bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review
Authors: Alanazi Bander , Butler-Henderson Kerryn , Alanazi Mohammed 
Published: January 2020

IntroductionElectronic health records (EHRs) can improve the quality and safety of care. However, the adoption and use of the EHR is influenced by several factors, including users’ perception.ObjectivesTo undertake a systematic review of the literature to understand healthcare professionals’ perceptions about the adoption and use of EHRs in Gulf Cooperation Council (GCC) countries in order to influence the implementation strategies, training programme and policy development in the GCC region.MethodA systematic literature search was undertaken on seven online databases to identify articles published between January 2006 and December 2017 examining healthcare professionals’ perception towards the adoption and use of EHR in the Gulf context.ResultsThe fourteen articles included in this review identified both positive and negative perceptions of the role of EHR in healthcare. The positive perceptions included EHR benefits, such as improvements to work efficiency, quality of care, communication and access to patient data. Conversely, the negative perceptions were associated with challenges or risks of adopting an EHR, such as disruption of provider–patient communication, privacy and security concerns and high initial costs. The perceptions were influenced by personal factors (eg, age, occupation and computer literacy) and system factors (perceived usefulness and perceived ease of use).ConclusionPositive perceptions of EHRs by the healthcare professionals could facilitate the adoption of this technology in the Gulf region, particularly when barriers are addressed early. Negative perceptions may inform change management strategies during adoption and implementation. The perceptions should be further evaluated from a technology acceptance perspective.
Application of a Common Data Model (CDM) to rank the paediatric user and prescription prevalence of 15 different drug classes in South Korea, Hong Kong, Taiwan, Japan and Australia: an observational, descriptive study
Authors: Brauer Ruth , Wong Ian Chi Kei , Man Kenneth KC , Pratt Nicole L , Park Rae Woong , Cho Soo-Yeon , Li Yu-Chuan (Jack) , Iqbal Usman , Nguyen Phung-Anh Alex , Schuemie Martijn 
Published: January 2020

ObjectiveTo measure the paediatric user and prescription prevalence in inpatient and ambulatory settings in South Korea, Hong Kong, Taiwan, Japan and Australia by age and gender. A further objective was to list the most commonly used drugs per drug class, per country.Design and settingHospital inpatient and insurance paediatric healthcare data from the following databases were used to conduct this descriptive drug utilisation study: (i) the South Korean Ajou University School of Medicine database; (ii) the Hong Kong Clinical Data Analysis and Reporting System; (iii) the Japan Medical Data Center; (iv) Taiwan’s National Health Insurance Research Database and (v) the Australian Pharmaceutical Benefits Scheme. Country-specific data were transformed into the Observational Medical Outcomes Partnership Common Data Model.PatientsChildren (≤18 years) with at least 1 day of observation in any of the respective databases from January 2009 until December 2013 were included.Main outcome measuresFor each drug class, we assessed the per-protocol overall user and prescription prevalence rates (per 1000 persons) per country and setting.ResultsOur study population comprised 1 574 524 children (52.9% male). The highest proportion of dispensings was recorded in the youngest age category (<2 years) for inpatients (45.1%) with a relatively high user prevalence of analgesics and antibiotics. Adrenergics, antihistamines, mucolytics and corticosteroids were used in 10%–15% of patients. For ambulatory patients, the highest proportion of dispensings was recorded in the middle age category (2–11 years, 67.1%) with antibiotics the most dispensed drug overall.ConclusionsCountry-specific paediatric drug utilisation patterns were described, ranked and compared between four East Asian countries and Australia. The widespread use of mucolytics in East Asia warrants further investigation.
Civil society stakeholders’ participation in national health reporting on sex/gender issues: a study protocol for an intersectionality-informed and sex/gender-sensitive approach to focus group research
Authors: Pöge Kathleen , Strasser Sarah Mirabella , Saß Anke-Christine , Rommel Alexander 
Published: January 2020

IntroductionHealth reporting is one of the foundations on which public health interventions and policies as well as prevention measures are developed. However, it faces the challenge of adequately reflecting social and sex/gender-related heterogeneity. The German Federal Ministry of Education and Research-funded joint project, AdvanceGender, aims to develop guidelines for sex/gender-sensitive and intersectional approach to population-based studies and health reporting. In its subproject, AdvanceHealthReport, four focus groups will be conducted to provide essential information on possible ways of participation of civil society stakeholders and on communication of health information for the further development of the guidelines (research period: from January 2019 to March 2020).Methods and analysisThe civil society stakeholders provide valuable information which health topics are relevant in regard to specific populations and how health information should be communicated in a non-stigmatising way. The groups will also discuss how civil society stakeholders should participate in health reporting. The starting point for intersections will be sex/gender. The intersection of sex/gender and migration and sex/gender and sexual orientation is particularly taken into account. The focus groups will be recorded, transcribed, anonymised and then analysed according to the qualitative content analysis.ResultsThe results will show the pathways as well as benefits and possible limitations of civil society stakeholder involvement in national health reporting and will contribute in developing guidelines for sex/gender-sensitive and intersectional health reporting.Ethics and DisseminationThe results of the focus groups will be published in scientific journals and presented at various national and international conferences. Furthermore, the findings will be incorporated into guidelines for research and health reporting. The study was approved by the Ethics Commission of Brandenburg Medical School Theodor Fontane (AZ: E-01–20180529).
Protocol for a systematic review of reporting standards of anaesthetic interventions in randomised controlled trials
Authors: Elliott Lucy , Coulman Karen , Blencowe Natalie S , Qureshi Mahim , Watson Sethina , Mouton Ronelle , Hinchliffe Robert J 
Published: January 2020

IntroductionThere is significant variation in how anaesthesia is defined and reported in clinical research. This lack of standardisation complicates the interpretation of published evidence and planning of future clinical trials. This systematic review will assess the reporting of anaesthesia as an intervention in randomised controlled trials (RCT) against the Consolidated Standards of Reporting Trials for Non-Pharmacological Treatments (CONSORT-NPT) framework.Methods and analysisOnline archives of the top six journals ranked by impact factor for anaesthesia and the top three general medicine and general surgery journals will be systematically hand searched over a 42-month time period to identify RCTs describing the use of anaesthetic interventions for any invasive procedure. All modes of anaesthesia and anaesthesia techniques will be included. All study data, including the type of anaesthetic intervention described, will be extracted in keeping with the CONSORT-NPT checklist. Descriptive statistics will be used to summarise general study details including types/modes of anaesthetic interventions, and reporting standards of the trials.Ethics and disseminationNo ethical approval is required. The results will be used to inform a funding application to formally standardise general, local, regional anaesthesia and sedation for use in clinical research. The systematic review will be disseminated via peer-reviewed manuscript and conferences.PROSPERO registration numberCRD42019141670.
Peripheral neuropathy from paclitaxel: risk prediction by serum microRNAs
Authors: Noda-Narita Shoko , Shimomura Akihiko , Tanabe Yuko , Kawauchi Jumpei , Matsuzaki Juntaro , Takizawa Satoko , Aoki Yoshiaki , Shimizu Chikako , Tamura Kenji , Ochiya Takahiro 
Published: January 2020

ObjectivesMicroRNAs (miRNAs) have recently been reported as useful diagnostic markers in cancer; however, relationships of miRNAs with adverse events during chemotherapy have yet to be fully described. In this study, we examined the relationship between serum miRNA and the risk of peripheral neuropathy (PN), a common and persistent adverse event induced by paclitaxel, in patients with breast cancer.MethodsA total of 84 serum samples from patients with breast cancer, who received paclitaxel as neoadjuvant or adjuvant chemotherapy, were obtained between January 2011 and September 2013 at National Cancer Center Hospital. Samples were divided, 2:1, into a training cohort and a test cohort, respectively; both cohorts included specimens from patients with severe PN (≥grade 2, PN group) and non-severe PN controls (non-PN group). The training cohort was used to identify miRNAs, and combinations thereof, that could predict PN, which then were validated in the test cohort.ResultsEighty-four patients received paclitaxel: 38 and 46 patients in the PN and non-PN groups, respectively. We identified 15 discriminatory miRNAs with |fold change|>0.5, and 14 combinations of three miRNAs showed the ability to discriminate, with sensitivity, specificity and accuracy of >50%. The most discriminatory miRNA, with the highest |fold change|, was miR-451a, which regulates the expression of the drug-transporter protein P-glycoprotein, potentially promoting paclitaxel resistance.ConclusionMiR-451a could be a predictive marker for PN caused by paclitaxel-containing chemotherapy; however, further investigation of the underlying mechanism is required to determine the role of miR-451a.
Novel CCM2 missense variants abrogating the CCM1–CCM2 interaction cause cerebral cavernous malformations
Authors: Bergametti Françoise , Viot Geraldine , Verny Christophe , Brechard Marie Pierre , Denier Christian , Labauge Pierre , Petit Paul , Nouet Aurélien , Viallet François , Chaussenot Annabelle , Hervé Dominique , Tournier-Lasserve Elisabeth , Riant Florence 
Published: January 2020

BackgroundCerebral cavernous malformations (CCMs) are vascular malformations mostly located within the central nervous system. Most deleterious variants are loss of function mutations in one of the threeCCMgenes. These genes code for proteins that form a ternary cytosolic complex with CCM2 as a hub. Very fewCCM2missense variants have been shown to be deleterious by modifying the ternary CCM complex stability.ObjectivesTo investigate the causality of novel missenseCCM2variants detected in patients with CCM.MethodsThe three CCM genes were screened in 984 patients referred forCCMmolecular screening. Interaction between CCM1 and CCM2 proteins was tested using co-immunoprecipitation experiments for theCCM2missense variants located in the phosphotyrosine binding (PTB) domain.Results11 distinctCCM2rare missense variants were found. Six variants predicted to be damaging were located in the PTB domain, four of them were novel. When co-transfected with CCM1 in HEK293T cells, a loss of interaction between CCM1 and CCM2 was observed for all six variants.ConclusionWe showed, using co-immunoprecipitation experiments, that CCM2 missense variants located in the PTB domain were actually damaging by preventing the normal interaction between CCM1 and CCM2. These data are important for diagnosis and genetic counselling, which are challenging in patients harbouring such variants.
Wakefield acceleration towards ZeV from a black hole emanating astrophysical jets
Authors: Ebisuzaki T. , Tajima T. 
Published: January 2020

We consider that electromagnetic pulses produced in the jets of this innermost part of the accretion disk accelerate charged particles (protons, ions, electrons) to very high energies via wakefield acceleration, including energies above 10[Formula: see text] eV for the case of protons and nucleus and 10[Formula: see text] eV for electrons by electromagnetic wave-particle interaction. Thereby, the wakefield acceleration mechanism supplements the pervasive Fermi’s stochastic acceleration mechanism (and overcomes its difficulties in the highest energy cosmic ray generation). The episodic eruptive accretion in the disk by the magneto-rotational instability gives rise to the strong Alfvenic pulses, which acts as the driver of the collective accelerating pondermotive force. This pondermotive force drives the wakes. The accelerated hadrons (protons and nuclei) are released to the intergalactic space to be ultra-high energy cosmic rays. The high-energy electrons, on the other hand, emit photons to produce various non-thermal emissions (radio, IR, visible, UV, and gamma-rays) of active galactic nuclei in an episodic manner, giving observational telltale signatures.
Probing correlation between photon orbits and phase structure of charged AdS black hole in massive gravity background
Authors: Chabab M. , El Moumni H. , Iraoui S. , Masmar K. 
Published: January 2020

The phase structure of charged anti-de Sitter black hole in massive gravity is investigated using the unstable circular photon orbits formalism, concretely we establish a direct link between the null geodesics and the critical behavior thermodynamic of such black hole solution. Our analysis reveals that the radius and the impact parameter corresponding to the unstable circular orbits can be used to probe the thermodynamic phase structure. We also show that the latter are key quantities to characterize the order of Van der Waals-like phase transition. Namely, we found a critical exponent around [Formula: see text]. All these results support further that the photon trajectories can be used as a useful and crucial tool to probe the thermodynamic black holes criticality.
Deep Learning to Distinguish Benign from Malignant Renal Lesions Based on Routine MR Imaging
Authors: Xi Ianto Lin , Zhao Yijun , Wang Robin , Chang Marcello , Purkayastha Subhanik , Chang Ken , Huang Raymond Y. , Silva Alvin C. , Vallières Martin , Habibollahi Peiman , Fan Yong , Zou Beiji , Gade Terence P. , Zhang Paul J. , Soulen Michael C. , Zhang Zishu , Bai Harrison X. , Stavropoulos S. William 
Published: January 2020

Abstract

Purpose:
With increasing incidence of renal mass, it is important to make a pretreatment differentiation between benign renal mass and malignant tumor. We aimed to develop a deep learning model that distinguishes benign renal tumors from renal cell carcinoma (RCC) by applying a residual convolutional neural network (ResNet) on routine MR imaging.

Experimental Design:
Preoperative MR images (T2-weighted and T1-postcontrast sequences) of 1,162 renal lesions definitely diagnosed on pathology or imaging in a multicenter cohort were divided into training, validation, and test sets (70:20:10 split). An ensemble model based on ResNet was built combining clinical variables and T1C and T2WI MR images using a bagging classifier to predict renal tumor pathology. Final model performance was compared with expert interpretation and the most optimized radiomics model.

Results:
Among the 1,162 renal lesions, 655 were malignant and 507 were benign. Compared with a baseline zero rule algorithm, the ensemble deep learning model had a statistically significant higher test accuracy (0.70 vs. 0.56, P = 0.004). Compared with all experts averaged, the ensemble deep learning model had higher test accuracy (0.70 vs. 0.60, P = 0.053), sensitivity (0.92 vs. 0.80, P = 0.017), and specificity (0.41 vs. 0.35, P = 0.450). Compared with the radiomics model, the ensemble deep learning model had higher test accuracy (0.70 vs. 0.62, P = 0.081), sensitivity (0.92 vs. 0.79, P = 0.012), and specificity (0.41 vs. 0.39, P = 0.770).

Conclusions:
Deep learning can noninvasively distinguish benign renal tumors from RCC using conventional MR imaging in a multi-institutional dataset with good accuracy, sensitivity, and specificity comparable with experts and radiomics.
Impact of EGFR-TKI Treatment on the Tumor Immune Microenvironment in EGFR Mutation–Positive Non–Small Cell Lung Cancer
Authors: Isomoto Kohsuke , Haratani Koji , Hayashi Hidetoshi , Shimizu Shigeki , Tomida Shuta , Niwa Takashi , Yokoyama Toshihide , Fukuda Yasushi , Chiba Yasutaka , Kato Ryoji , Tanizaki Junko , Tanaka Kaoru , Takeda Masayuki , Ogura Takashi , Ishida Tadashi , Ito Akihiko , Nakagawa Kazuhiko 
Published: January 2020

Abstract

Purpose:
The impact of EGFR tyrosine kinase inhibitors (TKI) on the tumor immune microenvironment (TME) in non–small cell lung cancer (NSCLC) is unclear.

Experimental Design:
We retrospectively identified 138 patients with EGFR-mutated NSCLC who underwent rebiopsy after progression during EGFR-TKI treatment. PD-L1 and CD73 expression in tumor cells and tumor-infiltrating lymphocyte (TIL) density at baseline and after progression were determined by IHC. Tumor mutation burden (TMB) was determined by next-generation sequencing.

Results:
The proportion of patients with a PD-L1 expression level of ≥50% (high) increased from 14% before to 28% after EGFR-TKI (P = 0.0010). Whereas CD8+ and FOXP3+ TIL densities were significantly lower after EGFR-TKI treatment than before, CD8+ TIL density was maintained in tumors with a high PD-L1 expression level. Expression of CD73 in tumor cells after EGFR-TKI treatment was higher than that before in patients with a high PD-L1 expression level. TMB tended to be higher after EGFR-TKI treatment than before (3.3→4.1 mutations/Mbp, P = 0.0508). Median progression-free survival for subsequent treatment with antibodies to PD-1 was longer for patients with a high than for those with a low PD-L1 expression after EGFR-TKI (7.1 vs. 1.7 months, P = 0.0033), and two of five patients whose PD-L1 expression level changed from low to high after EGFR-TKI treatment achieved a PFS of &gt;6 months.

Conclusions:
EGFR-TKI treatment was associated with changes in the TME of EGFR-mutated NSCLC, and such changes may provide clues for optimization of subsequent PD-1 inhibitor treatment.
First-in-Human Phase I Study to Evaluate the Brain-Penetrant PI3K/mTOR Inhibitor GDC-0084 in Patients with Progressive or Recurrent High-Grade Glioma
Authors: Wen Patrick Y. , Cloughesy Timothy F. , Olivero Alan G. , Morrissey Kari M. , Wilson Timothy R. , Lu Xuyang , Mueller Lars U. , Coimbra Alexandre F. , Ellingson Benjamin M. , Gerstner Elizabeth , Lee Eudocia Q. , Rodon Jordi 
Published: January 2020

Abstract

Purpose:
GDC-0084 is an oral, brain-penetrant small-molecule inhibitor of PI3K and mTOR. A first-in-human, phase I study was conducted in patients with recurrent high-grade glioma.

Patients and Methods:
GDC-0084 was administered orally, once daily, to evaluate safety, pharmacokinetics (PK), and activity. Fluorodeoxyglucose-PET (FDG-PET) was performed to measure metabolic responses.

Results:
Forty-seven heavily pretreated patients enrolled in eight cohorts (2–65 mg). Dose-limiting toxicities included 1 case of grade 2 bradycardia and grade 3 myocardial ischemia (15 mg), grade 3 stomatitis (45 mg), and 2 cases of grade 3 mucosal inflammation (65 mg); the MTD was 45 mg/day. GDC-0084 demonstrated linear and dose-proportional PK, with a half-life (∼19 hours) supportive of once-daily dosing. At 45 mg/day, steady-state concentrations exceeded preclinical target concentrations producing antitumor activity in xenograft models. FDG-PET in 7 of 27 patients (26%) showed metabolic partial response. At doses ≥45 mg/day, a trend toward decreased median standardized uptake value in normal brain was observed, suggesting central nervous system penetration of drug. In two resection specimens, GDC-0084 was detected at similar levels in tumor and brain tissue, with a brain tissue/tumor-to-plasma ratio of &gt;1 and &gt;0.5 for total and free drug, respectively. Best overall response was stable disease in 19 patients (40%) and progressive disease in 26 patients (55%); 2 patients (4%) were nonevaluable.

Conclusions:
GDC-0084 demonstrated classic PI3K/mTOR–inhibitor related toxicities. FDG-PET and concentration data from brain tumor tissue suggest that GDC-0084 crossed the blood–brain barrier.
Differentiating Atrioventricular Reentry Tachycardia and Atrioventricular Node Reentry Tachycardia Using Premature His Bundle Complexes
Authors: Padanilam Benzy J. , Ahmed Asim S. , Clark Brad A. , Gilge Jasen L. , Patel Parin J. , Prystowsky Eric N. , Steinberg Leonard A. 
Published: January 2020

Background:
Current maneuvers for differentiation of atrioventricular node reentry tachycardia (AVNRT) and atrioventricular reentry tachycardia (AVRT) lack sensitivity and specificity for AVRT circuits located away from the site of pacing. We hypothesized that a premature His complex (PHC) will always perturb AVRT because the His bundle is obligatory to the circuit. Further, AVNRT could not be perturbed by a late PHC (≤20 ms ahead of the His) due to the retrograde His conduction time. Earlier PHCs can advance the AVNRT circuit but only by a quantity less than the prematurity of the PHC.

Methods:
High-output pacing at the distal His location delivered PHCs. AVRT was predicted when late PHCs perturbed tachycardia or when earlier PHCs led to atrial advancement by an amount equal or greater than the degree of PHC prematurity.

Results:
Among the 73 supraventricular tachycardias, the test accurately predicted AVRT (n=29) and AVNRT (n=44) in all cases. Late PHC advanced the circuit in all 29 AVRTs and none of the AVNRTs (sensitivity and specificity, 100%). With earlier PHCs, the degree of atrial advancement was equal or greater than the PHC prematurity in 26/29 AVRTs and none of the AVNRTs (90% sensitivity and 100% specificity). The mean prematurity of the PHC required to perturb AVNRT was 48 ms (range, 28–70 ms) and the advancement less than the prematurity of the PHC (mean, 32 ms; range, 18–54 ms).

Conclusions:
The responses to PHCs distinguished AVRT and AVNRT with 100% specificity and sensitivity.
A Local Apocalypse: District Fairs and Poetry Recitation in Rural India
Authors: Tabor Nathan L.M. 
Published: January 2020

Abstract
Since the early twentieth century, Urdu poets have recited verse at locally-organized poetry gatherings held in country fairs across North India’s Gangetic plain. Critical engagement with these mushāʿarahs overturns assumptions about historical and affiliative aspects of vernacular and elite literary practices, revealing a patchwork of patronage, influence, and taste among poets and their audiences, while also highlighting unexpected routes of textual circulation outside urban locales. This essay examines poetry gatherings in and around the city of Muzaffarnagar located in North India’s Upper Doab. Ethnographic and archival materials tell a history of the performance arenas, tea stalls, and municipal structures of a semi-urban milieu that changes the scale of Urdu literary spaces over time.