bluuebunny/crossref_metadata_2025_split huggingface dataset:
The potential of leg-foot chest compression as an alternative to conventional hands-on compression during cardiopulmonary resuscitation
Authors: Takahashi Yoshiaki , Saitoh Takeji , Okada Misaki , Satoh Hiroshi , Akai Toshiya , Mochizuki Toshiaki , Hozumi Hironao , Saotome Masao , Urushida Tsuyoshi , Katoh Hideki , Hayashi Hideharu , Yoshino Atsuto 
Published: July 2018

Background: Conventional hands-on chest compression, in cardiopulmonary resuscitation, is often inadequate, especially when the rescuers are weak or have a small physique. Objectives: This study aimed to investigate the potential of leg-foot chest compression, with and without a footstool, during cardiopulmonary resuscitation. Methods and Results: We prospectively enrolled 21 medical workers competent in basic life support. They performed cardiopulmonary resuscitation on a manikin for 2 min using conventional hands-on compression (HO), leg-foot compression (LF), and leg-foot compression with a footstool (LF + FS). We analyzed the compression depths, changes in the rescuers’ vital signs, and the modified Borg scale scores after the trials. The compression depth did not differ between the cases using HO and LF. In the case of LF + FS, compression depths ⩾5 cm were more frequently observed (median, inter-quartile range: 93%, 81%–100%) than in HO (9%, 0%–57%, p < 0.01) and LF (28%, 11%–47%, p < 0.01). The increase in the heart rate or modified Borg scale scores, after the trials, did not differ between the HO and LF group; however, the values were the lowest in the case of LF + FS (49 ± 18 beats/min and 5 (4–7) in HO, 46 ± 18 and 6 (5–7) in LF, and 32 ± 11 and 2 (1–3) in LF + FS, respectively, p < 0.01). However, the increase in blood pressure, SpO2, and respiratory rate were not different among each group. The increases in the heart rate and modified Borg scale scores negatively were correlated with the rescuers’ body size, in the case of HO and LF, but not LF + FS. Conclusion: LF can be used as an alternative to HO, when adequate HO is difficult. LF + FS could be used when rescuers are weak or have a small physique and when the victims are bigger than the rescuers.
Exploring Physician Attitudes Regarding Electronic Documentation of E-cigarette Use: A Qualitative Study
Authors: Hurst Samantha , Conway Mike 
Published: July 2018

Background: In this article, we present qualitative work designed to explore physicians’ attitudes toward and knowledge of electronic cigarettes (or Electronic Nicotine Delivery Systems—ENDS), particularly focusing on personal attitudes held by physicians regarding ENDS use, physician beliefs regarding the relative safety of ENDS, attitudes regarding the efficacy of ENDS as a smoking cessation tool, and how physicians’ document ENDS use in the electronic health record (EHR). Methods: We completed a total of 17 semistructured qualitative interviews with physicians in 4 different outpatient clinic locations. Clinics were selected with the goal of reaching patient panels across a diversity of socioeconomic and local geographic locations. Results: The findings from our qualitative analysis suggest that physicians feel uninformed about the long-term health risks of ENDS and believe that they lack the critical medical knowledge required for discussing ENDS with their patients who smoke. Although physician responses did not endorse the view that ENDS use is a safer alternative to combustible tobacco use, approximately one-third of our physician sample did not hold strong objections to ENDS usage. Physicians placed varying degrees of importance on the issue of ENDS documentation practices. Discussion: Three overarching themes were revealed from our analysis. These themes included (1) physicians’ attitudes regarding the use of ENDS for smoking cessation, (2) physicians’ guidance and advisement to patients in the use of ENDS for smoking cessation, and (3) current practices of clinical documentation of ENDS use in an EHR. Our qualitative results indicate that physicians in our study rarely screen patients for ENDS use, even for those patients who are both documented smokers and recipients of physician-led tobacco cessation counseling. However, most physicians agreed that the prospect of creating a structured data field specifically for the documentation of ENDS use within the EHR would result in the likelihood of increased screening and documentation of ENDS use patterns.
Antibiotic resistance in Swiss nursing homes: analysis of National Surveillance Data over an 11-year period between 2007 and 2017
Authors: Kohler Philipp , Fulchini Rosamaria , Albrich Werner C. , Egli Adrian , Balmelli Carlo , Harbarth Stephan , Héquet Delphine , Kahlert Christian R. , Kuster Stefan P. , Petignat Christiane , Schlegel Matthias , Kronenberg Andreas 
Published: July 2018

Abstract
Background
We evaluated data from isolates of nursing home (NH) patients sent to the Swiss centre for antibiotic resistance (ANRESIS). We focussed on carbapenem-resistance (CR) among Gram-negative pathogens, extended-spectrum cephalosporin-resistant (ESC-R) Escherichia coli/Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), and glycopeptide-resistant enterococci (GRE).

Methods
NH patient isolates from 01/2007 to 10/2017 were extracted. Temporal trends in resistance were described and risk factors associated with ESC-R and MRSA were assessed. For every administrative subdivision in Switzerland (i.e. canton), we calculated a coverage rate, defined as number of beds of governmentally-supported nursing homes, which sent ≥1 isolate in each 2014, 2015, and 2016, divided by the total number of supported beds.

Results
We identified 16′804 samples from 9′940 patients. A majority of samples (12′040; 71.6%) originated from the French/Italian speaking part of Switzerland. ESC-R E. coli increased from 5% (16/299) in 2007 to 22% (191/884) in 2017 (P < 0.01), whereas MRSA decreased from 34% (35/102) to 26% (21/81) (P < 0.01). Provenience from the German (vs. French/Italian) speaking part of Switzerland was associated with decreased risk for ESC-R (OR 0.5, 95% CI 0.4–0.7) and for MRSA (OR 0.1, 95% CI 0.1–0.2). CR among Pseudomonas aeruginosa was 10% (105/1096) and showed an increasing trend over time; CR among Enterobacteriaceae (37/12′423, 0.3%) and GRE (5/1′273, 0.4%) were uncommon. Overall coverage rate was 9% (range 0–58% per canton). There was a significant difference between the French/Italian (median 13%, interquartile range [IQR] 4–43%) and the German speaking cantons (median 0%, IQR 0–5%) (P = 0.02).

Conclusions
ESC-R among E. coli is emerging in Swiss NHs, whereas MRSA show a declining trend over time. A minority of NHs are represented in ANRESIS, with a preponderance of institutions from the French/Italian speaking regions. Efforts should be undertaken to improve resistance surveillance in this high-risk setting.
Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada
Authors: Eskander Antoine , Campisi Paolo , Witterick Ian J. , Pothier David D. 
Published: July 2018

Background An analysis of the scope of practice of recent Otolaryngology – Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates. Methods Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded. Results There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as ‘otology’ (42%), ‘general otolaryngology’ (35%), ‘rhinology’ (17%) and ‘head and neck’ (4%). The most common procedure codes were categorized as ‘general otolaryngology’ (45%), ‘otology’ (23%), ‘head and neck’ (13%) and ‘rhinology’ (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon. Conclusion This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. The findings demonstrated a prominent representation of ‘otology’, ‘general’ and ‘rhinology’ based consultation diagnoses and procedures. The data derived from the study needs to be considered as residency curricula are modified to satisfy competency-based requirements.
Boundary violations in therapy: the patient's experience of harm
Authors: Hook John , Devereux Dawn 
Published: July 2018

SUMMARYHarm in talking therapies, and in healthcare professionals’ relationships with patients generally, has received little attention in comparison with harm by medication and other treatments. There has been little research into causes, types and effects. Professionals behave as if it does not happen and tend to react defensively to complaints. We believe that it is essential for professionals to understand the potential for harm and evaluate their actions in order to make them safer. This article defines harm in the therapeutic context, discusses its prevalence and then focuses on adverse idealising transference: the adverse effects that may arise when a patient transfers idealising feelings onto the professional.LEARNING OBJECTIVES•Develop a greater understanding of the problem of harm in psychotherapy•Be aware of adverse idealising transference and its possible harmful implications•Be aware of therapist actions that may encourage the development of an adverse idealising transferenceDECLARATION OF INTERESTNone.
Randomised clinical trial of community-based peer-led and psychologist-led group treatment for hoarding disorder
Authors: Mathews Carol A. , Mackin Robert Scott , Chou Chia-Ying , Uhm Soo Y. , Bain Larry David , Stark Sandra J. , Gause Michael , Vigil Ofilio R. , Franklin John , Salazar Mark , Plumadore Julian , Smith Lauren C. , Komaiko Kiya , Howell Gillian , Vega Eduardo , Chan Joanne , Eckfield Monika B. , Tsoh Janice Y. , Delucchi Kevin 
Published: July 2018

BackgroundTreatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.AimsWe aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).MethodWe randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.ResultsG-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points,t= −1.71, d.f. = 245,P= 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t= 2.79, d.f. = 175,P= 0.006;t= 2.89, d.f. = 175,P= 0.004).ConclusionsPeer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.Declaration of interestC.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
A realist approach to the evaluation of complex mental health interventions
Authors: Duncan Craig , Weich Scott , Fenton Sarah-Jane , Twigg Liz , Moon Graham , Madan Jason , Singh Swaran P. , Crepaz-Keay David , Parsons Helen , Bhui Kamaldeep 
Published: July 2018

SummaryConventional approaches to evidence that prioritise randomised controlled trials appear increasingly inadequate for the evaluation of complex mental health interventions. By focusing on causal mechanisms and understanding the complex interactions between interventions, patients and contexts, realist approaches offer a productive alternative. Although the approaches might be combined, substantial barriers remain.Declaration of interestAll authors had financial support from the National Institute for Health Research Health Services and Delivery Research Programme while completing this work. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the National Health Service, the National Institute for Health Research, the Medical Research Council, Central Commissioning Facility, National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, the Health Services and Delivery Research Programme or the Department of Health. S.P.S. is part funded by Collaboration for Leadership in Applied Health Research and Care West Midlands. K.B. is editor of the British Journal of Psychiatry.
Statistical Framework in Support of a Revised Children's Oncology Group Neuroblastoma Risk Classification System
Authors: Naranjo Arlene , Irwin Meredith S. , Hogarty Michael D. , Cohn Susan L. , Park Julie R. , London Wendy B. 
Published: July 2018

PurposeThe International Neuroblastoma Risk Group (INRG) Staging System (INRGSS) was developed through international consensus to provide a presurgical staging system that uses clinical and imaging data at diagnosis. A revised Children's Oncology Group (COG) neuroblastoma (NB) risk classification system is needed to incorporate the INRGSS and within the context of modern therapy. Herein, we provide statistical support for the clinical validity of a revised COG risk classification system.Patients and MethodsNine factors were tested for potential statistical and clinical significance in 4,569 patients diagnosed with NB who were enrolled in the COG biology/banking study ANBL00B1 (2006-2016). Recursive partitioning was performed to create a survival-tree regression (STR) analysis of event-free survival (EFS), generating a split by selecting the strongest prognostic factor among those that were statistically significant. The least absolute shrinkage and selection operator (LASSO) was applied to obtain the most parsimonious model for EFS. COG patients were risk classified using STR, LASSO, and per the 2009 INRG classification (generated using an STR analysis of INRG data). Results were descriptively compared among the three classification approaches.ResultsThe 3-year EFS and overall survival (± SE) were 72.9% ± 0.9% and 84.5% ± 0.7%, respectively (N = 4,569). In each approach, the most statistically and clinically significant factors were diagnostic category (eg, NB, ganglioneuroblastoma), INRGSS, MYCN status, International Neuroblastoma Pathology Classification, ploidy, and 1p/11q status. The results of the STR analysis were more concordant with those of the INRG classification system than with LASSO, although both methods showed moderate agreement with the INRG system.ConclusionThese analyses provide a framework to develop a new COG risk classification incorporating the INRGSS. There is statistical evidence to support the clinical validity of each of the three classifications: STR, LASSO, and INRG.
Pilot Dose Comparison of Apatinib in Chinese Patients With Progressive Radioiodine-Refractory Differentiated Thyroid Cancer
Authors: Zhang Xin , Wang Chen , Lin Yansong 
Published: July 2018

Abstract

Context
Apatinib has shown overwhelming efficacy in progressive radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) starting at a 750-mg dosing protocol; however, a relatively high incidence of treatment-associated adverse events (TAAEs) was observed, which reduced quality of life and interrupted the treatment.

Objectives
To evaluate the efficacy and safety of apatinib with two different dosing schedules [750 or 500 mg once a day (q.d.)] in RAIR-DTC.

Participants and Methods
Twenty patients were sequentially recruited to receive apatinib beginning at 750 (n = 10) or 500 (n = 10) mg q.d. Efficacy and safety were compared in each 28-day cycle at the beginning two cycles and every two cycles thereafter.

Results
After six treatment cycles, the best disease control rates were 100% for the 750- and 500-mg schedules, respectively, and the best objective response rates were 90.0% and 70.0% (P = 0.58), respectively. The two dosing schedules did not differ regarding greatest reduction in target lesion size (−42.7% vs −40.5% for the 750- vs 500-mg schedule, P = 0.48) and thyroglobulin level (−82.5% vs −94.3% for the 750- vs 500-mg schedule, P = 0.14). All patients experienced TAAEs, and the two dosing schedules showed similar incidence in TAAEs of grade ≥3 (100% vs 70% for 750 vs 500 mg, P = 0.21). However, the frequency of TAAEs was much higher in the 750-mg schedule (26.8 ± 6.5 vs 18.1 ± 6.5 in any grades, P = 0.01; 5.2 ± 3.0 vs 1.6 ± 1.3 in grade ≥3, P &lt; 0.01).

Conclusion
Within six cycles of follow-up, the 500-mg starting dose protocol might be less toxic than the 750-mg protocol, whereas the efficacy was similar between the two dosages.
Understanding eukaryotic chromosome segregation from a comparative biology perspective
Authors: Oliferenko Snezhana 
Published: July 2018

ABSTRACT
A long-appreciated variation in fundamental cell biological processes between different species is becoming increasingly tractable due to recent breakthroughs in whole-genome analyses and genome editing techniques. However, the bulk of our mechanistic understanding in cell biology continues to come from just a few well-established models. In this Review, I use the highly diverse strategies of chromosome segregation in eukaryotes as an instrument for a more general discussion on phenotypic variation, possible rules underlying its emergence and its utility in understanding conserved functional relationships underlying this process. Such a comparative approach, supported by modern molecular biology tools, might provide a wider, holistic view of biology that is difficult to achieve when concentrating on a single experimental system.
TECTONIC EVOLUTION OF THE BETIC CORDILLERA: AN OVERVIEW
Authors: Alonso-Chaves F. , Soto J. I. , Orozco M. , Kilias A. A. , Tranos M. D. 
Published: July 2018

The Betic (Southern Spain) and the Rif (Morocco) mountain chains, connected through the Gibraltar Strait, shapes a W-E elongated and arcuate Alpine orogenic belt. The Alborân Sea, in continuity to the east with the South Balearic Basin, is located in the inner part of this alpine belt. The Iberian and African continental forelands bound the region as a whole to the north and south, respectively, and to the east it is connected to the oceanic Sardine-Balearic Basin. The peculiarities of these westernmost Mediterranean chains result from: (1) its position between two large convergent plates -Africa and Europe- that have had variable directions of relative motion since the late Cretaceous; and (2) the Neogene westward migration of the orogenic hinterland and its simultaneous "back-arc"-like extension, generating the Alborén Sea basin. The complexes and large paleogeographic terrains traditionally recognized in the Betic and Rif chains belong to four pre-Neogene crustal domains: the South-Iberian and Maghrebian passive continental paleomargins (External Zones of the orogen), the Flysch Units, and the Alborân Crustal Domain composed mainly of a pre- Miocene metamorphosed thrust-stack (Nevado-Filabride, Alpujârride, and Malaguide complexes, from bottom to top). The boundaries between the main metamorphic complexes of the Alborân Domain are extensional detachments, which finally developed under brittle conditions and are commonly sealed by middle-to-late Miocene marine-to-continental sediments. They, nonetheless, are not the most recent structures in the Alborân Domain, because upright, E-W open folds warp the extensional detachments, and finally, high-angle normal faults and strike-slip faults, many of which are still active, offset folds and extensional detachments. The tectonic evolution of the Betic Alborân orogenic system shows close similarities with the one depicted in other arcuate-shaped, Alpine mountain ranges in the Mediterranean, such as the Hellenic Arc and the Aegean Sea. Like in the westernmost Mediterranean, a thickened (pre Miocene) crust is bounding there a thinned, continental (?) basin. Extension is also formed here in a "back-arc" setting, being developed simultaneously with the N-S convergence between the African and European plates.
Ο κοινωνικός ανθρωπολόγος και η υπό μελέτη κοινωνία. Διερευνώντας τη δυναμική των σχέσεων διαντίδρασης
Authors: Πέτρου Μιχάλης 
Published: July 2018

Το παρόν άρθρο, βασισμένο σε εμπειρικό ερευνητικό υλικό που συλλέχθηκε από μακροχρόνια επιτόπια έρευνα σε μια αγροτική κοινότητα, εστιάζει σε ορισμένες από τις βασικές πτυχές των σχέσεων που αναπτύσσονται ‒σε όλα τα στάδια της επιτόπιας έρευνας‒ ανάμεσα στον κοινωνικό ανθρωπολόγο και την υπό παρατήρηση κοινωνία, ανάμεσα τον «παρατηρητή» και τον «παρατηρούμενο», στον «οικείο» και τον «ξένο». Διερευνώντας τη δυναμική των διαπροσωπικών επαφών ανάμεσα στους πρωταγωνιστές της εθνογραφικής έρευνας, επιχειρείται ν’ αναδειχθεί η αξία και η μοναδικότητα που έχει ‒για την κατανόηση ενός διαφορετικού τρόπου ζωής‒ η συμμετοχή «από τα μέσα» του ερευνητή στη συλλογική ζωή της υπό μελέτης κοινωνίας.
An Economic Analysis of Peer Disclosure in Online Social Communities
Authors: Cao Zike , Hui Kai-Lung , Xu Hong 
Published: July 2018

We study a novel privacy concern, i.e., peer disclosure of sensitive personal information in online social communities. We model peer disclosure as the imposition of a negative externality on other people. Our model encompasses the benefits of posting information, positive externalities in the form of recognition and entertainment benefits due to others’ sharing of information, and heterogeneous privacy preferences. We find that regulation of peer disclosure is necessary. We consider two candidate regulations, i.e., nudging and quotas. Nudging reduces user participation and privacy harm and sometimes improves social welfare. By contrast, imposing a quota often improves user participation, privacy protection, and social welfare. Adding a nudge on top of a quota does not bring additional benefits. We show that any regulation that uniformly controls the disclosure of sensitive and nonsensitive information will not serve the triple objectives of reducing privacy harm, increasing social welfare, and increasing information contribution. We derive a necessary condition for solutions that can fulfill these three objectives. We also compare the incentives of the platform owner and social planner and draw related managerial and policy implications.The online appendix is available at https://doi.org/10.1287/isre.2017.0744 .