bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring fidelity to behavioural support delivery for smoking cessation and its association with outcomes
Authors: Dogar Omara , Boehnke Jan R. , Lorencatto Fabiana , Sheldon Trevor A. , Siddiqi Kamran 
Published: September 2019

AbstractBackground and aimsBehavioural support increases smoking cessation in clinical settings, but effect sizes differ among providers, due possibly to variations in delivery. This study evaluates a measure (‘fidelity index’) intended to capture fidelity to delivery of content‐ and interaction‐based items of a behavioural support (BS) for smoking cessation and the association of fidelity with quit rates.MethodsA fidelity index for scoring the adherence and quality domains of a specific BS intervention, ‘5As for quit’, was developed by classifying the intervention components using the taxonomy of behaviour change techniques. The index was applied to code 154 BS sessions audiotaped among 18 chest clinics in Pakistan to assess their fidelity and explore reliability of coding. The association between intervention fidelity and successful quit achieved by the same providers in a previous study was explored using regression analysis.ResultsThe index represented two domains: adherence to delivery of content‐based activities of 5As (37 items) and quality of interaction‐based activities (eight items). The intercoder reliability was good for content‐based (average Krippendorff's α = 0.80) and moderate for interaction‐based (average Krippendorff's α = 0.66) items. Approximately 70% (intraclass correlation coefficient: adherence scores = 0.72, quality scores = 0.71) of variation in BS delivery was contributed by providers, which increased to 97% (g‐coefficient: adherence scores = 0.973, quality scores = 0.974) after accounting for other sources of variation. Higher quit rates were positively associated with average quality scores [risk ratio = 2.15; 95% confidence interval (CI) = 1.43–3.24], but negatively associated with average adherence scores (risk ratio = 0.55; 95% CI = 0.40–0.77) within services.ConclusionsThe fidelity index is a reliable measure for quantifying intervention fidelity of delivering smoking cessation behavioural support. Recommended revisions of the fidelity index include incorporation of additional interaction‐based items, such as the relational techniques used in motivational interviewing.
Partnering with people with dementia and their care partners, aged care service experts, policymakers and academics: A co‐design process
Authors: Goeman Dianne P. , Corlis Megan , Swaffer Kate , Jenner Valerie , Thompson Jennifer F. , Renehan Emma , Koch Susan 
Published: September 2019

ObjectiveTo describe the co‐design process in a project that “evaluated how the key worker role can best support people living with dementia in the community setting.”MethodsPeople with dementia, care‐partners, aged‐care service experts, policymakers and academics utilised a co‐design process to undertake a systematic literature review and a qualitative evaluation study.ResultsThe development of a successful co‐design process that includes people living with dementia and their care‐partners (“consumers”) at all stages of the research process and addresses their individual needs.ConclusionsThe co‐design approach utilised in this project provided support, for consumers living in the community to be fully involved in the research design, conduct and plans for dissemination and implementation of the findings. Consequently, the research outcomes are based on solid evidence and consumer need. Additionally, a successful model for supporting consumers to facilitate their involvement in all aspects of the research process, was developed.
How do people with dementia and family carers value dementia‐specific quality of life states? An explorative “Think Aloud” study
Authors: Ratcliffe Julie , Hutchinson Claire , Milte Rachel , Nguyen Kim‐Huong , Welch Alyssa , Caporale Tessa , Corlis Megan , Comans Tracy 
Published: September 2019

ObjectiveTo investigate the decision‐making processes applied by people with dementia and family carers participating in using health economic approaches to value dementia‐specific quality of life states.MethodsPeople with dementia (n = 13) and family carers (n = 14) participated in valuing quality of life states using two health economic approaches: Discrete Choice Experiment (DCE) and Best Worst Scaling (BWS). Participants were encouraged to explain their reasoning using a “Think Aloud” approach.ResultsPeople with dementia and family carers adopted a range of decision‐making strategies including “anchoring” the presented states against current quality of life, or simplifying the decision‐making by focusing on the sub‐set of attributes deemed most important. Overall, there was strong evidence of task engagement for BWS and DCE.ConclusionsHealth economic valuation approaches can be successfully applied with people with dementia and family carers. These data can inform the assessment of benefits from their perspectives for incorporation within economic evaluation.
Putting the consumer in the driver's seat: A visual journey through the Australian health‐care system as experienced by people living with dementia and their carers
Authors: Fitzgerald Janna Anneke , Curry Joanne , Olde Meierink Angelique , Cully Ashley 
Published: September 2019

AbstractObjectiveTo better understand the individual journeys of people living with dementia and their carers through the Australian health‐care system.MethodsStories were collected from 25 participants, through five face‐to‐face workshops, across Australia. This produced 18 visual storyboards and a range of opportunities for improvement, which were then synthesised into an aggregated “ideal‐journey” model.ResultsSeveral issues were identified: long lead times to diagnosis; diverse experiences of treatment and support; and little coordination of care or thought for its impact on the consumer. Information about services, their purpose and eligibility criteria was difficult to obtain, and potential care pathways were largely unexplained. Much of the carer support received was reactive rather than proactive.ConclusionsA better understanding of the current health‐care pathway of dementia is essential for the design and delivery of future health‐care services. It is vital to include the consumer voice in future research and allocation of health‐care resources.
Short‐term repeatability of electrocardiographic criteria of left ventricular hypertrophy
Authors: Meyer Michelle L. , Soliman Elsayed Z. , Drager Dominique , Heiss Gerardo 
Published: September 2019

AbstractBackgroundLeft ventricular hypertrophy (LVH) is a marker of cardiac end‐organ damage and a risk factor for cardiovascular morbidity and mortality. Although clinical trials and cohort studies commonly use the electrocardiogram (ECG) for LVH assessment, the repeatability of ECG‐LVH criteria has not been sufficiently examined. Therefore, we evaluated the repeatability of ECG‐LVH criteria.MethodsParticipants (n = 63) underwent two standard ECGs at each of two visits, two weeks apart. The ECGs were processed centrally to calculate Cornell voltage (CV) LVH, Cornell voltage product (CVP) LVH, Sokolow–Lyon (SL) LVH, and Sokolow–Lyon product (SLP) LVH. We also used the waveforms measurements contributing to these LVH criteria as continuous variables, referred to here as CV‐index, CVP‐index, and SL‐index. We calculated the intraclass correlation coefficient (ICC), minimal detectable change (95% confidence), and the prevalence‐adjusted bias‐adjusted kappa (PABAK).ResultsICCs (95% confidence intervals (CI)) were 0.97 (0.96, 0.98) for CV‐index, 0.97 (0.95, 0.98) for CVP‐index, and 0.93 (0.90, 0.96) for log of SL‐index. Minimal detectable change between repeat measures of CV‐index, CVP‐index, and log of SL‐index were ≥236.7 mV, ≥26.7 mV, and ≥0.09 mV, respectively. The within‐visit PABAK was 1 for all ECG‐LVH criteria, except for the first visit SLP‐LVH (PABAK = 0.93). Between‐visit PABAK ranged from 0.83 to 0.97 across LVH criteria.ConclusionsCV, CVP, and SL ECG‐LVH as continuous variables have excellent repeatability, and as binary variables have excellent within‐visit agreement and good between‐visit agreement. These results alleviate concerns about the repeatability the ECG‐LVH use in clinical trials and epidemiologic studies.
Wellens’ syndrome and finding of multiple coronary cameral fistulae: Is it time to discard this term?
Authors: Ibarrola Martin 
Published: September 2019

AbstractWellens’ syndrome refers to electrocardiographic (ECG) abnormalities in the precordial T‐wave segment, which are associated with critical stenosis of the proximal left anterior descending (LAD) coronary artery. According to medical literature, this ECG abnormality is of paramount importance because this syndrome represents a preinfarction stage of coronary artery disease; however, same ECG pattern can also be seen in other conditions. Coronary fistula occurs due to anomalous communications between a coronary artery and a cardiac chamber or other vessel in the vicinity of the heart. We report a case of multiple coronary artery fistulae to the left ventricle in a 74‐year‐old woman who had a 2‐year history of intermittent atypical chest pain and exercise dyspnea with positive criteria mimicking Wellens’ syndrome without coronary atherosclerosis.
Correlation properties of heart rate variability during endurance exercise: A systematic review
Authors: Gronwald Thomas , Hoos Olaf 
Published: September 2019

AbstractBackgroundNon‐linear measures of heart rate variability (HRV) may provide new opportunities to monitor cardiac autonomic regulation during exercise. In healthy individuals, the HRV signal is mainly composed of quasi‐periodic oscillations, but it also possesses random fluctuations and so‐called fractal structures. One widely applied approach to investigate fractal correlation properties of heart rate (HR) time series is the detrended fluctuation analysis (DFA). DFA is a non‐linear method to quantify the fractal scale and the degree of correlation of a time series. Regarding the HRV analysis, it should be noted that the short‐term scaling exponent alpha1 of DFA has been used not only to assess cardiovascular risk but also to assess prognosis and predict mortality in clinical settings. It has also been proven to be useful for application in exercise settings including higher exercise intensities, non‐stationary data segments, and relatively short recording times.MethodTherefore, the purpose of this systematic review was to analyze studies that investigated the effects of acute dynamic endurance exercise on DFA‐alpha1 as a proxy of correlation properties in the HR time series.ResultsThe initial search identified 442 articles (351 in PubMed, 91 in Scopus), of which 11 met all inclusion criteria.ConclusionsThe included studies show that DFA‐alpha1 of HRV is suitable for distinguishing between different organismic demands during endurance exercise and may prove helpful to monitor responses to different exercise intensities, movement frequencies, and exercise durations. Additionally, non‐linear DFA of HRV is a suitable analytical approach, providing a differentiated and qualitative view of exercise physiology.
Clinically significant incidental QTc prolongation is subject to within‐individual variability
Authors: Gueta Itai , Klempfner Robert , Markovits Noa , Halkin Hillel , Segev Shlomo , Rott David , Peled Yael , Loebstein Ronen 
Published: September 2019

AbstractBackgroundProlonged QTc interval observed in daily practice is often deemed to be drug induced and might result in drug discontinuation, with possible therapeutic consequences. However, whether clinically significant prolonged QTc may be due to within‐individual variability occurs has yet to be described.MethodsA retrospective cohort study documenting within‐individual QTc variability in subjects attending annual routine medical evaluation. At each visit, QT interval was measured and corrected for heart rate using Bazett and three other commonly used formulae. Outcome measures were rates of ΔQTc ≥60 msec, absolute QTc ≥500 msec and QTc ≥25% from baseline.ResultsA total of 188 subjects [54 (29%)] females were recruited. Mean age at first ECG was 54 ± 12.8 years with mean time interval of 12.2 ± 1.1 months between measurements. Mean Bazett QTc was higher compared to the other 3 formulae: 412 ± 20 vs. 400 ± 16 msec. Using Bazett formula, 18/188 (9.6%) and 5/188 (2.7%) subjects showed at least one measurement with ΔQTc ≥60 msec and QTc ≥500 msec, respectively. Of the former, 5/18 (27.8%) showed QTc ≥25% prolongation. In multivariate analysis, QTc ≥500 msec was significantly associated with number of measurements (HR: 5.01, 95%CI: 1.21–20.78, p = .026) with no effect of other known confounders. Lower rates were demonstrated with the other three formulae.ConclusionIn clinical practice, significant prolonged QTc may be attributed to within‐individual variability, particularly when adjusting the QT interval with Bazett correction. This should be taken into consideration when decisions on changing current drug regimens are to be made.
Ten‐year evolution of a massive transfusion protocol in a level 1 trauma centre: have outcomes improved?
Authors: van der Meij Jessica E. , Geeraedts Jr Leo M. G. , Kamphuis Saskia J. M. , Kumar Nimmi , Greenfield Tony , Tweeddale Geoff , Rosenfeld David , D'Amours Scott K. 
Published: September 2019

AbstractBackgroundWe aimed to evaluate the evolution and implementation of the massive transfusion protocol (MTP) in an urban level 1 trauma centre. Most data on this topic comes from trauma centres with high exposure to life‐threatening haemorrhage. This study examines the effect of the introduction of an MTP in an Australian level 1 trauma centre.MethodsA retrospective study of prospectively collected data was performed over a 14‐year period. Three groups of trauma patients, who received more than 10 units of packed red blood cells (PRBC), were compared: a pre‐MTP group (2002–2006), an MTP‐I group (2006–2010) and an MTP‐II group (2010–2016) when the protocol was updated. Key outcomes were mortality, complications and number of blood products transfused.ResultsA total of 168 patients were included: 54 pre‐MTP patients were compared to 47 MTP‐I and 67 MTP‐II patients. In the MTP‐II group, fewer units of PRBC and platelets were administered within the first 24 h: 17 versus 14 (P = 0.01) and 12 versus 8 (P < 0.001), respectively. Less infections were noted in the MTP‐I group: 51.9% versus 31.9% (P = 0.04). No significant differences were found regarding mortality, ventilator days, intensive care unit and total hospital lengths of stay.ConclusionIntroduction of an MTP‐II in our level 1 civilian trauma centre significantly reduced the amount of PRBC and platelets used during damage control resuscitation. Introduction of the MTP did not directly impact survival or the incidence of complications. Nevertheless, this study reflects the complexity of real‐life medical care in a level 1 civilian trauma centre.
Clinicopathological factors associated with positive circumferential margins in rectal cancers
Authors: Pasch James A. , MacDermid Ewan , Pasch Lachlan B. , Premaratne Chatika , Fok Kar Yin , Kotecha Krishna , El Khoury Toufic , Barto Walid 
Published: September 2019

AbstractBackgroundPositive circumferential resections are associated with local disease recurrence and reduced survival in rectal cancer. We studied a cohort of consecutive rectal cancer resections to assess for clinicopathological differences and survival in patients with positive and negative circumferential margins.MethodsRectal cancers were identified from a retrospective histopathology database of colorectal resections performed at five western Sydney hospitals from 2010 to 2016. Univariate and multivariate analysis with binary logistic regression were performed on histopathology data matched with survival times from the New South Wales Registry of Births Deaths and Marriages.ResultsA total of 502 rectal cancer patients were identified including 66 (13.1%) with involved circumferential margins. Patients with positive and negative circumferential margins had a similar distribution of age, gender and use of neoadjuvant radiotherapy. Tumours with involved circumferential margin comprised 98.5% T3 and T4 disease of which 51.5% received neoadjuvant radiotherapy. These were significantly associated with metastatic disease, increasing tumour size, circumferential and perforated tumours on univariate analysis. Multivariate analysis identified abdomino‐perineal resection (odds ratio (OR) 3.35; P = 0.003), en‐bloc multivisceral resection (OR 2.56; P = 0.032), T4 stage (OR 6.99; P < 0.001), perineural (OR 5.61; P < 0.001) and vascular invasion (OR 2.46; P = 0.022) as independent risk factors. Five‐year survival was significantly worse for patients with involved circumferential margins (26% versus 69%; P < 0.001).ConclusionCircumferential margin status reflects not only technical success but also aggressive disease phenotypes which require adjuvant therapy. Further work is needed to determine whether omission of radiotherapy has had an effect on long‐term outcomes in some of our at‐risk patients.
How I manage severe von Willebrand disease
Authors: Leebeek Frank W. G. , Atiq Ferdows 
Published: September 2019

SummaryVon Willebrand disease (VWD) is the most common inherited bleeding disorder. Most patients with mild and moderate VWD can be treated effectively with desmopressin. The management of severe VWD patients, mostly affected by type 2 and type 3 disease, can be challenging. In this article we review the current diagnosis and treatment of severe VWD patients. We will also discuss the management of severe VWD patients in specific situations, such as pregnancy, delivery, patients developing alloantibodies against von Willebrand factor and VWD patients with recurrent gastrointestinal bleeding. Moreover, we review emerging treatments that may be applied in future management of patients with severe VWD.
Long non‐coding RNA MYOSLID functions as a competing endogenous RNA to regulate MCL‐1 expression by sponging miR‐29c‐3p in gastric cancer
Authors: Han Yuying , Wu Nan , Jiang Mingzuo , Chu Yi , Wang Zhiyang , Liu Hao , Cao Jiayi , Liu Hanming , Xu Bing , Xie Xin 
Published: September 2019

AbstractObjectiveLong non‐coding RNA (lncRNA) has become an important regulator of many human malignancies. However, the biological role and clinical significance of most lncRNA in gastric cancer (GC) remain unclear.MethodsWe investigate the biological function, mechanism of action and clinical expression of lncRNA MYOSLID in GC. First, we analysed the differential expression of lncRNA MYOSLID in GC tissues and non‐cancerous tissues by analysing the sequencing data obtained from The Cancer Genome Atlas. Subsequently, we verified that lncRNA MYOSLID regulates the proliferation and apoptosis of GC cells by acting as a ceRNA against miR‐29c‐3p. The nude mouse xenograft was used to further confirm the functional significance of lncRNA MYOSLID in vivo.ResultsWe found for the first time that the expression of lncRNA MYOSLID was significantly up‐regulated in GC tissues, and the up‐regulation of lncRNA MYOSLID in GC was correlated with tumour size, AJCC stage, depth of invasion and survival time. In addition, apoptosis and growth arrest can be induced in vitro after knockdown of lncRNA MYOSLID, which inhibits tumorigenesis in mouse xenografts in vivo. Further in‐depth studies revealed that lncRNA MYOSLID acts as a ceRNA of miR‐29c‐3p, resulting in de‐repression of its downstream target gene MCL‐1.ConclusionThe lncRNA MYOSLID‐miR‐29c‐3p‐MCL‐1 axis plays a key role in the development of GC. Our findings may provide potential new targets for the diagnosis and treatment of human GC.
When qualitative data contradict quantitative data: diabetes distress in the Chinese‐Canadian community
Authors: Xia A. , Yau K. W. , Tang T. S. 
Published: September 2019

AbstractAimsTo use both quantitative and qualitative approaches to characterize the diabetes distress profile of Chinese‐Canadians with Type 2 diabetes and to better understand their experience of living with diabetes.MethodsWe recruited 40 Chinese‐Canadian adults with Type 2 diabetes who completed a Mandarin‐ or Cantonese‐language diabetes education programme in Richmond, British Columbia. Using a mixed‐methods sequential explanatory research design, participants first completed a 15‐item Chinese version of the Diabetes Distress Scale, which included three subscales: emotional burden, regimen‐related distress, and physician distress. The self‐report survey was followed by a semi‐structured interview that addressed the following diabetes‐related topics: perspectives towards the healthcare team, emotional health, diabetes‐related concerns and stressors, diabetes diagnosis experience, and sources of social support and diabetes education.ResultsThe mean (sd) scores for total distress 1.5 (0.5), emotional burden 1.7 (0.7), regimen‐related distress 1.4 (0.5), and physician distress 1.4 (0.9), fell within the ‘low distress’ range (< 2.0). Qualitative analysis of semi‐structured interviews showed that some participants were dissatisfied with diabetes care providers and experienced emotional challenges, particularly early in their diagnosis. Other themes that emerged included eating distress, fear of complications, language barriers, and medication concerns.ConclusionsNot only did the qualitative findings from semi‐structured interviews capture aspects of diabetes distress that were not included in the quantitative survey, it also uncovered inconsistencies between the two datasets. To more accurately understand the diabetes distress experience of any ethnic community, both quantitative and qualitative approaches contribute unique value.
Does market power discipline CEO power? An agency perspective
Authors: Jaroenjitrkam Anutchanat , Yu Chia‐Feng (Jeffrey) , Zurbruegg Ralf 
Published: September 2019

AbstractWe examine how product market competition (PMC) shapes chief executive officer's (CEO) power. Using various measures to capture both PMC and CEO power, our analyses, which include a quasi‐natural experiment, find evidence that CEOs have less power when the product market is more competitive. Furthermore, the impact of PMC on CEO power is more pronounced for firms with entrenched management, lower CEO ownership, lower analyst coverage, and for firms experiencing good ‘luck’ (windfall performance). Our results suggest that market power can act as a substitute for corporate governance in disciplining CEO power, particularly when prone to agency problems.
Formation of large carbonate concretions in black cherts in the Gufeng Formation (Guadalupian) at Enshi, South China
Authors: Wei Hengye , Tang Zhanwen , Qiu Zhen , Yan Detian , Bai Maquzong 
Published: September 2019

AbstractThe formation of carbonate concretions is a cementation process which passively infills the pore spaces within sediments. They record the original environments of deposition and diagenetic conditions of the host rocks. Little is known about the precise mechanisms responsible for the precipitation of carbonate concretions. The most common host rocks are mudstones/shales, sandstones, and limestones. This study presents an example of large carbonate concretions from an unusual host rock, the black bedded cherts of the Gufeng Formation (Guadalupian) at Enshi on the northern Yangtze Platform, South China. Petrographic observations (X‐ray diffraction, optical microscopy, scanning electron microscopy) and multiple geochemical analyses (pyrite‐ and carbonate‐associated‐sulfate (CAS)‐sulfur isotopes, carbon isotopes) indicate that (a) the studied carbonate concretion are mainly composed of micritic calcite with subordinate dolomite; (b) the concretions may have been mainly formed in the bacterial sulfate reduction (BSR) zone during very early diagenesis near the sediment–water surface; (c) the paleo‐bottom water overlying the sediments during formation of the concretions was mainly euxinic; and (d) the growth of the studied concretions proceeded via a pervasive model, where later cementation phase initiated in the lower part of the concretions and progressed upward.