bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic effect of propiverine hydrochloride on mixed‐type urinary incontinence in women: The Female Urgency and Stress Urinary Incontinence Study of Propiverine Hydrochloride trial
Authors: Minagawa Tomonori , Gotoh Momokazu , Yokoyama Osamu , Sugaya Kimio , Yamanishi Tomonori , Kawahara Kazuya , Kaga Kanya , Kikuchi Takashi , Nishizawa Osamu ,   the FRESH study group
Published: April 2018

Objectives

To show the efficacy of propiverine hydrochloride in the management of symptoms of stress urinary incontinence in female patients with mixed‐type urinary incontinence.

Methods

The study was carried out as a multicenter single‐arm clinical trial at 64 institutions in Japan. The participants were female patients aged ≥20 years with mixed‐type urinary incontinence. The frequency of stress urinary incontinence and urgency urinary incontinence was evaluated at baseline and 4, 8 and 12 weeks after treatment with propiverine hydrochloride. Subjective symptoms were evaluated using the Overactive Bladder Symptom Score and the International Consultation on Incontinence Questionnaire‐Short Form. Functional urethral length and maximum urethral closing pressure were also measured at baseline and 12 weeks after treatment at the institutions where the urethral pressure profile was taken.

Results

In total, 49 mixed‐type urinary incontinence patients were enrolled in the present study. The number of cases of urgency urinary incontinence was reduced time‐dependently, which showed statistically significant differences between baseline and 4, 8 and 12 weeks after treatment. A similar statistically different reduction was also observed for stress urinary incontinence. The mean reduction rates of urgency urinary incontinence and stress urinary incontinence at 12 weeks after treatment were 63.9% and 44.3%, respectively. The total scores of International Consultation on Incontinence Questionnaire‐Short Form and Overactive Bladder Symptom Score were gradually reduced, and the differences were statistically significant. Functional urethral length and maximum urethral closing pressure at 12 weeks after treatment did not show any statistical differences compared with those at baseline.

Conclusions

Propiverine hydrochloride can be an effective therapeutic option for stress urinary incontinence in patients with mixed‐type urinary incontinence.
Characterization of the novel HLA‐B*40:366 allele by sequencing‐based typing
Authors: Zhang L.‐Q. , Xiao Y. , Zhou X. , Cai J.‐P.
Published: April 2018

HLA‐B*40:366 differs from HLA‐B*40:06:01:01 by one nucleotide substitution at position 362.
Characterization of the novel HLA‐DQB1*03:279 allele by sequencing‐based typing
Authors: Zhang L.‐Q. , Xiao Y. , Zhou X. , Cai J.
Published: April 2018

HLA‐DQB1*03:279 differs from HLA‐DQB1*03:02:01:01 by one nucleotide substitution at position 218 (A>T).
Characterization of the novel HLA‐C*07:613 allele by sequencing‐based typing
Authors: Zhang L.‐Q. , Xiao Y. , Zhou X.‐Y. , Cai J.‐P.
Published: April 2018

HLA‐C*07:613 differs from HLA‐C*07:01:01:01 by one nucleotide substitution at position 454.
Supra-aural transducer-related artifact contributes to overestimation of noise-induced hearing loss
Authors: Bhatt Ishan S.
Published: April 2018

This study compared the effects of supra-aural and insert receivers on the prevalence of noise-induced hearing loss (NIHL) in young adults. NIHL prevalence was found to be substantially higher when hearing thresholds were obtained with supra-aural compared to insert receivers on the same subjects. Real-ear sound pressure levels at 4000, 6000, and 8000 Hz were the major predictors of notched-audiograms obtained with supra-aural headphones. Distortion-product otoacoustic emissions were not significantly different between ears with and without notched-audiograms obtained with supra-aural headphones. The results demonstrated that supra-aural transducer-related artifacts can mimic a notch-like pattern leading to overestimation of NIHL prevalence.
β-Alanine Supplementation’s Improvement of High-Intensity Game Activities in Water Polo
Authors: Brisola Gabriel Motta Pinheiro , de Souza Malta Elvis , Santiago Paulo Roberto Pereira , Vieira Luiz Henrique Palucci , Zagatto Alessandro Moura
Published: April 2018

Objectives: To investigate whether 4 wk of β-alanine supplementation improves total distance covered, distance covered and time spent in different speed zones, and sprint numbers during a simulated water polo game. Design: Double-blind, parallel, and placebo controlled. A total of 11 male water polo players participated in the study, divided randomly into 2 homogeneous groups (placebo and β-alanine). Methods: The participants performed a simulated water polo game before and after the supplementation period (4 wk). They received 4.8 g·d−1 of dextrose or β-alanine on the first 10 d and 6.4 g·d−1 on the final 18 d. Results: Only the β-alanine group presented a significant improvement in total sprint numbers compared with the presupplementation moment (PRE = 7.8 [5.2] arbitrary units [a.u.]; POST = 20.2 [7.8] a.u.; P = .002). Furthermore, β-alanine supplementation presented a likely beneficial effect in improving total distance covered (83%) and total time spent (81%) in speed zone 4 (ie, speed ≥ 1.8 m·s−1). There was no significant interaction effect (group × time) for any variable. Conclusions: Four weeks of β-alanine supplementation slightly improved sprint numbers and had a likely beneficial effect on improving distance covered and time spent in speed zone 4 in a simulated water polo game.
Validity and Reliability of the 3-Minute All-Out Test in National and International Competitive Swimmers
Authors: Piatrikova Eva , Sousa Ana C. , Gonzalez Javier T. , Williams Sean
Published: April 2018

Purpose: To assess the concurrent and predictive validity of the 3-minute all-out test (3MT) against conventional methods (CM) of determining critical speed (CS) and curvature constant (D′) and to examine the test–retest reliability of the 3MT in highly trained swimmers. Methods: Thirteen highly trained swimmers (age 16 [2] y, weight 64.7 [8.5] kg, height 1.76 [0.07] m) completed 4 time trials and two 3MTs over 2 wk. The distance–time (DT) and speed–1/time (1/T) models were used to determine CS and D′ from 4 time trials. CS3MT and were determined as the mean speed in the final 30 s of 3MT and as the speed–time integral above CS, respectively. Results: CS3MT (1.33 [0.06] m·s−1) did not differ from CSCM (1.33 [0.06] m·s−1, P > .05) and correlated nearly perfectly with CSCM (r = .95, P < .0001). (19.50 [3.52] m) was lower than (23.30 [6.24] m, P < .05) and (22.15 [5.75] m, P = .09). Correlations between and were very large (r = .79, P = .002). CS and D′ between the two 3MT trials were not different (CS mean change = −0.009 m·s−1, P = .102; D′ mean change = 0.82 m, P = .221). Correlations between the two 3MT trials were nearly perfect and very large for CS (r = .97) and D′ (r = .87, P < .05), respectively, with coefficients of variation of 0.9% for CS and 9.1% for D′. Conclusion: The 3MT is a valid protocol for estimation of CS and produces high test–retest reliability for CS and D′ in highly trained swimmers.
The Effect of Uphill and Downhill Slopes on Weight Transfer, Alignment, and Shot Outcome in Golf
Authors: Blenkinsop Glen M. , Liang Ying , Gallimore Nicholas J. , Hiley Michael J.
Published: April 2018

The aim of the study was to examine changes in weight transfer, alignment, and shot outcome during golf shots from flat, uphill, and downhill slopes. Twelve elite male golfers hit 30 shots with a 6-iron from a computer-assisted rehabilitation environment used to create 5° slopes while collecting 3-dimensional kinematics and kinetics of the swing. A launch monitor measured performance outcomes. A shift in the center of pressure was found throughout the swing when performed on a slope, with the mean position moving approximately 9% closer to the lower foot. The golfers attempted to remain perpendicular to the slope, resulting in weight transfer toward the lower foot. The golfers adopted a wider stance in the sloped conditions and moved the ball toward the higher foot at address. Ball speed was not significantly affected by the slope, but launch angle and ball spin were. As the coaching literature predicted, golfers were more likely to hit shots to the left from an uphill slope and to the right from a downhill slope. No consistent compensatory adjustments in alignment at address or azimuth were found, with the change in final shot dispersion resulting from the lateral spin of the ball.
Crystal nucleation in metallic alloys using x-ray radiography and machine learning
Authors: Liotti Enzo , Arteta Carlos , Zisserman Andrew , Lui Andrew , Lempitsky Victor , Grant Patrick S.
Published: April 2018

Synchrotron x-ray radiography and machine learning computer vision help explain alloy effects on metallic crystal formation.
Multiple heteroatom substitution to graphene nanoribbon
Authors: Kawai Shigeki , Nakatsuka Soichiro , Hatakeyama Takuji , Pawlak Rémy , Meier Tobias , Tracey John , Meyer Ernst , Foster Adam S.
Published: April 2018

High-resolution atomic force microscopy can resolve the difference among B, C, and N atoms.
Platelets expressing IgG receptor FcγRIIA/CD32A determine the severity of experimental anaphylaxis
Authors: Beutier Héloïse , Hechler Béatrice , Godon Ophélie , Wang Yu , Gillis Caitlin M. , de Chaisemartin Luc , Gouel-Chéron Aurélie , Magnenat Stéphanie , Macdonald Lynn E. , Murphy Andrew J. ,   NASA study group, Chollet-Martin Sylvie , Longrois Dan , Gachet Christian , Bruhns Pierre , Jönsson Friederike
Published: April 2018

Platelet-derived serotonin contributes to FcγRIIA/CD32A-induced IgG-dependent anaphylaxis.
Intramuscular tendon injury is not associated with an increased hamstring reinjury rate within 12 months after return to play
Authors: van der Made Anne D , Almusa Emad , Reurink Gustaaf , Whiteley Rod , Weir Adam , Hamilton Bruce , Maas Mario , Ngai Aston S H , Moen Maarten H , Goudswaard Gert Jan , Tol Johannes L
Published: April 2018

Background

Acute hamstring injury that includes intramuscular tendon injury has been suggested to be associated with increased reinjury risk. These observations were based on a relatively small number of retrospectively analysed cases.

Objective

To determine whether intramuscular tendon injury is associated with higher reinjury rates in acute hamstring injury.

Methods

MRIs of 165 athletes with an acute hamstring injury were obtained within 5 days of injury. Treatment consisted of a standardised criteria-based rehabilitation programme. Standardised MRI parameters and intramuscular tendon injury, the latter subdivided into tendon disruption and waviness, were scored. We prospectively recorded reinjuries, defined as acute onset of posterior thigh pain in the same leg within 12 months after return to play.

Results

Participants were predominantly football players (72%). Sixty-four of 165 (39%) participants had an index injury with intramuscular hamstring tendon disruption, and waviness was present in 37 (22%). In total, there were 32 (19%) reinjuries. There was no significant difference (HR: 1.05, 95% CI 0.52 to 2.12, P=0.898) in reinjury rate between index injuries with intramuscular tendon disruption (n=13, 20%) and without tendon disruption (n=19, 20%). There was no significant difference in reinjury rate (X²(1)=0.031, P=0.861) between index injuries with presence of waviness (n=7, 19%) and without presence of waviness (n=25, 20%).

Conclusion

In athletes with an acute hamstring injury, intramuscular tendon injury was not associated with an increased reinjury rate within 12 months after return to play.
Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya
Authors: Adam Mary Beth , Muma Sarah , Modi Jecinter Achieng , Steere Mardi , Cook Nate , Ellis Wayne , Chen Catherine T , Shirk Arianna , Muma Nyagetuba John K , Hansen Erik N
Published: April 2018

Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-for-profit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike. The volume of patients increased and exceeded the hospital’s ability to respond to needs. There were substantial increases in sick newborn admissions during this time frame and an additional ward was opened to respond to this need. Increased need occurred across all services but staffing and space limited ability to respond to increased demand. There were increases in deaths during the strike period across the paediatric medical, newborn, paediatric surgical and obstetric units with an OR (95% CI) of death of 3.9 (95% CI 2.3 to 6.4), 4.1 (95% CI 2.4 to 7.1), 7.9 (95% CI 3.2 to 20) and 3.2 (95% CI 0.39 to 27), respectively. Increased mortality across paediatric and obstetrical services at AIC-Kijabe Hospital correlated with the crippling of healthcare delivery in the public sector during the national physicians’ strike in Kenya.
What is the quality of the maternal near-miss case reviews in WHO European Region? Cross-sectional study in Armenia, Georgia, Latvia, Republic of Moldova and Uzbekistan
Authors: Bacci Alberta , Hodorogea Stelian , Khachatryan Henrik , Babojonova Shohida , Irsa Signe , Jansone Maira , Dondiuc Iurie , Matarazde George , Lazdane Gunta , Lazzerini Marzia
Published: April 2018

Objectives

The maternal near-miss case review (NMCR) cycle is a type of clinical audit aiming at improving quality of maternal healthcare by discussing near-miss cases. In several countries this approach has been introduced and supported by WHO and partners since 2004, but information on the quality of its implementation is missing. This study aimed at evaluating the quality of the NMCR implementation in selected countries within WHO European Region.

Design

Cross-sectional study.

Settings

Twenty-three maternity units in Armenia, Georgia, Latvia, Moldova and Uzbekistan.

Assessment tools

A predefined checklist including 50 items, according to WHO methodology. Quality in the NMCR implementation was defined by summary scores ranging from 0 (totally inappropriate) to 3 (appropriate).

Results

Quality of the NMCR implementation was heterogeneous among different countries, and within the same country. Overall, the first part of the audit cycle (from case identification to case analysis) was fairly well performed (mean score 2.00, 95% CI 1.94 to 2.06), with the exception of the ‘inclusion of users’ views’ (mean score 0.66, 95% CI 0.11 to 1.22), while the second part (developing recommendations, implementing them and ensuring quality) was poorly performed (mean score 0.66, 95% CI 0.11 to 1.22). Each country had at least one champion facility, where quality of the NMCR cycle was acceptable. Quality of the implementation was not associated with its duration. Gaps in implementation were of technical, organisational and attitudinal nature.

Conclusions

Ensuring quality in the NMCR may be difficult but achievable. The high heterogeneity in results within the same country suggests that quality of the NMCR implementation depends, to a large extent, from hospital factors, including staff’s commitment, managerial support and local coordination. Efforts should be put in preventing and mitigating common barriers that hamper successful NMCR implementation.
Does bone mineral density improve the predictive accuracy of fracture risk assessment? A prospective cohort study in Northern Denmark
Authors: Dhiman Paula , Andersen Stig , Vestergaard Peter , Masud Tahir , Qureshi Nadeem
Published: April 2018

Objective

To evaluate the added predictive accuracy of bone mineral density (BMD) to fracture risk assessment.

Design

Prospective cohort study using data between 01 January 2010 and 31 December 2012.

Setting

North Denmark Osteoporosis Clinic of referred patients presenting with at least one fracture risk factor to the referring doctor.

Participants

Patients aged 40–90 years; had BMD T-score recorded at the hip and not taking osteoporotic preventing drugs for more than 1 year prior to baseline.

Main outcome measures

Incident diagnoses of osteoporotic fractures (hip, spine, forearm, humerus and pelvis) were identified using the National Patient Registry of Denmark during 01 January 2012–01 January 2014. Cox regression was used to develop a fracture model based on predictors in the Fracture Risk Assessment Tool (FRAX®), with and without, binary and continuous BMD. Change in Harrell’s C-Index and Reclassification tables were used to describe the added statistical value of BMD.

Results

Adjusting for predictors included in FRAX®, patients with osteoporosis (T-score ≤−2.5) had 75% higher hazard of a fracture compared with patients with higher BMD (HR: 1.75 (95% CI 1.28 to 2.38)). Forty per cent lower hazard was found per unit increase in continuous BMD T-score (HR: 0.60 (95% CI 0.52 to 0.69)).

Accuracy improved marginally, and Harrell’s C-Index increased by 1.2% when adding continuous BMD (0.76 to 0.77). Reclassification tables showed continuous BMD shifted 529 patients into different risk categories; 292 of these were reclassified correctly (57%; 95% CI 55% to 64%). Adding binary BMD however no improvement: Harrell’s C-Index decreased by 0.6%.

Conclusions

Continuous BMD marginally improves fracture risk assessment. Importantly, this was only found when using continuous BMD measurement for osteoporosis. It is suggested that future focus should be on evaluation of this risk factor using routinely collected data and on the development of more clinically relevant methodology to assess the added value of a new risk factor.
Association betweenhuman leucocyte antigen-DOpolymorphisms and interferon/ribavirin treatment response in hepatitis C virus type 1 infection in Chinese population: a prospective study
Authors: Yao Yinan , Liu Mei , Zang Feng , Yue Ming , Xia Xueshan , Feng Yue , Fan Haozhi , Zhang Yun , Huang Peng , Yu Rongbin
Published: April 2018

Objective

Thehuman leucocyte antigen-DO(HLA-DO) gene located in theHLAnon-classical class-II region may play a role in treatment response to hepatitis C virus (HCV). This study was conducted to explore the role of single nucleotide polymorphisms (SNPs) inHLA-DOin responding to HCV therapy.

Setting

All patients were recruited between January 2011 and September 2016 from the Jurong People’s Hospital, Jiangsu Province, China.

Participants

A total of 346 chronic hepatitis C (CHC) patients who finished the 48-week pegylated interferon-alpha and ribavirin (PEG IFN-α/RBV) treatment were enrolled in this study. All patients were former remunerated blood donors. The inclusion criteria for patients were as follows: (1) treatment-naive and treated with PEG IFN-α/RBV, (2) HCV RNA was present in serum for over 6 months before treatment, (3) negative for hepatitis B (HBV) or HIV infection and (4) lacked any other hepatic diseases.

All participants in this study were Chinese Han population and infected with HCV genotype 1b and treated with subcutaneous PEG IFN-α at a dose of 180 µg once a week with the addition of 800–1000 mg/d RBV according to weight orally for 48 weeks.

Results

The SNPsHLA-DOArs1044429 andHLA-DOBrs2284191 and rs2856997 of 18 SNPs were correlated with HCV treatment response in the Chinese Han population. The dominant model indicated that patients carrying favourable genotypes at rs1044429 AA and rs2284191 AA were more likely to achieve sustained virological response (SVR) (OR 1.99, 95% CI 1.25 to 3.19; OR 2.71, 95% CI 1.58 to 4.63, respectively), while patients carrying unfavourable genotypes at rs2856997 GG were less likely to achieve SVR (OR 0.48, 95% CI 0.29 to 0.78).

Conclusion

Genetic variations at rs1044429, rs2284191 and rs2856997 were independent predictors of HCV treatment response in the Chinese Han population.
Association between physical activity and health-related quality of life in elderly individuals with pre-diabetes in rural Hunan Province, China: a cross-sectional study
Authors: Xu Huilan , Tang Lu , Hu Zhao , Gao Fan , Yang Yang , Qin Lulu , Luo Bang-an
Published: April 2018

Objectives

There are few data on the relationship between health-related quality of life (HRQoL) and physical activity among elderly individuals with pre-diabetes. This study aimed to determine if differences existed in HRQoL between individuals with pre-diabetes who were physically active compared with those who were physically inactive in rural China.

Design, setting and participants

A cross-sectional survey was conducted among the elderly (≧60 years) in rural communities in Yiyang City of China. Multistage cluster random sampling was carried out to select 42 areas, and interviews were conducted among 434 elderly individuals with pre-diabetes. Pre-diabetes was screened using an oral glucose tolerance test.

Main outcome measures

The Medical Outcomes Study 36-Item Short Form Health Survey questionnaire was used to measure HRQoL. Physical activity was assessed using the International Physical Activity Questionnaire. Multivariate analysis of covariance (MANCOVA) was used to test for differences in HRQoL between the physically active group and the inactive group.

Results

A total of 434 individuals with pre-diabetes were included in this study. The physical component summary (PCS) score of HRQoL was 42.1±10.2 and the mental component summary score was 46.4±8.9. A median total physical activity of 524 metabolic equivalent-min/week was reported. A significant MANCOVA model (Wilks’ λ=0.962,F(2,423)=8.44, P<0.001) indicated that elderly individuals with pre-diabetes who were physically active reported higher PCS scores (Mdiff=5.2, P<0.001, effective size=0.47) compared with those physically inactive after adjusting for the following covariates: age, gender, marital status, education, smoking, chronic disease, body mass index and waist:hip ratio.

Conclusions

The HRQoL of elderly individuals with pre-diabetes is poor in rural China. These findings demonstrated that elderly individuals with pre-diabetes who were physically active had higher PCS scores than those who were physically inactive. Furthermore, these results support the rationale for developing a physical activity intervention for HRQoL of individuals with pre-diabetes.

Trial registration number

ChiCTR-IOR-15007033; Results.
OPTIMAL and ENSURE trials-based combined cost-effectiveness analysis of erlotinib versus chemotherapy for the first-line treatment of Asian patients with non-squamous non-small-cell lung cancer
Authors: Wen Feng , Zheng Hanrui , Zhang Pengfei , Hutton David , Li Qiu
Published: April 2018

Objectives

Erlotinib, the first generation of epidermoid growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has been recommended as an essential treatment in patients with non-small-cell lung cancer (NSCLC) with EGFR mutation. Although it has improved progression-free survival (PFS), overall survival (OS) was limited and erlotinib can be expensive. This cost-effectiveness analysis compares erlotinib monotherapy with gemcitabine-included doublet chemotherapy.

Setting

First-line treatment of Asian patients with NSCLC with EGFR mutation.

Methods

A Markov model was created based on the results of the ENSURE (NCT01342965) and OPTIMAL (CTONG-0802) trials which evaluated erlotinib and chemotherapy. The model simulates cancer progression and all causes of death. All medical costs were calculated from the perspective of the Chinese healthcare system.

Main outcome measures

The primary outcomes are costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs).

Results

The combined PFS was 11.81 months and 5.1 months for erlotinib and chemotherapy, respectively, while the OS was reversed at 24.68 months for erlotinib and 26.16 months for chemotherapy. The chemotherapy arm gained 0.13 QALYs compared with erlotinib monotherapy (1.17 QALYs vs 1.04 QALYs), while erlotinib had lower costs ($55 230 vs $77 669), resulting in an ICER of $174 808 per QALY for the chemotherapy arm, which exceeds three times the Chinese GDP per capita. The most influential factors were the health utility of PFS, the cost of erlotinib and the health utility of progressed disease.

Conclusion

Erlotinib monotherapy may be acceptable as a cost-effective first-line treatment for NSCLC compared with gemcitabine-based chemotherapy. The results were robust to changes in assumptions.

Trial registration number

NCT01342965and CTONG-0802.
A protocol for a Canadian prospective observational study of decision-making on active surveillance or surgery for low-risk papillary thyroid cancer
Authors: Sawka Anna M , Ghai Sangeet , Tomlinson George , Rotstein Lorne , Gilbert Ralph , Gullane Patrick , Pasternak Jesse , Brown Dale , de Almeida John , Irish Jonathan , Chepeha Douglas , Higgins Kevin , Monteiro Eric , Jones Jennifer M , Gafni Amiram , Goldstein David P
Published: April 2018

Introduction

Low-risk papillary thyroid cancer (PTC) is increasingly being diagnosed throughout the world; yet the mortality risk is low compared with other malignancies. Traditional management includes thyroid surgery, sometimes followed by radioactive iodine and thyroid hormone treatment. Active surveillance (AS) has been proposed as a means to reduce overtreatment of PTC. AS involves close disease follow-up, with the intention to intervene if the disease progresses, or on patient request.

Methods and analysis

This is a multiphase prospective observational study. In the first phase of this study, consenting eligible adults with low-risk PTC, that is, <2 cm in maximal diameter, confined to the thyroid and not immediately adjacent to critical structures in the neck, are provided verbal and written information about PTC disease prognosis following surgery or AS. Questionnaires are administered at baseline and after the disease management decision on AS or surgery is finalised. Patients may choose either option (surgery or AS), and the primary outcome is the frequency with which either disease management option is chosen. Secondary outcomes include: rationale for the decision, role of the patient in decision-making and decision satisfaction. In the second phase of the study, consenting eligible adult patients who completed the first study phase may enrol in respective AS or surgery group follow-up studies. The following outcomes are examined 1 year after enrolment in the follow-up phase: decision regret about disease management choice (primary outcome), psychological distress, disease-specific quality of life, fear of disease progression, body image satisfaction, disease progression, crossover to surgery in the AS group, new chronic thyroid hormone use and healthcare resource utilisation.

Ethics and dissemination

The University Health Network Research Ethics Board approved this study (ID 15-8942). The results will be published in an open access journal.

Trial registration number

NCT03271892; Pre-results.
Improving antibiotic prescribing by general practitioners: a protocol for a systematic review of interventions involving pharmacists
Authors: Saha Sajal K , Hawes Lesley , Mazza Danielle
Published: April 2018

Introduction

Effective antibiotic options in general practice for patients with infections are declining significantly due to antibiotic over-prescribing and emerging antibiotic resistance. To better improve antibiotic prescribing by general practitioner (GP), pharmacist–GP collaborations have been promoted under antibiotic stewardship programmes. However, there is insufficient information about whether and how pharmacists help GPs to more appropriately prescribe antibiotics. This systematic review aims to determine whether pharmacist-led or pharmacist-involved interventions are effective at improving antibiotic prescribing by GPs.

Methods and analysis

A systematic review of English language randomised controlled trials (RCTs), cluster RCTs, controlled before-and-after studies and interrupted time series studies cited in MEDLINE, EMBASE, EMCARE, CINAHL Plus, PubMed, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science databases will be conducted. Studies will be included if a pharmacist is involved as the intervention provider and GPs are the intervention recipients in general practice setting. Data extraction and management will be conducted using Effective Practice and Organisation of Care data abstraction tools and a template for intervention description and replication. The Cochrane and ROBINS-I risk of bias assessment tools will be used to assess the methodological quality of studies. Primary outcome measures include changes (overall, broad spectrum and guidelines concordance) of GP-prescribed antibiotics. Secondary outcomes include quality of antibiotic prescribing, delayed antibiotic use, acceptability and feasibility of interventions. Meta-analysis for combined effect and forest plots, χ2test and I2statistics for detailed heterogeneity and sensitivity analysis will be performed if data permit. Grading of Recommendations Assessment, Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidance will be used to report findings.

Ethics and dissemination

No ethics approval is required as no primary, personal or confidential data are being collected in this study. The findings will be disseminated to national and international scientific sessions and published in a peer-reviewed journal.

PROSPERO registration number

CRD42017078478.
Is there an association between nurse, clinical teacher and peer feedback for trainee doctors’ medical specialty choice? An observational study in Taiwan
Authors: Hsu Chih-Ming , Hsiao Cheng-Ting , Chang Li-Chun , Chang Hung-Yu
Published: April 2018

Objectives

This study explored whether there is an association between medical trainees’ future specialty choices and the 360-degree feedback they receive. We hypothesised that the higher the scores that teachers, trainees and/or nurses give to postgraduate year 1s (PGY1s) in any given specialty, the more likely that they will choose that specialty for their residency.

Setting

The study was conducted in a large regional teaching hospital in Taiwan.

Participants

The participants of this study were n=66 PGY1s who had completed their medical studies domestically or internationally and had received their PGY1 training in a single teaching hospital in southern Taiwan. Data from 990 assessments were included.

Primary and secondary outcome measures

Logistic regression analyses for teachers’, nursing staff and peers’ authentic assessments of trainees were undertaken for (1) desired specialty, (2) applied specialty, (3) enrolled specialty, (4) consistency between desired and applied specialties, (5) consistency between applied and enrolled specialties and (6) consistency between desired and enrolled specialties. Alpha was set at p<0.05.

Results

Nursing staff scores were significantly associated with all six dependent variables. Furthermore, teachers’ scores were significantly associated with trainees’ desired specialty and the consistency between desired and enrolled specialty. Peers’ scores were not significantly associated with any dependent variable.

Conclusions

Trainees’ specialty choices are associated with scores given by nursing staff and clinical teachers. We suggest that qualitative research methods should further explore this association to ascertain whether PGY1s are consciously influenced by these scores and if so, in what way.
Enhancing the quality and safety of care through training generalist doctors: a longitudinal, mixed-methods study of a UK broad-based training programme
Authors: Bullock Alison , Webb Katie Louise , Muddiman Esther , MacDonald Janet , Allery Lynne , Pugsley Lesley
Published: April 2018

Objective

Changing patient demographics make it ever more challenging to maintain the quality and safety of care. One approach to addressing this is the development of training for generalist doctors who can take a more holistic approach to care. The purpose of the work we report here is to consider whether a broad-based training programme prepares doctors for a changing health service.

Setting and participants

We adopted a longitudinal, mixed-methods approach, collecting questionnaire data from trainees on the broad-based training (BBT) programme in England (baseline n=62) and comparator trainees in the same regions (baseline n=90). We held 15 focus groups with BBT trainees and one-to-one telephone interviews with trainees post-BBT (n=21) and their Educational Supervisors (n=9).

Results

From questionnaire data, compared with comparator groups, BBT trainees were significantly more confident that their training would result in: wider perspectives, understanding specialty complementarity, ability to apply learning across specialties, manage complex patients and provide patient-focused care. Data from interviews and focus groups provided evidence of positive consequences for patient care from BBT trainees’ ability to apply knowledge from other specialties. Specifically, insights from BBT enabled trainees to tailor referrals and consider patients’ psychological as well as physical needs, thus adopting a more holistic approach to care. Unintended consequences were revealed in focus groups where BBT trainees expressed feelings of isolation. However, when we explored this sentiment on questionnaire surveys, we found that at least as many in the comparator groups sometimes felt isolated.

Conclusions

Practitioners with an understanding of care across specialty boundaries can enhance patient care and reduce risks from poor inter-specialty communication. Internationally, there is growing recognition of the place of generalism in medical practice and the need to take a more person-centred approach. Broad-based approaches to training support the development of generalist doctors, which is well-suited to a changing health service.
Comparative effectiveness of treatments to prevent dental caries given to rural children in school-based settings: protocol for a cluster randomised controlled trial
Authors: Ruff Ryan Richard , Niederman Richard
Published: April 2018

Introduction

Dental caries is the most prevalent childhood disease in the world and can lead to infection, pain and reduced quality of life. Multiple prevention agents are available to arrest and prevent dental caries; however, little is known of the comparative effectiveness of combined treatments when applied in pragmatic settings. The aim of the presented study is to compare the benefit of silver diamine fluoride and fluoride varnish versus fluoride varnish and glass ionomer therapeutic sealants in the arrest and prevention of dental caries.

Methods and analysis

A longitudinal, pragmatic, cluster randomised, single-blind, non-inferiority trial will be conducted in low-income rural children enrolled in public elementary schools in New Hampshire, USA, from 2018 to 2023. The primary objective is to compare the non-inferiority of alternative agents in the arrest and prevention of dental caries. The secondary objective is to compare cost-effectiveness of both interventions. Caries arrest will be evaluated after 2 years, and caries prevention will be assessed at the completion of the study. Data analysis will follow intent to treat, and statistical analyses will be conducted using a significance level of 0.05.

Ethics and dissemination

The standard of care for dental caries is office-based surgery, which presents multiple barriers to care including cost, fear and geographic isolation. The common intervention used in school-based caries prevention is dental sealants. The simplicity and affordability of silver diamine fluoride may be a viable alternative for the prevention of dental caries in high-risk children. Results can be used to inform policy for best practices in school-based oral healthcare.

Trial registration

NCT03448107. Pre-results.
Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition
Authors: Arasaradnam Ramesh P , Brown Steven , Forbes Alastair , Fox Mark R , Hungin Pali , Kelman Lawrence , Major Giles , O’Connor Michelle , Sanders Dave S , Sinha Rakesh , Smith Stephen Charles , Thomas Paul , Walters Julian R F
Published: April 2018

Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations.
Mesenchymal stromal cells: a novel therapy for the treatment of chronic obstructive pulmonary disease?
Authors: Broekman Winifred , Khedoe Padmini P S J , Schepers Koen , Roelofs Helene , Stolk Jan , Hiemstra Pieter S
Published: April 2018

COPD is characterised by tissue destruction and inflammation. Given the lack of curative treatments and the progressive nature of the disease, new treatments for COPD are highly relevant. In vitro cell culture and animal studies have demonstrated that mesenchymal stromal cells (MSCs) have the capacity to modify immune responses and to enhance tissue repair. These properties of MSCs provided a rationale to investigate their potential for treatment of a variety of diseases, including COPD. Preclinical models support the hypothesis that MSCs may have clinical efficacy in COPD. However, although clinical trials have demonstrated the safety of MSC treatment, thus far they have not provided evidence for MSC efficacy in the treatment of COPD. In this review, we discuss the rationale for MSC-based cell therapy in COPD, the main findings from in vitro and in vivo preclinical COPD model studies, clinical trials in patients with COPD and directions for further research.
Plasma procalcitonin concentrations are increased in dogs with sepsis
Authors: Goggs Robert , Milloway Matthew , Troia Roberta , Giunti Massimo
Published: April 2018

Sepsis, the life‐threatening organ dysfunction caused by a dysregulated host response to infection, is difficult to identify and to prognosticate for. In people with sepsis, procalcitonin (PCT) measurement aids diagnosis, enables therapeutic monitoring and improves prognostic accuracy. This study used a commercial canine PCT assay to measure plasma PCT concentrations in dogs with gastric dilatation volvulus (GDV) syndrome and in dogs with sepsis. It was hypothesised that dogs with GDV syndrome and with sepsis have greater plasma PCT concentrations than healthy dogs and that dogs with sepsis have greater PCT concentrations than dogs with GDV syndrome. Before analysing canine plasma samples, the ability of the assay to identify canine PCT, in addition to assay imprecision and the lower limit of detection were established. The assay had low imprecision with coefficients of variation ≤4.5 per cent. The lower limit of detection was 3.4 pg/ml. Plasma PCT concentrations were measured in 20 dogs with sepsis, in 32 dogs with GDV syndrome and in 52 healthy dogs. Median (IQR) PCT concentration in dogs with sepsis 78.7 pg/ml (39.1–164.7) was significantly greater than in healthy dogs 49.8 pg/ml (36.2–63.7) (P=0.019), but there were no significant differences between PCT concentrations in dogs with GDV syndrome and controls (P=0.072) or between dogs with sepsis and GDV syndrome (P=1.000). Dogs with sepsis have significantly increased plasma PCT concentrations compared with healthy dogs, although considerable overlap between these populations was identified. Future investigations should confirm this finding in other populations and evaluate the diagnostic and prognostic value of PCT in dogs with sepsis.
Reverse Bonnesen-style inequalities on surfaces of constant curvature
Authors: Zhu Baocheng , Xu Wenxue
Published: April 2018

This paper deals with the isoperimetric deficit upper bound for the convex domain in a surface [Formula: see text] of constant curvature [Formula: see text] by the containment measure of a convex domain to contain another convex domain in integral geometry. Some reverse Bonnesen-style inequalities are obtained. In particular, two of them strengthen Zhou’s result in [Formula: see text] and Bottema’s result in the Euclidean plane [Formula: see text].
Synchronization and anti-synchronization of a fractional order delayed memristor-based chaotic system using active control
Authors: Ding Dawei , Qian Xin , Wang Nian , Liang Dong
Published: April 2018

In this paper, the issue of synchronization and anti-synchronization for fractional-delayed memristor-based chaotic system is studied by using active control strategy. Firstly, some explicit conditions are proposed to guarantee the synchronization and anti-synchronization of the proposed system. Secondly, the influence of order and time delay on the synchronization (anti-synchronization) is discussed. It reveals that synchronization (anti-synchronization) is faster as the order increases or the time delay decreases. Finally, some numerical simulations are presented to verify the validity of our theoretical analysis.
A Bibliometric Analysis of the First Twenty-Five Years of the International Journal of Uncertainty, Fuzziness and Knowledge-Based Systems
Authors: Wang Wanru , Laengle Sigifredo , Merigó José M. , Yu Dejian , Herrera-Viedma Enrique , Cobo Manuel J. , Bouchon-Meunier Bernadette
Published: April 2018

Since the International Journal of Uncertainty, Fuzziness and Knowledge-Based Systems published its first issue in 1993, it has made important contributions to the research field of computer science. In this study, based on the dataset of the publications published in this journal between 1993 and 2016 retrieved from Web of Science, a general overview of this journal is performed using bibliometric methods and visualized networks. First, the productive and influential publications, authors, institutions, countries/territories, and supraregions are analysed based on the total number of citations, publications, and different citation thresholds. Second, network visualization analysis is applied to illustrate the links and connections between terms by using the VOSviewer software. Moreover, the most cited journals and common author keywords of three continents, including North America, Europe, and Asia, are also presented. This paper will hopefully help researchers understand the research patterns of this journal.
Improvement of COP with Heat Recovery Scheme for Solar Adsorption Cooling System
Authors: Ariful Kabir K. M. , Rouf Rifat A. , Sarker M. M. A. , Amanul Alam K. C. , Saha Bidyut B.
Published: April 2018

Heat recovery ensures optimum usage of the collected energy, and thus, minimizes heat loss for a solar adsorption chiller. Two-bed adsorption chiller with conventional single stage, run by direct solar coupling with heat recovery, has been studied mathematically. In a heat recovery adsorption refrigeration system, to facilitate heat transfer, heat transfer fluid is distributed between two adsorbers maintaining the same mass flow rate. There is no mass transfer between system components during this phase. It is a semi-continuous system performed between two adsorption beds. After completion of desorption/condensation mode, heat transfer fluid is allowed to circulate between the heated desorber and the cooled adsorber. This process distributes some heat of the desorption bed to the adsorber preparing it for the next preheating mode where heat transfer between them is done adiabatically. Consequently, the performance has been checked and a satisfactory increase in the Coefficient of Performance (COP) (approximately 15%) has been detected in the calculated results for the heat recovery operation. It is also observed that the heat recovery process enhances the working hour and overall performances of the solar heat driven adsorption chiller.
UK petrol retailing: competitive rivalry and the decline of the oil majors in the twentieth century
Authors: Ritson Neil H. , Byrne Ian , Cohen David A.
Published: April 2018

The development of the retail petroleum industry in the UK has received only sporadic attention by academics. This is curious, as the industry has vital importance to modern commerce. The industry is usually thought of as an oligarchy, with a small number of companies controlling the production and movement of products through vertical integration. However, there is evidence of change in the industry: there has been a significant number of exchanges of retailing sites between the major entities themselves, and a rise in the number and influence of competitors. These constitute both multiple retailers such as supermarket chains and, at the ‘competitive fringe’, a rise in the number of smaller independents. This paper identifies the historical changes and analyses the factors underlying them.
The history of exploration and development of the Liverpool Bay fields and the East Irish Sea Basin
Authors: Bunce J.
Published: April 2018

Hydrocarbon exploration in the East Irish Sea Basin began with the identification of surface oil seeps in peat beds in Lancashire, UK. This precipitated the drilling of the first onshore exploration wells. The discovery of the Formby Field in west Lancashire at the end of the 1930s triggered a wave of further drilling. Wells drilled in west Lancashire had limited success, with only minor hydrocarbon shows, whilst the production from the Formby Field was modest. Nonetheless, the invaluable geological information taken from onshore wells and the ratification of the Continental Shelf Act led to a shift in focus to the offshore and a period of significant interest in the East Irish Sea. Two key periods of oil and gas exploration activity stand out in the history of the offshore basin, the first headed by the Gas Council during the 1970s resulted in the discovery of the gas giants of Morecambe Bay, whilst the second fronted by Hamilton Oil during the 1990s heralded the discovery of oil with the Douglas and Lennox fields in Liverpool Bay. Exploration in the basin has waned during the last decade; however, to date, this mature hydrocarbon province has yielded estimated hydrocarbon reserves of over 1.8 BBOE (billion barrels of oil equivalent).
Archibald Geikie and the Ice Age controversy
Authors: Summerhayes Colin P.
Published: April 2018

In the early 1830s Charles Lyell was convinced that much of western Europe had been submerged during the Pleistocene by cold seas strewn with icebergs; the relicts of whose loads of rock and mud occurred on land as boulder clay and erratic blocks. Swiss scientist Louis Agassiz disagreed, considering in 1837 that these were the products of deposition by a great ice sheet. Archibald Geikie realized by 1863 that Lyell was wrong. Mountain glaciers had carved the topography of Scotland and other parts of the UK, feeding an ice sheet that left glacial erratics behind when it melted away. He hoped, in vain, to change Lyell's mind. Archibald Geikie's mantle passed to his brother James, who compiled evidence from around the world to demonstrate the correctness of his brother's thesis. It was published in 1874 just before Lyell died still arguing for the correctness of his iceberg theory, which gave us the word ‘drift’ for the unconsolidated deposits mantling the UK. Even so, by then Lyell had gone some way – no doubt partly influenced by the Geikies – to accepting that in certain instances glacial action had, indeed, moved large erratic blocks – locally even uphill, as in the Jura.