bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study
Authors: Brandt Carl Joakim , Clemensen Jane , Nielsen Jesper Bo , Søndergaard Jens 
Published: March 2018

ObjectivesAssisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool, including the support of peers and healthcare professionals.SettingGeneral practice clinics in the Region of Southern Denmark.Participants10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight.ResultsThe main themes identified were facilitators, barriers and support from family and peers. Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance. It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person. Often, significant life events were identified as catalysts for successful long-term lifestyle changes. Dominant barriers to change were perception of insurmountable obstacles, experience of lack of self-efficacy and excess eating of high-calorie food. Finally, experiencing of trustworthy person-to-person forums, need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change.ConclusionThe most important driver in long-term weight loss was a strong relationship with a healthcare professional. Collaborative e-health tools can support the relationship and behavioural changes through monitoring and providing relevant feedback. The support from family and peers also matters, and long-term success depends on the ability to establish strong, positive support on a day-to-day basis.
National trends in emergency readmission rates: a longitudinal analysis of administrative data for England between 2006 and 2016
Authors: Friebel Rocco , Hauck Katharina , Aylin Paul , Steventon Adam 
Published: March 2018

ObjectiveTo assess trends in 30-day emergency readmission rates across England over one decade.DesignRetrospective study design.Setting150 non-specialist hospital trusts in England.Participants23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016.Primary and secondary outcomesWe examined emergency admissions that occurred within 30 days of discharge from hospital (‘emergency readmissions’) as a measure of healthcare quality. Presented are overall readmission rates, and disaggregated by the nature of the indexed admission, including whether it was elective or emergency, and by clinical health condition recorded. All rates were risk-adjusted for patient age, gender, ethnicity, socioeconomic status, comorbidities and length of stay.ResultsThe average risk-adjusted, 30-day readmission rate increased from 6.56% in 2006/2007 to 6.76% (P<0.01) in 2012/2013, followed by a small decrease to 6.64% (P<0.01) in 2015/2016. Emergency readmissions for patients discharged following elective procedures decreased by 0.13% (P<0.05), whereas those following emergency admission increased by 1.27% (P<0.001). Readmission rates for hip or knee replacements decreased (−1.29%; P<0.001); for acute myocardial infarction (−0.04%; P<0.49), stroke (+0.62%; P<0.05), chronic obstructive pulmonary disease (+0.41%; P<0.05) and heart failure (+0.15%; P<0.05) remained stable; and for pneumonia (+2.72%; P<0.001), diabetes (+7.09%; P<0.001), cholecystectomy (+1.86%; P<0.001) and hysterectomy (+2.54%; P<0.001) increased.ConclusionsOverall, emergency readmission rates in England remained relatively stable across the observation period, with trends of slight increases contained post 2012/2013. However, there were large variations in trends across clinical areas, with some experiencing marked increases in readmission rates. This highlights the need to better understand variations in outcomes across clinical subgroups to allow for targeted interventions that will ensure highest standards of care provided for all patients.
Survival among Lung Cancer Patients in the U.S. Military Health System: A Comparison with the SEER Population
Authors: Lin Jie , Kamamia Christine , Brown Derek , Shao Stephanie , McGlynn Katherine A. , Nations Joel A. , Carter Corey A. , Shriver Craig D. , Zhu Kangmin 
Published: March 2018

Abstract
Background: The U.S. military health system (MHS) provides universal health care access to its beneficiaries. However, whether the universal access has translated into improved patient outcome is unknown. This study compared survival of non–small cell lung cancer (NSCLC) patients in the MHS with that in the U.S. general population.
Methods: The MHS data were obtained from The Department of Defense's (DoD) Automated Central Tumor Registry (ACTUR), and the U.S. population data were drawn from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. The study subjects were NSCLC patients diagnosed between January 1, 1987, and December 31, 2012, in ACTUR and a sample of SEER patients who were matched to the ACTUR patients on age group, sex, race, and year of diagnosis group with a matching ratio of 1:4. Patients were followed through December 31, 2013.
Results: A total of 16,257 NSCLC patients were identified from ACTUR and 65,028 matched patients from SEER. Compared with SEER patients, ACTUR patients had significantly better overall survival (log-rank P &lt; 0.001). The better overall survival among the ACTUR patients remained after adjustment for potential confounders (HR = 0.78, 95% confidence interval, 0.76–0.81). The survival advantage of the ACTUR patients was present regardless of cancer stage, grade, age group, sex, or race.
Conclusions: The MHS's universal care and lung cancer care programs may have translated into improved survival among NSCLC patients.
Impact: This study supports improved survival outcome among NSCLC patients with universal care access. Cancer Epidemiol Biomarkers Prev; 27(6); 673–9. ©2018 AACR.
Association of p27 and Cyclin D1 Expression and Benefit from Adjuvant Trastuzumab Treatment in HER2-Positive Early Breast Cancer: A TransHERA Study
Authors: Filipits Martin , Dafni Urania , Gnant Michael , Polydoropoulou Varvara , Hills Margaret , Kiermaier Astrid , de Azambuja Evandro , Larsimont Denis , Rojo Federico , Viale Giuseppe , Toi Masakazu , Harbeck Nadia , Prichard Kathleen I. , Gelber Richard D. , Dinh Phuong , Zardavas Dimitrios , Leyland-Jones Brian , Piccart-Gebhart Martine J. , Dowsett Mitch 
Published: March 2018

AbstractPurpose: To assess the prognostic and predictive value of selected biomarkers involved in cell-cycle regulation or proliferation in patients with HER2-positive early breast cancer.Experimental Design: Protein expression of TOP2A, Ki67, cyclin D1, and p27 was immunohistochemically determined in tissue microarrays of surgical specimens from 862 patients randomized to trastuzumab (1 or 2 years; N = 561) and observation (N = 301) arms of the HERA trial. The primary analysis endpoint was disease-free survival (DFS). Biomarkers were examined as continuous or categorical variables (predefined cutoffs). Interaction terms between biomarkers and treatment were assessed in multivariate Cox models adjusted for variables of clinical interest.Results: A significant interaction was detected between p27 and treatment (adjusted P = 0.0049). Trastuzumab effect was significant in the p27-low subgroup (≤70% p27-positive tumor cells; N = 318). HR Comb Trast vs. Obs 0.44, 95% CI, 0.29–0.65 (P &lt; 0.001). No trastuzumab effect was observed in the p27-high subgroup N = 435; HR Comb Trast vs. Obs 0.97, 95% CI, 0.66–1.44, P = 0.89), indicating that these patients derived little or no benefit from trastuzumab treatment. A prognostic effect of p27 on DFS was observed, with p27-high patients experiencing half the hazard of a DFS event compared with low ones (HR p27 High vs. Low 0.49, 95% CI, 0.32–0.75). TOP2A, Ki67, and cyclin D1, as categorical variables were not predictive, whereas cyclin D1 as continuous variable was predictive of trastuzumab benefit.Conclusions: In TransHERA, patients with HER2-positive early breast cancer with low p27 expression in their tumors benefited from trastuzumab treatment, whereas patients with high p27 expression did not. Clin Cancer Res; 24(13); 3079–86. ©2018 AACR.
Morphological and molecular characterisation of Longidorus pinus sp. n. (Nematoda: Longidoridae) from China and a key to known species of Longidorus in China
Authors: Xu Yumei , Ye Weimin , Wang Jianming , Zhao Zengqi 
Published: March 2018

SummaryLongidorus pinussp. n. from China is characterised by females 3.3-4.9 mm long; lip region 8-12 μm diam., distinctly offset by a constriction; amphidial fovea pocket-shaped without basal lobes; a short odontostyle (67-81 μm); anteriorly located guide ring (30-38 μm); and short and conoid tail (31-40 μm long, c = 84-138, c′ = 1.2-1.9), with one or two pairs of caudal pores on each side. Males were not found. Three developmental juvenile stages were identified, the first-stage juvenile with conoid tail (c′ = 2.4-2.9). The polytomous key codes for the new species are: A2(3), B1, C23, D4, E1, F2, G23, H23, I1, J2, K6. Molecular phylogenetic analyses based on SSU, D2-D3 of LSU, ITS1 and ITS2 rDNA sequences indicate thatL. pinussp. n. is closely related toL. hangzhouensis,L. asiaticus, andL. camelliae, all of which apparently share a common Asiatic geographic origin. In addition, a key for identification ofLongidorusfound in China, based on morphological characters of both female and first-stage juvenile, is provided.
Non-appearance before the International Court of Justice and the Role and Function of Judges ad hoc
Authors: Sarmiento Lamus Andres , Arévalo Ramírez Walter 
Published: March 2018

Abstract
An endless discussion has taken place regarding the role and function of judges ad hoc in contemporary international adjudication. In this regard, doctrine has been important through its ample contribution to the understanding of the institution of the judge ad hoc and its role and function. In fact, from these contributions it is possible to affirm the relevance of the judge ad hoc in contemporary international adjudication. Nonetheless, all these aspects have been analysed having in mind cases where both parties take part in the proceedings. Consequently, a question arises as to what is the role and function of a judge ad hoc when the appointing state fails to defend its case. This article seeks therefore to analyse the role and function of judges ad hoc in cases of partial non-appearance before the International Court of Justice.
Outcomes of Surgical Treatment for Anterior Tibial Stress Fractures in Athletes: A Systematic Review
Authors: Chaudhry Zaira S. , Raikin Steven M. , Harwood Marc I. , Bishop Meghan E. , Ciccotti Michael G. , Hammoud Sommer 
Published: March 2018

Background: Although most anterior tibial stress fractures heal with nonoperative treatment, some may require surgical management. To our knowledge, no systematic review has been conducted regarding surgical treatment strategies for the management of chronic anterior tibial stress fractures from which general conclusions can be drawn regarding optimal treatment in high-performance athletes. Purpose: This systematic review was conducted to evaluate the surgical outcomes of anterior tibial stress fractures in high-performance athletes. Study Design: Systematic review; Level of evidence, 4. Methods: In February 2017, a systematic review of the PubMed, MEDLINE, Cochrane, SPORTDiscus, and CINAHL databases was performed to identify studies that reported surgical outcomes for anterior tibial stress fractures. Articles meeting the inclusion criteria were screened, and reported outcome measures were documented. Results: A total of 12 studies, published between 1984 and 2015, reporting outcomes for the surgical treatment of anterior tibial stress fractures were included in this review. All studies were retrospective case series. Collectively, surgical outcomes for 115 patients (74 males; 41 females) with 123 fractures were evaluated in this review. The overall mean follow-up was 23.3 months. The most common surgical treatment method reported in the literature was compression plating (n = 52) followed by drilling (n = 33). Symptom resolution was achieved in 108 of 123 surgically treated fractures (87.8%). There were 32 reports of complications, resulting in an overall complication rate of 27.8%. Subsequent tibial fractures were reported in 8 patients (7.0%). Moreover, a total of 17 patients (14.8%) underwent a subsequent procedure after their initial surgery. Following surgical treatment for anterior tibial stress fracture, 94.7% of patients were able to return to sports. Conclusion: The available literature indicates that surgical treatment of anterior tibial stress fractures is associated with a high rate of symptom resolution and return to play in athletes, although the high complication rate and potential need for subsequent procedures are important considerations for surgeons and patients.
A Canadian Population-Based Cohort to the Study Cost and Burden of Surgically Resected Hidradenitis Suppurativa
Authors: Mehdizadeh Ali , Rosella Laura , Alavi Afsaneh , Sibbald Gary , Farzanfar Delaram , Hazrati Ali , Vernich Lee , Laporte Audrey , Hu Howard , Bashash Morteza 
Published: March 2018

Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease with long-lasting comorbidities that impose direct and indirect costs on the health care system. However, limited studies have estimated the burden of this disease in Canada, and no population-based studies have previously addressed this condition. Objectives: This work describes the characteristics of a population-based HS cohort to address the existing knowledge gap on the burden of HS for the Canadian health care system. This cohort will provide a foundation for further studies about clinical outcomes and risk factors of HS by providing opportunities for merging additional databases. Methods: Data on demographic information, morbidities, relative resource use, and the cost of sectorial services were obtained from the Institute for Clinical Evaluative Sciences (ICES). All residents of Ontario covered by the Ontario Health Insurance Plan (OHIP) between April 1, 2002, and March 31, 2013, who underwent surgery for HS, defined by OHIP billing codes, were included. Results: A total of 6244 cases were included in the analysis, following quality control procedures. Twice as many females were treated surgically relative to males. The majority of individuals treated were under the age of 64, with more than half having a moderate level of morbidity (according to Resource Utilization Bands defined by the Johns Hopkins Adjusted Clinical Group Classification System). Conclusions: This cohort study is the first population-based resource about HS in Canada. Administrative population-based databases provide essential information to assess the burden of chronic diseases and identify factors associated with higher cost.
Postoperative Delirium After Esophagectomy: The Efficacy of Continual Monitoring Using the NEECHAM Confusion Scale
Authors: Ono Hiroshi , Doki Yuichiro , Miyata Hiroshi , Yamasaki Makoto , Takahashi Tsuyoshi , Endo Yoshimi , Umeshita Koji 
Published: March 2018

Abstract Background Although a majority of nurses understand that delirium is a major issue in perioperative care, professional barriers to routine monitoring using delirium assessment tools exist. The aim of this study was to assess the effectiveness of continual monitoring of postoperative delirium in patients that have undergone esophagectomy using the Neelon and Champagne (NEECHAM) Confusion Scale (NCS). Methods Demographic data and case histories were obtained from medical records. We conducted NCS scoring for 1 week after surgery and verified the daily changes in scores. Patients were classified into normal, neurocognitive-change, and complication groups for the analysis of the influence of preoperative neurocognitive changes and postoperative complications. Results Data from 19 patients were analyzed. NCS scores decreased sharply on the first day and then significantly recovered each day. The normal group exhibited a steady recovery process, but the other groups deviated from this progression. The incidence of delirium was highest on the first day. The incidence in the normal group decreased each day, but other groups developed delirium for an extended time. In the NCS subscale score analyses, the information processing score was low in the neurocognitive-change group. The complication group exhibited delayed recovery of the physiologic control score. Conclusions We observed the recovery process of mental function after esophagectomy as well as the impact of preoperative neurocognitive changes and postoperative complications. Continual monitoring of postoperative mental function may predict postoperative delirium. For early detection and prevention of delirium, nurses should monitor postoperative mental function via daily observation.
Selumetinib in Combination With Dacarbazine in Patients With Metastatic Uveal Melanoma: A Phase III, Multicenter, Randomized Trial (SUMIT)
Authors: Carvajal Richard D. , Piperno-Neumann Sophie , Kapiteijn Ellen , Chapman Paul B. , Frank Stephen , Joshua Anthony M. , Piulats Josep M. , Wolter Pascal , Cocquyt Veronique , Chmielowski Bartosz , Evans T.R. Jeffry , Gastaud Lauris , Linette Gerald , Berking Carola , Schachter Jacob , Rodrigues Manuel J. , Shoushtari Alexander N. , Clemett Delyth , Ghiorghiu Dana , Mariani Gabriella , Spratt Shirley , Lovick Susan , Barker Peter , Kilgour Elaine , Lai Zhongwu , Schwartz Gary K. , Nathan Paul 
Published: March 2018

Purpose Uveal melanoma is the most common primary intraocular malignancy in adults with no effective systemic treatment option in the metastatic setting. Selumetinib (AZD6244, ARRY-142886) is an oral, potent, and selective MEK1/2 inhibitor with a short half-life, which demonstrated single-agent activity in patients with metastatic uveal melanoma in a randomized phase II trial. Methods The Selumetinib (AZD6244: ARRY-142886) (Hyd-Sulfate) in Metastatic Uveal Melanoma (SUMIT) study was a phase III, double-blind trial ( ClinicalTrial.gov identifier: NCT01974752) in which patients with metastatic uveal melanoma and no prior systemic therapy were randomly assigned (3:1) to selumetinib (75 mg twice daily) plus dacarbazine (1,000 mg/m2 intravenously on day 1 of every 21-day cycle) or placebo plus dacarbazine. The primary end point was progression-free survival (PFS) by blinded independent central radiologic review. Secondary end points included overall survival and objective response rate. Results A total of 129 patients were randomly assigned to receive selumetinib plus dacarbazine (n = 97) or placebo plus dacarbazine (n = 32). In the selumetinib plus dacarbazine group, 82 patients (85%) experienced a PFS event, compared with 24 (75%) in the placebo plus dacarbazine group (median, 2.8 v 1.8 months); the hazard ratio for PFS was 0.78 (95% CI, 0.48 to 1.27; two-sided P = .32). The objective response rate was 3% with selumetinib plus dacarbazine and 0% with placebo plus dacarbazine (two-sided P = .36). At 37% maturity (n = 48 deaths), analysis of overall survival gave a hazard ratio of 0.75 (95% CI, 0.39 to 1.46; two-sided P = .40). The most frequently reported adverse events (selumetinib plus dacarbazine v placebo plus dacarbazine) were nausea (62% v 19%), rash (57% v 6%), fatigue (44% v 47%), diarrhea (44% v 22%), and peripheral edema (43% v 6%). Conclusion In patients with metastatic uveal melanoma, the combination of selumetinib plus dacarbazine had a tolerable safety profile but did not significantly improve PFS compared with placebo plus dacarbazine.
Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase II Study of Fruquintinib After Two Prior Chemotherapy Regimens in Chinese Patients With Advanced Nonsquamous Non‒Small-Cell Lung Cancer
Authors: Lu Shun , Chang Jianhua , Liu Xiaoqing , Shi Jianhua , Lu You , Li Wei , Yang Jin-ji , Zhou Jianying , Wang Jie , An Tongtong , Yang Lei , Liu Zhe , Zhou Xiangdong , Chen Mo , Hua Ye , Su Weiguo 
Published: March 2018

Purpose Patients with advanced non‒small-cell lung cancer (NSCLC) who fail two lines of chemotherapy have unmet medical needs. The kinase inhibitor fruquintinib selectively targets vascular endothelial growth factor receptors and, hence, tumor angiogenesis and lymphogenesis. This randomized, double-blind, placebo-controlled, multicenter phase II trial evaluated the efficacy and safety of fruquintinib in patients with advanced nonsquamous NSCLC who experienced disease progression after second-line chemotherapy. Patients and Methods Eligible patients were randomly assigned (two to one; stratified by epidermal growth factor receptor status) to receive fruquintinib or placebo, both in combination with best supportive care. Oral fruquintinib (5 mg once daily) was given in 4-week cycles of 3 weeks of treatment followed by 1 week off. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1. The primary end point was progression-free survival (PFS) evaluated by a blinded image central review (BICR) committee. Secondary end points included investigator-evaluated PFS, objective response rate, disease control rate, overall survival, and safety. Results Ninety-one patients from 12 hospitals received treatment with fruquintinib (n = 61) or placebo (n = 30). Median PFS was 3.8 months with fruquintinib by both BICR and investigators’ evaluations (hazard ratio by BICR, 0.34; 95% CI, 0.20 to 0.57; P < .001). Three- and 6-month survival rates were 90.2% and 67.2% in the fruquintinib group and 73.3% and 58.8% in the placebo group, respectively. The objective response rate and disease control rate were 13.1% and 60.7% with fruquintinib, compared with 0% and 13.3% with placebo ( P = .041 and < .001), respectively. The most common treatment-emergent adverse events with fruquintinib (≥ grade 3) were hypertension (8.2%), hand-foot syndrome (4.9%), and proteinuria (4.9%). Conclusion Third- and fourth-line fruquintinib for advanced NSCLC was superior to placebo and had an acceptable safety profile.