the desired polymer properties and meet specific product material characteristics. The model could be applied to other PET wastes (e.g., bottles and films) and extended to investigate different aspects of the recycling process.
Porous Cellulose Beads Fabricated from Regenerated Cellulose as Potential Drug Delivery Carriers
Authors: Voon Lee Ken , Pang Suh Cem , Chin Suk Fun
Published: September 2017

Highly porous cellulose beads (CBs) of various mean sizes were successfully prepared from regenerated cellulose of paper wastes. The drug delivery characteristics of CBs with different mean sizes were investigated using curcumin as the model drug under controlled conditions. The loading capacity and efficiency of curcumin onto CBs were substantially influenced by factors such as their morphological characteristics, curcumin concentration, and duration of loading. The release kinetic profiles of curcumin from CBs of different mean sizes were investigated in media of pH values resembling digestive juices and intestinal fluids. Release kinetic models were used to simulate and elucidate release kinetics and mechanisms of curcumin from CBs under specific conditions. The loading capacity and efficiency of curcumin onto CBs could be enhanced via the optimization of curcumin solution concentration and the morphological characteristics of CBs, whereas the release kinetic profiles of curcumin from CBs could be modulated by varying the mean diameter of CBs. Optimized CBs derived from regenerated cellulose of paper wastes are potentially useful as cost-effective drug delivery carriers.
The Ethanol Extract of Licorice (Glycyrrhiza uralensis) Protects against Triptolide‐Induced Oxidative Stress through Activation of Nrf2
Authors: Cao Ling-Juan , Hou Zhen-Yan , Li Huan-De , Zhang Bi-Kui , Fang Ping-Fei , Xiang Da-Xiong , Li Zhi-Hua , Gong Hui , Deng Yang , Ma Yan-Xia , Tang Huai-Bo , Yan Miao
Published: September 2017

To investigate the potential role of nuclear factor erythroid 2‐related factor 2 (Nrf2) in licorice ethanol extract (LEE) against triptolide‐ (TP‐) induced hepatotoxicity, HepG2 cells were exposed to LEE (30, 60, and 90 mg·L−1) for 12 h and then treated with TP (50 nM) for 24 h. Besides, an acute liver injury model was established in ICR mice by a single dose of TP (1.0 mg·kg−1, i.p.). Relevant oxidant and antioxidant mediators were analyzed. TP led to an obvious oxidative stress as evidenced by increasing levels of ROS and decreasing GSH contents in HepG2 cells. In vitro results were likely to hold true in in vivo experiments. LEE protected against TP‐induced oxidative stress in both in vitro and in vivo conditions. Furthermore, the decreased level of Nrf2 in the TP‐treated group was observed. The mRNA levels of downstream genes decreased as well in ICR mice liver, whereas they increased in HepG2 cells. In contrast, LEE pretreatment significantly increased the level of Nrf2 and its downstream genes. LEE protects against TP‐induced oxidative stress partly via the activation of Nrf2 pathway.
Interval‐Valued Hesitant Fuzzy Multiattribute Group Decision Making Based on Improved Hamacher Aggregation Operators and Continuous Entropy
Authors: Liu Jun , Zhou Ning , Zhuang Li-Hua , Li Ning , Jin Fei-Fei
Published: September 2017

Under the interval‐valued hesitant fuzzy information environment, we investigate a multiattribute group decision making (MAGDM) method with continuous entropy weights and improved Hamacher information aggregation operators. Firstly, we introduce the axiomatic definition of entropy for interval‐valued hesitant fuzzy elements (IVHFEs) and construct a continuous entropy formula on the basis of the continuous ordered weighted averaging (COWA) operator. Then, based on the Hamacher t‐norm and t‐conorm, the adjusted operational laws for IVHFEs are defined. In order to aggregate interval‐valued hesitant fuzzy information, some new improved interval‐valued hesitant fuzzy Hamacher aggregation operators are investigated, including the improved interval‐valued hesitant fuzzy Hamacher ordered weighted averaging (I‐IVHFHOWA) operator and the improved interval‐valued hesitant fuzzy Hamacher ordered weighted geometric (I‐IVHFHOWG) operator, the desirable properties of which are discussed. In addition, the relationship among these proposed operators is analyzed in detail. Applying the continuous entropy and the proposed operators, an approach to MAGDM is developed. Finally, a numerical example for emergency operating center (EOC) selection is provided, and comparative analyses with existing methods are performed to demonstrate that the proposed approach is both valid and practical to deal with group decision making problems.