bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews
Authors: Gartlehner Gerald , Wagner Gernot , Matyas Nina , Titscher Viktoria , Greimel Judith , Lux Linda , Gaynes Bradley N , Viswanathan Meera , Patel Sheila , Lohr Kathleen N 
Published: July 2018

ObjectivesThis study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects.DesignThis is a review of systematic reviews.Data sourcesThis study used MEDLINE, Embase, Cochrane Library, PsycINFO and Epistemonikos from 2011 up to February 2017 for systematic reviews of randomised controlled trials in adult patients with acute-phase MDD.MethodsWe dually reviewed abstracts and full-text articles, rated the risk of bias of eligible systematic reviews and graded the strength of evidence.ResultsNineteen systematic reviews provided data on 28 comparisons of interest. For general efficacy, only second-generation antidepressants were supported with high strength evidence, presenting small beneficial treatment effects (standardised mean difference: −0.35; 95% CI −0.31 to −0.38), and a statistically significantly higher rate of discontinuation because of adverse events than patients on placebo (relative risk (RR) 1.88; 95% CI 1.0 to 3.28).Only cognitive behavioural therapy is supported by reliable evidence (moderate strength of evidence) to produce responses to treatment similar to those of second-generation antidepressants (45.5% vs 44.2%; RR 1.10; 95% CI 0.93 to 1.30). All remaining comparisons of non-pharmacological treatments with second-generation antidepressants either led to inconclusive results or had substantial methodological shortcomings (low or insufficient strength of evidence).ConclusionsIn contrast to pharmacological treatments, the majority of non-pharmacological interventions for treating patients with MDD are not evidence based. For patients with strong preferences against pharmacological treatments, clinicians should focus on therapies that have been compared directly with antidepressants.Trial registration numberInternational Prospective Register of Systematic Reviews (PROSPERO) registration number: 42016035580.
Deprescribing in primary care in Portugal (DePil17-20): a three-phase observational and experimental study protocol
Authors: Simões Pedro Augusto , Santiago Luiz Miguel , Simões José Augusto 
Published: July 2018

IntroductionPolypharmacy is commonly defined as the simultaneous taking of five or more drugs. Deprescribing is the process of tapering or stopping medications with the aim of improving patient outcomes and optimising current therapy, and there are several tools aiming at identifying potentially inappropriate medications, especially in the elderly. The direct involvement of patients and their caregivers in the choice and administration of drugs has long been known to be very important, but it is not usually applied. The aim of this study is to assess the knowledge of older adults about deprescription, the effect on willingness to have regular medications deprescribed and its quality-of-life outcome.Methods and analysisThis study protocol comprises three phases. The first two phases will be nationwide and aim to evaluate the prevalence and patterns of polypharmacy and assess the barriers and facilitators of deprescribing perceived by older adults, as well as their willingness to have regular medications deprescribed and to self-medicate. The third and last phase will be a non-pharmacological randomised clinical study to measure older patients’ acceptance to have regular medications deprescribed and related quality of life.Ethics and disseminationThe study will be conducted in accordance with the principles expressed in the Declaration of Helsinki. It has been approved by the Ethics Committee of the University of Beira Interior and Portuguese National Data Protection Commission. Study results will be published in peer-reviewed journals and presented at national and international conferences. In short, no action will be taken without written consent from patients and doctors.Trial registration number>NCT03283735.
Sex differences in the 1-year risk of dying following all-cause and cause-specific hospital admission after age 50 in comparison with a general and non-hospitalised population: a register-based cohort study of the Danish population
Authors: Höhn Andreas , Larsen Lisbeth Aagaard , Schneider Daniel Christoph , Lindahl-Jacobsen Rune , Rau Roland , Christensen Kaare , Oksuzyan Anna 
Published: July 2018

ObjectivesWe examine the mortality of men and women within the first year after all-cause and cause-specific hospital admission to investigate whether the sex differences in mortality after hospitalisation are higher than in the corresponding general and non-hospitalised population.DesignThis is a population-based, longitudinal study with nationwide coverage. The study population was identified by linking the National Patient Register with the Central Population Register using a 5% random sample of the Danish population.SettingThe population born between 1898 and 1961, who was alive and residing in Denmark after 1977, was followed up between 1977 and 2011 with respect to hospital admissions and mortality while aged 50–79.Primary outcome measuresThe absolute sex differences in the 1-year risk of dying after all-cause and cause-specific hospital admission. The hospitalised population sex differentials were then compared with the sex differences in a general and a non-hospitalised population, randomly matched by age, sex and hospitalisation status.ResultsThe risk of dying was consistently higher for hospitalised men and women. At all ages, the absolute sex differences in mortality were largest in the hospitalised population, were smaller in the general population and were smallest in the non-hospitalised population. This pattern was consistent across all-cause admissions, and with respect to admissions for neoplasms, circulatory diseases and respiratory diseases. For all-cause hospital admissions, absolute sex differences in the 1-year risk of dying resulted in 43.8 excess male deaths per 1,000 individuals within the age range 50–79, while the levels were lower in the general and the non-hospitalised population, at levels of 13.5 and 6.6, respectively.ConclusionsThis study indicates a larger male disadvantage in mortality following hospitalisation, pointing towards an association between the health status of a population and the magnitude of the female advantage in mortality.
To intubate or not: ventilation is the question. A manikin-based observational study
Authors: Sall Fatimata Seydou , De Luca Alban , Pazart Lionel , Pugin Aurore , Capellier Gilles , Khoury Abdo 
Published: July 2018

IntroductionThere is a continuous debate concerning the superiority of endotracheal intubation on bag-valve-mask (BVM) ventilation in patients with cardiac arrest. In this manikin-based observational study, we evaluate and compare the performance of manual ventilation through a facemask (BVM) and an endotracheal tube (ETT).MethodsOne hundred and forty healthcare providers were instructed to manually ventilate a manikin as they would do for a 75 kg adult patient in respiratory arrest. Each one was ventilating both through a facemask and an ETT for a 5 min period in a random order. Ventilatory parameters were measured by the ASL 5000 lung simulator and ventilation performance was analysed using a sliding window method published in a previous study to assess accurately ventilation efficiency.ResultsThe mean ventilation rate was high whatever the technique used (24 bpm). A weak relationship between manual ventilation performance and the type of interface used was observed (p=0.0484). The overall rate of adequate ventilation was low even if we noticed a slight improvement when ventilating through an ETT (13.21% vs 7.5% of adequate ventilation). However, the rate of hyperventilation did not differ between mask and tube (79% vs 77%). A significant relationship is observed between professional category, the size of the hand squeezing the bag and manual ventilation performance (p<0.05).ConclusionWhatever the interface used, healthcare professionals are still struggling to perform manual ventilation efficiently according to international guidelines. Ventilation with an ETT does not prove to be significantly more efficient than with a facemask. It would be therefore important to recentre the debate on controlling ventilatory parameters with current devices. Focusing on training may maximise manual ventilation efficiency and minimise the loss of time during cardiopulmonary resuscitation.
Self-reported chronic injuries in climbing: who gets injured when?
Authors: Grønhaug Gudmund 
Published: July 2018

ObjectivesTo assess self-reported chronic injuries in climbing and possible connections with gender, experience and style of climbing.MethodRetrospective survey.SettingWeb-based questionnaire.Participants667 active climbers (385 with chronic injuries, 289 males and 96 females).Main outcome measureClimbers who had experienced at least one chronic injury during the last 6 months.ResultAbout 2/3 of male outdoor climbers had experienced a chronic injury. The three most frequent sites of injury were fingers (41.3%), shoulders (19.4%) and elbows (17.7%). The most frequent injury for the females were fingers (29.2%), shoulder (21.9%), wrist (12.5%), elbow (11.5%) and foot/ankle (10.4%). The most frequent injuries for the male were fingers (45.3%), elbow (19.7%) and shoulder (18.7%). Respondents who preferred outdoor climbing were more prone to injury than others.ConclusionFingers were the most prevalent site of injury regardless of level of experience, gender and whether level of expertise is reported in terms of bouldering or route climbing. There seems to be a gender difference in respect of site of injury prevalence and a different prevalence of injuries according to style of climbing and different levels of expertise. Furthermore, the use of the suggested way of reporting levels of expertise to compare between bouldering and route climbing seems to be robust with no huge differences in terms of incidence level of different injuries.
The predictive value of fall assessment tools for patients admitted to hospice care
Authors: Patrick Rebecca J , Slobodian Dana , Debanne Sara , Huang Ying , Wellman Charles 
Published: July 2018

ObjectivesFall assessment tools are commonly used to evaluate the likelihood of fall. For patients found to be at high risk, patient-specific fall prevention interventions are implemented. The purposes of this study were to describe the population, evaluate and compare the efficacy of fall assessment tools, and suggest the best use for these tools in hospice.MethodsData were downloaded from the electronic medical record for all patients who were admitted to and died in hospice care in 2013. Variables included demographic, clinical and initial fall assessment scores that had been computed on admission to hospice care, using our standard fall assessment tool. To facilitate comparison among three tools, additional fall assessment calculations were made for each patient using the Morse Fall Scale and MACH-10, two tools commonly used in a variety of healthcare settings.ResultsData were available for 3446 hospice patients. Female patients were less likely to fall than males; Fallers lived longer than Nonfallers; and patients with a primary dementia diagnosis fell 10 days sooner than those with a primary non-dementia diagnosis. A comparison of three fall assessment tools revealed that no tool had a good positive predictive value, but each demonstrated a good negative predictive value.ConclusionsFall assessment scores should not be used as the sole predictor of likelihood of fall, and are best used as a supplement to clinical judgement. Patients with a primary dementia diagnosis are likely to fall earlier in their hospice care than those with other primary diagnoses.
Predictors of medium-term mortality in patients hospitalised with coronary artery disease in a resource-limited South-East Asian setting
Authors: Qanitha Andriany , Uiterwaal Cuno S. P. M. , Henriques Jose P. S. , Mappangara Idar , Idris Irfan , Amir Muzakkir , de Mol Bastianus A. J. M. 
Published: July 2018

ObjectiveTo measure medium-term outcomes and determine the predictors of mortality in patients with coronary artery disease (CAD) both during and after hospitalisation in a resource-limited South-East Asian setting.MethodsFrom February 2013 to December 2014, we conducted a prospective observational cohort study of 477 patients admitted to Makassar Cardiac Center, Indonesia, with acute coronary syndrome and stable CAD. We actively obtained data on clinical outcomes and after-discharge management until April 2017. Multivariable Cox proportional hazard analysis was performed to examine predictors for our primary outcome, all-cause mortality.ResultsFrom hospital admission, patients were followed over a median of 18 (IQR 6–36) months; in total 154 (32.3%) patients died. More patients with acute myocardial infarction died in the hospital compared with patients with unstable and stable angina (p=0.002). Over the total follow-up, there was a difference in mortality between non-ST-segment elevation myocardial infarction (n=41, 48.2%), ST-segment elevation myocardial infarction (n=65, 30.8%), unstable angina (n=18, 26.5%) and stable coronary artery disease (n=30, 26.5%) groups (p=0.007). The independent predictors of all-cause mortality were hyperglycaemia on admission (HR 1.55 (95% CI 1.12 to 2.14), p=0.008), heart failure/Killip class ≥2 (HR 2.50 (95% CI 1.76 to 3.56), p<0.001), estimated glomerular filtration rate <60 mL/min (HR 1.77 (95% CI 1.26 to 2.50), p=0.001), no revascularisation (percutaneous coronary intervention/coronary artery bypass grafting) (HR 2.38 (95% CI 1.31 to 4.33), p=0.005) and poor adherence to after-discharge medications (HR 10.28 (95% CI 5.52 to 19.16), p<0.001). Poor medication adherence predicted postdischarge mortality and did so irrespective of underlying CAD diagnosis (p interaction=0.88).ConclusionsPatients with CAD in a poor South-East Asian setting experience high in-hospital and medium-term mortality. The initial severity of the disease, lack of access to guidelines-recommended therapy and poor adherence to after-discharge medications are the main drivers for excess mortality. Improved access to early and late hospital care and patient education should be prioritised for better survival.
ModelHeart: a resident-led implementation of metrics to reduce 30-day heart failure readmissions
Authors: Kachur Sergey , Kachur Patricia , Akhtar Tauseef , Collado Elias , Espinosa-Friedman Martha , Asher Craig , Hernandez Marlow , Tabaquin Stephen 
Published: July 2018

AbstractHospitals have been penalised for excessive 30-day readmissions via Medicare payment penalties. As such there has been keen interest in finding ways of reducing readmissions. The basis for the study was a retrospective review of heart failure (HF) admissions at Cleveland Clinic Florida from 1 January 2010 to 31 December 2010. The result of this was a set of metrics associated with &gt;30 day span between admissions: N-terminal pro-brain natriuretic peptide by at least 23%, fluid balance of ≤−1.3 L and sodium ≥135 mEq/L on discharge. The ModelHeart trial was a prospective resident-led validation of these criteria that consisted of education about and implementation of these metrics. A total of 200 patients carrying a diagnosis of HF, admitted between 1 November 2012 and 14 January 2014 were included in the trial. Of the 200 enrolled patients, 94% of discharged patients met at least one criteria, 58% met at least two criteria and 20% met all three. There were forty-eight all-cause 30-day readmissions. 30-day readmission rates between themore than equal to two criteria cohort and the remaining patients were not significantly different (p=0.71). Overall readmission rates were higher in the 2011–2012 retrospective patient pool (19%) versus the ModelHeart cohort (11%), and proportional differences were significant, (p&lt;0.001). This may suggest that education provided sufficient awareness to alter discharge practices outside of the measured metrics. However, the lack of significant differences between groups with respect to discharge metrics suggests that further study is needed to refine the metrics and that reducing HF readmissions involves a continuum of care that spans the inpatient and outpatient setting.
Productivity burden of smoking in Australia: a life table modelling study
Authors: Owen Alice J , Maulida Salsabil B , Zomer Ella , Liew Danny 
Published: July 2018

ObjectivesThis study aimed to examine the impact of smoking on productivity in Australia, in terms of years of life lost, quality-adjusted life years (QALYs) lost and the novel measure of productivity-adjusted life years (PALYs) lost.MethodsLife table modelling using contemporary Australian data simulated follow-up of current smokers aged 20–69 years until age 70 years. Excess mortality, health-related quality of life decrements and relative reduction in productivity attributable to smoking were sourced from published data. The gross domestic product (GDP) per equivalent full-time (EFT) worker in Australia in 2016 was used to estimate the cost of productivity loss attributable to smoking at a population level.ResultsAt present, approximately 2.5 million Australians (17.4%) aged between 20 and 69 years are smokers. Assuming follow-up of this population until the age of 70 years, more than 3.1 million years of life would be lost to smoking, as well as 6.0 million QALYs and 2.5 million PALYs. This equates to 4.2% of years of life, 9.4% QALYs and 6.0% PALYs lost among Australian working-age smokers. At an individual level, this is equivalent to 1.2 years of life, 2.4 QALYs and 1.0 PALY lost per smoker. Assuming (conservatively) that each PALY in Australia is equivalent to $A157 000 (GDP per EFT worker in 2016), the economic impact of lost productivity would amount to $A388 billion.ConclusionsThis study highlights the potential health and productivity gains that may be achieved from further tobacco control measures in Australia via application of PALYs, which are a novel, and readily estimable, measure of the impact of health and health risk factors on work productivity.
Testing Lorentz symmetry violation with an invariant minimum speed
Authors: Nassif Cláudio , Amaro de Faria A. C. , dos Santos Rodrigo Francisco 
Published: July 2018

This work presents an experimental test of Lorentz invariance violation in the infrared (IR) regime by means of an invariant minimum speed in spacetime and its effects on the time when an atomic clock given by a certain radioactive single-atom (e.g. isotope Na[Formula: see text]) is a thermometer for an ultracold gas like the dipolar gas Na[Formula: see text]K[Formula: see text]. So, according to a Deformed Special Relativity (DSR) so-called Symmetrical Special Relativity (SSR), where there emerges an invariant minimum speed V in the subatomic world, one expects that the proper time of such a clock moving close to V in thermal equilibrium with the ultracold gas is dilated with respect to the improper time given in lab, i.e. the proper time at ultracold systems elapses faster than the improper one for an observer in the lab, thus leading to the so-called proper time dilation so that the atomic decay rate of an ultracold radioactive sample (e.g. Na[Formula: see text]) becomes larger than the decay rate of the same sample at room temperature. This means a suppression of the half-life time of a radioactive sample thermalized with an ultracold cloud of dipolar gas to be investigated by NASA in the Cold Atom Lab (CAL).
An Epidemiological Review of Diet and Cutaneous Malignant Melanoma
Authors: Yang Keming , Fung Teresa T. , Nan Hongmei 
Published: July 2018

AbstractIncidence of cutaneous malignant melanoma has continued to rise despite public efforts to promote sun protection behaviors among populations at risk. However, dietary factors may also affect the development of melanoma. In the past few decades, findings from epidemiologic and experimental research have linked consumption of several foods and other nutrients to the risk of melanoma. Caffeine has been associated with a lower risk of melanoma, and citrus fruits and alcohol with increased risk. Associations between polyunsaturated fatty acid, niacin/nicotinamide, folate, and vitamin D with melanoma remain controversial. Diet likely influences melanoma development through several potential mechanisms, such as enhancing UV-induced apoptosis and increasing photosensitivity. We conducted a narrative review to summarize recent epidemiologic studies of diet and melanoma based on published literature. Given the high prevalence of the food items and nutrients covered in this review and the decades-long rising melanoma incidence worldwide, the associations we discuss may have important public health implications in terms of reducing melanoma incidence through dietary modification. Cancer Epidemiol Biomarkers Prev; 27(10); 1115–22. ©2018 AACR.
Wnt3a/β-Catenin Signaling Conditions Differentiation of Partially Exhausted T-effector Cells in Human Cancers
Authors: Schinzari Valeria , Timperi Eleonora , Pecora Giulia , Palmucci Francesco , Gallerano Daniela , Grimaldi Alessio , Covino Daniela Angela , Guglielmo Nicola , Melandro Fabio , Manzi Emy , Sagnotta Andrea , Lancellotti Francesco , Sacco Luca , Chirletti Piero , Grazi Gian Luca , Rossi Massimo , Barnaba Vincenzo 
Published: July 2018

Abstract
In this study, we investigated the role of the Wnt/β-catenin signaling pathway in antitumor immune responses. We report that the concentration of secreted Wnt3a was significantly higher in conditioned medium from tumor or nontumor tissues obtained from all hepatocellular carcinoma or colorectal cancer patients tested, than in serum of healthy donors or patients. In addition, both Wnt3a and β-catenin were overexpressed by tumor-infiltrating and nontumor-infiltrating CD4+ or CD8+ T cells. The majority of these T cells expressed a dysfunctional effector memory Eomes+T-bet−phenotype that we defined as partially exhausted, because they performed effector functions (in terms of interferon-γ and tumor necrosis factor-α production, as well as CD107a mobilization) despite their PD-1 expression. Wnt3a/β-catenin signaling in T naïve cells in vitro recapitulated the T-cell setting in vivo. Indeed, the differentiation of cultured T naïve cells was arrested, producing cells that resembled the EomeshighT-betlowβ-cateninhigh T cells with moderate effector functions that infiltrated tumor and nontumor areas. Wnt3a blockade improved the capacity of T naïve cells to differentiate into effector cells in vitro. However, Wnt3a blockade did not affect the function and phenotype of differentiated, partially exhausted, tumor-infiltrating T cells ex vivo. Taken together, our data suggest that Wnt3a blockade halts the capacity of Wnt/β-catenin signaling to inhibit the differentiation of T naïve cells, but it does not restore the dysfunction of differentiated T cells, in the tumor setting. Cancer Immunol Res; 6(8); 941–52. ©2018 AACR.