bluuebunny/crossref_metadata_2025_split huggingface dataset:
An intervention model with self‐assessment and subsequent multi‐professional review might be effective and feasible to improve drug safety in primary healthcare. A survey‐based evaluation of SÄKLÄK2
Authors: Skoog Jessica , Lenander Cecilia , Modig Sara 
Published: June 2019

AbstractRationale, aims, and objectivesDrug‐related morbidity is common, which results in suffering for the patients and a high cost to society. SÄKLÄK2 is a multi‐professional intervention model aiming at improving drug safety in primary health care. The objective of this study was to elucidate the perceptions of the participants' regarding the efficiency of the intervention and the feasibility to introduce this model widely.MethodSÄKLÄK2 is a multi‐professional intervention model in primary health care in Sweden that consisted of self‐assessment, peer‐review, written feedback, and agreements for change. Web‐based surveys were sent to both the management of participating primary health care centres (PHC) and to reviewers. The participating PHCs were fairly well‐staffed and had a high interest in improvement work. Descriptive analysis and content analysis was used.ResultsFor the PHC management, the following categories were formed: Comprehensive project, Time‐consuming, Multi‐professional character, Relevant action agreements, and Feasible to implement. For the reviewers, the following categories were formed: Multi‐professional character, Relevant action agreements, Feasible to implement, Useful self‐assessment questionnaire, and Valuable visit at the PHC. There was a high degree of consistency between the PHC management and the reviewers' answers, especially regarding the efficiency of the model to improve drug safety and the feasibility to implement it on a broad front.ConclusionSÄKLÄK2, a model with self‐assessment, peer review, written feedback, and the formation of action agreements was considered by both the participating heads of the PHC centres and the reviewers to be effective to improve drug safety in primary health care. Though time‐consuming, this multi‐professional model was considered to be feasible to implement on a broad front and might thereby be one way of working with quality improvement regarding drug safety.
Lifestyle interventions for cancer prevention in primary care: Differences between family physicians and nursing professionals
Authors: Esteban‐Vasallo María D. , García‐Riolobos Carmen , Domínguez‐Berjón M. Felicitas , Zoni Ana Clara 
Published: June 2019

AbstractRationale, aims, and objectivesPrevention offers the most cost‐effective long‐term strategy for cancer control. The objective of this study was to ascertain opinions, attitudes, and professional practices towards cancer prevention among primary care professionals and to assess differences between family physicians (FP) and nursing professionals (NP).MethodA cross‐sectional study was performed in 2012 in the Community of Madrid. A random sample of 3586 professionals received an online questionnaire about opinions/attitudes, training, and interventions in cancer prevention. The chi‐square test was used to analyse the association of the profession with all the variables. Factors associated with the usual practice of individual, group, and community interventions were analysed using multivariate logistic regression, with separate models for FP and NP.ResultsThe response rate was 39.4% (N = 1413). Approximately 90% of the participants attributed “sufficient/high” utility to individualized counselling. NP attributed higher utility to group and community interventions than FP (70.1% vs 60.1% and 64.9% vs 57.7%, respectively, P‐value < 0.01). The usual practice of group and community interventions was more frequent among NP. The practice of group and community interventions was associated with knowledge of resources for prevention, specific training in group interventions, and the utility attributed to these methods. Among FP, the ability to dispense effective health advice and the utility attributed to this advice were associated with the usual practice of the three interventions.ConclusionsGroup and community interventions are rarely practised, especially among FP. Actions targeting improved ability and knowledge could lead to higher involvement in the promotion of health. It would also be necessary to intervene in the examination of the utility of such interventions.
The Cingulate Island Sign on FDG‐PET vs. IMP‐SPECT to Assess Mild Cognitive Impairment in Alzheimer's Disease vs. Dementia with Lewy Bodies
Authors: Chiba Yuhei , Fujishiro Hiroshige , Iseki Eizo , Kasanuki Koji , Sato Kiyoshi 
Published: June 2019

ABSTRACTBACKGROUND AND PURPOSEThe cingulate island sign (CIS) on 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET); ie, the relative preservation of mid‐posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG‐PET or 123I‐iodoamphetamine single‐photon emission computed tomography (IMP‐SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI‐AD) and MCI due to DLB (MCI‐DLB).METHODSWe examined the CIS ratio in 9 AD patients, 9 DLB patients, 8 patients with MCI‐AD, and 9 patients with MCI‐DLB using FDG‐PET and IMP‐SPECT. The CIS ratio was calculated using NEUROSTAT software.RESULTSIn the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG‐PET and IMP‐SPECT. In the MCI groups, only the FDG‐PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB.CONCLUSIONSThe FDG‐PET and IMP‐SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG‐PET derived CIS ratio is more valuable than the IMP‐SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
Genetic relationships and diversity patterns within the invasive range of the Mediterranean Painted Frog
Authors: Pujol‐Buxó E. , Garcia‐Cisneros A. , Miaud C. , Llorente G. A. 
Published: June 2019

AbstractRange expansions are an intrinsic part of the biogeography of most species. Among them, some invasive species represent a paradigmatic case in which local introductions are followed by rapid expansions in several directions. Theoretically, this creates a recursive founder effect, leading to sustained losses of genetic diversity and – through stochastic changes in allele frequency – to a population structure that mirrors invasion history. Here, we use restriction site‐associated DNA (RAD) markers to detect these patterns in the invasive range of the Mediterranean Painted Frog (Discoglossus pictus) in Europe. We identify and genotype a large panel of loci using genotyping‐by‐sequencing in several sites along its two main directions of invasion – northwards and southwards. Although the frog has a few translocated isolated populations, most of the invasive range is contiguous, allegedly corresponding to a self‐sustained expansion from a single introduction point in Banyuls de la Marenda (Southern France) more than a century ago. As expected, the highest genetic diversity was found in this location, with progressive losses of genetic diversity north‐ and southwards. Genetic similarities among sampling sites also coincided with predictions according to the documented process of expansion, showing a latitudinal population structure matching predictions according to geographic distance among locations. This poses the two opposite expansion directions as independent processes of loss of genetic diversity and creation of population structure, that is, two different cases of range expansion which are ready for further examinations.
Discontinuation of Chronic Opiate Therapy After Successful Spinal Cord Stimulation Is Highly Dependent Upon the Daily Opioid Dose
Authors: Simopoulos Thomas , Sharma Sanjiv , Wootton Raymond Joshua , Orhurhu Vwaire , Aner Moris , Gill Jatinder S 
Published: June 2019

AbstractObjectivesThe aim of this study was to determine if any of the factors recorded on a standard clinical history of a patient considered for spinal cord stimulation (SCS) would be associated with reduction or cessation of opioids following implantation.DesignRetrospective, single academic center.MethodsPatients included in the chart analysis underwent implantation of percutaneous SCS devices from 1999 to 2015 with follow‐up until the end of September 2018. Patients who achieved at least an average of 50% pain reduction were included for analysis of daily opioid intake. Patients were then divided into 4 groups that included no opioid use, stable opioid daily dose, weaned opioid dose, and complete cessation of opioids. Statistical methods were used to analyze for associations between opioid intake after SCS insertion and usual elements of a clinical history, including adjuvant medications, numeric pain rating, past medical history, psychiatric illness, substance abuse, employment, and smoking history.ResultsIn a group of 261 patients who had undergone implantation, 214 met the criteria for analysis and had a median age of 50 years, with majority having the diagnoses of failed back surgery syndrome and complex regional pain syndrome. The only factor that was associated with complete cessation of opioid use was a median dose of 30 mg of morphine per day (P < 0.01) and was observed in 15% of subjects who used opioids preoperatively.ConclusionThe elimination of opioid dependence following initiation of SCS therapy is highly dependent on the daily dose.
A xylem‐produced peptide PtrCLE20 inhibits vascular cambium activity in Populus
Authors: Zhu Yingying , Song Dongliang , Zhang Rui , Luo Laifu , Cao Shumin , Huang Cheng , Sun Jiayan , Gui Jinshan , Li Laigeng 
Published: June 2019

SummaryIn trees, lateral growth of the stem occurs through cell divisions in the vascular cambium. Vascular cambium activity is regulated by endogenous developmental programmes and environmental cues. However, the underlying mechanisms that regulate cambium activity are largely unknown. Genomic, biochemical and genetic approaches were used here to elucidate the role of PtrCLE20, a CLAVATA3 (CLV3)/embryo surrounding region (ESR)‐related peptide gene, in the regulation of lateral growth in Populus. Fifty‐two peptides encoded by CLE genes were identified in the genome of Populus trichocarpa. Among them PtrCLE20 transcripts were detected in developing xylem while the PtrCLE20 peptide was mainly localized in vascular cambium cells. PtrCLE20 acted in repressing vascular cambium activity indicated by that upregulation of PtrCLE20 resulted in fewer layers of vascular cambium cells with repressed expression of the genes related to cell dividing activity. PtrCLE20 peptide also showed a repression effect on the root growth of Populus and Arabidopsis, likely through inhibiting meristematic cell dividing activity. Together, the results suggest that PtrCLE20 peptide, produced from developing xylem cells, plays a role in regulating lateral growth by repression of cambium activity in trees.
Optimal timing of video‐assisted thoracoscopic surgery for patent ductus arteriosus in preterm infants born at ≤ 28 weeks of gestation
Authors: Kemmochi Manabu , Senzaki Hideaki , Miyaji Kagami , Hashimoto Megumi , Yamaguchi Ayano , Ooka Mari , Yokozeki Yuuichirou , Ishii Masahiro 
Published: June 2019

AbstractBackgroundVideo‐assisted thoracoscopic surgery for patent ductus arteriosus (VATS‐PDA) is an alternative surgical procedure to open chest surgery, even in premature infants. This study investigated whether the timing of VATS‐PDA has a prognostic impact in premature infants whose operative indication was determined according to the symptomatic PDA and the ineffectiveness of or contraindication to indomethacine therapy.MethodsWe studied 49 infants born at or before 28 weeks of gestation who were admitted to the neonatal intensive care unit between January 2004 and June 2016, and who underwent VATS‐PDA. The patients were divided into two groups according to median age at the time of surgery (early group, 24 infants who underwent surgery at ≤ 24 days of life; late group, 25 infants who underwent surgery at ≥ 25 days of life).ResultsNo significant differences were found in bodyweight at 30 days of age and 40 weeks of corrected gestational age between the groups. The timing of surgery did not affect the operative procedure or postoperative complications. In addition, no differences were observed between the early and late groups in terms of complications associated with prematurity, including intraventricular hemorrhage, incidence and severity of bronchopulmonary dysplasia, and necrotizing enteropathy.ConclusionVideo‐assisted thoracoscopic surgery for patent ductus arteriosus can be safely performed in premature infants without a preferential timing for the intervention, suggesting that this procedure allows for an elective basis approach after heart failure management with conservative and/or drug therapy in premature infants with PDA.
A Case Study of Factors Influencing Performance in the Practice Environment
Authors: Smith Steve M. , Cotterill Stewart T. , Brown Hazel 
Published: June 2019

Athletes’ practice environment can influence their competitive performance. The influencing performance factors present in practice are understudied, and the aim of this study was to explore these factors. Using a case-study approach, the authors investigated a basketball practice environment to reveal influencing performance factors. Participants were 15 members of a U.K. Elite Academy Basketball League team based in a sixth-form college (equivalent to American high school age) that included 10 players, 2 coaches, 1 strength and conditioning coach, 1 academic teacher, and the head of sport (mean age 21.8 yr). A case-study approach was adopted to collect data from interviews, focus groups, and direct observations to provide a holistic assessment of the practice environment. Data were analyzed using inductive thematic analysis, which revealed 6 overarching themes: effort, status, individuality, preparation, team drive, and practice vision. Data analysis exposed several themes of influencing performance factors unreported in previous literature, suggesting that practice environments should be viewed as a stand-alone field of investigative enquiry. The results from this study provide a much-needed foray into the psychological influences of practice and give practitioners the opportunity to reflect on the results against their own practice environments.
Neuron-specific enolase is correlated with lesion topology, relative infarct volume and outcome of symptomatic NAIS
Authors: Arca Gemma , Arnaez Juan , Agut Thais , Núñez Christian , Stephan-Otto Christian , Valls Anna , García-Alix Alfredo 
Published: June 2019

ObjectiveTo correlate neuron-specific enolase (NSE) levels in cerebrospinal fluid (CSF) in neonate infants with symptomatic neonatal arterial ischaemic stroke (NAIS) with the arterial distribution of infarct, infarct volume and outcome.DesignProspective observational multicentre cohort.SettingThree paediatric university hospitals in Spain.SubjectsThirty-eight neonates with more than 35 weeks’ gestational age between 2006 and 2016 were studied. They were diagnosed with NAIS by MRI. They underwent a lumbar puncture to measure CSF-NSE concentrations within 96 hours after the onset of symptoms. Sixty-seven neonates admitted with suspected infections served as controls. We used a classification based on the arterial distribution, and the lesions were segmented with ITK-Snap software to determine their volume. Neurodevelopment was assessed at 24 months using the Bayley-III, Gross Motor Function Classification System and Bimanual Fine Motor Function.ResultsCSF-NSE levels were higher in patients with symptomatic NAIS when compared with controls. Neonates with multifocal NAIS and with NAIS located in middle cerebral artery (MCA)-M1 arterial territory showed higher CSF-NSE levels when compared with cases with MCA-M2-M3-M4 territories (p<0.001). A significant correlation was found between CSF-NSE and relative infarction volume (rs=0.597; p<0.001). CSF-NSE values were higher in those infants with symptomatic NAIS with adverse outcome compared with infants with good development (p=0.020). Infants with CSF-NSE values above 55 ng/mL had an OR of adverse outcome of 6.48 (95% CI 1.48 to 28.33).ConclusionsCSF-NSE is a potential early prognostic biomarker after an NAIS due to the relation between volume, topology and neurodevelopment at 2 years of age.
Effect of trabeculectomy on corneal endothelial cell loss
Authors: Hirooka Kazuyuki , Nitta Eri , Ukegawa Kaori , Sato Shino , Kiuchi Yoshiaki 
Published: June 2019

AimTo investigate changes in corneal endothelial cell density (CECD) after trabeculectomy.MethodsThis prospective, observational study followed 117 eyes of 117 patients for 2 years after trabeculectomy. The central cornea was examined by corneal specular microscopy prior to and at every 6 months after the surgery. Survival analysis of patients who exhibited a 10% or less reduction of the postoperative CECD compared with preoperative levels was assessed using the Kaplan-Meier survival curve. A Cox proportional hazards model was used to evaluate prognostic factors for decreasing CECD.ResultsAt baseline, the mean CECD was 2420±357 cells/mm2, while at 6, 12, 18 and 24 months after surgery, the mean CECD was 2324±373 cells/mm2 (p<0.001), 2276±400 cells/mm2 (p<0.001), 2290±398 cells/mm2 (p<0.001) and 2267±446 cells/mm2 (p<0.001), respectively. At 6, 12, 18 and 24 months after surgery, the results of the Kaplan-Meier survival analysis of the 10% loss of CECD from baseline were 91%, 85%, 83% and 77%, respectively. Uveitic glaucoma was a significant prognostic factor for decreasing CECD (p=0.041).ConclusionsCECD significantly and continuously decreased after trabeculectomy.
Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs
Authors: Herout Jennifer , Baggetta Donna , Cournoyer Amanda , Dietz Aaron S , Robbins Jane , Maddox Kyle , Dobre Jolie 
Published: June 2019

BackgroundThe promise of Health Information Exchange (HIE) systems rests in their potential to provide clinicians and administrative staff rapid access to relevant patient data to support judgement and decision-making. However, HIE systems can have usability and technical issues, as well as fail to support user workflow.ObjectiveShare the findings from a series of studies that address HIE system deficiencies for an Electronic Health Record (EHR) viewer which accesses multiple data sources.MethodsA variety of methods were used, in a series of studies, to gain a better understanding of issues and their mitigation through use of promising EHR viewer features.ResultsThe study series results are presented by the themes that underscore the importance for users to distinguish between data that are available but missing due to connection or system errors, data that are omitted entirely because they are not available and data that are excluded due to filtered search criteria.ConclusionsThe principal findings from this study series led to improvement recommendations for the EHR viewer, as well as citing areas that are ripe for further investigation and analysis.
Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
Authors: Trinkley Katy E , Blakeslee Weston W , Matlock Daniel D , Kao David P , Van Matre Amanda G , Harrison Robert , Larson Cynthia L , Kostman Nic , Nelson Jennifer A , Lin Chen-Tan , Malone Daniel C 
Published: June 2019

BackgroundTo improve user-centred design efforts and efficiency; there is a need to disseminate information on modern day clinician preferences for technologies such as computerised clinical decision support (CDS).ObjectiveTo describe clinician perceptions regarding beneficial features of CDS for chronic medications in primary care.MethodsThis study included focus groups and clinicians individually describing their ideal CDS. Three focus groups were conducted including prescribing clinicians from a variety of disciplines. Outcome measures included identification of favourable features and unintended consequences of CDS for chronic medication management in primary care. We transcribed recordings, performed thematic qualitative analysis and generated counts when possible.ResultsThere were 21 participants who identified four categories of beneficial CDS features during the group discussion: non-interruptive alerts, clinically relevant and customisable support, presentation of pertinent clinical information and optimises workflow. Non-interruptive alerts were broadly defined as passive alerts that a user chooses to review, whereas interruptive were active or disruptive alerts that interrupted workflow and one is forced to review before completing a task. The CDS features identified in the individual descriptions were consistent with the focus group discussion, with the exception of non-interruptive alerts. In the individual descriptions, 12 clinicians preferred interruptive CDS compared with seven clinicians describing non-interruptive CDS.ConclusionClinicians identified CDS for chronic medications beneficial when they are clinically relevant and customisable, present pertinent clinical information (eg, labs, vitals) and improve their workflow. Although clinicians preferred passive, non-interruptive alerts, most acknowledged that these may not be widely seen and may be less effective. These features align with literature describing best practices in CDS design and emphasise those features clinicians prioritise, which should be considered when designing CDS for medication management in primary care. These findings highlight the disparity between the current state of CDS design and clinician-stated design features associated with beneficial CDS.
Conformity of Diabetes Mobile apps with the Chronic Care Model
Authors: Salari Raheleh , R Niakan Kalhori Sharareh , Ghazisaeidi Marjan , Fatehi Farhad 
Published: June 2019

BackgroundDespite the growing use of mobile applications (apps) for chronic disease management, the evidence on the effectiveness of this technology on clinical and behavioural outcomes of the patients is scant. Many studies highlight the importance of the theoretical foundations of mobile-based interventions. One of the most widely accepted models for the management of chronic diseases, such as diabetes, is the Chronic Care Model (CCM). In this study, we investigated the conformity of the selected diabetes mobile apps with CCM.MethodWe searched online journal databases related to diabetes mobile apps to find common features. Then considering the components of the CCM as a reference model, features of some popular and top-ranking apps were compared with CCM.ResultsAmong 23 studied apps, 34 per cent of them had medium conformity and 66 per cent of these apps were in weak conformity. The self-management support component is covered by 100 per cent of them. Ninety-five per cent of apps have covered the proactive follow-up component.ConclusionsApp conformance with CCM is generally weak. App developers are recommended to give greater consideration to established theoretical models in their design and implementation.