bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluation of intrahospital clinical practices in injury care: protocol for a 10-year systematic review
Authors: Conombo Blanchard , Guertin Jason Robert , Tardif Pier-Alexandre , Farhat Imen , Moore Thomas , Bouderba Samy , Soltana Kahina , Archambault Patrick , Berthelot Simon , Lauzier François , Turgeon Alexis F , Stelfox Henry Thomas , Chasse Michaël , Hoch Jeffrey , Moore Lynne 
Published: July 2020

IntroductionUnderuse of high-value clinical practices and overuse of low-value practices are major sources of inefficiencies in modern healthcare systems. Injuries are second only to cardiovascular disease in terms of acute care costs but data on the economic impact of clinical practices for injury admissions are lacking. This study aims to summarise evidence on the economic value of intrahospital clinical practices for injury care.Methods and analysisWe will perform a systematic review to identify research articles in economic evaluation of intrahospital clinical practices in acute injury care. We will search MEDLINE and databases such as Embase, Web of Science, NHS Economic Evaluation Database, Cochrane CENTRAL, BIOSIS and CINAHL for randomised or non-randomised controlled trials and observational studies using a combination of keywords and controlled vocabulary. We will consider the following outcomes relative to economic evaluations: incremental cost-effectiveness ratio, incremental cost-utility ratio, incremental net health benefit, incremental net monetary benefit (iNMB) and incremental cost-benefit ratio. Pairs of independent reviewers will evaluate studies that meet eligibility criteria and extract data from included articles using an electronic data extraction form. All outcomes will be converted into iNMB. We will report iNMB for practices classified by type of practice (hospitalisation, consultation, diagnostic, therapeutic-surgical, therapeutic-drugs, therapeutic-other). Results obtained with a ceiling ratio of $50 000 per quality-adjusted life year gained for identified clinical practices will be summarised by charting forest plots. In line with Cochrane recommendations for systematic reviews of economic evaluations, meta-analyses will not be conducted.Ethics and disseminationEthics approval is not required as original data will not be collected. This study will summarise existing evidence on the economic value of clinical practices in injury care. Results will be used to advance knowledge on value-based care for injury admissions and will be disseminated through a peer-reviewed article, international scientific meetings and clinical and healthcare quality associations.
Validation study of bullous pemphigoid and pemphigus vulgaris recording in routinely collected electronic primary healthcare records in England
Authors: Persson Monica S M , Harman Karen E , Vinogradova Yana , Langan Sinead M , Hippisley-Cox Julia , Thomas Kim S , Gran Sonia 
Published: July 2020

ObjectivesThe validity of bullous pemphigoid and pemphigus vulgaris recording in routinely collected healthcare data in the UK is unknown. We assessed the positive predictive value (PPV) for bullous pemphigoid and pemphigus vulgaris primary care Read codes in the Clinical Practice Research Datalink (CPRD) using linked inpatient data (Hospital Episode Statistics (HES)) as the diagnostic benchmark.SettingAdult participants with bullous pemphigoid or pemphigus vulgaris registered with HES-linked general practices in England between January 1998 and December 2017. Code-based algorithms were used to identify patients from the CPRD and extract their benchmark blistering disease diagnosis from HES.Primary outcome measureThe PPVs of Read codes for bullous pemphigoid and pemphigus vulgaris.ResultsOf 2468 incident cases of bullous pemphigoid and 431 of pemphigus vulgaris, 797 (32.3%) and 85 (19.7%) patients, respectively, had a hospitalisation record for a blistering disease. The PPV for bullous pemphigoid Read codes was 93.2% (95% CI 91.3% to 94.8%). Of the bullous pemphigoid cases, 3.0% had an HES diagnosis of pemphigus vulgaris and 3.8% of another blistering disease. The PPV for pemphigus vulgaris Read codes was 58.5% (95% CI 48.0% to 68.9%). Of the pemphigus vulgaris cases, 24.7% had an HES diagnosis of bullous pemphigoid and 16.5% of another blistering disease.ConclusionsThe CPRD can be used to study bullous pemphigoid, but recording of pemphigus vulgaris needs to improve in primary care.
Non-conveyance in the ambulance service: a population-based cohort study in Stockholm, Sweden
Authors: Lederman Jakob , Lindström Veronica , Elmqvist Carina , Löfvenmark Caroline , Djärv Therese 
Published: July 2020

ObjectivesNon-conveyed patients represent a significant proportion of all patients cared for by ambulance services in the western world. However, scientific knowledge on non-conveyance is sparse. Therefore, the aim of this study was to describe the prevalence of non-conveyance, investigate associations and compare patients’ characteristics, drug administration, initial problems and vital signs between non-conveyed and conveyed patients.DesignA population-based retrospective cohort study.SettingThe study setting area, Stockholm, Sweden, has a population of 2.3 million inhabitants, with seven emergency hospitals. Annually, approximately 210 000 assignments are performed by 73 ambulances. All ambulance assignments performed from 1 January to 31 December 2015 were included.ResultsIn total, 23 603 ambulance assignments ended in non-conveyance—13.8% of all ambulance assignments performed in 2015. Compared with conveyed patients, non-conveyed patients were younger and more often female (median age 50.1 years for non-conveyed vs 61.7 years for conveyed; female=52 %, both p values <0.001). Approximately half of all ambulance assignments ending in non-conveyance were initially prioritised and dispatched as the highest priority. Non-conveyed patients were more often assessed by ambulance clinicians as presenting non-specific symptoms or symptoms related to psychiatric problems. Low blood glucose levels were highly associated with non-conveyance (adjusted OR (AOR): 15; 95 % CI 11.18 to 20.13), although non-conveyed patients presented abnormal vital signs across all categories of vital signs. Moreover, drugs were more often administered to younger non-conveyed patients. Older patients were more often conveyed and administered drugs once conveyed (AOR: 1.29; 95 % CI 1.07 to 1.56).ConclusionsThis study shows that non-conveyed patients represent a non-negligible proportion of all patients in contact with ambulance services. In general, most cases of non-conveyance occur at the highest dispatch level, to a large extent involve younger patients, and features problems assessed by ambulance clinicians as non-specific or related to psychiatric symptoms.
Improving the HIV PrEP continuum of care using an intervention for healthcare providers: a stepped-wedge study protocol
Authors: Ming Kristin , Shrestha Isha , Vazquez Alexander , Wendelborn James , Jimenez Veronica , Lisha Nadra , Neilands Torsten B , Scott Hyman , Liu Albert , Steward Wayne , Johnson Mallory O , Saberi Parya 
Published: July 2020

IntroductionPre-exposure prophylaxis (PrEP) has demonstrated to be a highly effective method for preventing HIV; however, many individuals with PrEP indications are not receiving PrEP. Primary care settings provide an opportunity to offer PrEP to a wide range of patients. In this paper, we describe the PrEP Optimisation Intervention (PrEP-OI), which includes a PrEP Coordinator and a web-based panel management tool (called PrEP-Rx), and is targeted at healthcare providers (HCPs) to increase PrEP uptake and persistence among those at risk for acquiring HIV.Methods and analysisThe PrEP-OI study evaluates the efficacy of the PrEP intervention (PrEP Coordinator + PrEP-Rx) to increase PrEP prescriptions through a stepped-wedge design among 10 primary care clinical sites in the San Francisco Department of Public Health. The number of PrEP initiation prescriptions constitute the primary outcome, and we hypothesise that the mean number of PrEP prescriptions written will significantly increase after the clinics initiate PrEP-OI versus before this intervention. Secondary objectives include: 1-differences in PrEP initiation, duration of use and reasons for discontinuation based on patient’s age, race/ethnicity and sex/gender, and by clinic and HCP characteristics, 2-sustainability of the intervention during a 12-month follow-up after the stepped-wedge phase, and 3-facilitators and barriers of PrEP delivery and experiences with the proposed PrEP intervention through qualitative interviews with HCPs. The results of this study can provide valuable insight into methods to reduce the burden of PrEP care on HCPs and improve PrEP continuum of care.Ethics and disseminationThis study and its protocols have been approved by the University of California, San Francisco (UCSF) Institutional Review Board. Study staff will disseminate findings locally (eg, the UCSF Centre for AIDS Prevention Studies’ Community Engagement Core), statewide (eg, the California Department of Public Health’s Office of AIDS) and nationally and internationally at conferences related to HIV.Trial registration numberNCT03532191.
Do static and dynamic activities induce potentially damaging breast skin strain?
Authors: Norris Michelle , Mills Chris , Sanchez Amy , Wakefield-Scurr Joanna 
Published: July 2020

Background/AimThis study aimed to quantify breast skin strain and strain rate and the effect of support garments at reducing strain and to determine characteristics that correlate with strain during static and dynamic activity.Methods39 women (UK size 32C to 36G) had electromagnetic sensors applied to their breast skin. Sensor coordinates were recorded while standing, walking, running, in no, low and high breast support conditions, plus bare-breasted in the estimated neutral position to calculate strain. Relative breast coordinates and 35 inter-sensor distances identified peak breast skin strain (%) and strain rate (%·s-1), which were then correlated with nipple kinematics, breast pain and participant characteristics.ResultsMean peak breast skin strain was generally <60% during standing, walking and running; however, some individuals exhibited 93% strain in bare-breasted running. Compared with low support, high support did not further reduce strain during standing and walking. Peak breast skin strain/strain rate location was longitudinal, in lateral and medial breast regions and displayed strong correlations with breast volume, body mass index and bust circumference.ConclusionStatic and dynamic activity did not result in excessive breast skin strain, suggesting low risk of skin damage. However, during running, some individuals experienced excessive skin strains (up to 93%) and strain rates (up to 1258%·s-1). Breast skin strain/strain rate location suggests lift is required in the lateral and medial bra cup to reduce strain, particularly in larger breast volumes due to increased skin strain risk.
Impact of the Four-Hour Rule policy on emergency medical services delays in Australian EDs: a longitudinal cohort study
Authors: Man Nicola Wing Young , Forero Roberto , Ngo Hanh , Mountain David , FitzGerald Gerard , Toloo Ghasem (Sam) , McCarthy Sally , Mohsin Mohammed , Fatovich Daniel M , Bailey Paul , Bosley Emma , Carney Rosemary , Lai Harry Man Xiong , Hillman Ken 
Published: July 2020

IntroductionDelayed handover of emergency medical services (EMS) patients to EDs is a major issue with hospital crowding considered a primary cause. We explore the impact of the 4-hour rule (the Policy) in Australia, focusing on ambulance and ED delays.MethodsEMS (ambulance), ED and hospital data of adult patients presenting to 14 EDs from 2002 to 2013 in three jurisdictions were linked. Interrupted time series ‘Before-and-After’ trend analysis was used for assessing the Policy’s impact. Random effects meta-regression analysis was examined for associations between ambulance delays and Policy-associated ED intake, throughput and output changes.ResultsBefore the Policy, the proportion of ED ambulances delayed increased between 1.1% and 1.7% per quarter across jurisdictions. After Policy introduction, Western Australia’s increasing trend continued but Queensland decreased by 5.1% per quarter. In New South Wales, ambulance delay decreased 7.1% in the first quarter after Policy introduction. ED intake (triage delay) improved only in New South Wales and Queensland. Each 1% ambulance delay reduction was significantly associated with a 0.91% reduction in triage delay (p=0.014) but not ED length of stay ≤4 hours (p=0.307) or access-block/boarding (p=0.605) suggesting only partial improvement in ambulance delay overall.ConclusionThe Policy was associated with reduced ambulance delays over time in Queensland and only the immediate period in New South Wales. Associations may be due to local jurisdictional initiatives to improve ambulance performance. Strategies to alleviate ambulance delay may need to focus on the ED intake component. These should be re-examined with longer periods of post-Policy data.
Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis
Authors: den Braanker Hannah , Wervers Kim , Mus Adriana M C , Bangoer Priyanka S , Davelaar Nadine , Luime Jolanda , Tchetverikov Ilja , Hazes J M W , Vis Marijn , Lubberts Erik , Kok Marc R 
Published: July 2020

ObjectivesMethotrexate (MTX) is currently the recommended first-line therapy for treating psoriatic arthritis (PsA), despite lacking clear evidence. No estimates of efficacy of MTX in usual care and no clear MTX responsive clinical or laboratory variables are currently available. This study describes the response to MTX monotherapy in newly diagnosed patients with PsA in usual care. Second, we compared clinical variables and cytokine profiles in patients responding and not responding to MTX monotherapy.MethodsWe used data collected in the Dutch southwest Early Psoriatic Arthritis cohoRt study to select patients with PsA with oligoarthritis or polyarthritis, and at least 1 year follow-up. We analysed disease activity at 6 months of patients who started MTX monotherapy and still used MTX monotherapy 1 year after diagnosis. Cytokine profiles were determined at baseline and after 3 and 6 months with a bead-based multi-immunoassay.ResultsWe identified 219 patients of which 183 (84%) patients started MTX monotherapy within 6 months after diagnosis. 90 patients used MTX monotherapy throughout the first year of which 44 patients (24%) reached minimal disease activity(MDA) at 6 months, decreasing to 33 patients (18%) after 1 year. Non-responders had significantly higher concentrations of interleukin (IL) 23 and IL-10 before and during MTX therapy.ConclusionsOur results showed that only 18% of patients with PsA are in sustained MDA after 1 year of MTX monotherapy and non-responders more often had IL-23-driven disease. Our results indicate the need for more treat-to-target and personalised therapy strategies in PsA.
Impact of a comprehensive tobacco control policy package on acute myocardial infarction and stroke hospital admissions in Beijing, China: interrupted time series study
Authors: Zheng Yunting , Wu Yiqun , Wang Mengying , Wang Zijing , Wang Siyue , Wang Jiating , Wu Junhui , Wu Tao , Chang Chun , Hu Yonghua 
Published: July 2020

ObjectiveTo evaluate a comprehensive tobacco control policy package on hospital admissions for acute myocardial infarction (AMI) and stroke in a global city.DesignInterrupted time series study.SettingBeijing, China.Population31 707 AMI and 128 116 stroke hospital admissions recorded by the Beijing Medical Claim Data for Employees in 17.7 million residents from January 2013 to June 2017.InterventionThe policy package including all components of MPOWER has been implemented since June 2015.Main outcome measuresThe immediate change of AMI and stroke hospital admissions and the annual change in the secular trend.ResultsThere was a secular increase trend for the crude hospital admission rates of AMI and stroke during the observational period. After implementation of the policy, immediate reductions were observed in the hospital admissions for both AMI (−5.4%, 95% CI −10.0% to −0.5%) and stroke (−5.6%, 95% CI −7.8% to −3.3%). In addition, the secular increase trend for stroke was slowed down by −15.3% (95% CI −16.7% to −13.9%) annually. Compared with the hypothetical scenario where the policy had not taken place, an estimated 18 137 (26.7%) stroke hospital admissions had been averted during the 25 months of postpolicy period.ConclusionsThe results indicated significant health benefits on cardiovascular morbidity after the Beijing tobacco control policy package, which highlighted the importance for a comprehensive tobacco control policy at the national level in China. Similar tobacco control policy which consists of all components of MPOWER is urgently needed in other areas, especially in settings with high tobacco consumption, to achieve greater public health gains.
Mechanics of isolated horizons in scalar-tensor theories
Authors: Song Shupeng , Ma Yongge 
Published: July 2020

AbstractBased on the first-order action for scalar-tensor theories with the Immirzi parameter, the symplectic form for the spacetimes admitting a weakly isolated horizon as internal boundary is derived by the covariant phase space approach. The first law of thermodynamics for the weakly isolated horizons with rotational symmetry is obtained. It turns out that the Immirzi parameter appears in the expression of the angular momentum of isolated horizon, and the scalar field contributes to the horizon entropy.
Finite-dimensional Nichols algebras over dual Radford algebras
Authors: Márquez O. , Bagio D. , Giraldi J. M. J. , García G. A. 
Published: July 2020

For [Formula: see text], let [Formula: see text] be the dual of the Radford algebra of dimension [Formula: see text]. We present new finite-dimensional Nichols algebras arising from the study of simple Yetter–Drinfeld modules over [Formula: see text]. Along the way, we describe the simple objects in [Formula: see text] and their projective envelopes. Then we determine those simple modules that give rise to finite-dimensional Nichols algebras for the case [Formula: see text]. There are 18 possible cases. We present by generators and relations, the corresponding Nichols algebras on five of these eighteen cases. As an application, we characterize finite-dimensional Nichols algebras over indecomposable modules for [Formula: see text] and [Formula: see text], [Formula: see text], which recovers some results of the second and third author in the former case, and of Xiong in the latter.Cualquier destino, por largo y complicado que sea, consta en realidad de un solo momento: el momento en que el hombre sabe para siempre quién es.Jorge Luis Borges
Examples of liftings of modular and unidentified type: 𝔲𝔣𝔬(7,8) and 𝔟𝔯(2,a)
Authors: García Iglesias Agustín , Pacheco Rodríguez Edwin 
Published: July 2020

We compute all liftings of braidings of unidentified types [Formula: see text] and [Formula: see text]. Some of these examples had been previously computed by Helbig. We also present a list of examples of liftings of modular type [Formula: see text]. Watching a coast as it slips by the ship is like thinking about an enigma. There it is before you, smiling, frowning, inviting, grand, mean, insipid, or savage, and always mute with an air of whispering, “Come and find out”. CONRAD
Pannotia: in defence of its existence and geodynamic significance
Authors: Murphy J. Brendan , Nance R. Damian , Cawood Peter A. , Collins William J. , Dan Wei , Doucet Luc S. , Heron Philip J. , Li Zheng-Xiang , Mitchell Ross N. , Pisarevsky Sergei , Pufahl Peir K. , Quesada Cecilio , Spencer Christopher J. , Strachan Rob A. , Wu Lei 
Published: July 2020

Abstract

The status of Pannotia as an Ediacaran supercontinent, or even its mere existence as a coherent large landmass, is controversial. The effect of its hypothesized amalgamation is generally ignored in mantle convection models claiming the transition from Rodinia to Pangaea represents a single supercontinent cycle. We apply three geodynamic scenarios to Pannotia amalgamation that are tested using regional geology. Scenarios involving quasi-stationary mantle convection patterns are not supported by the geological record. A scenario involving feedback between the supercontinent cycle and global mantle convection patterns predicts upwellings beneath the Gondwanan portion of Pannotia and the arrival of plumes along the entire Gondwanan (but not Laurentian) margin beginning at
c.
0.6 Ga. Such a scenario is compatible with regional geology, but the candidates for plume magmatism we propose require testing by detailed geochemical and isotopic studies. If verified, this scenario could provide geodynamic explanations for the origins of the late Neoproterozoic and Early Paleozoic Iapetus and Rheic oceans and the terranes that were repeatedly detached from their margins.
Ganetespib in Combination with Pemetrexed–Platinum Chemotherapy in Patients with Pleural Mesothelioma (MESO-02): A Phase Ib Trial
Authors: Fennell Dean A. , Danson Sarah , Woll Penella J. , Forster Martin , Talbot Denis , Child Jennifer , Farrelly Laura , Sharkey Annabel , Busacca Sara , Ngai Yenting , Hackshaw Allan , Wheeler Graham M. 
Published: July 2020

Abstract

Purpose:
Ganetespib, a highly potent, small-molecule Heatshock protein 90 inhibitor, has potential efficacy in malignant pleural mesothelioma (MPM) via activity on critical survival pathways and known synergies with antifolates and platinum chemotherapy. We conducted a dose-escalation study to identify the maximum tolerated dose (MTD) of ganetespib in patients with chemotherapy-naïve MPM.

Patients and Methods:
MESO-02 (ClinicalTrials.gov: NCT01590160) was a nonrandomized, multicenter, phase Ib trial of 3-weekly ganetespib (100 mg/m2, 150 mg/m2, 200 mg/m2; days 1 and 15) with pemetrexed (500 mg/m2; day 1) and cisplatin (75 mg/m2; day 1) or carboplatin (area under concentration–time curve 5; day 1) in patients with MPM. Dose escalation was performed using the 3 + 3 design (cisplatin) and accelerated titration design (carboplatin). Secondary endpoints included best response, progression-free survival (PFS), and pharmacogenomic analyses.

Results:
Of 27 patients enrolled (cisplatin, n = 16; carboplatin, n = 11), 3 experienced dose-limiting toxicities: grade 3 nausea (cisplatin, n = 1; carboplatin, n = 1) and grade 2 infusion-related reaction (carboplatin, n = 1). Ganetespib's MTD was 200 mg/m2. Partial response was observed in 14 of 27 patients (52%; 61% in 23 response-evaluable patients) and 13 of 21 (62%) with epithelioid histology. At the MTD, 10 of 18 patients (56%) had partial response, 15 of 18 (83%) had disease control, and median PFS was 6.3 months (95% CI, 5.0–10.0). One responder exhibited disease control beyond 50 months. Global loss of heterozygosity was associated with shorter time to progression (HR 1.12; 95% CI, 1.02–1.24; P = 0.018).

Conclusions:
Ganetespib can be combined safely with pemetrexed and platinum chemotherapy to treat patients with MPM. This class of agent should be investigated in larger randomized studies.