bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring clinical competencies in facilitating group-based rehabilitation interventions: development of a new competency checklist
Authors: Wong Dana , Grace Nicci , Baker Katharine , McMahon Genevieve 
Published: February 2019

Objective: Group-based intervention formats are common in rehabilitation, but no tool for objectively measuring clinical competencies in group facilitation currently exists. We aimed to develop a psychometrically sound group facilitation competency checklist for use in clinical, training, and research settings. Method: The Delphi method of expert consensus was used to establish checklist items that clearly describe competencies considered important for effective group facilitation. Inter-rater reliability was determined with two experienced psychologists who used the checklist to rate the competencies of psychology trainees facilitating a memory skills group. Results: After two Delphi rounds, consensus was reached on 17 items, defined as at least 80% agreement among the panel of 15 experts. The four checklist item categories were (a) Facilitating focused group discussion, (b) Communication skills, (c) Interpersonal style, and (d) Session structure. One item was removed after piloting. Inter-rater reliability was excellent (88% agreement) using a simple coding method (competent/incompetent). When using a detailed coding method that discriminated between ‘done adequately’ and ‘done well’, inter-rater reliability was weaker (κ = 0.481, 55% agreement); however, it improved to almost perfect after the raters calibrated their standards. Conclusion: The new group facilitation competency checklist is fit for purpose for measuring clinical competencies in delivering group-based rehabilitation interventions and can be used in the training of effective group facilitators.
Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period
Authors: Wang Yubing , Xu Yanping , Ling Zhiyu , Chen Weijie , Su Li , Du Huaan , Xiao Peilin , Liu Zengzhang , Yin Yuehui 
Published: February 2019

Objective This study was performed to observe the effect of radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF) and to explore the risk factors for late recurrence of atrial fibrillation (LRAF) after a single RFCA session. Methods In this retrospective study, 243 patients with PAF underwent RFCA and were followed up regularly. Results At a median follow-up of 37 months after a single procedure, 60.5% of patients maintained sinus rhythm (SR), and at a median follow-up of 42 months after multiple procedures, 74.9% of patients maintained SR. The statistically significant risk factors for LRAF after a single RFCA session were the left atrial diameter (LAD), left inferior pulmonary vein superior–inferior diameter (LIPV SID), PV number variation, circumferential pulmonary vein isolation (CPVI) combined with additional ablation, and early recurrence of atrial fibrillation (ERAF). The best cut-off value for LAD was 35.5 mm. Conclusions During a 3-year follow-up, about 70% of the patients with PAF maintained SR. LRAF after a single procedure was associated with the LAD, LIPV SID, PV number variation, CPVI combined with additional ablation, and ERAF.
TeleHospice: A Community-Engaged Model for Utilizing Mobile Tablets to Enhance Rural Hospice Care
Authors: Doolittle Gary C. , Nelson Eve-Lynn , Spaulding Ashley O. , Lomenick Adam F. , Krebill Hope M. , Adams Natasia J. , Kuhlman Sandy J. , Barnes Joe L. 
Published: February 2019

Background: In rural communities, providing hospice care can be a challenge. Hospice personnel sometimes travel great distances to reach patients, resulting in difficulty maintaining access, quality, cost-effectiveness, and safety. In 1998, the University of Kansas Medical Center piloted the country’s first TeleHospice (TH) service. At that time, challenges with broad adoption due to cost and attitudes regarding technology were noted. A second TH project was launched in early 2017 using newer technology; this article updates that ongoing implementation. Methods: The Organizational Change Manager was followed for the guided selection of the hospice partner. The University of Kansas Medical Center partnered with Hospice Services, Inc. (HSI), a leader in rural hospice care, providing services to 16 Kansas counties. Along with mobile tablets, a secure cloud-based videoconferencing solution was chosen for ease of use. Results: From August 2017 through January 2018, 218 TH videoconferencing encounters including 917 attendees occurred. Calls were made for direct patient care, family support, and administrative purposes. These TH calls have been shown to save HSI money, and initial reports suggest they may strengthen the communication and relationships between staff, patients, and the patient’s family. Conclusion: Finding innovative, cost-effective, and community-driven approaches such as TH are needed to continually advance hospice care. TeleHospice’s potential to supplement and improve hospice services while reducing costs is significant, but continued research is needed to understand best fit within frontier hospices, to inform future urban applications, and to address reimbursement.
Patient Perspectives on Advance Care Planning via a Patient Portal
Authors: Jordan Sarah R. , Brungardt Adreanne , Phimphasone-Brady Phoutdavone , Lum Hillary D. 
Published: February 2019

Background:Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits.Objective:To describe patient perspectives on use of patient portal-based ACP tools.Design:Interviews with patients who used portal-based ACP tools. The tools included an electronic Medical Durable Power of Attorney (MDPOA) form to designate a medical decision maker, a patient-centered educational web page, online messaging, and patient access to completed advance directives stored in the electronic health record (EHR).Setting:Regional health-care system with a common EHR.Measurements:Semistructured interviews with purposefully sampled patients who used the ACP tools. Questions explored motivations for using the tools and perceptions about how the tools fit into ACP. Analysis followed a grounded hermeneutic editing approach.Results:From 46 patients (mean age: 49, 63% female), 4 key themes emerged: (1) individualized explorations of the ACP tools, (2) personal initiation and engagement with ACP tools through the portal, (3) value of connecting ACP portal tools to clinical care, and (4) practicality of the ACP tools. Patients described benefits of communicating with health-care team members who referred them to online ACP tools, as well as having the electronic MDPOA form connected to clinical care.Conclusions:Patients considered the portal-based ACP tools to be practical and feasible to use within the scope of their own ACP experiences. Further study is needed to understand whether portal-based ACP tools increase the quality and quantity of ACP conversations and documentation that is available to inform medical decision-making.
Thoracic dog bite wounds in cats: a retrospective study of 22 cases (2005–2015)
Authors: Frykfors von Hekkel Anna K , Halfacree Zoë J 
Published: February 2019

Objectives The aim of this study was to describe a series of cats suffering from thoracic dog bite wounds, in order to detail the clinical, radiographic and surgical findings, and evaluate outcomes and factors associated with mortality. Methods The medical records of cats with thoracic dog bite wounds presenting to a single institution between 2005 and 2015 were retrospectively reviewed. Data relating to clinical presentation, wound depth and management, radiographic findings, surgical findings and mortality were collected. Wound depth was defined as no external wound, superficial, deep or penetrating, and wound management was defined as conservative, exploratory or thoracic exploration. Statistical analyses were performed using Fisher’s exact test, the Mann–Whitney U-test and the χ2 test. Results Twenty-two cats were included, of which two were euthanased on presentation. In cats where wound depth could be assessed (21/22), six had no external wounds, four had superficial wounds, three had deep wounds and eight suffered penetrating wounds. Sixteen cats also suffered wounds elsewhere, most commonly to the abdomen. Neither an abdominal wound nor abdominal surgery were associated with mortality. Pneumothorax was the most common radiographic finding (11/18). Individual radiographic lesions were not significantly associated with respiratory pattern, presence of pseudo-flail, need for thoracotomy or lung lobectomy, or survival. The presence of ⩾3 radiographic lesions was associated with the presence of a penetrating wound ( P = 0.025) and with having thoracic exploration ( P = 0.025). Local exploration was performed in 7/20 cats, while 8/20 underwent thoracic exploration. Wound management type was not significantly associated with mortality. Overall mortality rate was 27%. Conclusions and relevance Presence of ⩾3 radiographic lesions should raise suspicion of a penetrating injury and may be suggestive of injury requiring a greater level of intervention. The treating veterinarian should have a high index of suspicion for penetrating injury and be prepared in case thoracic exploratory surgery is necessary, particularly in the presence of pseudo-flail chest, pneumothorax or ⩾3 radiographic lesions.
Modelling the impact of multiple sclerosis on life expectancy, quality-adjusted life years and total lifetime costs: Evidence from Australia
Authors: Palmer Andrew J , van der Mei Ingrid , Taylor Bruce V , Clarke Philip M , Simpson Steve , Ahmad Hasnat 
Published: February 2019

Objectives: To quantify life expectancy (LE), quality-adjusted life years (QALYs) and total lifetime societal costs for a hypothetical cohort of Australians with multiple sclerosis (MS). Methods: A 4-state Markov model simulated progression from no/mild to moderate and severe disability and death for a cohort of 35-year-old women over a lifetime horizon. Death risks were calculated from Australian life tables, adjusted by disability severity. State-dependent relapse probabilities and associated disutilities were considered. Probabilities of MS progression and relapse were estimated from AusLong and TasMSL MS epidemiological databases. Annual societal (direct and indirect) costs (2017 Australian dollars) and health-state utilities for each state were derived from the Australian MS Longitudinal Study. Costs were discounted at 5% annually. Results: Mean (95% confidence interval (CI)) LE from age 35 years was 42.7 (41.6–43.8) years. This was 7.5 years less than the general Australian population. Undiscounted QALYs were 28.2 (26.3–30.0), a loss of 13.1 QALYs versus the Australian population. Discounted lifetime costs were $942,754 ($347,856–$2,820,219). Conclusion: We have developed a health economics model of the progression of MS, calculating the impact of MS on LE, QALYs and lifetime costs in Australia. It will form the basis for future cost-effectiveness analyses of interventions for MS.
Cardiology electronic consultations: Efficient and safe, but consultant satisfaction is equivocal
Authors: Bauer Brenton S , Nguyen-Phan Ai Len , Ong Michael K , Ziaeian Boback , Nguyen Kim-Lien 
Published: February 2019

Background Cardiovascular electronic consultation is a new service line in consultative medicine and enables care without in-person office visits. We aimed to evaluate accessibility and time saved as measures of efficiency, determine the safety of cardiology electronic consultations, and assess satisfaction by responding cardiologists. Methods Using a mixed-methods approach and a modified time-driven, activity-based, costing framework, we retrospectively analysed cardiology electronic consultations. A random subset of 500 electronic consultations referred between 2013–2017 were reviewed. Accessibility was determined based upon increased number of patients served without the need for an in-person clinic visit. To assess safety, medical records were reviewed for emergency room visits or hospital admission at six months from the initial electronic consultation date. Responding cardiologist satisfaction was assessed by voluntary completion of an online survey. Results The majority of electronic consultations were related to medication advice, clearance for surgery, evaluation of images, or guidance after abnormal testing. Recommendations included echo (10.8%), stress testing (5.0%), other imaging (4.0%) and other subspecialist referrals (3.8%). Electronic consultations were completed within 0.7±0.5 days of the request, with a time to completion of 5–30 min. Over a six-month follow-up, 13.9% of patients had an in-person visit and 2.2% of patients were hospitalised, but none were directly related to the electronic consultation question. Satisfaction by responding cardiologists was modest. Conclusion In conclusion, within a single-payer system, cardiology electronic consultations represent a convenient and safe alternative for providing consultative cardiovascular care, but further optimization is necessary to minimise electronic consultation fatigue experienced by cardiologists.
Precision microcatheter shaping in vertebrobasilar aneurysm coiling
Authors: Namba Katsunari , Higaki Ayuho , Kaneko Naoki , Nemoto Shigeru , Kawai Kensuke 
Published: February 2019

Background Inventing an optimal curve on a microcatheter is required for successful intracranial aneurysm coiling. Shaping microcatheters for vertebrobasilar artery aneurysm coiling is difficult because of the vessel’s long, tortuous and mobile anatomy. To overcome this problem, we devised a new method of shaping the microcatheter by using the patient’s specific vessel anatomy and the highly shapable microcatheter. We report our preliminary results of treating posterior circulation aneurysms by this method. Methods An unshaped microcatheter (Excelsior XT-17; Stryker Neurovascular, Fremont, CA, USA) was pretreated by exposure to the patient’s vessel for five minutes. The microcatheter was placed in the vicinity of the targeted aneurysm and was left in contact with the patient’s vessel before extraction. This treatment precisely formed a curve on the microcatheter shaft identical to the patient’s vessel anatomy. Following the pretreatment, the tip of the microcatheter was steam shaped according to the long axis of the target aneurysm. Five consecutive vertebrobasilar aneurysms were treated using this shaping method and evaluated for the clinical and anatomical outcomes and microcatheter accuracy and stability. Results All of the designed microcatheters matched the vessel and aneurysm anatomy except in one case that required a single modification. All aneurysms were successfully catheterized without the assistance of a microguidewire, and matched the long axis of the aneurysm. All microcatheters retained stability until the end of the procedure. Conclusions A precise microcatheter shaping for a vertebrobasilar artery aneurysm may be achieved by using the patient’s actual vessel anatomy and the highly shapable microcatheter.
Neuroform Atlas stent in treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries: a single-centre experience
Authors: Borota Ljubisa , Mahmoud Ehab , Nyberg Christoffer 
Published: February 2019

Aim of the study To present our experience in the treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent. Materials and methods Between January 2017 and February 2018 we treated iatrogenic dissections of three internal carotid arteries and three vertebral arteries. These iatrogenic dissections occurred during the endovascular treatment of ruptured and unruptured intracranial aneurysms. The indication for stenting was haemodynamically significant, flow-limiting dissection with threatening flow arrest. In all six cases, the dissections were treated by placement of Neuroform Atlas stents in the dissected segments of internal carotid or vertebral arteries. Deployment of the stent was followed by the usual dual antiplatelet regimen. Results Single or multiple Neuroform Atlas stents were deployed without any technical difficulties, and blood flow was restored immediately after placement of the stents in all six cases. Midterm follow-up (6–8 months) showed complete reconstruction of the shape and lumen of all treated arteries, with negligible intimal hyperplasia. Conclusion Our results indicate that a favourable outcome can be achieved by treating iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.
Sero-prevalence of transfusion-transmittable infections and associated factors among blood donors in Eastern Ethiopia: an Institutional-based cross-sectional study
Authors: Heyredin Ibrahim , Mengistie Bezatu , Weldegebreal Fitsum 
Published: February 2019

Background: Blood transfusion saves millions of lives each year globally. But, it was associated with certain risks which can lead to adverse consequences. However, there is paucity of information regarding to the sero-prevalence and risk factor of transfusion-transmittable infections among blood donors in Eastern Ethiopia. Objective: The aim of this study was to determine the sero-prevalence of transfusion-transmittable infections and associated factors among blood donors in Eastern Ethiopia from February to March 2018. Methods: An institutional-based cross-sectional study was conducted among 500 blood donors in Eastern Ethiopia. Data were collected using a structured questionnaire and laboratory blood screening. Data were analyzed using Statistical Package for Social Sciences version 20. Statistically significance was considered at p < 0.05. Results: The overall sero-prevalence of transfusion-transmittable infections was 12.4% (95% confidence interval: 9.5, 15.3). Hepatitis B virus (6.6%) and syphilis (3.4%) were found at high magnitude. Those with family having human immunodeficiency virus or hepatitis (adjusted odd ratio = 2.91; 95% confidence interval: 1.33, 6.33), giving care for human immunodeficiency virus or hepatitis patient (adjusted odd ratio = 3.24; 95% confidence interval: 1.49, 7.07), multiple sex partner (adjusted odd ratio = 2.56; 95% confidence interval: 1.21, 5.19), unsafe sex (adjusted odd ratio = 2.99; 95% confidence interval: 1.51, 5.92), dental procedure (adjusted odd ratio = 2.75; 95% confidence interval: 1.20, 6.28), and had no formal education (adjusted odd ratio = 2.46; 95% confidence interval: 1.24, 4.86) were significantly associated with transfusion-transmittable infections. Conclusion: The prevalence of transfusion-transmittable infections in this study was relatively high compared to studies conducted earlier in Ethiopia. Factors such as unsafe sex, multiple sex partner, dental procedure, and family with human immunodeficiency virus or hepatitis, provide health care for human immunodeficiency virus–infected or hepatitis patients, donor type, and educational level were significantly associated with transmission-transmittable infections. Thus, health promotion about prevention and control transmission-transmittable infections should be given to the community by considering the identified risk factors. Each of the blood banks and regional health bureaus in the study area should mobilize community for increasing repeated voluntary donors through promotion of blood bank activity.
Cross-sectional study of smoking exposure: no differential effect on OCT metrics in a cohort of MS patients
Authors: Rosso Mattia , Kimbrough Dorlan J , Gonzalez Cindy T , Glanz Bonnie I , Healy Brian C , Rocca Maria Assunta , Filippi Massimo , Weiner Howard , Chitnis Tanuja 
Published: February 2019

Background Optical coherence tomography (OCT) provides quantitative measures of retinal layer thickness. Cigarette smoking is a risk factor for multiple sclerosis (MS) onset and disease severity: its effects on OCT metrics have not been assessed. Objective The objective of this study was to assess the effect of smoking history on retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform (GCIP) of MS patients by OCT. Methods 112 MS patients were recruited from the Brigham and Women’s Hospital. Spectralis OCT scans were acquired to measure GCIP, peripapillary RNFL, and total macular volume. Multivariable linear mixed effects regression model assessed RNFL and GCIP change with fixed effects for smoking history while adjusting for optic neuritis eye status, age, disease duration, sex, baseline EDSS, and disease modifying therapies (DMTs). Results Smoking histories were available for 102 patients: 46 (45.10%) had a history of smoking cigarettes and 56 (54.90%) never smoked. No statistically significant differences were found between ever-smokers and never-smokers with respect to GCIP, RNFL, and macular volume. Conclusion Our study shows no significant difference in retinal thickness between ever-smokers and never-smokers. If confirmed, this result suggests mechanistic differences between the retina and other central nervous system (CNS) compartments in response to smoking and should be noted when considering OCT as a surrogate measure of CNS activity.
Investigation of the effect of para-amino benzoic acid (PABA) added starch-coated chemicals on the printability properties of paper
Authors: Ozcan Arif 
Published: February 2019

Introduction: Paper is the most important material of the printing industry and is being improved due to the increasing needs of industry. The most important process to improve the optical and physical properties of paper is the surface coating. Paper has a smoother and opaquer surface with surface coating. In addition, brightness, whiteness, and yellowness values   are improved with surface coating. Ultraviolet (UV) light in sunlight causes changes in the structure of the paper and coating chemicals and accordingly causes yellowing. Para-amino benzoic acid (PABA), due to its chemical structure, is a UV-blocking agent used in sunscreen creams. Methods: The effect of PABA on paper gloss, yellowness, and lightfastness values   was investigated by adding it into the surface coating formulation. For this purpose, coating formulations were prepared with cationic starch and 3%, 5%, and 7% PABA; coatings were applied to the paper according to laboratory condition standards. Coated papers were printed with an IGT-C1 lab-type offset printability device with magenta ink. The printed papers were then exposed to a light fastness test with Solarbox. The color, brightness, and yellowness values   of all samples before and after lightfastness were measured with an X-Rite spectrophotometer. The gloss of coated and printed paper sample values was measured with a BYK-Gardner glossmeter. Results: The gloss values   of paper to which PABA was added, increased; however, it was determined that these gloss values   decreased after the lightfastness test. Conclusions: PABA-added cationic starch coatings are more affected by UV light than cationic starch coatings.