bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacist-led adherence support in general practice: a qualitative interview study of adults with asthma
Authors: Mes Marissa Ayano , Katzer Caroline Brigitte , Wileman Vari , Chan Amy Hai Yan , Horne Robert , Taylor Stephanie Jane Caroline 
Published: November 2019

ObjectivesThe National Health Service (NHS) in England recently introduced general practice pharmacists (GPPs) to provide medication-focused support to both patients and the general practice team. This healthcare model may benefit people with asthma, who currently receive suboptimal care and demonstrate low medication adherence. This study aimed to explore the perspectives of adults with asthma on the potential for pharmacist-led adherence support delivered in general practice, with a focus on how these perspectives are formed.Design and settingThe study was conducted in the United Kingdom (UK) utilising a qualitative interview methodology. Participants were invited to partake in a telephone-based semistructured interview, followed by an online questionnaire for demographic details and asthma history. Qualitative data were analysed using thematic analysis.ParticipantsParticipants (n=17) were adults with asthma in the UK with a prescription for an inhaled corticosteroid. Participants did not have previous experience with GPPs and were asked to provide their views on a proposed GPP-led service.ResultsParticipant perspectives of GPPs were determined by trust in pharmacists, perceived gaps in asthma care and the perceived strain on the NHS. Trust was based on pharmacists’ perceived clinical competency, established over time, and gauged through a ‘benchmarking’ process. GPP’s fit in current asthma care was assessed based on potential role overlap with other healthcare professionals, continuity of care and medication-related support needs. Participants navigated the NHS based on a perceived hierarchy of healthcare professionals (general practitioners on top, nurses, then pharmacists), and this influenced their perspectives of GPPs.ConclusionWhile the GPP scheme shows promise based on the perspectives of people with asthma, the identified barriers to optimal patient engagement and service implementation will need to be addressed for the service to be effective.
Evaluation of a 1-hour troponin algorithm for diagnosing myocardial infarction in high-risk patients admitted to a chest pain unit: the prospective FAST-MI cohort study
Authors: Amann Michael , Gaiser Felix , Schwenk Sandra Iris , Rahimi Faridun , Schmitz Roland , Mashayekhi Kambis , Ferenc Miroslaw , Neumann Franz-Josef , Valina Christian Marc , Hochholzer Willibald 
Published: November 2019

ObjectiveThis study sought to evaluate the diagnostic performance of the 1-hour troponin algorithm for diagnosis of myocardial infarction (MI) without persistent ST-segment elevations (non-ST-segment MI (NSTEMI)) in a cohort with a high prevalence of MI. This algorithm recommend by current guidelines was previously developed in cohorts with a prevalence of MI of less than 20%.DesignProspective cohort study from November 2015 until December 2016.SettingDedicated chest pain unit of a single referral centre.ParticipantsConsecutive patients with suspected MI were screened. Patients with subacute symptoms lasting more than 24 hours, new ST-segment elevations at presentation, or an already diagnosed or ruled-out acute MI were excluded. All enrolled patients (n=1317) underwent a full clinical assessment and measurements of high-sensitivity troponin, and were scheduled for an early invasive strategy if clinically indicated.Main outcome measuresFinal diagnosis of MI according to the Fourth Universal Definition of MI.ResultsThe prevalence of NSTEMI in the present cohort was 36.9%. The sensitivity for rule-out of MI was 99.8%. The specificity for rule-in of MI was found to be 94.3%. However, in 35.7% of patients neither rule-in nor rule-out was possible. In 51.4% of patients diagnosed with MI, a primary non-coronary reason for MI was found (type 2 MI). Different receiver operating characteristic-curve derived cut-offs for troponin and its dynamics did not provide a sufficient differentiation between type 1 and 2 MI for clinical decision making (negative predictive value for rule-out of type 1 MI <70%).ConclusionsThe 1-hour diagnosis algorithm for patients with suspected NSTEMI can accurately diagnose acute MI in high-risk cohorts. However, discrimination between patients needing an early invasive strategy or not is limited.Trial registration numberDRKS00009713.
Best emollients for eczema (BEE) – comparing four types of emollients in children with eczema: protocol for randomised trial and nested qualitative study
Authors: Ridd Matthew J , Wells Sian , Edwards Louisa , Santer Miriam , MacNeill Stephanie , Sanderson Emily , Sutton Eileen , Shaw Alison R G , Banks Jonathan , Garfield Kirsty , Roberts Amanda , Barrett Tiffany J , Baxter Helen , Taylor Jodi , Lane J Athene , Hay Alastair D , Williams Hywel C , Thomas Kim Suzanne 
Published: November 2019

IntroductionAtopic dermatitis/eczema affects around 20% of children and is characterised by inflamed, dry, itchy skin. Guidelines recommend ‘leave-on’ emollients that are applied directly to the skin to add or trap moisture and used regularly, they can soothe, enhance the skin barrier and may prevent disease ‘flares’. However, the suitability of the many different emollients varies between people and there is little evidence to help prescribers and parents and carers decide which type to try first.Methods and analysisDesign: pragmatic, multicentre, individually randomised, parallel group superiority trial of four types of emollient (lotions, creams, gel or ointments).Setting: general practitioner surgeries in England.Participants: children aged over 6 months and less than 12 years with mild-to-severe eczema and no known sensitivity to study emollients.Interventions: study-approved lotion, cream, gel or ointment as the only leave-on emollient for 16 weeks, with directions to apply twice daily and as required. Other treatments, such as topical corticosteroids, used as standard care.Follow-up: 52 weeks.Primary outcome: validated patient-orientated eczema measure measured weekly for 16 weeks.Secondary outcomes: eczema signs (Eczema Area Severity Index) by masked researcher, treatment use, parent satisfaction, adverse events, child and family quality of life (Atopic Dermatitis Quality of Life, Child Health Utility 9D and Dermatitis Family Impact).Sample size: 520 participants (130 per group).Analysis: intention-to-treat using linear mixed models for repeated measures.Nested qualitative study: audio-recording of sample of baseline appointments and up to 60 interviews with participants at 4 and 16 weeks, interviews to be transcribed and analysed thematically.Ethics and disseminationEthics approval granted by the NHS REC (South West - Central Bristol Research Ethics Committee 17/SW/0089). Findings will be presented at conferences, published in open-access peer-reviewed journals and the study website; and summaries shared with key stakeholders.Trial registration numberISRCTN84540529
Seed coat anatomy ofCercis chinensisand its relationship to water uptake
Authors: Wang Huan , Chen Li , Dai Song , Ma Qiuyue , Wu Yang , Ma Qingjiang , Li Shuxian 
Published: November 2019

The hard seed coat of Cercis chinensis Bunge is an important factor of its dormancy. A study of the characteristics of water absorption is vital for understanding seed dormancy and germination. This investigation found that soaking in water at an initial temperature of 80 °C for 5 min was optimal for breaking the hardness of C. chinensis seeds. Scanning electron microscopy (SEM), dye-tracking, and blocking experiments were used to examine the major water entry sites and the relationship between water uptake and seed coat structure during C. chinensis seed imbibition. The SEM images showed that the seed coat consisted of three layers: epidermis, palisade, and sclereid. Special light line, vascular bundle, and counter-palisade layer structures were found in the side of the hilum. The blocking experiments showed that the hilar region was an important water absorption site because, if the region was not blocked, it showed the highest water absorption when imbibed for 3–12 h. However, all parts of the seed coat can absorb water if enough time is allowed after the seed coat hardness has been broken. The dye-tracking test showed that after 3 h water entered the seed only via the hilum fissure. Therefore, the hilum fissure acts as the initial site of water absorption. When more time was allowed, water moved more rapidly on the side with vascular bundles than on the opposite side.
$$D=4$$ supergravity from the Maxwell-Weyl superalgebra
Authors: Kibaroğlu Salih , Cebecioğlu Oktay 
Published: November 2019

Abstract
We present the construction of the first-order $$D=4$$D=4, $${\mathcal {N}}=1$$N=1 supergravity action by gauging the Maxwell-Weyl superalgebra. The four-form lagrangian is constructed by using the curvatures of the algebra and the local scale invariance of the action is achieved through the introduction of a compensating scalar field. Finally, we find the generalized Einstein equation with a coordinate dependent cosmological term.
Reasons for the Failure of Platelet Function Testing to Adjust Antiplatelet Therapy
Authors: Lattuca Benoit , Silvain Johanne , Yan Yan , Pouillot Christophe , Cuisset Thomas , Cayla Guillaume , Henry Patrick , Diallo Abdourahmane , Elhadad Simon , Rangé Grégoire , Lhermusier Thibault , Boueri Ziad , Motreff Pascal , Carrié Didier , Vicaut Eric , Montalescot Gilles , Collet Jean-Philippe 
Published: November 2019

Background:
In the ARCTIC trial (Assessment by a Double Randomization of a Conventional Antiplatelet Strategy Versus a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation and of Treatment Interruption Versus Continuation One Year After Stenting), treatment adjustment following platelet function testing failed to improve clinical outcomes. However, high-on-treatment platelet reactivity (HPR) is considered as a predictor of poor ischemic outcome. This prespecified substudy evaluated clinical outcomes according to the residual platelet reactivity status after antiplatelet therapy adjustment.

Methods:

We analyzed the 1213 patients assigned to the monitoring arm of the ARCTIC trial in whom platelet reactivity was evaluated by the VerifyNow P2Y
12
test before percutaneous coronary intervention and during the maintenance phase (at 14 days). HPR was defined as platelet reaction unit≥235U. The primary ischemic end point, a composite of death, myocardial infarction, stent thrombosis, stroke, or urgent revascularization and the safety end point of major bleeding were assessed according to the platelet reactivity status.

Results:

Before percutaneous coronary intervention, 35.7% of patients displayed HPR (n=419). During the acute phase, between percutaneous coronary intervention and the 14-day platelet function testing, ischemic (adjusted hazard ratio, 0.94 [95% CI, 0.74–1.18];
P
=0.58) and safety outcomes (hazard ratio, 1.28 [95% CI, 0.22–7.59];
P
=0.78) were similar in HPR and non-HPR patients. During the maintenance phase, the proportion of HPR patients (n=186, 17.4%) decreased by 56%. At 1-year, there was no difference for the ischemic end point (5.9% versus 6.0%; adjusted hazard ratio, 0.79 [95% CI, 0.40–1.58];
P
=0.51) and a nonsignificant higher rate of major bleedings (2.7% versus 1.0%, hazard ratio, 2.83 [95% CI, 0.96–8.41];
P
=0.06) in HPR versus non-HPR patients.

Conclusions:
The proportion of HPR was halved after platelet function testing and treatment adjustment but without significant ischemic benefit at 1 year. HPR seems more as a modifiable risk marker than a risk factor of ischemic outcome.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00827411.
Nighttime Cool Skin Effect Observed from Infrared SST Autonomous Radiometer (ISAR) and Depth Temperatures
Authors: Zhang Haifeng , Beggs Helen , Ignatov Alexander , Babanin Alexander V. 
Published: November 2019

AbstractThe nighttime ocean cool skin signal ΔT [defined as skin sea surface temperature (SSTskin) minus depth SST (SSTdepth)] is investigated using 103 days of matchups between shipborne Infrared SST Autonomous Radiometer (ISAR) SSTskin and water intake SSTdepth at ~7.1–9.9-m depths, in oceans around Australia. Before data analysis, strict quality control of ISAR SSTskin data is conducted and possible diurnal warming contamination is carefully minimized. The statistical distribution of ΔT, and its dependencies on wind speed, heat flux, etc., are consistent with previous findings. The overall average ΔT value is −0.23 K. It is observed that the magnitude of the cool skin signal increases after midnight and a coolest skin offset (with an average value of −0.36 K) is found at around dawn. The dependency of ΔT on SST conditions is observed. Direct warm skin events are discovered when the net heat flux direction is from the atmosphere to the ocean, which is more likely to occur at high latitudes when the air is very humid and warmer than the SST. In addition, several cool skin models are validated: one widely used physical model performs best and can capture most skin-effect trends and details; the empirical models only reflect the basic features of the observed ΔT values. If the user cannot apply the physical model (due to, e.g., the algorithm complexity or missing inputs), then the empirical parameterization in the form proposed in a 2002 study can be used. However, we recommend using a new set of parameters, calculated in this study, based on much more representative dataset, and with more rigorous quality control.
Places visited for activities outside the home after stroke: Relationship with the severity of disability
Authors: Olofsson Alexandra , Nyman Anneli , Kassberg Ann Charlotte , Malinowsky Camilla , Larsson Lund Maria 
Published: November 2019

Introduction Knowledge about the places people visit or do not visit after stroke is lacking. The aim of this study was to describe and compare the places visited for activities outside the home of people with stroke of working age and to explore the influence of the severity of disability, fatigue, driving a car and sociodemographic characteristics on the total number of places visited for activities outside the home. Methods An exploratory cross-sectional study was conducted and 63 people with stroke were interviewed with instruments that covered places outside the home, severity of disability and fatigue. Data were analysed using non-parametric tests, analysis of variance and the general linear model. Results Significant difference in the total number of places visited for activities outside the home were found between all three groups of severity of disability. The good recovery group visited eight places to a significantly higher extent than those with severe/moderate disability. The severity of disability and driving a car were the only aspects that significantly influenced the total number of places visited. Conclusions Places for activities outside the home people with stroke visit and changes therein can add valuable knowledge about participation that can be used in the design of rehabilitation.
Early Identification of Argatroban Resistance and the Consideration of Factor VIII
Authors: Poyant Janelle O. , Gleason Augustus M. 
Published: November 2019

Background: Argatroban, a synthetic, parenteral, nonheparin anticoagulant, is a direct thrombin inhibitor indicated for the prophylaxis or treatment of venous thromboembolism (VTE) in patients with heparin-induced thrombocytopenia with thrombosis (HITT) and for use during percutaneous coronary intervention (PCI) in patients who have or are at risk for developing HITT. Although heparin resistance occurs in approximately 0.5% to 5% of heparin-treated patients and is well documented in the literature, argatroban resistance is limited to a single case report. The objective of this case is to describe a case in which argatroban resistance was suspected in a patient with critical limb ischemia. Methods: This is a case report of a single patient. Results: A 68-year-old female admitted for critical limb ischemia requiring vascular intervention was treated for presumed HITT with argatroban. A therapeutic activated partial thromboplastin time (aPTT) was not attained (31 seconds) despite multiple uptitrations of the dose to 2.8 μg/kg/min (adjusted based on the institutional protocol and with consideration of organ dysfunction). A coagulopathy workup revealed a high level of factor VIII (265%). Conclusion: This case supports early assessment of factor VIII levels and the consideration of argatroban resistance and in patients who have a subtherapeutic aPTT, despite multiple increases in dose with an elevated factor VIII level. Early identification should prompt the use of an alternative anticoagulant to ensure efficacy.
Psychotropic-Induced Priapism in a Treatment-Refractory Patient: A Case Report
Authors: Burk Bradley G. , Nelson Leigh Anne 
Published: November 2019

Purpose: A case report of multiple episodes of priapism associated with the use of 4 different psychotropic medications. Summary: A 34-year-old African American male with treatment-refractory schizoaffective disorder suffered priapism on 6 separate occasions. His medical history is relatively unremarkable, with the exception of possible undiagnosed thalassemia. All incidences were potentially attributable to psychotropic medications, with chlorpromazine, risperidone, trazodone, and quetiapine being the most likely culprits. The onset of priapism ranged from hours after a single injection of chlorpromazine, to years after multiple injections of risperidone, with nothing to indicate a medication dose or duration relationship to priapism. While on clozapine, fluphenazine, haloperidol, lurasidone, and olanzapine at varying times, the patient did not appear to develop priapism. The commonality of high-affinity alpha-1 antagonism with these psychotropics may be to blame. No pharmacokinetic or pharmacodynamic interactions were noted, which would have produced elevations in the levels of these psychotropics, nor was the patient on any phosphodiesterase type 5 (PDE-5) inhibitors or antihypertensives known to cause priapism. Depending on the offending agent, the Naranjo et al’s Adverse-Reaction Probability Scale scores ranged from 5 to 8 (probable). Conclusion: A man suffered from multiple episodes of priapism attributed to psychotropic medications. This is not the first case to describe this effect, but will give clinicians a timeline of events and medications that did and did not appear to elicit priapism in a patient with treatment-refractory schizoaffective disorder. Knowledge of which psychotropic medications may be more likely to induce priapism is crucial to preventing long-term penile damage.
Survival of monoblock RM vitamys compared with modular PINNACLE cups: mid-term outcomes of 200 hips performed by a single surgeon
Authors: Kenanidis Eustathios , Kakoulidis Panagiotis , Leonidou Andreas , Anagnostis Panagiotis , Potoupnis Michael , Tsiridis Eleftherios 
Published: November 2019

Introduction: Monoblock cups have theoretical advantages over modular cups; however, their superiority in terms of survival has not been confirmed in comparative studies. Methods: We compared the mid-term survivorship of 107 RM Pressfit vitamys monoblock cups (Mathys Ltd., Bettlach, Switzerland) with 93 modular pressfit Pinnacle cups (DePuy Synthes, Warsaw, IN, USA). All cases were registered in the Arthroplasty Registry Thessaloniki and performed by a senior surgeon through the same approach between 2013 and 2014. The groups were comparable in sex distribution, preoperative diagnosis, follow-up, cup diameter, head diameter, type and use of screws, HOOS and HSS preop scores; the recipients of RM cup were significantly younger. Results: 3 sockets were revised. The 6-year survival for any reason was 99.1% for the RM and 97.8 % for the PINNACLE group. There was no difference in survival for aseptic loosening and any reason between groups (log-rank test p = 0.921 and p = 0.483, respectively). The age (95% CI, 0.79–1.1), sex (95% CI, 0.2–45.0), cup diameter (95% CI, 0.18–1.1), head diameter (95% CI, 0.004–6.2), preoperative diagnosis and use of screws (95% CI, 0.02–4.3), did not influence hazard ratio for revision between groups. HHS and HOOS were comparable at the last follow-up. Conclusions: Our study demonstrated that both cup designs had similar revision rates at mid-term follow-up, regardless the fact that the RM vitamys was used in a cohort of younger patients; which according to the literature would have led to earlier failures. Further long-term data are needed to evaluate the superiority of RM vitamys in the clinical setting, especially in the young.
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area
Authors: Jacob Seethal A , Carroll Aaron E , Bennett William E 
Published: November 2019

Introduction Sickle cell disease (SCD) is the most common inherited haematological disease, with potentially devastating complications. Improvements in therapies have increased the life span of patients with SCD, but this is contingent on receiving timely evidence-based medical care, including regular evaluations with haematologists, disease-specific education and psychosocial care. Our objective was to evaluate the feasibility of utilizing telemedicine for the provision of subspecialty paediatric SCD care in a rural medically underserved area. Methods This was a cross-sectional, observational, feasibility study. All patients 0–21 years old with SCD seen at Riley Hospital for Children Comprehensive Pediatric Sickle Cell Clinic who lived within 30 miles of the spoke telemedicine facility were eligible for recruitment. The Telehealth Satisfaction Scale (TeSS) was adapted for the SCD population and administered at each visit. Results Ten SCD patients, ranging in age from 10 months to 18 years old, initiated telemedicine visits during this timeframe. Some 60% were lost to follow-up or did not attend >50% of scheduled visits prior to beginning telemedicine visits. Following initiation of telemedicine, all Hb SS patients were started and/or maintained on hydroxyurea. Nine out of 10 patients who participated during this timeframe had a 100% follow-up rate. All who participated rated the comfort and ease of using the telehealth system as good or excellent and would do a telemedicine visit again. Discussion This study provides critical information to determine the feasibility and acceptability of a telemedicine intervention to aid in SCD care. To our knowledge, this is the first study to examine the effectiveness of telemedicine to deliver comprehensive paediatric SCD care. Future research with a larger sample size is needed to confirm findings of our study, including expansion of telemedicine sites to include more urban areas.