bluuebunny/crossref_metadata_2025_split huggingface dataset:
How human factors affect escalation of care: a protocol for a qualitative evidence synthesis of studies
Authors: Ede Jody , Westgate Verity , Petrinic Tatjana , Darbyshire Julie , Watkinson Peter J 
Published: April 2019

IntroductionFailure to rescue is defined as mortality after complications during hospital care. Incidence ranges 10.9%–13.3% and several national reports such as National Confidential Enquiry into Patient Outcomes and Death and National Institute of Clinical Excellence CG 50 highlight failure to rescue as a significant problem for safe patient care.To avoid failure to rescue events, there must be successful escalation of care. Studies indicate that human factors such as situational awareness, team working, communication and a culture promoting safety contribute to avoidance of failure to rescue events. Understanding human factors is essential to developing work systems that mitigate barriers and facilitate prompt escalation of care. This qualitative evidence synthesis will identify and synthesise what is known about the human factors that affect escalation of care.Methods and analysisWe will search MEDLINE (Ovid), EMBASE (Ovid) and CINAHL, between database inception and 2018, for studies describing human factors affecting failure to rescue and/or care escalation. A search strategy was developed by two researchers and a medical librarian. Only studies exploring in-hospital (ward) populations using qualitative data collection methods will be included. Screening will be conducted by two researchers. We are likely to undertake a thematic synthesis, using the Thomas and Harden framework. Selected studies will be assessed for quality, rigour and limitations. Two researchers will extract and thematically synthesise codes using a piloted data extraction tool to develop analytical themes.Ethics and disseminationThe qualitative evidence synthesis will use available published literature and no ethical approval is required. This synthesis will be limited by the quality of studies, rigour and reproducibility of study findings. Results will be published in a peer-reviewed journal, publicised at conferences and on social media.PROSPERO registration numberCRD42018104745.
Application of electroacupuncture for postoperative pain management after total knee arthroplasty: a study protocol for a single-blinded, randomised placebo-controlled trial
Authors: Zhong Sheng , Huang Hai , Xie Jun , Zhao Ling , Song Xiu-ling , Chen Yue-lai , Xiao Lian-bo 
Published: April 2019

IntroductionThe purpose of this study is to assess the efficacy of electroacupuncture (EA) to relieve pain and promote functional rehabilitation after total knee surgery.Methods and analysisWe propose a single-blinded, randomised placebo-controlled trial to evaluate the efficacy of EA. Patients with osteoarthritis (aged 55–80 years) undergoing unilateral total knee arthroplasty (TKA) will be included in the trial. They will be randomised to receive either EA or sham-EA. A total of 110 patients will receive EA and sham-EA for 3 days after TKA. Postoperative pain will be measured using visual analogue score, and the need for an additional dose of opioid and analgesics will be recorded as the primary outcome. Secondary outcomes include knee function and swelling, postoperative anxiety, postoperative nausea and vomiting among other complications.Ethics and disseminationThis study has been approved by the ethics committee, and subsequent modifications of the protocol will be reported and approved by it. Written informed consent will be obtained from all of the participants or their authorised agents.Trial registration numberChiCTR1800016200; Pre-results.
Role of comprehensive geriatric assessment in healthcare of older people in UK care homes: realist review
Authors: Chadborn Neil H , Goodman Claire , Zubair Maria , Sousa Lídia , Gladman John R F , Dening Tom , Gordon Adam, L 
Published: April 2019

ObjectivesComprehensive geriatric assessment (CGA) may be a way to deliver optimal care for care home residents. We used realist review to develop a theory-driven account of how CGA works in care homes.DesignRealist review.SettingCare homes.MethodsThe review had three stages: first, interviews with expert stakeholders and scoping of the literature to develop programme theories for CGA; second, iterative searches with structured retrieval and extraction of the literature; third, synthesis to refine the programme theory of how CGA works in care homes.We used the following databases: Medline, CINAHL, Scopus, PsychInfo, PubMed, Google Scholar, Greylit, Cochrane Library and Joanna Briggs Institute.Results130 articles informed a programme theory which suggested CGA had three main components: structured comprehensive assessment, developing a care plan and working towards patient-centred goals. Each of these required engagement of a multidisciplinary team (MDT). Most evidence was available around assessment, with tension between structured assessment led by a single professional and less structured assessment involving multiple members of an MDT. Care planning needed to accommodate visiting clinicians and there was evidence that a core MDT often used care planning as a mechanism to seek external specialist support. Goal-setting processes were not always sufficiently patient-centred and did not always accommodate the views of care home staff. Studies reported improved outcomes from CGA affecting resident satisfaction, prescribing, healthcare resource use and objective measures of quality of care.ConclusionThe programme theory described here provides a framework for understanding how CGA could be effective in care homes. It will be of use to teams developing, implementing or auditing CGA in care homes. All three components are required to make CGA work—this may explain why attempts to implement CGA by interventions focused solely on assessment or care planning have failed in some long-term care settings.Trial registration numberCRD42017062601.
Multifactorial correlates of blood pressure in South Asian children in Canada: a cross-sectional study
Authors: Fowokan Adeleke , Punthakee Zubin , Waddell Charlotte , Rosin Miriam , Morrison Katherine M , Gupta Milan , Rangarajan Sumathy , Teo Koon , Lear Scott 
Published: April 2019

ObjectiveWe sought to explore various correlates of blood pressure (BP) and hypertension, and to identify the most important aggregate combination of correlates for BP in South Asian children.DesignCross-sectional studySettingCommunity-based recruitment in two Canadian citiesParticipantsSouth Asian children (n=762) provided a range of physiological, lifestyle and social variables. BP was assessed using an automated device. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and BP were transformed to z-scores using published standards.Outcome measuresLinear and logistic regression analyses were used to explore associations between the range of variables with BP z-scores and hypertension while stepwise regression was used to identify aggregate factors that provided explanatory capacity for systolic BP (SBP) and diastolic BP (DBP) z-scores.ResultsA range of variables were associated with BP z-score and hypertension in unadjusted analysis. On adjustment for confounders, the association between age (β=−0.054, 95% CI=−0.078 to 0.029), female sex (β=−0.208, 95% CI=−0.350 to –0.067), height (β=0.022, 95% CI=0.011 to 0.033), weight (β=0.047, 95% CI=0.040 to 0.055), BMI z-score (β=0.292, 95% CI=0.249 to 0.336), WC z-score (β=0.273, 95% CI=0.219 to 0.326), WHtR z-score (β=0.289, 95% CI=0.236 to 0.342), heart rate (β=0.016, 95% CI=0.010 to 0.022), child’s perception of body image (β=0.183, 95% CI=0.128 to 0.239) and grip strength (β=0.025, 95% CI=0.007 to 0.043) with SBP z-score remained. In stepwise regression, age, sex, BMI z-score, heart rate and weight accounted for 30% of the variance of SBP z-score, while age, BMI z-score, heart rate and daily fast food intake accounted for 23% of the DBP z-score variance.ConclusionOur findings suggest that variables, such as age, sex, height, adiposity and heart rate, provide stronger explanatory capacity to BP variance and hypertension risk than other variables in South Asian children.
Tailored digital behaviour change intervention with e-referral system to increase attendance at NHS stop smoking services (the MyWay project): study protocol for a randomised controlled feasibility trial
Authors: Fulton Emily , Newby Katie , Gokal Kajal , Kwah Kayleigh , Schumacher Lauren , Jackson Louise J , Naughton Felix , Coleman Tim , Brown Katherine 
Published: April 2019

IntroductionIn the UK, smokers who use stop smoking services (SSSs) are four times more likely to stop smoking than smokers who do not. Attendance has declined, warranting the development of interventions to address this. StopApp is a novel, brief online behaviour change intervention designed to address common barriers to SSS attendance. It links to widely commissioned service management software that enables instant appointment booking at a user’s location and time of choice.Methods and analysisA two-arm parallel group, individual participant feasibility randomised controlled trial of StopApp (intervention) compared with the standard promotion of and referral to SSSs (control). The study includes a nested qualitative process evaluation to assess the acceptability of the research processes, with a subsample of participants. Smokers aged over 16 years will be recruited via three routes: General Practice (GP), community settings and online. After consenting and the collection of baseline data, participants will be randomised to control or intervention groups. Participants in the intervention group receive a link to StopApp and those in the control group receive standard web-based information about the SSSs. All participants are told they can book a SSS appointment but are under no obligation to do so. Online follow-up 2 months post randomisation includes data on SSS use and carbon monoxide verified 4-week quit rates. The study aims to recruit 162 smokers.Ethics and disseminationEthics approval has been granted by the West Midlands—Edgbaston NHS Research Ethics Committee. The findings will be reported in conferences and peer-reviewed publications; and will be used to design the parameters necessary for a definitive trial to ascertain the effectiveness of StopApp at increasing booking and attendance at SSSs compared with existing methods for encouraging uptake.
Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study
Authors: Lloyd Therese , Conti Stefano , Santos Filipe , Steventon Adam 
Published: April 2019

BackgroundThirteen residential care homes and 10 nursing homes specialising in older people in Rushcliffe, England, participated in an improvement programme. The enhanced support provided included regular visits from named general practitioners and additional training for care home staff. We assessed and compared the effect on hospital use for residents in residential and nursing homes, respectively.MethodsUsing linked care home and administrative hospital data, we examined people aged 65 years or over who moved to a participating care home between 2014 and 2016 (n=568). We selected matched control residents who had similar characteristics to the residents receiving enhanced support and moved to similar care homes not participating in the enhanced support (n=568). Differences in hospital use were assessed for residents of each type of care home using multivariable regression.ResultsResidents of participating residential care homes showed lower rates of potentially avoidable emergency admissions (rate ratio 0.50, 95% CI 0.30 to 0.82), emergency admissions (rate ratio 0.60, 95% CI 0.42 to 0.86) and Accident & Emergency attendances (0.57, 95% CI 0.40 to 0.81) than matched controls. Hospital bed days, outpatient attendances and the proportion of deaths that occurred out of hospital were not statistically different. For nursing home residents, there were no significant differences for any outcome.ConclusionsThe enhanced support was associated with lower emergency hospital use for older people living in residential care homes but not for people living in nursing homes. This might be because there was more potential to reduce emergency care for people in residential care homes. In nursing homes, improvement programmes may need to be more tailored to residents’ needs or the context of providing care in that setting.
Early application of haemostatic powder added to standard management for oesophagogastric variceal bleeding: a randomised trial
Authors: Ibrahim Mostafa , El-Mikkawy Ahmed , Abdel Hamid Mohamed , Abdalla Haitham , Lemmers Arnaud , Mostafa Ibrahim , Devière Jacques 
Published: April 2019

BackgroundAcute variceal bleeding (AVB) requires early therapeutic management by experienced endoscopists that often poses logistical challenges for hospitals. We assessed a different management concept with early application of haemostatic powder—which does not require high endoscopic expertise—added to conventional management in a randomised trial.MethodsCirrhotic patients with AVB received standard medical therapy and were randomised to either immediate endoscopy with haemostatic powder application within 2 hours of admission, followed by early elective endoscopy on the next day, that is, within 12–24 hours of admission for definitive treatment (study group) or to early elective endoscopy only (control group). In both groups, failures to achieve clinical haemostasis until the time of early elective endoscopy underwent rescue endoscopy with attempted conventional haemostasis. Primary outcome was endoscopic haemostasis at the elective endoscopy.ResultsOf 86 randomised patients with AVB, 5/43 in the study group required rescue endoscopy for failure of controlling spurting bleeding (n=4) after powder application or for early bleeding recurrence in one patient who died before repeating rescue endoscopy. In the control group, 13/43 patients required rescue endoscopic haemostasis for failure of clinical haemostasis (12%vs30%, p=0.034). In the remaining patients, early elective endoscopic haemostasis was achieved in all 38 patients in the study group, while all remaining 30 patients in the control group had fresh gastric blood or (10%) spurting bleeding at early elective endoscopy with successful haemostasis in all of them. Six-week survival was significantly improved in the study group (7%vs30%, p=0.006).ConclusionThe new concept of immediate powder application improves early clinical and endoscopic haemostasis. This simplified endoscopic approach may have an impact on early and 6-week survival.Trial registration numberNCT03061604.
PASS-THROUGH RATE STUDY FOR HONG KONG BANKING INDUSTRY AND ITS APPLICATION TO NONMATURITY DEPOSITS INTEREST RATE RISK MANAGEMENT
Authors: WANG ZHIFENG , WEI FANGYING , FANG YUZHOU 
Published: April 2019

Basel Committee on Banking Supervision published Standards on Interest Rate Risk in Banking Book in April 2016. Apart from others, it proposed a standardized framework under which banks should identify core and noncore deposits within their stable nonmaturity deposits (NMD) and determine appropriate cash flow slotting for the NMD. This paper proposed a unique solution to slot Core NMD into repricing time buckets to address Basel requirements on NMD. The proposed solution was based on pass-through rate model under ECM (error correction model) framework. The solution itself showed interesting mathematical property to form a generalized Fibonacci sequence with converged partial sum. What is more, this paper proposed a model-neutral back testing scheme to make objective comparison of performance across different NMD repricing behavior models. The contents of this paper are expected to be useful for practitioners due to lack of quantitative modeling and model validation methodologies on this topic in the industry while, at the same time, to motivate academic discussion on the best practice and further enhancement of the modeling approach for the industry.
Neutralization of BCL-2/XL Enhances the Cytotoxicity of T-DM1 In Vivo
Authors: Zoeller Jason J. , Vagodny Aleksandr , Taneja Krishan , Tan Benjamin Y. , O'Brien Neil , Slamon Dennis J. , Sampath Deepak , Leverson Joel D. , Bronson Roderick T. , Dillon Deborah A. , Brugge Joan S. 
Published: April 2019

Abstract
One of the most recent advances in the treatment of HER2+ breast cancer is the development of the antibody–drug conjugate, T-DM1. T-DM1 has proven clinical benefits for patients with advanced and/or metastatic breast cancer who have progressed on prior HER2-targeted therapies. However, T-DM1 resistance ultimately occurs and represents a major obstacle in the effective treatment of this disease. Because anti-apoptotic BCL-2 family proteins can affect the threshold for induction of apoptosis and thus limit the effectiveness of the chemotherapeutic payload, we examined whether inhibition of BCL-2/XL would enhance the efficacy of T-DM1 in five HER2-expressing patient-derived breast cancer xenograft models. Inhibition of BCL-2/XL via navitoclax/ABT-263 significantly enhanced the cytotoxicity of T-DM1 in two of three models derived from advanced and treatment-exposed metastatic breast tumors. No additive effects of combined treatment were observed in the third metastatic tumor model, which was highly sensitive to T-DM1, as well as a primary treatment-exposed tumor, which was refractory to T-DM1. A fifth model, derived from a treatment naïve primary breast tumor, was sensitive to T-DM1 but markedly benefited from combination treatment. Notably, both PDXs that were highly responsive to the combination therapy expressed low HER2 protein levels and lacked ERBB2 amplification, suggesting that BCL-2/XL inhibition can enhance sensitivity of tumors with low HER2 expression. Toxicities associated with combined treatments were significantly ameliorated with intermittent ABT-263 dosing. Taken together, these studies provide evidence that T-DM1 cytotoxicity could be significantly enhanced via BCL-2/XL blockade and support clinical investigation of this combination beyond ERBB2-amplified and/or HER2-overexpressed tumors.
A Tumor-Peptide–Based Nanoparticle Vaccine Elicits Efficient Tumor Growth Control in Antitumor Immunotherapy
Authors: Heße Carolin , Kollenda Sebastian , Rotan Olga , Pastille Eva , Adamczyk Alexandra , Wenzek Christina , Hansen Wiebke , Epple Matthias , Buer Jan , Westendorf Astrid M. , Knuschke Torben 
Published: April 2019

AbstractRecognition of immunoactive oligonucleotides by the immune system, such as Toll-like receptor ligand CpG, leads to increased antibody and T-cell responses. Systemic application often results in unwanted generalized nonantigen-specific activation of the immune system. Nanoparticles are ideal carriers for small and large molecules. Recently, we have demonstrated that calcium phosphate (CaP) nanoparticles functionalized with CpG, and viral antigens are able to induce specific T-cell immunity that protects mice against viral infection and efficiently reactivates the exhausted CD8+ T-cell compartment during chronic retroviral infection. Therefore, CaP nanoparticles are promising vaccine vehicles for therapeutic applications. In this study, we investigated the therapeutic potential use of these nanoparticles in a murine xenograft colorectal cancer model. Therapeutic vaccination with CaP nanoparticles functionalized with CpG and tumor model antigens increased the frequencies of cytotoxic CD8+ T cells in the tumor in a type I interferon-dependent manner. This was accompanied with significantly repressed tumor growth in contrast to the systemic administration of soluble CpG and antigens. Combination therapy of CaP nanoparticles and immune checkpoint blocker against PD-L1 further enhanced the cytotoxic CD8+ T-cell response and eradicated the tumors. Strikingly, vaccination with CaP nanoparticles functionalized with CpG and a primary tumor cell lysate was also sufficient to control the tumor growth. In conclusion, our results represent a translational approach for the use of CaP nanoparticles as a potent cancer vaccine vehicle.
Interroga virtutes naturales: Nature in Giles of Rome’s On Ecclesiastical Power
Authors: Adamson Peter 
Published: April 2019

AbstractGiles of Rome’s On Ecclesiastical Power (De ecclesiastica potestate), a polemical work arguing for the political supremacy of the pope, claims that the papacy holds a ‘plenitude of power’ and has direct or indirect authority over all aspects of human life. This paper shows how Giles uses themes from natural philosophy in developing his argument. He compares cosmic and human ordering and draws an analogy between the relations of soul to body and of Church to state. He also understands the pope’s power to be ‘universal’ in nature, another idea taken from Aristotelian physics. Further, Giles views the pope’s right to intervene arbitrarily in the affairs of the Christian community as mirroring God’s ability to work miracles. We thus see that Giles, no less than intellectuals on the other side of this debate such as Dante and Marsilius of Padua, believed that Aristotelian natural philosophy could be enlisted in the service of political thought.
Faith and Rhetoric in Giles of Rome
Authors: Faucher Nicolas 
Published: April 2019

AbstractGiles of Rome’s view of faith in the reportatio of his questions on book III of the Sentences (q. 38, d. 23) is founded on a likening of faith to rhetoric. The firm intellectual assent that characterizes them both is caused by the will, motivated by emotion, or affective bias. This paper argues that this is made possible by Giles’ move away from Aquinas’ position on the assent produced by rhetorical discourse, which Aquinas thought to be of little certainty, while Giles affirms that, based on the will’s natural control over the intellect, it can be as certain as faithful assent, and that the psychological process that produces it can serve as a model for that which produces faithful assent. The new function Giles gives to rhetoric underlines the evolution of thirteenth-century views on faith, as shown through a comparison of Giles’ view with two other doctrines of faith that use examples similar to the one Giles employs: those of Philip the Chancellor and Peter John Olivi. For the former, faith founded on affective bias is a typical example of non-virtuous faith, while for the latter, just as for Giles, it is the very model of virtuous faith.
Mesoscale Convective Vortex that Causes Tornado-Like Vortices over the Sea: A Potential Risk to Maritime Traffic
Authors: Tochimoto Eigo , Yokota Sho , Niino Hiroshi , Yanase Wataru 
Published: April 2019

AbstractStrong gusty winds in a weak maritime extratropical cyclone (EC) over the Tsushima Strait in the southwestern Sea of Japan capsized several fishing boats on 1 September 2015. A C-band Doppler radar recorded a spiral-shaped reflectivity pattern associated with a convective system and a Doppler velocity pattern of a vortex with a diameter of 30 km [meso-β-scale vortex (MBV)] near the location of the wreck. A high-resolution numerical simulation with horizontal grid interval of 50 m successfully reproduced the spiral-shaped precipitation pattern associated with the MBV and tornado-like strong vortices that had a maximum wind speed exceeding 50 m s−1 and repeatedly developed in the MBV. The simulated MBV had a strong cyclonic circulation comparable to a mesocyclone in a supercell storm. Unlike mesocyclones associated with a supercell storm, however, its vorticity was largest near the surface and decreased monotonically with increasing height. The strong vorticity of the MBV near the surface originated from a horizontal shear line in the EC. The tornado-like vortices developed in a region of strong horizontal shear in the western part of the MBV, suggesting that they were caused by a shear instability.