bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluation of the cost of different methods of retesting chlamydia positive individuals in England
Authors: Looker Katharine J , Buitendam Erna , Woodhall Sarah C , Hollis Emma , Ong Koh-Jun , Saunders John M , Dunbar Kevin , Turner Katherine M E 
Published: March 2019

ObjectivesThe National Chlamydia Screening Programme (NCSP) in England opportunistically screens eligible individuals for chlamydia infection. Retesting is recommended three3 months after treatment following a positive test result, but no guidance is given on how local areas should recall individuals for retesting. Here , we compare cost estimates for different recall methods to inform the optimal delivery of retesting programmes.DesignEconomic evaluation.SettingEngland.MethodsWe estimated the cost of chlamydia retesting for each of the six most commonly used recall methods in 2014 based on existing cost estimates of a chlamydia screen. Proportions accepting retesting, opting for retesting by post, returning postal testing kits and retesting positive were informed by 2014 NCSP audit data. Health professionals ‘sense-checked’ the costs.Primary and secondary outcomesCost and adjusted cost per chlamydia retest; cost and adjusted cost per chlamydia retest positive.ResultsWe estimated the cost of the chlamydia retest pathway, including treatment/follow-up call, to be between £45 and £70 per completed test. At the lower end, this compared favourably to the cost of a clinic-based screen. Cost per retest positive was £389–£607. After adjusting for incomplete uptake, and non-return of postal kits, the cost rose to £109–£289 per completed test (cost per retest positive: £946–£2,506). The most economical method in terms of adjusted cost per retest was no active recall as gains in retest rates with active recall did not outweigh the higher cost. Nurse-led client contact by phone was particularly uneconomical, as was sending out postal testing kits automatically.ConclusionsRetesting without active recall is more economical than more intensive methods such as recalling by phone and automatically sending out postal kits. If sending a short message service (SMS) could be automated, this could be the most economical way of delivering retesting. However, patient choice and local accessibility of services should be taken into consideration in planning.
‘Managing scarcity’– a qualitative study on volunteer-based healthcare for chronically ill, uninsured migrants in Berlin, Germany
Authors: Linke Charlotte , Heintze Christoph , Holzinger Felix 
Published: March 2019

ObjectivesIn Germany, healthcare for people lacking legal residency status and European Union citizens without health insurance is often provided by non-governmental organisations. Scientific studies assessing the situation of the patients with chronic diseases in this context are scarce. We aimed to characterise medical care for chronically ill migrants without health insurance and outline its possibilities and limitations from the treating physicians’ perspective.DesignQualitative semi-structured interviews; qualitative content analysis.SettingOrganisations and facilities providing healthcare for uninsured migrants: free clinics, medical practices and public health services.Participants14 physicians working regularly in healthcare for uninsured migrants.ResultsDelayed contact to the healthcare system was frequently addressed in the interviews. Care was described as constrained by a scarcity of resources that often impedes adequate treatment for many conditions, most pronounced in the case of oncological diseases or chronic viral infections (HIV, hepatitis). For other chronic conditions such as cardiovascular diseases or diabetes, some diagnostics and basic medications were described as partially available, while management of complications or rehabilitative measures are frequently unfeasible. For the patients with mental health problems, attainability of psychotherapeutic treatment is reported as severely limited. Care is predominantly described as fragmented with limitations to information flow and continuity. Which level of care a patient receives appears to depend markedly on the respective non-governmental organisation and the individual commitment, subjective decisions and personal connections of the treating physician.ConclusionsRestrictions in medical care for uninsured migrants have even more impact on chronically ill patients. Volunteer-based care often constitutes an inadequate compensation for regular access to the healthcare system, as it is strongly influenced by the limitation of its resources and its arbitrariness.
‘Being normal’ and self-identity: the experience of volunteering in individuals with severe mental disorders—a qualitative study
Authors: Pérez-Corrales Jorge , Pérez-de-Heredia-Torres Marta , Martínez-Piedrola Rosa , Sánchez-Camarero Carlos , Parás-Bravo Paula , Palacios-Ceña Domingo 
Published: March 2019

ObjectiveThis study sought to explore the views and experiences of a group of people with severe mental disorders (SMDs) who performed volunteer services.DesignA qualitative phenomenological study.SettingCommunity public mental health services of the Community of Madrid and the province of Barcelona (Spain).ParticipantsPurposive sampling techniques were used between September 2016 and April 2017. The inclusion criteria were: individuals aged 18–65 years who participated in volunteer activities during the performance of this study, based on the regulations of volunteer services in Spain and the community of Madrid; a diagnosis of non-organic psychotic disorder (F20.x, F21, F22, F24, F25, F28, F29, F31.x, F32.3 and F33) according to the International Classification of Diseases, 10th Revision; an evolution of ≥2 years; and a moderate to severe dysfunction of global functioning with scores ≤70 in the Global Assessment of Functioning Scale. Ultimately, 23 people with SMD participated in the study with a mean age of 47 years (SD 8.23).MethodsData were collected through in-depth interviews and researcher field notes. A thematic analysis was performed following appropriate guidelines for qualitative research.ResultsTwo main themes emerged to describe the experience of participating in volunteer activities: (1) rebuilding self-identity, based on the participant’s experience of volunteering, of acquiring a new role and a new perceived identity that made them feel valued and respected; and (2) being a so-called normal person with a ‘normal’ life, based on recovering a sense of normality, unmarked by the illness, thanks to daily responsibilities and occupations.ConclusionsQualitative research offers insight into the way people with SMD experience volunteering and may help to improve understanding of the underlying motivations that drive these individuals. These findings may be applied to improve guidance during their process of recovery and subsequent inclusion into society.
Patient involvement in the implementation of infection prevention and control guidelines and associated interventions: a scoping review
Authors: Fernandes Agreli Heloise , Murphy Michael , Creedon Sile , Ni Bhuachalla Cliodhna , O’Brien Deirdre , Gould Dinah , Savage Eileen , Barry Fiona , Drennan Jonathan , Smiddy Maura P , Condell Sarah , Horgan Sinead , Murphy Siobhan , Wills Teresa , Burton Aileen , Hegarty Josephine 
Published: March 2019

ObjectiveTo explore patient involvement in the implementation of infection prevention and control (IPC) guidelines and associated interventions.DesignScoping review.MethodsA methodological framework was followed to identify recent publications on patient involvement in the implementation of IPC guidelines and interventions. Initially, relevant databases were searched to identify pertinent publications (published 2013–2018). Reflecting the scarcity of included studies from these databases, a bidirectional citation chasing approach was used as a second search step. The reference list and citations of all identified papers from databases were searched to generate a full list of relevant references. A grey literature search of Google Scholar was also conducted.ResultsFrom an identified 2078 papers, 14 papers were included in this review. Our findings provide insights into the need for a fundamental change to IPC, from being solely the healthcare professionals (HCPs) responsibility to one that involves a collaborative relationship between HCPs and patients. This change should be underpinned by a clear understanding of patient roles, potential levels of patient involvement in IPC and strategies to overcome barriers to patient involvement focusing ontheprofessional–patient relationship (eg, patient encouragement through multimodal educational strategies and efforts to disperse professional’s power).ConclusionsThere is limited evidence regarding the best strategies to promote patient involvement in the implementation of IPC interventions and guidelines. The findings of this review endorse the need for targeted strategies to overcome the lack of role clarity of patients in IPC and the power imbalances between patients and HCPs.
Knowledge and motivations of researchers publishing in presumed predatory journals: a survey
Authors: Cobey Kelly D , Grudniewicz Agnes , Lalu Manoj M , Rice Danielle B , Raffoul Hana , Moher David 
Published: March 2019

ObjectivesTo develop effective interventions to prevent publishing in presumed predatory journals (ie, journals that display deceptive characteristics, markers or data that cannot be verified), it is helpful to understand the motivations and experiences of those who have published in these journals.DesignAn online survey delivered to two sets of corresponding authors containing demographic information, and questions about researchers' perceptions of publishing in the presumed predatory journal, type of article processing fees paid and the quality of peer review received. The survey also asked six open-ended items about researchers' motivations and experiences.ParticipantsUsing Beall’s lists, we identified two groups of individuals who had published empirical articles in biomedical journals that were presumed to be predatory.ResultsEighty-two authors partially responded (~14% response rate (11.4%[44/386] from the initial sample, 19.3%[38/197] from second sample) to our survey. The top three countries represented were India (n=21, 25.9%), USA (n=17, 21.0%) and Ethiopia (n=5, 6.2%). Three participants (3.9%) thought the journal they published in was predatory at the time of article submission. The majority of participants first encountered the journal via an email invitation to submit an article (n=32, 41.0%), or through an online search to find a journal with relevant scope (n=22, 28.2%). Most participants indicated their study received peer review (n=65, 83.3%) and that this was helpful and substantive (n=51, 79.7%). More than a third (n=32, 45.1%) indicated they did not pay fees to publish.ConclusionsThis work provides some evidence to inform policy to prevent future research from being published in predatory journals. Our research suggests that common views about predatory journals (eg, no peer review) may not always be true, and that a grey zone between legitimate and presumed predatory journals exists. These results are based on self-reports and may be biased thus limiting their interpretation.
Active change interventions to de-implement low-value healthcare practices: a scoping review protocol
Authors: Parker Gillian , Rappon Tim , Berta Whitney 
Published: March 2019

BackgroundThere is recognition that the overuse of procedures, tests and medications strains the healthcare system financially and can cause unnecessary stress and harm to patients. In recent years, several initiatives have targeted the reduction or elimination of low-value practices in healthcare. Research suggests that passive interventions, such as the publication of guidelines, are often not sufficient to change behaviour and that active change interventions - interventions which actively implement strategies to change practices - are required to effect significant, sustained practice change. The purpose of this scoping review is to identify and characterise studies of active change interventions designed to reduce or eliminate low-value healthcare practices.MethodsWe will conduct a review of MEDLINE, EMBASE, CINAHL and Scopus databases from inception. Building on previous research, 40 key terms will be used to search literature. The screening process will be conducted separately by two researchers, with discrepancies resolved by a third. Empirical studies of active change interventions used to reduce or eliminate low-value practices will be included. Descriptive statistics and thematic analysis will be used to categorise the characteristics of the studies.Ethics and disseminationEthics approval is not required for this study. This scoping review will provide insights into the impact of several characteristics of active change interventions, including the number of interventions (single-faceted or multifaceted) and the level of implementation (individual or organisational). These results can provide guidance and direction for future research in de-implementation. The results will be disseminated through presentations at national and international conferences and the publication of a manuscript.
Exploring communication between parents and clinical teams following children’s heart surgery: a survey in the UK
Authors: Pagel Christina , Bull Catherine , Utley Martin , Wray Jo , Barron David J , Stoica Serban , Tibby Shane M , Tsang Victor , Brown Katherine L 
Published: March 2019

ObjectiveTo explore communication between clinicians and families of children undergoing heart surgery.DesignThis study was part of a larger study to select, define and measure the incidence of postoperative complications in children undergoing heart surgery. Parents of children recruited to a substudy between October 2015 and December 2017 were asked to complete a questionnaire about communication during their child’s inpatient stay. We explored all responses and then disaggregated by the following patient characteristics: presence of a complication, length of stay, hospital site, ethnicity and child’s age. This was a descriptive study only.SettingFour UK specialist hospitals.ResultsWe recruited 585 children to the substudy with 385 responses (response rate 66%).81% of parents reported that new members of staff always introduced themselves (18% sometimes, 1% no). Almost all parents said they were encouraged to be involved in decision-making, but often only to some extent (59% ‘yes, definitely’; 37% ‘to some extent’). Almost two-thirds of parents said they were told different things by different people which left them feeling confused (10% ‘a lot’; 53% ‘sometimes’). Two-thirds (66%) reported that staff were definitely aware of their child’s medical history (31% ‘to some extent’). 90% said the operation was definitely explained to them (9% ‘to some extent’) and 79% that they were definitely told what to do if they were worried after discharge (17% ‘to some extent’).Parents of children with a complication tended to give less positive responses for involvement in decision-making, consistent communication and staff awareness of their child’s medical history. Parents whose children had longer stays in hospital tended to report lower levels of consistent communication and involvement in decision-making.ConclusionsOur results emphasise the need for consistent communication with families, particularly where complications arise or for children who have longer stays in the hospital.
Electrodiagnostic data-driven clustering identifies a prognostically different subgroup of patients with chronic inflammatory demyelinating polyneuropathy
Authors: Baek Seol-Hee , Hong Yoon-Ho , Choi Seok-Jin , Ahn So Hyun , Park Kee Hong , Shin Je-Young , Sung Jung-Joon 
Published: March 2019

ObjectiveThis study aimed to explore the correlations between electrodiagnostic (EDX) features in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and to investigate whether EDX data-driven clustering can identify a distinct subgroup regarding clinical phenotype and treatment response.MethodsWe reviewed clinical and EDX data of 56 patients with definite CIDP fulfilling the 2010 European Federation of Neurological Societies and Peripheral Nerve Society criteria at two teaching hospitals. A hierarchical agglomerative clustering algorithm with complete linkage was used to partition the patients into subgroups with similar EDX features. A stepwise logistic regression analysis was performed to evaluate predictors of the long-term outcome.ResultsEDX data-driven clustering partitioned the patients into two clusters, identifying a distinct subgroup characterised by coexistence of prominent conduction slowing and markedly reduced distally evoked compound muscle action potential (CMAP) amplitudes. This cluster of patients was significantly over-represented by an atypical subtype (distal acquired demyelinating symmetric polyneuropathy) compared with the other cluster (70% vs 26.1%, p=0.042). Furthermore, patients in this cluster invariably showed favourable long-term treatment outcome (100% vs 63%, p=0.023). In logistic regression analyses, the initial disability (OR 6.1, 95% CI 2.4 to 25.4), F-wave latency (OR 0.93, 95% CI 0.86 to 0.98) and distal CMAP duration (OR 0.96, 95% CI 0.91 to 0.99) were significant predictors of the poor long-term outcome.ConclusionOur results show that EDX data-driven clustering could differentiate a pattern of EDX features with prognostic implication in patients with CIDP. Reduced distally evoked CMAPs may not necessarily predict poor responses to treatment, and active treatment is warranted when prominent slowing of conduction is accompanied in the distal segments.
Structure analysis of a dragline tooth and its wear prediction
Authors: Das Manbodh Kumar , Sarkar Shibayan , Choudhary Bhanwar Singh 
Published: March 2019

Dragline teeth are used to dig overburden rocks and fill the bucket by its action in surface mining. Thus, these teeth are very important for a better performance of the dragline. In the present investigation, efforts were made to determine the failure zone within the teeth through modeling, using the finite element software ANSYS workbench. The maximum deformation and maximum von-Mises stress were 0.286 mm and 801.38 MPa, respectively. From fatigue analysis, the minimum tool life was 24 540 cycle and the minimum factor of safety was 0.1 at the tip of the tool. Beyond the cutting edge (tip), the factor of safety was greater than 1.13. Finite element analysis was extended by varying the working load on the edge of the tool (68–86 tonnes) as well as the cutting angle (30°–36°). It was found that if the working load was increased, both corresponding maximum deformation and maximum von-Mises stress were increased, while the factor of safety was decreased. In the scanning electron microscopy analysis, wear phenomena such as rock intermixed, fracture of WC-grain, oxidized WC-grain, plastic deformation, cavity formation, cracking, and crushing were visible at magnification of 1000×.
Influence of inverter output voltage harmonic on surface-mounted permanent-magnet synchronous motor performance
Authors: Qiu Hongbo , Zhang Yong , Yang Cunxiang , Yi Ran 
Published: March 2019

The application of an inverter is becoming more and more widespread in the surface-mounted permanent-magnet synchronous motor (SMPMSM). A large number of voltage harmonics can be generated by the inverter. The electromagnetic torque, loss, and air-gap magnetic density of the SMPMSM are affected by voltage harmonic. To analyze its influence, taking a 3 kW 1500 r/min SMPMSM as an example, a two-dimensional transient electromagnetic field model is established. The correctness of the model is verified by comparing the experimental data with the calculated data. Firstly, the finite element method is used to calculate the electromagnetic field of the SMPMSM, and the performance parameters of the SMPMSM are obtained. Based on these parameters, the influence of voltage harmonic on motor performance is analyzed quantitatively. Secondly, the influence of the voltage harmonic on the air-gap magnetic field is analyzed, and the influence degree of the time harmonic on the air-gap magnetic field is determined. At the same time, torque ripple, average torque, and loss are studied when the different harmonics orders, amplitudes, and phase angles are contained in voltage, and the variation is obtained. Finally, the variation mechanism of eddy current loss is revealed. The conclusion of this paper provides reliable theoretical guidance for improving motor performance.
Relationship Between Body Mass Index, Antidiabetic Agents, and Midterm Mortality in Patients With Both Type 2 Diabetes Mellitus and Acute Coronary Syndrome
Authors: Jong Chien‐Boon , Li Hung‐Yuan , Pan Shin‐Liang , Hsieh Mu‐Yang , Su Fang‐Ying , Chen Kuan‐Chun , Yin Wei‐Hsian , Chan Shih‐Hung , Wu Yen‐Wen , Wang Kuo‐Yung , Chang Kuan‐Cheng , Hwang Juey‐Jen , Wu Chih‐Cheng 
Published: March 2019

Background
The aim of this study was to determine the influence of various antidiabetic therapies on the relationship between body mass index and all‐cause mortality in patients with diabetes mellitus and acute coronary syndrome.

Methods and Results

This was a prospective, observational study comprising 1193 patients diagnosed with type 2 diabetes mellitus and acute coronary syndrome. The patients were stratified into 4 body mass index categories, and their mortality rates were compared using time‐dependent Cox regression analysis using normal weight (body mass index, 18.5–23.9) as the reference. Subsequently, the influence of antidiabetic therapies on the association between
BMI
and mortality were analyzed. Seventy‐four patients (6.2%) died over 2 years of follow‐up. The mortality rate was lowest in the class I obese group (3.35%) and highest in the normal‐weight group (9.67%). After adjusting for covariates, class I obesity paradoxically remained significantly protective against mortality compared with normal weight (hazard ratio, 0.141;
P
=0.049); interaction term analysis showed that insulin therapy influenced this “obesity paradox” (
P
=0.045). When the patients were stratified by insulin use, the protective effect of obesity disappeared in the insulin‐treated patients but persisted in the non–insulin‐treated patients.

Conclusions
In patients with type 2 diabetes mellitus and acute coronary syndrome, the relationship between body mass index and mortality rate is U‐shaped, with class I obesity representing the nadir and normal weight the peak. The protective effect of obesity disappeared in patients treated with insulin.