bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes in 40 cats with discrete intermediate‐ or large‐cell gastrointestinal lymphoma masses treated with surgical mass resection (2005‐2015)
Authors: Tidd Kathleen S. , Durham Amy C. , Brown Dorothy C. , Velovolu Sridhar , Nagel Jonathan , Krick Erika L. 
Published: July 2019

AbstractObjectiveTo report outcomes in cats with discrete intermediate‐ and large‐cell gastrointestinal (GI) lymphoma masses after surgical resection.Study designRetrospective clinical case series.AnimalsForty client‐owned cats in which intermediate‐ or large‐cell GI lymphoma was diagnosed.MethodsRecords of 40 cats in which discrete intermediate‐ or large‐cell GI lymphoma masses were diagnosed between 2005 and 2015 were reviewed. Cats were included if they survived curative intent surgery and had a known outcome for at least two weeks. Postoperative death was permitted. Data collected included anatomic site, surgical margins, lymphoma subtype, chemotherapy use, and postoperative and long‐term outcome (beyond two weeks).ResultsAffected sites consisted of small intestines (n = 23), large intestines (n = 9), and stomach (n = 8). Thirty‐six of 40 cats survived to discharge, and 31 cats were alive at suture removal. Median long‐term follow‐up of 22 cats was 111 days (range, 16‐1407). Cats that survived to suture removal had a median survival time (MST) of 185 days (95% confidence interval: 72‐465). Cats with large intestinal masses lived longer than those with small intestinal or gastric masses whether all cats (MST, 675, 64, 96 days, respectively;P= .03) or only those surviving to suture removal were considered. Complete surgical resection (n = 20) was positively associated with survival (370 vs 83 days,P= .016).ConclusionMost cats in this population survived the perioperative period, with MST similar to those reported historically with medical management.Clinical significanceSurgical resection may be a reasonable consideration in cats with solitary lymphoma, particularly those with large intestinal masses.
Expanding on the Expanding Englishes of the Expanding Circle
Authors: Berns Margie 
Published: July 2019

AbstractIssue after issue of such journals as World Englishes and English Today deliver insights into and an understanding of the nature of the world's Englishes. Most of these scholarly contributions rely upon the Concentric Circle Model of World Englishes, a central feature of the Kachruvian paradigm since 1985. While the Englishes of each circle are covered in each issue, my interest in this paper is the Expanding Circle. I give attention to its representation in these two journals and to the model's integrity as a tool for investigating the sociolinguistic reality of English worldwide. I first report on two studies which I conducted that examined the representation of the Expanding Circle in the forenamed journals. Each study, conducted in two separate time periods, recorded the number of articles that appeared in each issue, listed the regions and countries covered, and tallied how often each region or country was the focus of an article. I then consider some implications of the findings and apply them to an analysis of the strength of claims made about alleged weaknesses in the Concentric Circles Model. I argue that the more that is known about Expanding Circle Englishes, the more that the model proves to be a robust, productive tool for description and analysis, even as varieties change and develop and users acquire new identities.
Measuring dynamic levels of self-perceived anxiety and concern during simulated mobility tasks in people with non-neovascular age-related macular degeneration
Authors: Taylor Deanna J , Smith Nicholas D , Jones Pete R , Binns Alison M , Crabb David P 
Published: July 2019

Background/aimsTo assess response to real-world mobility scenarios in people with dry age-related macular degeneration (AMD) using a computer-based test.MethodsParticipants were shown 18 point-of-view computer-based movies simulating walking through real-world scenarios, and pressed a button during scenes which would cause them self-perceived anxiety or concern in their day-to-day life. Button pressure was recorded throughout. Pressure traces were generated, which aligned with each movie time point. Group averages based on AMD severity were generated. Bootstrapped confidence intervals (CIs) for responses by group were generated around traces. Traces were examined to discover events causing the greatest differences between groups.ResultsParticipants had early/no AMD (n=8), intermediate AMD (n=7) or geographic atrophy (n=15 (GA)). Median (IQR) logMAR visual acuity was 0.04 (−0.04, 0.18), 0.26 (0.10, 0.40) and 0.32 (0.20, 0.56), respectively. Participants with intermediate AMD or GA recorded greater pressure than those with early and no AMD (Kruskal-Wallis, p=0.04). Four events involving navigating stairs and three under low luminance elicited greatest differences between groups (p<0.001).ConclusionPeople with intermediate AMD or GA likely experience higher levels of concern associated with mobility. The test highlights areas of specific concern. Results should be useful in patient management and educating the public about the everyday effects of AMD.
3Ts of low cure rate: taxonomy, themes and theory of low cure rate in Pakistan’s TB control programme and gathering a 360-degree perspective through qualitative, in-depth interviewing approach
Authors: Ali Syed Mustafa , Hussain Sumaira , Ishaq Muhammad , Ali Shoukat , Naureen Farah , Noor Arif , Rashid Aamna , Anjum Naveed 
Published: July 2019

ObjectiveWHO recommends cure of tuberculosis (TB) as the best prevention strategy; however, information about factors associated with low cure rate in patients with drug-susceptible TB is limited in Pakistan. Therefore, the purpose of this study was to explore the factors that account for low TB cure rate.MethodologyThe present qualitative study recruited diverse informants through purposive sampling to explore low cure rate situation in Badin between March and June 2017. Data were collected from clinicians, paramedics, lab technicians, district field supervisors, patients and treatment supporters through indepth and face-to-face interviews. Interviews were conducted in local languages (Urdu and Sindhi) and transcribed into English. Coding structure was developed inductively and applied on textual data to draw output at the levels of taxonomy, themes and theory, as proposed by Bradleyet al.FindingsThirty-seven individuals consented to participate in this study and provided detailed account of the subject under enquiry. Review of interview data collected from a variety of informants resulted in the identification of four broad factors (taxonomy) that contributed to the situation of low cure rate in one of the districts implementing the public–private mix intervention. These factors were (1) health-seeking behaviour, (2) technical capacity of the healthcare provider, (3) managerial capacity of the healthcare provider, and (4) access to healthcare facility and services. Each factor is deconstructed into key dimensions (themes) that emerged from the dialogue between the interviewer and the respondents. Moreover, dimensions were exemplified through underlying concepts that correspond to theories for low cure rate.ConclusionChange in programme reporting requirement has demeaned the significance of having cure as treatment outcome. Therefore, returning the focus to achieving cure status for TB cases will be beneficial for assessing the effectiveness of TB control efforts. In parallel to the care delivery system, a mechanism for disseminating disease-related and treatment-related information should be introduced.
The ‘Pleasure&Pregnancy’ web-based interactive educational programme versus expectant management in the treatment of unexplained subfertility: protocol for a randomised controlled trial
Authors: Dancet Eline A F , D’Hooghe Thomas M , Dreischor Felicia , van Wely Madelon , Laan Ellen T M , Lambalk Cornelius B , Repping Sjoerd , Custers Inge M 
Published: July 2019

IntroductionMany subfertile couples are diagnosed with (relatively) unexplained subfertility and a good prognosis. National professional guidelines (eg, the Netherlands and UK) advise ‘expectant management (EM)’ for 6–12 months, in which no interaction with healthcare staff is offered. Underpowered studies indicate that face-to-face sex-counselling increases the ongoing pregnancy rates of these couples. In patients with other conditions, web-based interactive educational programmes have the same effect on sexual functioning as face-to-face sex counselling. The ‘Pleasure&Pregnancy randomised controlled trial (RCT)’ will examine in couples with unexplained subfertility and a good prognosis whether a new web-based interactive educational programme results in a higher chance of naturally conceiving an ongoing pregnancy within 6 months as compared with EM.Methods and analysisA multicentre RCT with cost-effectiveness analysis will include heterosexual couples diagnosed with (relatively) unexplained subfertility and a good prognosis in Dutch and Belgian secondary or tertiary fertility clinics. Couples will be randomised between 6 months of EM and 6 months of the Pleasure&Pregnancy-programme. This new web-based interactive educational programme includes eight progressive modules of information (on the biology of conception and pleasurable sex) and sensate focus, couple communication and mindfulness exercises. Couples are offered interaction with their coaches via email and can take part in three moderated chat sessions with peers. The primary outcome of this RCT is the probability of naturally conceiving an ongoing pregnancy within 6 months after randomisation. Secondary outcomes include time-to-pregnancy, live birth rate, costs, sexual functioning and personal and relational well-being. Analysis will be according to intention to treat.Ethics and disseminationThis study has been approved by the Medical Ethical Committees of the Academic Medical Centre (the Netherlands) and the Leuven University Hospital (Belgium). The findings of this RCT will be disseminated through presentations at international scientific meetings and peer-reviewed publications.Trail registration numberNTR5709; Pre-results.
Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial
Authors: Breen Dorothy , O’Brien Sinead , McCarthy Nora , Gallagher Anthony , Walshe Nuala 
Published: July 2019

ObjectiveThis study aimed to determine the effectiveness of a proficiency-based progression (PBP) training approach to clinical communication in the context of a clinically deteriorating patient.DesignThis is a randomised controlled trial with three parallel arms.SettingThis study was conducted in a university in Ireland.ParticipantsThis study included 45 third year nursing and 45 final year medical undergraduates scheduled to undertake interdisciplinary National Early Warning Score (NEWS) training over a 3-day period in September 2016.InterventionsParticipants were prospectively randomised to one of three groups before undertaking a performance assessment of the ISBAR (Identification, Situation, Background, Assessment, Recommendation) communication tool relevant to a deteriorating patient in a high-fidelity simulation facility. The groups were as follows: (i) E, the Irish Health Service national NEWS e-learning programme only; (ii) E+S, the national e-learning programme plus standard simulation; and (iii) E+PBP, the national e-learning programme plus PBP simulation.Main outcome measuresThe primary outcome was the proportion in each group reaching a predefined proficiency benchmark comprising a series of predefined steps, errors and critical errors during the performance of a standardised, high-fidelity simulation assessment case which was recorded and scored by two independent blinded assessors.Results6.9% (2/29) of the E group and 13% (3/23) of the E+S group demonstrated proficiency in comparison to 60% (15/25) of the E+PBP group. The difference between the E and the E+S groups was not statistically significant (χ2=0.55, 99% CI 0.63 to 0.66, p=0.63) but was significant for the difference between the E and the E+PBP groups (χ2=22.25, CI 0.00 to 0.00, p<0.000) and between the E+S and the E+PBP groups (χ2=11.04, CI 0.00 to 0.00, p=0.001).ConclusionsPBP is a more effective way to teach clinical communication in the context of the deteriorating patient than e-learning either alone or in combination with standard simulation.Trial registration numberNCT02886754; Results.
Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
Authors: Dew Rosie , Wilkes Scott 
Published: July 2019

ObjectiveExploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.DesignThis was an in-depth qualitative semi-structured interview study.Participants and setting32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK.MethodInterviews using a grounded theory approach and thematic analysis.ResultsThe main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated.ConclusionAlthough RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders.
Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
Authors: Santo Karla , Isiguzo Godsent C , Atkins Emily , Mishra Shiva R , Panda Rajmohan , Mbau Lilian , Fayomi Samuel B , Ugwu Collins , Odili Augustine , Virani Salim 
Published: July 2019

IntroductionThe prevalence of hypertension in sub-Saharan Africa is among the world’s highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Community peer-support groups are an alternative and promising strategy to improve adherence and blood pressure (BP) control. The CLUBMEDS study aims to evaluate the feasibility and impact of adherence clubs to improve hypertension control in Nigeria.Methods and analysisThe CLUBMEDS study will include a formative (pre-implementation) qualitative evaluation, a pilot study and a process (postimplementation) qualitative evaluation. At the formative stages, focus group discussions with patient groups and in-depth interviews with healthcare providers, managers and key decision makers will be conducted to understand the feasibility, barriers and facilitators, opportunities and challenges for the successful implementation of the CLUBMEDS strategy. The CLUBMEDS pilot study will be implemented in two primary healthcare facilities, one urban and one rural, in Southeast Nigeria. Each adherence club, which consists of a group of 10–15 patients with hypertension under the leadership of a role-model patient, serves as a support group to encourage and facilitate adherence, BP self-monitoring and medication delivery on a monthly basis. A process evaluation will be conducted at the end of the pilot study to evaluate the acceptability and engagement with the CLUBMEDS strategy. To date, 104 patients were recruited and grouped into nine clubs, in which patients will be followed-up for 6 months.Ethics and disseminationThe study was approved by the University of Abuja Teaching Hospital and the Federal Teaching Hospital Abakaliki Human Research Ethics Committees and all patients provided informed consent. Our findings will provide preliminary data on the potential effectiveness and acceptance of this strategy in a hypertension context. Study findings will be disseminated via scientific forums.
Right versus left thoracic approach oesophagectomy for oesophageal cancer: a systematic review and meta-analysis protocol
Authors: Chai Tianci , Shen Zhimin , Chen Sui , Lin Yuhan , Zhang Zhenyang , Lin Wenwei , Hong Junjie , Yang Chuangcai , Kang Mingqiang , Lin Jiangbo 
Published: July 2019

IntroductionOesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.Methods and analysisWe will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO registration numberCRD42019124133.Ethics and disseminationBecause this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.
Ageing as a mindset: a study protocol to rejuvenate older adults with a counterclockwise psychological intervention
Authors: Pagnini Francesco , Cavalera Cesare , Volpato Eleonora , Comazzi Benedetta , Vailati Riboni Francesco , Valota Chiara , Bercovitz Katherine , Molinari Enrico , Banfi Paolo , Phillips Deborah , Langer Ellen 
Published: July 2019

IntroductionAlthough ageing is generally perceived as a biologically determined process, the literature increasingly points to the importance of psychological factors in the ageing process, specifically age-related stereotypes or cognitive mindsets. Such stereotypes reflect self-perceptions and others’ perceptions about the ageing process and can have a strong influence on health and life satisfaction, specifically through self-fulfilling prophecy mechanisms. This study aimed to investigate whether changes in mindsets can change the ageing process.Methods and analysisThis study replicates in large part the original 1979 ‘Counterclockwise’ experiment by Ellen Langer and will involve a group of older adults (aged 75+) taking part of a 1-week retreat outside of Milan, Italy. Participants will be instructed and helped torelivetheir younger selves, actingas ifthey are living in the year 1989. The week-long residential programme is designed to prime this perception by incorporating a completely retrofitted physical environment, as well as providing opportunities to engage in social activities that would have been common in the late 1980s. This ‘counterclockwise’ intervention will be tested as a randomised control trial comprised of the experimental (‘counterclockwise’) group, an active control group (same activities, no time manipulation) and a no-treatment group. Ninety participants will be randomly allocated to one of these three conditions. Every participant will be assessed for medical, cognitive, psychological and age appearance at four time points: at the time of recruitment, after the intervention (ie, after a week for the no-treatment group) and again after 6 and 12 months.Ethics and disseminationThe study has been approved by the Ethics Committees of the Department of Psychology of Università Cattolica del Sacro Cuore and Don Gnocchi Foundation. Results will be disseminated through peer-reviewed journals, scientific meetings and direct presentation to the general population.Trial registration numberNCT03552042; Pre-results.
Non-Invasive Temperature Measurements by Neutron Diffraction in Aero-Engine Components
Authors: Holden T. M. , Root J. H. , Tennant D. C. , Leggett D. 
Published: July 2019

Abstract
A requirement exists in the aeronautical industry for measuring temperature non-invasively in critical components, such as the turbine disc in an operating engine. Neutron diffraction, unique among nuclear techniques, offers the possibility of measuring both temperature and strain within an operating engine by virtue of the high penetration of neutrons through industrial materials. Static diffraction experiments on Waspaloy and Ti6A14V showed, by comparison with thermocouples, that both the diffraction peak position and the peak intensity can measure the tempeiaturc to within ±6 K aL 800 K. Measurements on a rotating Waspaloy disc, heated from its rim, showed that temperature gradients could be determined accurately by lattice parameter measurements. The large grain size in Waspaloy prevented accurate peak intensity measurements in this dynamic test. Finally, the structures within a small Pratt &amp; Whitney engine in its equatorial plane were mapped by mounting the engine on an X-Y translator on the diffractometer and moving it through a grid of positions. Possible future directions in the field will be discussed.
Altered Steroid Milieu in AI-Resistant Breast Cancer Facilitates AR Mediated Gene-Expression Associated with Poor Response to Therapy
Authors: Creevey Laura , Bleach Rachel , Madden Stephen F. , Toomey Sinead , Bane Fiona T. , Varešlija Damir , Hill Arnold D. , Young Leonie S. , McIlroy Marie 
Published: July 2019

Abstract
Divergent roles for androgen receptor (AR) in breast cancer have been reported. Following aromatase inhibitor (AI) treatment, the conversion of circulating androgens into estrogens can be diminished by &gt;99%. We wished to establish whether the steroid environment can dictate the role of AR and the implications of this for subsequent therapy. This study utilizes models of AI resistance to explore responsiveness to PI3K/mTOR and anti-AR therapy when cells are exposed to unconverted weak androgens. Transcriptomic alterations driven by androstenedione (4AD) were assessed by RNA-sequencing. AR and estrogen receptor (ER) recruitment to target gene promoters was evaluated using ChIP, and relevance to patient profiles was performed using publicly available data sets. Although BEZ235 showed decreased viability across AI-sensitive and -resistant cell lines, anti-AR treatment elicited a decrease in cell viability only in the AI-resistant model. Serum and glucocorticoid-regulated kinase 3 (SGK3) and cAMP-dependent protein kinase inhibitor β (PKIB) were confirmed to be regulated by 4AD and shown to be mediated by AR; crucially, reexposure to estradiol suppressed expression of these genes. Meta-analysis of transcript levels showed high expression of SGK3 and PKIB to be associated with poor response to endocrine therapy (HR = 2.551, P = 0.003). Furthermore, this study found levels of SGK3 to be sustained in patients who do not respond to AI therapy. This study highlights the importance of the tumor steroid environment. SGK3 and PKIB are associated with poor response to endocrine therapy and could have utility in tailoring therapeutic approaches.