bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care and social support from family and community in patients with pulmonary tuberculosis in Pakistan
Authors: Saqib Shahab E , Ahmad Mokbul Morshed , Panezai Sanaullah 
Published: January 2020

ObjectivesThis study aimed to validate the Medical Outcome Study–Social Support Survey (MOS-SSS) instrument in Pakistan and to quantify the nature of care and social support currently extended to patients with pulmonary tuberculosis (TB) in Pakistan.DesignThis is a cross-sectional study design conducted within a period of 3 months from 1 November 2016 to 31 January 2017.ParticipantsA total of 269 patients, registered at 11 TB centres and private clinics, were interviewed through an interviewer-administered questionnaire.Main outcome measuresCronbach’s alpha was used to measure the internal consistency and reliability of the MOS-SSS survey instrument. Univariate and multivariable logistic regressions have been used to explore the association between care and social support, and socioeconomic factors.ResultThis study validated the use of the MOS-SSS among patients with TB in Pakistan. Findings of the study revealed significant differences among the socioeconomic groups of patients in each subscale of social support. Additionally, results of logistic regressions showed that patients who were older (adjusted OR=6.17, 95% CI 1.55 to 24.59, p≤0.01), male (adjusted OR=2.73, 95% CI 1.49 to 4.98, p≤0.01), widow (adjusted OR=0.17, 95% CI 0.04 to 0.80, p≤0.05), and had a larger household size (adjusted OR=5.69, 95% CI 1.32 to 24.65, p≤0.05), higher monthly income (adjusted OR=2.00, 95% CI 1.11 to 3.60, p≤0.05) and house ownership (adjusted OR=1.99, 95% CI 1.10 to 3.60, p≤0.05) were significant factors associated with the extent of care and social support that the participants received.ConclusionTo cure TB, this study suggests a coordinated approach that includes not only clinical services to address this issue but also a strong social support system based on family and community necessary throughout the treatment process.
Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
Authors: Saleem Zikria , Hassali Mohamed Azmi , Hashmi Furqan Khurshid , Godman Brian , Saleem Fahad 
Published: January 2020

BackgroundThere are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.ObjectiveTo explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.DesignIn this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.SettingInterviews were conducted among community pharmacists in Lahore, Pakistan.ParticipantsIn order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.ResultsA total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.ConclusionThe results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.
Improving patient satisfaction through improved telephone triage in a primary care practice
Authors: Vitale Rebecca , Smith Samantha , Doolittle Benjamin R 
Published: January 2020

ObjectiveThe objective of this study was to improve the telephone communication experience for patients in a primary care practice.DesignAn exploratory survey was conducted that revealed suboptimal patient satisfaction with clinic access due to the telephone triage system. Several interventions were designed: a monthly quality meeting was established among clinic staff, all phone interactions were recorded in the electronic medical record (EMR) and clinic appointments were made available several months in advance. A follow-up survey was conducted to evaluate these interventions.SettingThe study was conducted in a multispecialty, urban-based, resident-faculty practice from November 2016 to November 2017.ParticipantsSubjects were recruited in a convenience sample from the waiting room. 200 subjects participated in the initial survey and 215 in the second survey.ResultsAfter the interventions, patients felt that their questions were answered more frequently than before (p<0.01). They also felt that appointments were easier to make (p=0.03). A similar number of patients reported seeking emergency care because they were unable to reach a provider (33.8% vs 31.9%, p=0.68). The percentage of patients who received a call back within 24 hours increased, but it was not statistically significant (38.6% vs 44%, p=0.13).ConclusionImproving telephone triage through implementing a monthly quality improvement meeting, optimising use of the EMR and opening schedules several months in advance resulted in several improvements in the patient experience, but did not change use of emergency services. Further interventions, including increased resource allocation, are needed to optimise patient experience.
Comparison of general practice residents’ attitudes and perceptions about training in two programmes in China: a mixed methods survey
Authors: Lian Siqing , Xia Yu , Zhang Jinzhi , Han Xiaoning , Chi Chunhua , Fetters Michael D 
Published: January 2020

ObjectiveTo understand general practice (GP) residents’ attitudes about their residency training in China.DesignMixed methods survey administered cross-sectionally.SettingTwo GP training programmes similar in most regards according to current GP training policy of 5 years’ undergraduate degree in medicine and 3 years of postgraduate GP residency training—but differing as the Beijing programme has adopted educational innovations beyond the nationally prescribed standard curriculum used by the second Shenzhen programme.Participants105 (85%) of eligible GP trainees, 35 (90%) in the innovative Beijing programme and 70 (83%) in the standard training Shenzhen programme.ResultsOverall, residents felt discrimination because of specialty choice, and that they lacked competency as a general practitioner. Many residents commented faculty had negative teaching attitudes. Beijing residents were more satisfied than Shenzhen residents with their training (p=0.001), and felt teaching faculty had sufficient knowledge (p<0.001), and appropriate attitudes towards teaching (p=0.004). Beijing residents more strongly agreed on five items about good future job prospects (all p<0.05).ConclusionThese Chinese GP residents identify areas for improvement in their training as well as strengths. Higher satisfaction with faculty teaching and job optimism in Beijing where GP residents receive training from specifically qualified faculty, and can earn special certification, suggest that the educational innovations enhance training and promote positivity about job prospects. These findings imply that GP residents in China face many training challenges that are similar to other international reports, while also implicating benefits of using an innovative curricular approach.
Accuracy of a smartwatch based single-lead electrocardiogram device in detection of atrial fibrillation
Authors: Rajakariar Kevin , Koshy Anoop N , Sajeev Jithin K , Nair Sachin , Roberts Louise , Teh Andrew W 
Published: January 2020

ObjectiveThe AliveCor KardiaBand (KB) is an Food and Drug Administration-approved smartwatch-based cardiac rhythm monitor that records a lead-Intelligent ECG (iECG). Despite the appeal of wearable integrated ECG devices, there is a paucity of data evaluating their accuracy in diagnosing atrial fibrillation (AF). We evaluated whether a smartwatch-based device for AF detection is an accurate tool for diagnosing AF when compared with 12-lead ECG.MethodsA prospective, multi-centre, validation study was conducted in an inpatient hospital setting. The KB paired with a smartwatch, generated an automated diagnosis of AF or sinus rhythm (SR). This was compared with a 12-lead ECG performed immediately after iECG tracing. Where an unclassified or no-analysis tracing was generated, repeat iECG was performed.Results439 ECGs (iECGs (n=239) and 12-lead ECG (n=200)) were recorded in 200 patients (AF: n=38; SR: n=162) from three tertiary centres. Sensitivity and specificity using KB was 94.4% and 81.9% respectively, with a positive predictive value of 54.8% and negative predictive value of 98.4%. Agreement between 12-lead ECG and KB diagnosis was moderate when unclassified tracings were included (κ=0.60, 95% CI 0.47 to 0.72). Combining the automated device diagnosis with blinded electrophysiologists (EP) interpretation of unclassified tracings improved overall agreement (EP1: κ=0.76, 95% CI 0.65 to 0.87; EP2: κ=0.74, 95% CI 0.63 to 0.86).ConclusionThe KB demonstrated moderate diagnostic accuracy when compared with a 12-lead ECG. Combining the automated device diagnosis with EP interpretation of unclassified tracings yielded improved accuracy. However, even with future improvements in automated algorithms, physician involvement will likely remain an essential component when exploring the utility of these devices for arrhythmia screening.Clinical trial registrationURL:https://www.anzctr.org.au/Unique identifier: ACTRN12616001374459.
Histone deacetylase inhibitors valproic acid and vorinostat enhance trastuzumab-mediated antibody-dependent cell-mediated phagocytosis
Authors: Laengle Johannes , Kabiljo Julijan , Hunter Leah , Homola Jakob , Prodinger Sophie , Egger Gerda , Bergmann Michael 
Published: January 2020

BackgroundThe monoclonal antibody (mAb) trastuzumab is part of the standard of care for patients with human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer. Antibody-dependent cell-mediated phagocytosis (ADCP) and cytotoxicity (ADCC) are major mechanisms of action of the mAb trastuzumab. Histone deacetylase inhibitors (HDACi), such as valproic acid (VPA) or vorinostat (SAHA), exert several immunostimulatory properties, which contribute at least in part to their anticancer effect. However, the impact of HDACi-induced immunostimulatory effects on trastuzumab-mediated anti-tumor immune response is not well characterized.MethodsWe analyzed the ADCP and ADCC activity of peripheral blood mononuclear cells (PBMCs) from age and gender-matched healthy volunteers (n=5) against HDACi-treated HER2-overexpressing breast cancer cells (SKBR3), using a well-established in vitro three-color imaging flow cytometry and flow cytometry approach.ResultsVPA and SAHA enhanced trastuzumab-mediated ADCP and trastuzumab-independent cytotoxicity. Mechanistically, VPA upregulated the activating antibody-binding receptor Fc-gamma receptor (FcγR) IIA (CD32A) on monocytes (CD14+). Moreover, VPA and SAHA downregulated the anti-apoptotic protein myeloid leukemia cell differentiation 1 (MCL1) in breast cancer cells. Additionally, VPA and SAHA induced an immunogenic cell death, characterized by the exposure of calreticulin (CALR), as well as decreased the “do not eat me” signal CD47 on tumor cells.ConclusionsHDACi VPA and SAHA increase trastuzumab-mediated phagocytosis and trastuzumab-independent cytotoxicity. The immunomodulatory activities of those HDACi support a rationale combined treatment approach with mAb for cancer treatment.
SURFACE-COVERED 1×3 GRATING WITH DIELECTRIC-METAL SLABS UNDER SECOND BRAGG INCIDENCE
Authors: FU CHEN , WANG BO , ZHU WENHUA , WEN KUNHUA , MENG ZIMING , NIE ZHAOGANG , XING XIANGJUN , CHEN LI , LEI LIANG , ZHOU JINYUN 
Published: January 2020

This paper designed a novel three-port reflective surface-covered grating with a connecting layer. The grating can be used as a splitter, and the polarized light can be divided into zero order, first order and second order. Through rigorous coupled-wave analysis, the efficiency of the three orders of diffraction light is close to 33% under the condition that the incident light at 1550 nm is incident at the second Bragg angle and the given duty cycle is 0.5. The efficiency and bandwidth of the surface-covered grating are improved compared with that of the surface-relief grating reported in the past. Especially for transverse magnetic polarized light, the beam splitting effect is more uniform, the efficiency ratio of the zeroth order to first order can reach 1.01, and the efficiency ratio of the first order to second order can reach 1.
The role of pre-subduction sediment diagenesis in a shallow tsunami-generated slip, Sunda Trench, south of Sumatra
Authors: Kawamura Kiichiro , Kuranaga Mebae , Mochizuki Kenta , Kanamatsu Toshiya 
Published: January 2020

Abstract
The progressive development of microfabrics in sediments was investigated in an active subduction zone using cores recovered during the Integrated Ocean Drilling Program Expedition 362. A sequence of Paleocene–Holocene rock was recorded at Site U1480, which is located in the Sunda Trench, south of Sumatra. Hemipelagic clayey sediments from the drilled succession were recovered from a depth of 1327.23 m. Cardhouse fabrics were observed initially, consisting of clay flakes with edge-to-edge (E–E) or edge-to-face (E–F) contacts. These initial microfabrics developed into compacted bookhouse fabrics (which are random and consolidated), and consist of clay flakes with E–F or face-to-face (F–F) contacts as the domain. These microfabrics developed due to individual particle sliding. Bookhouse fabric developed into a shape-preferred orientation of clay minerals with F–F contacts as a shaly fabric due to domain sliding. Finally, clay flakes with F–F contacts deformed into an undulated shape due to further increased overburden pressure. These pervasive fabrics comprising clay flakes stacked with F–F contacts resisted shear deformation due to their strong cohesion. This strong cohesion in the undulated shaly fabric might be an important factor in the locking of shallow tsunami-generating slip in subduction zones.
Education versus Punishment? Silo Effects and the School-to-prison Pipeline
Authors: Brown Samantha J. , Mears Daniel P. , Collier Nicole L. , Montes Andrea N. , Pesta George B. , Siennick Sonja E. 
Published: January 2020

Objectives: This article examines the influence of social context on punishment decisions. To this end, we present a theoretical framework to identify outcomes that can occur when police and probation officers work in schools. Method: The proposed framework draws on organizational theory as well as scholarship on school discipline and punishment and the effects of placing officers in schools. It also draws from insights gathered from site visits, interviews, and focus groups conducted as part of a process evaluation of a school-based delinquency prevention program. We then present data from interviews and focus groups with 41 school-based safety staff to examine the plausibility of the hypothesized framework. Results: We find that officers’ goals interact with the goals of school-based actors to influence punishment-related outcomes. We also find that officers are not always the more punitive force in the schools and that placing officers in schools may have positive as well as negative effects for youth. Conclusions: The findings suggest that current accounts of officers in schools are incomplete. Dynamic interactions may occur within organizational partnerships and should be considered when seeking to understand punishment decisions not only in schools but also in other settings.
Electroconvulsive therapy, depression severity and mortality: Data from the Danish National Patient Registry
Authors: Jørgensen Martin Balslev , Rozing Maarten Pieter , Kellner Charles H , Osler Merete 
Published: January 2020

Background: The effects of electroconvulsive therapy are usually estimated from changes in depression scales from studies with relatively small patient samples. Larger patient samples can be achieved from epidemiological registers, which provide information on other social and clinical predictors, results and risks. Aims: To examine whether depression severity predicts the use of electroconvulsive therapy, risk of re-hospitalization, suicidal behaviour and mortality following electroconvulsive therapy in patients with major depression. Methods: A cohort of 92,895 patients diagnosed with single or recurrent depression between 2005 and 2016 in the Danish National Patient Registry was followed for electroconvulsive therapy and adverse outcomes. Associations between electroconvulsive therapy and outcomes were analysed using Cox regression. Results: A total of 5004 (5.4%) patients were treated with electroconvulsive therapy. Depression severity was the strongest predictor of electroconvulsive therapy. Electroconvulsive therapy was used more frequently above age 70, in those better educated or married, whereas comorbid alcohol abuse or history of prior stroke at study entry were associated with lower rates. Electroconvulsive therapy was associated with lower mortality. The adjusted hazard ratio for the association between electroconvulsive therapy and suicide in patients with mild depression was 6.99 (3.30–14.43), whereas it was 1.10 (0.55–2.20) in those with severe depression and psychotic symptoms. A similar pattern was seen for emergency contacts and attempted suicide. Conclusions: Electroconvulsive therapy was associated with lower all-cause mortality and the relative risk for re-hospitalization and attempted and committed suicide was lowest in patients with the most severe depression. Electroconvulsive therapy is an important treatment, with significant public health benefits, for patients with severe depression.
Systematic analysis of the number needed to treat
Authors: Vancak V , Goldberg Y , Levine SZ 
Published: January 2020

The number needed to treat is often used to measure the efficacy of a binary outcome in randomized clinical trials. There are three different available measures of the number needed to treat. Two of these measures, Furukawa and Leucht’s and Kraemer and Kupfer’s, focus on converting Cohen’s δ index into the number needed to treat, while Laupacis et al.’s measure deals primarily with the number needed to treat’s estimation rather than with a reformulation. Mathematical and numerical analysis of numbers needed to treat and their estimators was conducted. Three novel number needed to treat estimators were introduced to supplement the numbers needed to treat introduced by Laupacis, Furukawa and Leucht, and Kraemer and Kupfer. The analysis showed that Laupacis et al.’s number needed to treat is intrinsically different from Kraemer and Kupfer’s number needed to treat, and that Furukawa and Leucht’s estimator is appropriate to use only for normally distributed outcomes with equal standard deviations. Based on the numerical analysis, the novel numbers needed to treat outperformed the existing ones under correct model specifications. Asymptotic analysis was used to test three different types of confidence intervals to supplement the numbers needed to treat. An R-package to calculate these numbers needed to treat and their confidence intervals has been developed and made available for users online.
Cilostazol Mediates Immune Responses and Affects Angiogenesis During the Acute Phase of Hind Limb Ischemia in a Mouse Model
Authors: Paronis Efthymios , Katsimpoulas Michalis , Kadoglou Nikolaos P. E. , Provost Claire , Stasinopoulou Marianna , Spyropoulos Christos , Poulaki Elpida , Prignon Aurelie , Kakisis Ioannis , Kostomitsopoulos Nikolaos G. , Bouziotis Penelope , Kostopoulos Ioannis V. , Tsitsilonis Ourania , Lazaris Andreas 
Published: January 2020

Background: Cilostazol is a drug of choice for the treatment of intermittent claudication that also affects innate and adaptive immune cells. The purpose of our study was the evaluation of cilostazol’s impact on the immune and angiogenic response in murine models of hind limb ischemia. Methods: We used 108 immunodeficient NOD.CB17-Prkdcscid/J mice and 108 wild-type CB17 mice. At day 0 (D0), all animals underwent hind limb ischemia. Half of them in both groups received daily cilostazol starting at D0 and for the next 7 postoperative days, while the rest of them served as controls, receiving vehicle. Interleukin (IL) 2, IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor α (TNF-α), and interferon γ (IFN-γ) serum concentrations were measured by flow cytometry on postsurgery days D1, D3, D5, and D7. On D7, both groups underwent positron emission tomography scan with 68Ga-RGD. Mice were euthanatized and gastrocnemius muscles were obtained for histological evaluation. Results: There was a statistically significant augmentation ( P < .05) in IL-4, IL-10, IL-6, and IFN-γ concentrations in treated CB17 animals, while IL-2 was significantly suppressed. Significant difference was detected between the CiBisch and Bisch groups on D1 and D7 ( P < .05) in CD31 staining. In treated NOD.CB17 animals, TNF-α, IL-6, and IFN-γ presented significant augmentation, while 68Ga-NODAGA-RGDfK uptake and CD31 expression were found significantly lower for both legs in comparison to the control. Conclusion: Cilostazol seems to significantly increase angiogenesis in wild-type animals during the first postoperational week. It also influences immune cells, altering the type of immune response by promoting anti-inflammatory cytokine production in wild-type animals, while it helps toward inflammation regression in immunodeficient animals.