bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluations of palliative care models: A systematic review
Authors: Mathew Christine , Hsu Amy T. , Prentice Michelle , Lawlor Peter , Kyeremanteng Kwadwo , Tanuseputro Peter , Welch Vivian 
Published: December 2019

Background: Palliative care aims to improve quality of life by relieving physical, emotional, and spiritual suffering. Health system planning can be informed by evaluating cost and effectiveness of health care delivery, including palliative care. Aim: The objectives of this article were to describe and critically appraise economic evaluations of palliative care models and to identify cost-effective models in improving patient-centered outcomes. Design: We conducted a systematic review and registered our protocol in PROSPERO (CRD42016053973). Data sources: A systematic search of nine medical and economic databases was conducted and extended with reference scanning and gray literature. Methodological quality was assessed using the Drummond checklist. Results: We identified 12,632 articles and 5 were included. We included two modeling studies from the United States and England, and three economic evaluations from England, Australia, and Italy. Two studies compared home-based palliative care models to usual care, and one compared home-based palliative care to no care. Effectiveness outcomes included hospital readmission prevented, days at home, and palliative care symptom severity. All studies concluded that palliative care was cost-effective compared to usual care. The methodological quality was good overall, but three out of five studies were based on small sample sizes. Conclusion: Applicability and generalizability of evidence is uncertain due to small sample sizes, short duration, and limited modeling of costs and effects. Further economic evaluations with larger sample sizes are needed, inclusive of the diversity and complexity of palliative care populations and using patient-centered outcomes.
Assessment of plasma homocysteine levels in patients with craniocerebral injury and prognosis
Authors: Zhang Wenjia , Qin Zhongqiao , Xian Kecong , Tang Shuhong 
Published: December 2019

Objective To investigate the effect of plasma homocysteine (Hcy) and C-reactive protein (CRP) levels in patients with craniocerebral injury. Methods A retrospective analysis of data from patients with craniocerebral injury who underwent surgery. Patients were stratified according to the extent of the craniocerebral injury into severe, moderate and mild craniocerebral injury groups. Serum Hcy and CRP levels were determined at admission, at 7 days after treatment and at 3 months after injury. Univariate and multivariate Cox regression analyses were undertaken to identify prognostic factors. Results The study enrolled 96 patients: 29 patients with mild injury; 33 patients with moderate injury; and 34 patients with severe injury. Serum Hcy and CRP levels at admission were significantly higher in the severe craniocerebral injury group than in the other two groups; and they were significantly higher the moderate craniocerebral injury group compared with the mild craniocerebral injury group. Serum Hcy and CRP levels of the three groups of patients were significantly lower after 7 days of treatment than those before treatment. The levels of Hcy and CRP were positively correlated in all three groups. Conclusion Serum Hcy and CRP levels in patients could be used to monitor the condition and prognosis of patients with craniocerebral injury.
The efficacy and safety of fluticasone propionate/formoterol compared with fluticasone propionate/salmeterol in treating pediatric asthma: a systematic review and meta-analysis
Authors: Guan Renzheng , Liu Yanli , Ren Dunqiang , Li Jinfeng , Xu Tao , Hu Haiyan 
Published: December 2019

Objective To evaluate the efficacy and safety of fluticasone propionate/formoterol (FP/FORM) versus fluticasone propionate/salmeterol (FP/SAL) in treating pediatric asthma during a 12-week treatment cycle. Methods Randomized controlled trials of FP/FORM compared with FP/SAL in treating pediatric asthma were searched systematically using Medline, Embase, and the Cochrane Controlled Trials Register. Results Two articles including 546 patients were evaluated. The FP/SAL group showed obvious improvements in pre-dose forced expiratory volume in 1 s (FEV1) from day 0 to 84, asthma symptom scores, and sleep disturbance scores compared with the FP/FORM group; however, the FP/FORM group had improved peak expiratory flow rate (PEFR). In terms of 2-hour post-dose FEV1 from day 0 to 84, 2-hour forced expiratory flow at 25%, 50%, and 75%, and 2-hour forced vital capacity, we observed no significant differences between the two groups. For safety, including patients with at least one adverse event, bronchitis, cough, or pharyngitis, both groups had similar incidences, differing only in incidence of nasopharyngitis. Conclusion Compared with FP/FORM, FP/SAL showed a clear improvement in pre-dose FEV1, asthma symptom scores, and sleep disturbance scores. However, FP/FORM resulted in improved PEFR with a lower incidence of nasopharyngitis.
Management of Failed Proximal Biceps Surgery: Clinical Outcomes After Revision to Subpectoral Biceps Tenodesis
Authors: Savin David D. , Waterman Brian R. , Sumner Shelby , Richardson Catherine , Newgren John , Gowd Anirudh K. , Romeo Anthony A. 
Published: December 2019

Background: The preferred surgical technique to manage biceps–superior labral pathology is often debated, and rates of revision and persistence of pain vary widely according to surgical technique and patient characteristics. Purpose: To evaluate the clinical and functional outcomes of patients undergoing revision subpectoral tenodesis after failed primary tenodesis or tenotomy of the long head of the biceps. Study Design: Case series; Level of evidence, 4. Methods: All patients undergoing revision biceps management by the senior surgeon between 2006 and 2016 and with a minimum 24-month follow-up were retrospectively identified. Patients being treated with concomitant rotator cuff repair or capsular release were excluded. Patient characteristic variables were recorded. Patient-reported outcomes including the functional score, Single Assessment Numeric Evaluation (SANE), visual analog scale (VAS), Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons were obtained, and range of motion, strength, and complications were quantified. Results: In total, 25 patients with revision biceps tenodesis were identified at a mean follow-up of 76.5 ± 31.5 months. The average age was 44.4 ± 14.3 years, and the surgical indications included failure of index suprapectoral biceps tenodesis (56%), subpectoral biceps tenodesis (36%), and patient dissatisfaction after tenotomy (8%). There was a significant improvement in the VAS score ( P < .001), SANE ( P = .001), SST ( P = .035), functional score ( P < .001), and forward elevation ( P = .028), whereas postoperative strength ( P = .440), abduction ( P = .100), and external rotation ( P = .745) improvement failed to achieve statistical significance after revision surgery. There was no difference in postoperative outcome measures between modes of failures, concomitant procedures, and sex. Twenty-two (88%) patients reported high satisfaction and stated they would have this revision surgery again. The overall complication rate was 48%, with half of these reporting pain of >3 on a scale of 10 and 4% of patients requiring additional surgeries. Conclusion: The current study demonstrates high patient satisfaction (88%) and significant improvement in functional outcomes with revision biceps tenodesis, a mini-open subpectoral technique, after previous failed tenodesis or tenotomy. Although this may be an effective strategy to address failed prior biceps surgery, the potential complication of persistent pain must be emphasized. Patients should be counseled on the high complication rate (48%), with persistent pain being the most common complaint.
Prognostic Awareness, Disease and Palliative Understanding Among Caregivers of Patients With Dementia
Authors: Gabbard Jennifer , Johnson Devin , Russell Greg , Spencer Shenita , Williamson Jeff D. , McLouth Laurie E. , Ferris Keren G. , Sink Kaycee , Brenes Gretchen , Yang Mia 
Published: December 2019

Background: Persons with dementia (PwD) often have significant cognitive deficits and functional limitations, requiring substantial caregiver assistance. Given the high symptom burden and terminal nature of dementia, good prognostic awareness and integration of palliative care (PC) is needed. Objective: To evaluate prognostic awareness, disease, and PC understanding among caregivers of PwD and to assess for improvements in routine care. Design: A cross-sectional study of 2 cohorts at a single-academic medical center. Surveys were mailed to 200 caregivers of PwD in 2012 (cohort 1). Surveys were sent to new subset of caregivers of PwD (n = 80) in 2018 (cohort 2) to assess trends over time. Results: A total of 154 of caregivers completed the survey (response rate 55%). Compared to 2012, a higher proportion of caregivers in 2018 reported having conversations about prognosis with PwD’s physicians (25% in 2012 vs 45% in 2018; P = .027). However, a large percentage (43% in 2012 and 40% in 2018) of caregivers reported no understanding of the PwD’s prognosis. Despite most stating dementia was not curable, only 39% in 2012 and 52% in 2018 ( P = .015) understood that dementia was a terminal disease. In addition, only 32% in 2012 and 40% in 2018 ( P = .39) felt that they were knowledgeable about PC. Conclusions: Prognostic discussions between caregivers of PwD and the PwD’s physicians may be occurring more often; however, a high percentage of caregivers report a poor understanding about the terminal nature of dementia and the role of PC.
Foot and Ankle Related Sex-Specific Analysis Within High-Impact Journals
Authors: Gianakos Arianna L. , George Nicole , Merklein Meghan , Chambers Lori , Ferkel Richard , DiGiovanni Christopher , Kennedy John G. 
Published: December 2019

Background: The impact of patient sex on the prevalence of foot and ankle injuries has been established. Reporting of differences on treatment outcomes is lacking. The purpose of this study was to identify trends in sex-specific outcomes across high-impact journals over a 5-year time period. Methods: Two independent investigators reviewed journal issues published during 2 calendar years (2011 and 2016) in the 5 highest-impact orthopedic foot and ankle/sports subspecialty journals ( Foot & Ankle International [ FAI], Foot and Ankle Surgery [ FAS], American Journal of Sports Medicine [ AJSM], Arthroscopy, and Knee Surgery, Sports Traumatology, Arthroscopy [ KSSTA]). Studies were stratified into those that involved sex-specific analysis (SSA), where sex was a variable in a multifactorial statistical model, and those that only reported sex as a demographic characteristic or utilized sex-matched cohorts. Results: A total of 473 studies evaluating a total of 273 128 patients met criteria. An average of 43.9% (119 967 patients) of the population were female. Only 16.7% (79/473) of studies included sex as variable in a statistical model. Thirteen percent (25/193) and 19.3% (54/280) of studies reported SSA in 2011 and 2016, respectively. FAI was the only journal demonstrating a significant improvement of reporting SSA from 2011 to 2016 ( P < .002). Thirty percent (24/79) of studies that performed SSA demonstrated significant differences between male and female outcomes. Conclusion: Reporting of SSA in the orthopedic literature continued to be lacking. Only 16.7% of all articles evaluated in 2011 and 2016 performed SSA, with 30% of this subset reporting a statistically significant difference in outcomes. Level of Evidence: Level III, comparative study.
Healthcare professionals’ attitudes of implementing a chemotherapy electronic prescribing system: A mixed methods study
Authors: Cracknell Annette (Netty) V 
Published: December 2019

Purpose Recent research has investigated the attitudes of healthcare professionals when implementing electronic healthcare systems such as electronic medical records or electronic prescribing in primary care. There is limited research on implementation of electronic prescribing in secondary care and no published research exploring implementation of systemic-anticancer therapy (includes chemotherapy, TKIs, monoclonal antibodies, etc) electronic prescribing. By considering what attitudes healthcare professionals had towards the implementation of systemic-anticancer therapy (SACT) electronic prescribing systems, recommendations could be developed and used to aid successful future implementations. Methods This mixed methods study was in three phases. The first phase was a qualitative exploration of attitudes of healthcare professionals towards the implementation of a systemic-anticancer therapy electronic prescribing system, with the development of a questionnaire based on these findings. This was followed by a quantitative second phase where the results from the questionnaire were used to assess if the qualitative results could be generalised to a larger population. Further progression in phase three looked at developing recommendations based on the factors found in order to aid future implementations for hospitals. Results Thirteen factors were found relating to attitudes of healthcare staff when implementing systemic-anticancer therapy electronic prescribing. Nine of these factors were cited by other researchers when implementing other electronic healthcare systems. Four factors appeared to be specific to systemic-anticancer therapy electronic prescribing implementations. Nineteen recommendations were proposed when implementing a systemic-anticancer therapy electronic prescribing system. Conclusion This is the first study, to our knowledge, to examine the attitudes of healthcare professionals when implementing a systemic-anticancer therapy electronic prescribing system and the first to define important factors and list recommendations to manage these.
Associations between a risky psychosocial childhood and recurrent addiction compulsory care as adult
Authors: Grahn Robert , Padyab Mojgan , Lundgren Lena 
Published: December 2019

Background: Treatment for substance use disorder (SUD), results, in general, in improvements in terms of both drug use and social functioning. However, there are clients who are in need of repeated treatment. The aim of this retrospective study was to identify, for adults in compulsory care for severe SUD, the association between reporting having experienced a risky psychosocial childhood and repeated entries into the Swedish compulsory care system for SUD. Method: Hierarchical logistic regression and mediation analysis methods were used to analyse data from the Swedish National Board of Institutional Care (SiS) database. The sample included 2719 adults assessed at their compulsory care intake. The study examined the association between history of institutional care, family with SUD or psychiatric problem and repeated compulsory care entries as an adult controlling for main drug, age and gender. Results: In the regression model the factor with the strongest association with repeated compulsory care intakes for SUD, was as a child having been in mandated institutional care ( OR = 2.0 (1.60–2.51)). The proportion of the total effect that is mediated through LVU (law (1990:52) the care of young persons (special provisions) act) was 33% for SUD problems in family during childhood, 44% for psychiatric problems in family during childhood, and 38% for having been in foster care. Conclusion: Having been in mandated institutional care as a youth was strongly associated with repeated compulsory care for SUD as an adult. This is concerning since receipt of services as a child is supposed to mediate against the consequences of risky childhood conditions. These adults, as a group, are in need of a well-coordinated and integrated system of extensive aftercare services to reduce the likelihood of re-entry into compulsory care for an SUD.
Mapping Influence: Partisan Networks across the United States, 2000 to 2016
Authors: Reuning Kevin 
Published: December 2019

AbstractThe parties as networks approach has become a critical component of understanding American political parties. Research on it has so far mainly focused on variation in the placement of candidates within a network at the national level. This is in part due to a lack of data on state-level party networks. In this article, I fill that gap by developing state party networks for 47 states from 2000 to 2016 using candidate donation data. To do this, I introduce a backboning network analysis method not yet used in political science to infer relationships among donors at the state level. Finally, I validate these state networks and then show how parties have varied across states and over time. The networks developed here will be made publicly available for future research. Being able to quantify variation in party network structure will be important for understanding variation in party-policy linkages at the state level.
Cerebral aneurysms treated with low-profile visualized intraluminal support device (LVIS Jr) Y-stent constructs: Technical experience with a single microcatheter technique
Authors: Son Colin , Page Paul , Niemann David 
Published: December 2019

Background The LVIS Jr device holds a number of advantages but poses unique technical challenges compared to such, especially, complex multistent constructs. We report our experience with the technical feasibility and early to mid-term outcomes of Y-stent-assisted coiling with the LVIS Jr using a simple, single microcatheter technique. Methods Using a departmental database, we retrospectively reviewed a single surgeon’s experience with Y-stent-assisted coiling with LVIS Jr over a three-year period. Eighteen aneurysms in 17 patients were treated over this period. We assessed the technical success of the procedures, the initial and follow-up radiographic success with the modified Raymond-Roy occlusion score and follow-up clinical outcome with the modified Rankin scale. Results All stents were successfully deployed, and 17 of 18 aneurysms were successfully coiled at the initial treatment for a technical success rate of 94.4%. Of the 17 aneurysms with follow-up imaging, all were modified Raymond-Roy grade 1 or 2. One aneurysm required retreatment for coil compaction and a growing neck. There were two immediate postprocedure symptomatic strokes and one delayed stroke related to antiplatelet non-compliance. The two immediate symptomatic strokes recovered to neurological baseline with no residual deficits by the time of discharge. The long-term morbidity rate was 5.5%. The mortality rate was 0%. All patients had a modified Rankin Scale ≤ 2 at most recent follow-up. Conclusion Treatment with LVIS Jr Y-stent constructs via a single microcatheter technique is technically feasible with good radiographic and clinical outcomes.
Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) study protocol
Authors: Kate Mahesh Pundlik , Arora Deepti , Verma Shweta Jain , Sylaja PN , Renjith Vishnu , Sharma Meenakshi , Pandian Jeyaraj Durai ,   on behalf of SPRINT India Collaborators
Published: December 2019

Rationale Recurrent stroke, cardiovascular morbidity, and mortality are important causes of poor outcome in patients with index stroke. Despite the availability of best medical management recurrent stroke occur in up to 15–20% of patients with stroke in India. Education for stroke prevention could be a strategy to prevent recurrent strokes. Hypothesis We hypothesize that a structured semi-interactive stroke prevention package can reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke at the end of one year. Design Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA) is a multi-center stroke trial involving 25 centers under the Indian Stroke Clinical Trial Network. Patients with first ever sub-acute stroke within two days to three months of onset, age 18–85 years, mRS <5, showing recent stroke in imaging are included. Participants or caregivers able to read and complete tasks suggested in a stroke prevention workbook and have a cellular device for receiving short message service and watching videos. A total of 5830 stroke patients speaking 11 different languages are being randomized to intervention or control arm. Patients in the intervention arm are receiving a stroke prevention workbook, regular educational short messages, and videos. All patients in the control arm are receiving standard of care management. Summary Structured semi-interactive stroke prevention package may reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke. Trial registration This trial is registered with clinicaltrials.gov (NCT03228979) and CTRI (Clinical Trial Registry India; CTRI/2017/09/009600).
Before the ‘Arab Spring’: How challengers pushed counter-issues in Egypt’s hybrid media system
Authors: Badr Hanan 
Published: December 2019

Eight years after the ‘Arab Spring’, literature is still marked by techno-deterministic interpretations. This article contributes to examining the role of agenda-building processes just before the outbreak of the Egyptian uprising in 2011 within authoritarian systems. Using the ‘hybrid media system’ concept, the article not only focuses on new media effects but, by including print media, it takes into consideration the media system in its entirety. Focusing on Khaled Said’s case as a counter-issue, the qualitative content analysis investigates how challengers in Egypt successfully pushed the media salience of police torture onto the mainstream media agenda. By reconstructing the issue cycle and intermedia spill-over effects, the author investigates the agenda-building processes within hybrid media systems in Arab authoritarian contexts. The qualitative content analysis includes 415 articles and posts from 12 diverse print, online and social media outlets between June 2010 and January 2011. The central finding is that successful spill-over effects occurred from online media to private print media, even though state media tried to ignore the issue. The coverage transferred the issue’s salience from new media into mainstream media, thus reaching wider non-politicized audiences. These proven interlinkages between old and new media are often an overlooked aspect in the literature on media and the ‘Arab Spring’.