bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the priorities of residents, family members and care staff in residential aged care using Q methodology: a study protocol
Authors: Ludlow Kristiana , Churruca Kate , Ellis Louise A , Mumford Virginia , Braithwaite Jeffrey 
Published: March 2019

IntroductionResidential aged care facilities (RACFs) are under increasing pressure to provide high-quality, round the clock care to consumers. However, they are often understaffed and without adequate skill mix and resources. As a result, staff must prioritise care by level of importance, potentially leading to care that is missed, delayed or omitted. To date, the literature on prioritisation and missed care has been dominated by studies involving nursing staff, thereby failing to take into account the complex networks of diverse stakeholders that RACFs comprise. This study aims to investigate the priorities of residents, family members and care staff in order to make comparisons between how care is prioritised in RACFs by the different stakeholder groups.Methods and analysisThis study comprises a Q sorting activity using Q methodology, a think-aloud task, a demographics questionnaire and semi-structured interview questions. The study will be conducted in five RACFs across NSW and QLD, Australia. Using purposive sampling, the project will recruit up to 33 participants from each of the three participant groups. Data from the Q sorting activity will be analysed using the analytic software PQMethod to identify common factors (shared viewpoints). Data from the think-aloud task and semi-structured interviews questions will be thematically analysed using the Framework Method and NVivo qualitative data analysis software.Ethics and disseminationThe study has been approved by St Vincent’s Health and Aged Care Human Research and Ethics Committee and Macquarie University Human Research Ethics Committee. It is expected that findings from the study will be disseminated: in peer-reviewed journals; as an executive report to participating facilities and a summary sheet to participants; as a thesis to fulfill the requirements of a Doctor of Philosophy; and presented at conferences and seminars.
Effects of L-Menthol and Carbon Dioxide on the Adenoma Detection Rate during Colonoscopy: L-Menthol and Carbon Dioxide on Colonoscopy
Authors: Inoue Ken , Okuda Takashi , Oka Kohei , Sugino Satoshi , Endo Yuki , Ota Takayuki , Minagawa Yuki , Yasue Chihiro , Tsuji Toshifumi , Katayama Takayuki , Nakamura Hideki , Nagata Akihiro , Komaki Toshiyuki , Naito Yuji , Itoh Yoshito , Kagawa Keizo 
Published: March 2019

Background and Aims: We examined the efficacy of the combined use of L-menthol spraying (L-mentholS) as an antispasmodic agent and carbon dioxide insufflation (CO2I) on the adenoma detection rate (ADR) in a prospective, single-center trial with a 2 × 2 factorial design. Methods: We randomly assigned 611 patients scheduled to undergo colonoscopy to 4 groups: (1) the L-mentholS + CO2I (n = 153), (2) L-mentholS + air insufflation (AI; n = 156), (3) CO2I (n = 153), and (4) AI (n = 149) groups. We used 20 mL of 0.8%-L-menthol solution for the L-mentholS. The primary outcome was the difference in the ADR, and the secondary outcomes were the differences in colonic peristalsis and abdominal pain. ­Results: The ADRs were not different among the groups: 1/2/3/4; 39.9%/43.6%/41.2%/51.0%. CO2I was associated with a significant decrease in the ADR (OR 0.57; 95% CI 0.35– 0.93) with a multiple logistic regression. The interaction between L-mentholS and CO2I was associated with a suppression of the decrease in the ADR. Both L-mentholS and CO2I were associated with a significant decrease in abdominal pain, and L-mentholS was associated with a significant improvement of peristalsis. Conclusions: The fact that CO2I was associated with significant decreases in the ADR was a problem. The combined use of L-mentholS and CO2I could help to suppress the decrease in the ADR.
Three-Dimensional Printed Biopatches With Conductive Ink Facilitate Cardiac Conduction When Applied to Disrupted Myocardium
Authors: Pedrotty Dawn M. , Kuzmenko Volodymyr , Karabulut Erdem , Sugrue Alan M. , Livia Christopher , Vaidya Vaibhav R. , McLeod Christopher J. , Asirvatham Samuel J. , Gatenholm Paul , Kapa Suraj 
Published: March 2019

Background:
Reentrant ventricular arrhythmias are a major cause of sudden death in patients with structural heart disease. Current treatments focus on electrically homogenizing regions of scar contributing to ventricular arrhythmia with ablation or altering conductive properties using antiarrhythmic drugs. The high conductivity of carbon nanotubes may allow restoration of conduction in regions where impaired electrical conduction results in functional abnormalities. We propose a new concept for arrhythmia treatment using a stretchable, flexible biopatch with conductive properties to attempt to restore conduction across regions in which activation is disrupted.

Methods:
Carbon nanotube patches composed of nanofibrillated cellulose/single-walled carbon nanotube ink 3-dimensionally printed in conductive patterns onto bacterial nanocellulose were developed and evaluated for conductivity, flexibility, and mechanical properties. The patches were applied on 6 canines to epicardium before and after surgical disruption. Electroanatomic mapping was performed on normal epicardium, then repeated over surgically disrupted epicardium, and then finally with the patch applied passively.

Results:
We developed a 3-dimensional printable carbon nanotube ink complexed on bacterial nanocellulose that was (1) expressable through 3-dimensional printer nozzles, (2) electrically conductive, (3) flexible, and (4) stretchable. Six canines underwent thoracotomy, and, during epicardial ventricular pacing, mapping was performed. We demonstrated disruption of conduction after surgical incision in all 6 canines based on activation mapping. The patch resulted in restored conduction based on mapping and assessment of conduction direction and velocities in all canines.

Conclusions:
We have demonstrated 3-dimensional custom-printed electrically conductive carbon nanotube patches can be surgically manipulated to improve cardiac conduction when passively applied to surgically disrupted epicardial myocardium in canines.
Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (>90 cc): early intervention essential
Authors: Tapping Charles R , Boardman Phil 
Published: March 2019

Background Prostate artery embolization (PAE) is safe and effective at improving lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). Purpose To assess the effectiveness of PAE on allowing successful voiding in patients with obstructive BPH (>90 cc) necessitating a urethral catheter for complete urinary retention. Material and Methods Ten consecutive patients with urethral catheters for obstructing BPH were included in the prospective study. Prostate arteries were embolized (Embosphere 300–500 um) and they had an attempted trial without catheter (TWOC) at two weeks and then at two-week intervals thereafter, if unsuccessful. They were clinically reviewed; an MRI was performed three and 12 months after PAE. Quality of life (QOL) questionnaires, International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF) were also performed. Results All cases were technically successful (100%). Eight patients had their catheters removed by their three-month follow-up (80%). The two cases that failed their TWOC by three months remained with a urethral catheter at 12-month follow-up. Seven of ten patients had their PAE procedure < 3 months following insertion of the urethral catheter and 100% of these had a successful TWOC before their three-month follow-up. Of the three patients that had their urethral catheter inserted > 3 months before their PAE (range 6–24 months), only 1/3 (33%) became catheter-free by 12 months after PAE. There was a dramatic reduction in LUTS and improvements in QOL indices, IPSS, and IIEF. There was no associated sexual dysfunction. Conclusion PAE is very successful in allowing spontaneous voiding in men with obstructing BPH requiring a urethral catheter. However, the PAE should be performed as soon as possible after the urethral catheter is inserted. Direct referral from acute urology services or emergency departments once the catheter is inserted are warranted.
Self-citations in musculoskeletal radiology: frequency and pattern analysis
Authors: Dessouky Riham , Zhang Lihua , Wadhwa Vibhor , Xi Yin , Chhabra Avneesh 
Published: March 2019

Background Author self-citation can affect quantitative aspects of scientific research. However, little is known about its prevalence in radiology literature. Purpose The aim of this study was to determine the frequency and factors associated with author self-citation in musculoskeletal radiology. Material and Methods Retrospective review of bibliographic data in musculoskeletal radiology articles of two separate journals over a 23-month period (January 2015 to November 2016) was performed to determine frequency of author self-citations. Other data included article type, topic, title length, author order, affiliation, and geographic location. Results One-third of all included articles had author self-citations with a mean and median of 2.8 and 2 citations per article. Case reports contained up to 52.4% self-citations (mean = 11.2%, 95% CI = 5.9–16.5). Larger frequencies of self-citations were found among first and second authors and university-affiliated authors. The United States was the most frequent country to produce publications but did not have the highest percentage of self-citations. Conclusion Self-citations in musculoskeletal radiology is no different than other medical fields. It does not currently seem to pose a threat on the integrity of scientific research and is usually needed to expand on previous knowledge. Nevertheless, authors and journals should be aware of implications of abusing such practice on future medical research.
Who Are High Users of Hospitals in Canada? Findings From a Population-Based Study
Authors: Wilson Donna M. , Shen Ye , Birch Stephen 
Published: March 2019

Background Dying people and older people have often been thought of as high users of hospitals, but current population-based evidence is needed to confirm or refute this claim. Purpose Quantitative population-based study designed to identify and describe hospital patients who are high users. Methods Data for all 2014–2015 Canadian hospital patients (excluding Quebec) were analyzed to identify and describe high users through descriptive-comparative and regression analysis tests. Results Only a small proportion of patients are high users in relation to multiple admissions or 30+ inpatient days of care, and with considerable diversity among them and relatively few of these advanced in age or dying in hospital. Conclusions Relatively few patients are high users of hospitals. These people are most often under age 65, so they have the potential to be ill and high users for many years. Flagging would enable individualized care planning to reduce illness exacerbations or slow disease progression and address other risk factors for long or repeat hospitalizations.
Vitamin K for reversal of excessive vitamin K antagonist anticoagulation: a systematic review and meta-analysis
Authors: Khatib Rasha , Ludwikowska Maja , Witt Daniel M. , Ansell Jack , Clark Nathan P. , Holbrook Anne , Wiercioch Wojtek , Schünemann Holger , Nieuwlaat Robby 
Published: March 2019

AbstractPatients receiving vitamin K antagonists (VKAs) with an international normalized ratio (INR) between 4.5 and 10 are at increased risk of bleeding. We systematically reviewed the literature to evaluate the effectiveness and safety of administering vitamin K in patients receiving VKA therapy with INR between 4.5 and 10 and without bleeding. Medline, Embase, and Cochrane databases were searched for relevant randomized controlled trials in April 2018. Search strategy included terms vitamin K administration and VKA-related terms. Reference lists of relevant studies were reviewed, and experts in the field were contacted for relevant papers. Two investigators independently screened and collected data. Risk ratios (RRs) were calculated, and certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Six studies (1074 participants) were included in the review and meta-analyses. Pooled estimates indicate a nonsignificant increased risk of mortality (RR = 1.42; 95% confidence interval [CI], 0.62-2.47), bleeding (RR = 2.24; 95% CI, 0.81-7.27), and thromboembolism (RR = 1.29; 95% CI, 0.35-4.78) for vitamin K administration, with moderate certainty of the evidence resulting from serious imprecision as CIs included potential for benefit and harm. Patients receiving vitamin K had a nonsignificant increase in the likelihood of reaching goal INR (1.95; 95% CI, 0.88-4.33), with very low certainty of the evidence resulting from serious risk of bias, inconsistency, and imprecision. Our findings indicate that patients on VKA therapy who have an INR between 4.5 and 10.0 without bleeding are not likely to benefit from vitamin K administration in addition to temporary VKA cessation.
Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis
Authors: Yu Hua , Meng Ya-jing , Li Xiao-jing , Zhang Chengcheng , Liang Sugai , Li Ming-li , Li Zhe , Guo Wanjun , Wang Qiang , Deng Wei , Ma Xiaohong , Coid Jeremy , Li Tao 
Published: March 2019

BackgroundWhether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency.AimsTo detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder.MethodWeb-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P&lt; 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed.ResultsPatients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder.ConclusionsOur results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum.Declaration of interestNone.
The clinical impact of bone scan (BS) flare with enzalutamide (ENZA) in men with metastatic castration-resistant prostate cancer (mCRPC).
Authors: Armstrong Andrew J. , Al-Adhami Mohammed , Lin Ping , Parli Teresa , Sugg Jennifer , Steinberg Joyce Leta , TOMBAL Bertrand F. , Sternberg Cora N. , De Bono Johann S. , Scher Howard I. , Beer Tomasz M. 
Published: March 2019

183 Background: Current PCWG3 guidelines for men with mCRPC define BS progression during therapy as requiring confirmation of new bone lesions that develop over time with additional new lesions. New unconfirmed BS lesions may reflect slow progression or a favorable osteoblastic reaction called a “BS flare” that can be misinterpreted as radiographic progression and lead to premature therapy discontinuation. The prevalence and clinical impact of BS flare is unknown for ENZA. Methods: We analyzed the association of BS flare with clinical outcomes and quality of life (QoL) in a retrospective analysis of two phase 3 trials of men with mCRPC treated with ENZA after (AFFIRM n = 1199) and before (PREVAIL n = 1717) docetaxel. Early and late BS flare was defined as new lesions on the first posttreatment BS (weeks 9-13) or subsequent BS, respectively, that were not confirmed to meet progression criteria on the next BS, while also requiring responding/stable PSA and soft-tissue disease. Results: Unconfirmed BS lesions were observed in 22% and 25% of stable/responding men receiving ENZA in AFFIRM and PREVAIL, respectively. Most BS flares were early, but late flares (week 17 or later) were seen in 2% and 13% of men, respectively. Unconfirmed BS lesions (early or late) had no impact on OS (HR 0.87; 95% CI 0.62-1.21) or rPFS (HR 0.91; 95% CI 0.58-1.44) in PREVAIL, but were associated with worse OS (HR 2.26; 95% CI 1.55-3.30) and rPFS (HR 1.73; 95% CI 1.33-2.26) in AFFIRM. Soft-tissue responses and PSA declines were more prominent in chemo-naïve men with unconfirmed BS lesions, which also had no impact on QoL or pain deterioration in either setting. Conclusions: BS flare occurred in ≈25% of responding men with mCRPC receiving ENZA and was not associated with adverse outcomes in chemo-naïve men. Our findings support the importance of avoiding premature treatment discontinuation in the presence of unconfirmed new BS lesions in the first 4 months of therapy. Worse outcomes associated with unconfirmed lesions in men post docetaxel illustrate the need for improved functional bone imaging in mCRPC and broader patient assessment to decide on treatment continuation. Clinical trial information: NCT00974311; NCT01212991.
A phase III, randomized, double-blind, placebo-controlled study of enzalutamide in men with nonmetastatic castration-resistant prostate cancer: Post-hoc analysis of PROSPER by prior therapy.
Authors: De Giorgi Ugo , Efstathiou Eleni , Berry William R. , Payne Heather Ann , Madziarska Katarzyna , Modelska Katharina , Guan Xiaowei , Sugg Jennifer , Steinberg Joyce Leta , Sternberg Cora N. 
Published: March 2019

185 Background: Men with nonmetastatic castration-resistant prostate cancer (nmCRPC) are at high risk of developing metastatic CRPC. In the primary analysis of PROSPER, enzalutamide (ENZA) provided a statistically significant and clinically meaningful improvement in metastasis-free survival (MFS) in men with nmCRPC. Here we report the impact of prior therapy on MFS. Methods: Eligible men with nmCRPC, prostate-specific antigen (PSA) doubling time ≤ 10 months, and PSA ≥ 2 ng/mL at screening continued androgen deprivation therapy and were randomized 2:1 to ENZA 160 mg or placebo (PBO). The primary endpoint was MFS. Results: 1401 men were enrolled, with a median age of 74 y (range, 50-95 y). In all men, ENZA reduced the risk of metastasis or death by 71% (hazard ratio [HR], 0.29; 95% confidence interval [CI], 0.24-0.35; P < .0001). The treatment effect consistently favored ENZA regardless of whether men had prior bilateral orchiectomy, prior radiation, ≤1 or > 1 prior hormonal therapy, or prior bone-targeting therapy (Table). Men who received > 1 prior hormonal therapy had a shorter median MFS than those who received ≤1 line of hormonal therapy (5 months and 3 months in the ENZA and PBO groups, respectively). Conclusions: In men with nmCRPC and rapidly rising PSA, ENZA treatment resulted in a clinically meaningful reduction in the risk of developing metastases or death irrespective of prior surgery, radiation, or bone-targeting therapy. MFS was longer in men who had received ≤1 prior hormonal therapy. Clinical trial information: NCT02003924. [Table: see text]
Defining Essential Elements of Caregiver Support in Gynecologic Cancers Using the Modified Delphi Method
Authors: Hand Lauren C. , Thomas Teresa H. , Belcher Sarah , Campbell Grace , Lee Young Ji , Roberge Mary , Donovan Heidi S. 
Published: March 2019

PURPOSE: Family caregivers are instrumental to patients with gynecologic cancer and can be deeply affected by the demands of caregiving. Our aims were as follows: (1) increase awareness of unmet needs of caregivers and (2) identify and prioritize the unmet needs of caregivers and essential support services to be provided in gynecologic cancer centers. METHODS: From July 2017 to June 2018, a 16-person steering committee and 40 stakeholders, including caregivers, patients, and clinicians, participated in a modified Delphi approach to generate, review, and prioritize a set of essential elements for caregiver support. Stakeholders prioritized caregiver needs and brainstormed, discussed, and prioritized essential support services to meet those needs, using three rounds of a consensus-building protocol. Basic descriptive statistics were performed to feed means and rankings back to stakeholders before each round. RESULTS: The top three caregiver needs were as follows: (1) to obtain information about their loved one’s cancer, (2) how to provide support and comfort to their loved one, and (3) how to maintain their own emotional health and well-being. Fifteen essential elements of support for caregivers of patients with gynecologic cancer were identified and ranged from elements currently attainable (eg, information on managing symptoms, skilled-care training, a point person to help navigate the system) to more aspirational elements (eg, integrative services to promote caregiver well-being). CONCLUSION: To ensure comprehensive quality care, clinicians and health care providers should strive to provide caregivers with the identified essential elements of support. Health care settings should work to incorporate caregiver needs into cancer care delivery.