bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of sick leave after same-day discharge for lower extremity arterial disease and varicose vein interventions in active population of French patients, 2013–2016: observational study
Authors: Hamid Asma , Lamirault Guillaume , Gouëffic Yann , Le Meur Nolwenn 
Published: June 2020

ObjectiveTo assess whether disparities in rates of same-day discharge for lower extremities arterial disease (5%) and varicose vein interventions (90%) are associated with the burden of postprocedural rehabilitation process, measured through the duration of sick leave.DesignRetrospective observational study using French National Health Insurance data in 2012–2016.SettingThe French National Health Data System (Système National des Données de Santé), which covers 98.8% of the 66 million people in the French population.ParticipantsFrench workforce population aged 18 to 65 years old who underwent a first angioplasty with stent placement for lower extremities arterial disease (LEAD, n=30 238) or a first varicose vein intervention (n=265 670) between 2013 and 2016.Main outcome measuresDuration and renewals of sick leave within 180 days after endovascular intervention, continuity of care and prescription indices to assess coordination among healthcare professionals after intervention associated with specific intervention settings: conventional (inpatient) or same-day discharge (outpatient). Association was estimated by multivariate negative binomial regressions adjusting for age, gender and comorbidities.ResultsOutpatient settings decrease the incidence rate ratio (IRR) of the number of cumulated days of sick leave by 14% in both interventions. The increasing variety of prescribers decreases the IRR of cumulated days of sick leave and prescription renewals for varicose interventions by 25% and 21%, respectively, but increases them for LEAD interventions by 240% and 106%. Less coordination between healthcare specialists increases the IRR of cumulative days of sick leave and renewals by 37% and 29% for varicose, and 11% and 9% for LEAD interventions.ConclusionsLow rates of outpatients in LEAD angioplasty does not seem related to the duration of sick leave. Outpatient setting reduces the duration of sick leave and their renewals, whatever the intervention. Coordination of healthcare professionals is a key element of interventions follow-up with pathology specificities.
Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study
Authors: Cardwell Karen , Smith Susan M , Clyne Barbara , McCullagh Laura , Wallace Emma , Kirke Ciara , Fahey Tom , Moriarty Frank 
Published: June 2020

ObjectiveLimited evidence suggests integration of pharmacists into the general practice team could improve medicines management for patients, particularly those with multimorbidity and polypharmacy. This study aimed to develop and assess the feasibility of an intervention involving pharmacists, working within general practices, to optimise prescribing in Ireland.DesignNon-randomised pilot study.SettingPrimary care in Ireland.ParticipantsFour general practices, purposively sampled and recruited to reflect a range of practice sizes and demographic profiles.InterventionA pharmacist joined the practice team for 6 months (10 hours/week) and undertook medication reviews (face to face or chart based) for adult patients, provided prescribing advice, supported clinical audits and facilitated practice-based education.Outcome measuresAnonymised practice-level medication (eg, medication changes) and cost data were collected. Patient-reported outcome measure (PROM) data were collected on a subset of older adults (aged ≥65 years) with polypharmacy using patient questionnaires, before and 6 weeks after medication review by the pharmacist.ResultsAcross four practices, 786 patients were identified as having 1521 prescribing issues by the pharmacists. Issues relating to deprescribing medications were addressed most often by the prescriber (59.8%), compared with cost-related issues (5.8%). Medication changes made during the study equated to approximately €57 000 in cost savings assuming they persisted for 12 months. Ninety-six patients aged ≥65 years with polypharmacy were recruited from the four practices for PROM data collection and 64 (66.7%) were followed up. There were no changes in patients’ treatment burden or attitudes to deprescribing following medication review, and there were conflicting changes in patients’ self-reported quality of life.ConclusionsThis non-randomised pilot study demonstrated that an intervention involving pharmacists, working within general practices is feasible to implement and has potential to improve prescribing quality. This study provides rationale to conduct a randomised controlled trial to evaluate the clinical and cost-effectiveness of this intervention.
Biomarkers versus traditional risk factors to predict cardiovascular events in very old adults: cross-validated prospective cohort study
Authors: Vaes Bert , Indestege Paulien , Serneels Tinne , Hegendörfer Eralda , van Peet Petra G , Poortvliet Rosalinde K E , Wallemacq Pierre , Gussekloo Jacobijn , Degryse Jan 
Published: June 2020

ObjectivesTo test new cardiovascular (CV) risk models in very old adults with and without a history of CV disease (CVD), based on traditional risk factors and biomarkers.DesignCross-validated prospective cohort study. The models were tested in the BELFRAIL Study and externally validated in the Leiden 85-plus Study.SettingGeneral practice, Belgium and The Netherlands.ParticipantsThe BELFRAIL cohort consisted of 266 patients aged 80 years or older without a history of CVD and 260 with a history of CVD. The Leiden 85-plus Study consisted of 264 patients aged 85 years without a history of CVD and 282 with a history of CVD.Outcome measuresThe model with traditional risk factors and biomarkers, as well as the model using only biomarkers, was compared with the model with only traditional risk factors to predict 3-year CV morbidity and mortality. A competing-risk analysis was performed, and the continuous net reclassification improvement (NRI), integrated discrimination improvement (IDI) and net benefit were used to compare the predictive value of the different models.ResultsTraditional risk factors poorly predicted CV mortality and morbidity. In participants without a history of CVD, adding N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) improved the prediction (NRI 0.56 (95% CI 0.16 to 0.99) and relative IDI 4.01 (95% CI 2.19 to 6.28)). In participants with a history of CVD, the NRI with the addition of NT-pro-BNP and high-sensitivity C reactive protein was 0.38 (95% CI 0.09 to 0.70), and the relative IDI was 0.53 (95% CI 0.23 to 0.90). Moreover, in participants without a history of CVD, NT-pro-BNP performed well as a stand-alone predictor (NRI 0.32 (95% CI −0.12 to 0.74) and relative IDI 3.44 (95% CI 1.56 to 6.09)).ConclusionsThis study tested new risk models to predict CV morbidity and mortality in very old adults. Especially, NT-pro-BNP showed a strong added predictive value. This opens perspectives for clinicians who are in need of an easily applicable strategy for CV risk prediction in very old adults.
Barriers in care for children with life-threatening conditions: a qualitative interview study in the Netherlands
Authors: Brouwer Marije , Maeckelberghe Els L M , van der Heide Agnes , Hein Irma , Verhagen Eduard 
Published: June 2020

ObjectiveTo identify barriers, as perceived by parents, to good care for children with life-threatening conditions.DesignIn a nationwide qualitative study, we held in-depth interviews regarding end-of-life care with parents of children (aged 1 to 12 years) who were living with a life-threatening illness or who had died after a medical trajectory (a maximum of 5 years after the death of the child). Sampling was aimed at obtaining maximum variety for a number of factors. The interviews were transcribed and analysed.SettingThe Netherlands.Participants64 parents of 44 children.ResultsParents identified six categories of difficulties that create barriers in the care for children with a life-threatening condition. First, parents wished for more empathetic and open communication about the illness and prognosis. Second, organisational barriers create bureaucratic obstacles and a lack of continuity of care. Third, parents wished for more involvement in decision-making. Fourth, parents wished they had more support from the healthcare team on end-of-life decision-making. Fifth, parents experienced a lack of attention for the family during the illness and after the death of their child. Sixth, parents experienced an overemphasis on symptom-treatment and lack of attention for their child as a person.ConclusionsThe barriers as perceived by parents focussed almost without exception on non-medical aspects: patient-doctor relationships; communication; decision-making, including end-of-life decision-making; and organisation. The perceived barriers indicate that care for children with a life-threatening condition focusses too much on symptoms and not enough on the human beings behind these symptoms.
Alcohol-related mortality following the loss of a child: a register-based follow-up study from Norway
Authors: Christiansen Solveig Glestad , Reneflot Anne , Stene-Larsen Kim , Hauge Lars Johan 
Published: June 2020

ObjectivesThe death of one’s child is one of the most stressful events a person can experience. Research has shown that bereaved parents have a higher mortality than non-bereaved parents. This increased mortality might partly be caused directly by long-term stress. However, changes in health behaviour such as an increase in alcohol consumption might also play a role. This study examines the association between losing a child and alcohol-related mortality. In addition to Cox regression models using data covering the entire Norwegian adult population, we employ sibling fixed-effect models in order to partly control for genes and childhood experiences that might be associated with both losing a child and alcohol-related mortality.DesignA follow-up study between 1986 and 2014 based on Norwegian register data.SettingNorway.ParticipantsThe entire Norwegian adult population.Primary outcome measureAlcohol-related mortality.ResultsAn increased alcohol-related mortality was found among parents who had experienced the death of a child. The HR of alcohol-related mortality among those bereaved of a child was 1.59 (95% CI 1.48 to 1.71) compared with non-bereaved parents, for women 2.03 (95% CI 1.78 to 2.32) and for men 1.46 (95% CI 1.34 to 1.59). After including sibling fixed effects, the HR of alcohol-related mortality among parents who had lost a child was 1.30 (95% CI 1.03 to 1.64).ConclusionsThis study provides evidence of an elevated alcohol-related mortality among parents who have lost a child compared with non-bereaved parents. Although strongly attenuated, there is still an association when adjusting for genetic predisposition for alcohol problems as well as childhood environment using sibling fixed-effect models.
Clinician responses to legal requests for hastened death: a systematic review and meta-synthesis of qualitative research
Authors: Patel Tejal , Christy Kayonne , Grierson Lawrence , Shadd Joshua , Farag Alexandra , O'Toole Danielle , Lawson Jennifer , Vanstone Meredith 
Published: June 2020

BackgroundThe legalisation of medical assistance in dying in numerous countries over the last 20 years represents a significant shift in practice and scope for many clinicians who have had little-to-no training to prepare them to sensitively respond to patient requests for hastened death.AimsOur objective was to review the existing qualitative literature on the experiences of healthcare providers responding to requests for hastened death with the aim of answering the question: how do clinicians make sense of, and respond to patients’ expressed wishes for hastened death?MethodsWe performed a systematic review and meta-synthesis of primary qualitative research articles that described the experiences and perspectives of healthcare professionals who have responded to requests for hastened death in jurisdictions where MAiD (Medical Assistance in Dying) was legal or depenalised. A staged coding process was used to identify and analyse core themes.ResultsAlthough the response to requests for hastened death varied case-by-case, clinicians formulated their responses by considering seven distinct domains. These include: policies, professional identity, commitment to patient autonomy, personal values and beliefs, the patient-clinician relationship, the request for hastened death and the clinician’s emotional and psychological response.ConclusionResponding to a request for hastened death can be an overwhelming task for clinicians. An approach that takes into consideration the legal, personal, professional and patient perspectives is required to provide a response that encompasses all the complexities associated with such a monumental request.
Colorectal cancer survivors’ quality of life: a qualitative study of unmet need
Authors: Drury Amanda , Payne Sheila , Brady Anne-Marie 
Published: June 2020

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of theirrelationships with healthcare professionals, many experienced a range ofunmet information and supportive care needs. Participants described a range of positive and negative experiences, aspower dynamicsandnavigation of healthcare systemshad implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed asafety net(work) of supports to bridge the gap of unmet needs in healthcarewith varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.
On the breaking of Casimir scaling in jet quenching
Authors: Apolinário Liliana , Barata João , Milhano Guilherme 
Published: June 2020

AbstractWe study the breaking of Casimir scaling, $$C_F/C_A$$CF/CA, due to the evolution of jets in a hot and extended medium. By using JEWEL, a medium modified Monte Carlo event generator validated for a wide set of observables, we are able to study separately the development of quark and gluon-initiated jets produced back-to-back with a $$Z-$$Z- boson. Focusing on the $$p_T$$pT distribution, we conclude first that the colour charge ratio is constant but larger than Casimir scaling for high $$p_T$$pT jets. In addition, our results seem to indicate that the medium induced cascade is more similar between quarks and gluons, thus driving the overall medium shower scaling away from the vacuum expectation. Finally, we compare our results to another Monte Carlo generator and observe the same scaling violation.
A new class of f(R)-gravity model with wormhole solutions and cosmological properties
Authors: Restuccia Alvaro , Tello-Ortiz Francisco 
Published: June 2020

AbstractA spherically symmetric wormhole family of solutions, with null red-shift, in the context of f(R)-gravity is presented. The model depends on two parameters: m and $$\beta $$β and meets all requirements to be an asymptotically and traversable wormhole. To solve the field equations, an EoS is imposed: $$p_{\perp }=-\rho $$p⊥=-ρ. It is found that for $$m=1$$m=1 the solution satisfies the null energy condition, although $$F(R)<0$$F(R)<0 everywhere. For $$m=0$$m=0, the model satisfies the null energy condition away from the throat, where the function F(R) is everywhere positive and together with dF(R)/dR vanish at the throat of the wormhole. This fact is beyond the scope of the non-existence theorem. Furthermore, the cosmological viability of the model, to address the late – time accelerated epoch, is analyzed on the background of a flat FLRW space-time. The model satisfies consistency of local gravity tests, stability under cosmological perturbations, ghosts free and stability of the de Sitter point.
Algorithms and Data Structures for Matrix-Free Finite Element Operators with MPI-Parallel Sparse Multi-Vectors
Authors: Davydov Denis , Kronbichler Martin 
Published: June 2020

Traditional solution approaches for problems in quantum mechanics scale asO(M3), whereMis the number of electrons. Various methods have been proposed to address this issue and obtain a linear scalingO(M). One promising formulation is the direct minimization of energy. Such methods take advantage of physical localization of the solution, allowing users to seek it in terms of non-orthogonal orbitals with local support.This work proposes a numerically efficient implementation of sparse parallel vectors within the open-source finite element library deal.II. The main algorithmic ingredient is the matrix-free evaluation of the Hamiltonian operator by cell-wise quadrature. Based on ana-priorichosen support for each vector, we develop algorithms and data structures to perform (i) matrix-free sparse matrix multivector products (SpMM), (ii) the projection of an operator onto a sparse sub-space (inner products), and (iii) post-multiplication of a sparse multivector with a square matrix. The node-level performance is analyzed using a roofline model. Our matrix-free implementation of finite element operators with sparse multivectors achieves a performance of 157 GFlop/s on an Intel Cascade Lake processor with 20 cores. Strong and weak scaling results are reported for a representative benchmark problem using quadratic and quartic finite element bases.
Randomized Phase II Trial of Carboplatin–Paclitaxel Compared with Carboplatin–Paclitaxel–Trastuzumab in Advanced (Stage III–IV) or Recurrent Uterine Serous Carcinomas that Overexpress Her2/Neu (NCT01367002): Updated Overall Survival Analysis
Authors: Fader Amanda N. , Roque Dana M. , Siegel Eric , Buza Natalia , Hui Pei , Abdelghany Osama , Chambers Setsuko , Secord Angeles Alvarez , Havrilesky Laura , O'Malley David M. , Backes Floor J. , Nevadunsky Nicole , Edraki Babak , Pikaart Dirk , Lowery William , ElSahwi Karim , Celano Paul , Bellone Stefania , Azodi Masoud , Litkouhi Babak , Ratner Elena , Silasi Dan-Arin , Schwartz Peter E. , Santin Alessandro D. 
Published: June 2020

Abstract

Purpose:
Uterine-serous-carcinoma (USC) is an aggressive variant of endometrial cancer. On the basis of preliminary results of a multicenter, randomized phase II trial, trastuzumab (T), a humanized-mAb targeting Her2/Neu, in combination with carboplatin/paclitaxel (C/P), is recognized as an alternative in treating advanced/recurrent HER2/Neu-positive USC. We report the updated survival analysis of NCT01367002.

Patients and Methods:
Eligible patients had stage III to IV or recurrent disease. Participants were randomized 1:1 to receive C/P for six cycles ± T followed by maintenance T until progression or toxicity. Progression-free survival (PFS) was the primary endpoint; overall survival (OS) and toxicity were secondary endpoints.

Results:
Sixty-one patients were randomized. After a median-follow-up of 25.9 months, 43 progressions and 38 deaths occurred among 58 evaluable patients. Updated median-PFS continued to favor the T-arm, with medians of 8.0 months versus 12.9 months in the control and T-arms (HR = 0.46; 90% CI, 0.28–0.76; P = 0.005). Median-PFS was 9.3 months versus 17.7 months among 41 patients with stage III to IV disease undergoing primary treatment (HR = 0.44; 90% CI, 0.23–0.83; P = 0.015), and 7.0 months versus 9.2 months among 17 patients with recurrent disease (HR = 0.12; 90% CI, 0.03–0.48; P = 0.004). OS was higher in the T compared with the control arm, with medians of 29.6 months versus 24.4 months (HR = 0.58; 90% CI, 0.34–0.99; P = 0.046). The benefit was most notable in those with stage III to IV disease, with survival median not reached in the T-arm versus 24.4 months in the control arm (HR = 0.49; 90% CI, 0.25–0.97; P = 0.041). Toxicity was not different between arms.

Conclusions:
Addition of T to C/P increased PFS and OS in women with advanced/recurrent HER2/Neu-positive USC, with the greatest benefit seen for the treatment of stage III to IV disease.
Appendiceal Endometriosis Presenting as Possible Cecal Mass
Authors: Feldhaus Danielle J. , Harris Rachel K. , Dayal Saraswati D. 
Published: June 2020

Background Endometriosis is endometrial tissue located outside of the uterus. Endometriosis is rarely found in the appendix and can present very similar to acute appendicitis and is often indistinguishable on physical exam and imaging. The diagnosis is typically made after an appendectomy on pathology. Case Summary A 45-year-old female presented with right sided abdominal pain and CT revealed a possible cecal or appendiceal lesion. Colonoscopy revealed a submucosal non-obstructing cecal mass. In the operating room, the appendix was completely adherent to the cecum and a laparoscopic ileocecectomy was performed. Pathology revealed endometriosis of the appendix and cecum. Discussion Endometriosis of the appendix is a rare condition reported in less than 1% of females that is diagnosed after an appendectomy is performed for suspected appendicitis or other pathology. This diagnosis is made based on the finding of endometrial glands and stroma in the appendix. This can present as acute appendicitis or appendiceal or peri-appendiceal mass on imaging. When symptomatic, pain can align with the menstrual cycle and hemoperitoneum may be encountered intra-operatively. Treatment can be appendectomy, ileocecectomy, or right hemicolectomy if malignancy is suspected. In the patient we described, an ileocecectomy was performed with the intention of converting to a right hemicolectomy if the frozen section pathology had revealed malignancy. This case illustrates the importance of having a broad differential when diagnosing patients with abdominal pain, especially in women of childbearing age. Conclusion Appendiceal endometriosis should be considered in females of childbearing age with abdominal pain or cecal/appendiceal mass on imaging.
Effect of Low-Pressure Drainage Suction on Pharyngocutaneous Fistula After Total Laryngectomy
Authors: Maleki Delarestaghi Mojtaba , Ahmadi Aslan , Dehghani Firouzabadi Fatemeh , Roomiani Maryam , Dehghani Firouzabadi Mohammad , Faham Zhaleh 
Published: June 2020

Objective: Pharyngocutaneous fistula (PCF) is one of the most severe multifactorial complications following laryngectomy. The current study aimed at determining the effect of a low-pressure vacuum drain on the incidence of PCF after total laryngectomy. Methods: The current randomized clinical trial was conducted on 35 patients undergoing total laryngectomy in Hazrat Rasoul Akram and Firoozgar hospitals in Tehran, Iran. The subjects were divided into the vacuum drain (n = 15) and control (without vacuum drain) (n = 20) groups. The incidence of PCF and the recovery time were recorded. Results: The rate of PCF formation from the stoma and wound edges was significantly lower in the low-pressure vacuum drain group than in the control group (6.7% vs 40%) ( P < .05). There was no significant difference between the groups in time to recovery from PCF. Conclusion: The low-pressure vacuum drain method is effective in reducing the incidence of PCF after total laryngectomy.