bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning knee arthrocentesis using YouTube videos
Authors: Karim Jumanah , Marwan Yousef , Dawas Ahmed , Esmaeel Ali , Snell Linda 
Published: May 2019

SummaryBackgroundThis study aims to compare medical students’ educational outcomes in performing knee arthrocentesis through searching and using YouTube videos versus traditional supervisor‐led sessions.MethodSeventy‐one medical students were randomly assigned to three groups. Group A had a traditional supervisor‐led clinical session, where the supervisor demonstrated the procedure. Students in group B were provided with links to YouTube videos of knee arthrocentesis that were deemed to be of high educational quality, whereas group C searched and learned from any YouTube video that they found themselves based on the learning objectives provided. Student performance was first examined following the learning sessions, and then again after receiving feedback on the performance.ResultsPrior to feedback, statistically significant higher mean scores were noted for group A in the identification of an appropriate puncture site (p = 0.015), puncture site sterilization (p = 0.046), wearing sterile gloves (p < 0.001) and direction of needle insertion (p < 0.001). The overall mean scores (maximum possible score is 21) before feedback for groups A, B and C were 17.9 ± 1.9, 14.9 ± 2.0 and 15.4 ± 1.8, respectively (p < 0.001). The overall mean scores after feedback for groups A, B and C were 21.0 ± 0.0, 20.9 ± 0.3 and 21.0 ± 0.0, respectively (p = 0.037).ConclusionStudents performed equally whether they were provided with videos or found their own; however, without appropriate learner feedback from an instructor, YouTube videos cannot replace traditional supervisor‐led sessions for learning knee arthrocentesis.
Practicing Healthcare Professionals’ Evidence‐Based Practice Competencies: An Overview of Systematic Reviews
Authors: Saunders Hannele , Gallagher‐Ford Lynn , Kvist Tarja , Vehviläinen‐Julkunen Katri 
Published: May 2019

AbstractBackgroundEvidence‐based practice (EBP) competencies are essential for all practicing healthcare professionals to provide evidence‐based, quality care, and improved patient outcomes. The multistep EBP implementation process requires multifaceted competencies to successfully integrate best evidence into daily healthcare delivery.AimsTo summarize and synthesize the current research literature on practicing health professionals’ EBP competencies (i.e., their knowledge, skills, attitudes, beliefs, and implementation) related to employing EBP in clinical decision‐making.DesignAn overview of systematic reviews.MethodsPubMed/MEDLINE, CINAHL, Scopus, and Cochrane Library were systematically searched on practicing healthcare professionals’ EBP competencies published in January 2012–July 2017. A total of 3,947 publications were retrieved, of which 11 systematic reviews were eligible for a critical appraisal of methodological quality. Three independent reviewers conducted the critical appraisal using the Rapid Critical Appraisal tools developed by the Helene Fuld National Institute for Evidence‐Based Practice in Nursing & Healthcare.ResultsPracticing healthcare professionals’ self‐reported EBP knowledge, skills, attitudes, and beliefs were at a moderate to high level, but they did not translate into EBP implementation. Considerable overlap existed in the source studies across the included reviews. Few reviews reported any impact of EBP competencies on changes in care processes or patient outcomes. Most reviews were methodologically of moderate quality. Significant variation in study designs, settings, interventions, and outcome measures in the source studies precluded any comparisons of EBP competencies across healthcare disciplines.Linking Evidence to ActionAs EBP is a shared competency, the development, adoption, and use of an EBP competency set for all healthcare professionals are a priority along with using actual (i.e., performance‐based), validated outcome measures. The widespread misconceptions and misunderstandings that still exist among large proportions of practicing healthcare professionals about the basic concepts of EBP should urgently be addressed to increase engagement in EBP implementation and attain improved care quality and patient outcomes.
Role of human and porcine MHC DRB1 alleles in determining the intensity of individual human anti‐pig T‐cell responses
Authors: Hundrieser Joachim , Hein Rabea , Pokoyski Claudia , Brinkmann Antje , Düvel Heike , Dinkel Astrid , Trautewig Britta , Siegert Janina‐Franziska , Römermann Dorothee , Petersen Björn , Schwinzer Reinhard 
Published: May 2019

AbstractBackgroundDifferences in quality and strength of immune responses between individuals are mainly due to polymorphisms in major histocompatibility complex (MHC) molecules. Focusing on MHC class‐II, we asked whether the intensity of human anti‐pig T‐cell responses is influenced by genetic variability in the human HLA‐DRB1 and/or the porcine SLA‐DRB1 locus.MethodsELISpot assays were performed using peripheral blood mononuclear cells (PBMCs) from 62 HLA‐DRB1‐typed blood donors as responder and the porcine B cell line L23 as stimulator cells. Based on the frequency of IFN‐γ‐secreting cells, groups of weak, medium, and strong responder individuals were defined. Mixed lymphocyte reaction (MLR) assays were performed to study the stimulatory capacity of porcine PBMCs expressing different SLA‐DRB1 alleles.ResultsConcerning the MHC class‐II configuration of human cells, we found a significant overrepresentation of HLA‐DRB1*01 alleles in the medium/strong responder group as compared to individuals showing weak responses to stimulation with L23 cells. Evaluation of the role of MHC class‐II variability in porcine stimulators revealed that cells expressing SLA‐DRB1*06 alleles triggered strong proliferation in approximately 70% of humans. Comparison of amino acid sequences indicated that strong human anti‐pig reactivity may be associated with a high rate of similarity between human and pig HLA/SLA‐DRB1 alleles.ConclusionVariability in human and porcine MHC determines the intensity of individual human anti‐pig T‐cell responses. MHC typing and cross‐matching of prospective recipients of xenografts and donor pigs could be relevant to select for donor‐recipient combinations with minimal anti‐porcine immunity.
Safety and efficacy of herbal medicine for acute intracerebral hemorrhage (CRRICH): a multicentre randomised controlled trial
Authors: Zeng Liling , Tang Guanghai , Wang Jing , Zhong Jianbin , Xia Zhangyong , Li Jiexia , Chen Guangsheng , Zhang Yongbo , Luo Saihua , Huang Gan , Zhao Qianshan , Wan Yue , Chen Chaojun , Zhu Kaiyun , Qiao Hanzi , Wang Jian , Huang Tao , Liu Xian , Zhang Qixin , Lin Rongming , Li Haijun , Gong Baoying , Chen Xiuyan , Zhou Yuexiang , Wen Zehuai , Guo Jianwen 
Published: May 2019

ObjectiveTo evaluate the safety and efficacy of removing blood stasis (RBS) herbal medicine for the treatment of acute intracerebral haemorrhage (AICH) within a 6-hour time window.Study designA randomised, multicentre, double-blind, placebo-controlled study performed in 14 hospitals in China.Participants and interventionsPatients with AICH were randomly assigned to receive a placebo, the ICH-1 (Intracerebral Haemorrhage) formula (eight herbs, including the RBS herbshirudoandtabanus) or the ICH-2 formula (six herbs without the RBS herbshirudoandtabanus) within 6 hours of ICH onset.OutcomesThe primary safety outcome was the incidence of haematoma enlargement at 24 hours and at 10 days after treatment. The secondary outcome was the incidence of poor prognosis (mortality or modified Rankin Scale score ≥5) assessed at 90 days after symptom onset.ResultsA total of 324 subjects were randomised between October 2013 and May 2016: 105 patients received placebo; 108 patients received the ICH-1 formula; and 111 patients received the ICH-2 formula. The incidence of haematoma enlargement at 24 hours was 7.8% in the placebo group, 12.3% in the ICH-1 group and 7.5% in the ICH-2 group; the incidence of haematoma enlargement on day 10 was 1.1% in the placebo group, 1.1% in the ICH-1 group, and 3.1% in the ICH-2 group, with no significant differences among the groups (P>0.05). The mortality rates were 3.8% in the placebo group, 2.8% in the ICH-1 group, and 0.9% in the ICH-2 group; the incidences of poor prognosis were 7.1% in the placebo group, 6.0% in the ICH-1 group and 4.8% in the ICH-2 group at 3 months, with no significant differences among the groups (p>0.05). However, the overall frequency of treatment-emergent adverse events in the ICH-1 group (12.1%) was higher among the three groups (5.8% and 2.8%, respectively, p<0.05). All three cases of serious adverse events were in the ICH-1 group.ConclusionsUltra-early administration of ICH-1 formula for AICH patients did not exert significant beneficial effects on clinical outcomes but increased the risk of bleeding, which probably resulted from the inclusion of RBS herbal medicines in ICH-1.Trialregistration numberNCT01918722.
Patient and public involvement in health research in low and middle-income countries: a systematic review
Authors: Cook Natalie , Siddiqi Najma , Twiddy Maureen , Kenyon Richard 
Published: May 2019

ObjectivesPatient and public involvement (PPI) is argued to lead to higher quality health research, which is more relatable to and helps empower the public. We synthesised the evidence to look for examples of PPI in health research in low/middle-income countries (LMICs), looking at levels of involvement and impact. Additionally, we considered the impact of who was undertaking the research on the level of involvement and reported impact.DesignSystematic review.Data sourcesEMBASE, Medline and PsychINFO, along with hand-searching references, grey literature, Google search and expert advice.Eligibility criteriaAny health research with evidence of patient or public involvement, with no language restrictions dated from 1978 to 1 Dec 2017.Data extraction and synthesisData relating to stage and level of involvement, as well as impact, were extracted by one researcher (NC), and a coding framework was developed using an inductive approach to examine the impact of PPI on research. Extracted data were then independently coded by a second lay researcher (RK) to validate the data being collected. Discrepancies were referred to a third independent reviewer (MT) for review and consensus reached.ResultsSixty-two studies met the inclusion criteria. The review revealed the most common stage for PPI was in research planning, and the most common level of involvement was collaboration. Most studies did not provide evidence of effectiveness or elaborate on the impact of PPI, and they tended to report impact from the researcher’s perspective. Where impact was mentioned, this generally related to increased relevance to the community, empowerment of participants and alterations in study design.ConclusionsThe literature describing approaches to and impact of PPI on LMIC health research is sparse. As PPI is essential to conducting high-quality research, it should be fully reported and evaluated at the end of the research project.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) in non-traumatic out-of-hospital cardiac arrest: evaluation of an educational programme
Authors: Brede Jostein Rødseth , Lafrenz Thomas , Krüger Andreas J , Søvik Edmund , Steffensen Torjus , Kriesi Carlo , Steinert Martin , Klepstad Pål 
Published: May 2019

BackgroundOut-of-hospital cardiac arrest (OHCA) is a critical incident with a high mortality rate. Augmentation of the circulation during cardiopulmonary resuscitation (CPR) might be beneficial. Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) redistribute cardiac output to the organs proximal to the occlusion. Preclinical data support that patients in non-traumatic cardiac arrest might benefit from REBOA in the thoracic level during CPR. This study describes a training programme to implement the REBOA procedure to a prehospital working team, in preparation to a planned clinical study.MethodsWe developed a team-based REBOA training programme involving the physicians and paramedics working on the National Air Ambulance helicopter base in Trondheim, Norway. The programme consists of a four-step approach to educate, train and implement the REBOA procedure in a simulated prehospital setting. An objective structured assessment of prehospital REBOA application scoring chart and a special designed simulation mannequin was made for this study.ResultsSeven physicians and 3 paramedics participated. The time needed to perform the REBOA procedure was 8.5 (6.3–12.7) min. The corresponding time from arrival at scene to balloon inflation was 12.0 (8.8–15) min. The total objective assessment scores of the candidates’ competency was 41.8 (39–43.5) points out of 48. The advanced cardiovascular life support (ACLS) remained at standard quality, regardless of the simultaneous REBOA procedure.ConclusionThis four-step approach to educate, train and implement the REBOA procedure to a prehospital working team ensures adequate competence in a simulated OHCA setting. The use of a structured training programme and objective assessment of skills is recommended before utilising the procedure in a clinical setting. In a simulated setting, the procedure does not add significant time to the prehospital resuscitation time nor does the procedure interfere with the quality of the ACLS.Trial registration numberNCT03534011.
Low rates of radiographic progression of structural joint damage over 2 years of baricitinib treatment in patients with rheumatoid arthritis
Authors: van der Heijde Desirée , Schiff Michael , Tanaka Yoshiya , Xie Li , Meszaros Gabriella , Ishii Taeko , Casillas Marta , Ortmann Robert A , Emery Paul 
Published: May 2019

ObjectivesTo evaluate radiographic progression of structural joint damage over 2 years in patients with rheumatoid arthritis from baricitinib clinical trials who were disease-modifying antirheumatic drug (DMARD)–naïve or had an inadequate response to conventional synthetic DMARDs (csDMARD-IR).MethodsPatients had completed one of three phase III studies and entered a long-term extension (LTE) study, continuing on the same baricitinib dose as at originating study completion. At 52 weeks, DMARD-naïve patients receiving methotrexate (MTX) or combination therapy (baricitinib 4 mg+MTX) were switched to baricitinib 4 mg monotherapy (±MTX per investigator opinion); MTX-IR patients receiving adalimumab were switched to baricitinib 4 mg on background MTX. At 24 weeks, csDMARD-IR patients receiving placebo were switched to baricitinib 4 mg on background csDMARD. Radiographs at baseline, year 1 and year 2 were scored using the van der Heijde modified Total Sharp Score. Linear extrapolation was used for missing data.ResultsOf 2573 randomised patients, 2125 (82.6%) entered the LTE, of whom 1893 (89.1%) entered this analysis. At year 2, progression was significantly lower with initial baricitinib (monotherapy or combination therapy) versus initial MTX in DMARD-naïve patients (proportion with non-progression defined by ≤smallest detectable change (SDC): 87.3% baricitinib 4 mg+MTX; 70.6% MTX; p≤ 0.001). In MTX-IR patients, progression with initial baricitinib was significantly lower than with initial placebo and similar to initial adalimumab (≤SDC: 82.7% baricitinib 4 mg; 83.5% adalimumab; 70.6% placebo; p≤0.001). In csDMARD-IR patients, significant benefit was seen with baricitinib 4 mg (≤SDC: 87.2% vs 73.2% placebo; p≤0.01).ConclusionsTreatment with once-daily baricitinib resulted in low rates of radiographic progression for up to 2 years.
Controls on creek margin stability by the root systems of saltmarsh vegetation, Beaulieu Estuary, Southern England
Authors: Chen Yining , Thompson Charlotte , Collins Michael 
Published: May 2019

Abstract
The retreat of cliffs (lateral expansion) within tidal creeks results in a net loss of saltmarshes, but this retreat process can be retarded by root systems. To understand the interaction between root presence and bank sediment, quantitative measurements of two saltmarsh species root systems (Atriplex portulacoides and Juncus maritima) were carried out in a saltmarsh in Southern England, and their relationships with bank stability were examined. Computed Tomography (CT) Scanning techniques were used to investigate three-dimensional root architecture. The data obtained (e.g., root volume, diameter, and distribution patterns of roots) were examined alongside more traditional root density measurements. The volumetric percentage, ratio between horizontal (lateral) and vertical roots (H/V ratio), and root diameter distribution are discussed in relation to their influence on bank sediment erosion threshold and shear strength. The results suggest that Atriplex portulacoides is more effective than Juncus maritimus in stabilising banks. This is because root systems that provide a high resistance to flow-induced erosion are better than those that provide a high resistance to gravity-induced erosion in stabilising cliff banks. This conclusion is relevant to future saltmarsh protection and re-establishment.
Characteristics of information entropy in spin–orbit coupled spin-1 Bose–Einstein condensates
Authors: Zhao Qiang , Mi Bin-Zhou , Li Yushan 
Published: May 2019

In this paper, we study the properties of information entropy in spin–orbit coupled spin-1 Bose–Einstein condensates. Our discussion is divided into two parts, stationary state and dynamics. For the former, we find that the coordinate component Sr and total entropy S increase with the strength of the spin–orbit coupling [Formula: see text]. The momentum component Sk shows a discontinuity behavior, it increases with [Formula: see text] when [Formula: see text] is lesser than a critical value [Formula: see text], while it decreases with [Formula: see text] when [Formula: see text] is greater than [Formula: see text]. In order to characterize the disorder-to-order transition, we introduce an order parameter [Formula: see text]. Numerical results display that [Formula: see text] gradually increases with increasing [Formula: see text] and reaches its saturation, which implies that the system becomes more and more ordered. For the latter, the Sr increases and Sk decreases with increasing [Formula: see text] at the same time. The entropic uncertainty relation is well obeyed at fixed [Formula: see text]. Moreover, [Formula: see text] decreases as a function of t. The strength effect of spin–orbit coupling on order-to-disorder transition becomes weak.
Is the world small enough? — A view from currencies
Authors: Baydilli Yusuf Yargi , Türker İlker 
Published: May 2019

Exchange rates are important indicators of the economic power of countries, directly affected by the international trading patterns and relations. Since almost every pair of countries in the globalized world are economically and financially related, exchange rates can be evaluated as nodes of a global financial network to make meaningful inferences. In this study, a financial network approach is conducted by evaluating the movements of the most traded 35 currencies against gold between years 2005 and 2017. Using graph theory and statistical methods, the analysis of economic relations between currencies is carried out, supported with geographical and cultural inferences. A risk map of currencies is generated through the portfolio optimization. Another approach of applying various threshold levels for correlations to determine connections between currencies is also employed. Results indicate that there exists a saddle point for correlation threshold as 0.9 which results in a robust network topology that is highly modular and clustered, also dominantly displaying small-world and scale-free properties.
A thorough study on genetic algorithms in feedback-based wavefront shaping
Authors: Wu Daixuan , Luo Jiawei , Li Zhaohui , Shen Yuecheng 
Published: May 2019

Feedback-based wavefront shaping focuses light through scattering media by employing phase optimization algorithms. Genetic algorithms (GAs), inspired by the process of natural selection, are well suited for phase optimization in wavefront shaping problems. In 2012, Conkey et al. first introduced a GA into feedback-based wavefront shaping to find the optimum phase map. Since then, due to its superior performance in noisy environment, the GA has been widely adopted by lots of implementations. However, there have been limited studies discussing and optimizing the detailed procedures of the GA. To fill this blank, in this study, we performed a thorough study on the performance of the GA for focusing light through scattering media. Using numerical tools, we evaluated certain procedures that can be potentially improved and provided guidance on how to choose certain parameters appropriately. This study is beneficial in improving the performance of wavefront shaping systems with GAs.
Abstract 225: The first use of a live listeria cancer vaccine in man
Authors: Rothman John 
Published: May 2019

Abstract
We report herein on the first in man use of a live Listeria cancer vaccine. 15 women with progressive, recurrent, or advanced cervical cancer who had failed prior chemotherapy, and/or radiotherapy and/or surgery were treated with Lovaxin C (Lm-LLO-E7) in a phase I/II assessment of safety. Lm-LLO-E7 is a living bioengineered strain of Listeria based upon the parent strain 10403S that has been attenuated by the excision of prfA, and modified by plasmid insertion to secrete a fusion protein comprised of the tumor specific antigen HPV-16-E7 fused to a non-hemolytic fragment of the endogenous Listeria protein Listeriolysin O (LLO). This results in a bacterial vector attenuated by approximately 105.
Listeria in general, and this vector in specific, has been shown to have numerous effects presumed to be efficacious in the treatment of cancer including; induction of strong innate immunity, strong activation of both CD4+ and CD8+ lymphocytes, stimulated release of a variety of salutary cytokines and chemokines, the upregulation of co-stimulatory molecules, the generation of an inter-tumor environment conducive to tumor cell killing, the stimulation of myelopoesis and maturation of immature myeloid cells, and a lack of T regulatory cell activation.
In this study, 5 patients each received two doses of either 1x109, 3.3x109, or 1x1010 cfu separated by 3 weeks. Ampicillin was given 5 days after each dose IV and then orally for 10 days. Follow-up assessments were made at 3 weeks and 3 months subsequent to the second vaccination. Patients had metastatic disease and most were stage IVb at the time of their first vaccination.
All 15 treated patients were evaluable for safety analysis and 13 were evaluable in an intent-to-treat analysis of efficacy. Lovaxin C resulted in a flu-like syndrome in all patients comprised of fever, chills, and nausea with or without vomiting. In the 2 lower dose cohorts these symptoms were treated adequately with non-prescription NSAIDs and anti-emetics. At the dose of 1x1010 the same symptoms were observed, however they were dose limiting in severity, with fevers of 40-41oC and associated severe hypotensive diastolic BP. Other side effects observed were likely associated with prior therapies or disease severity. No serum, urine or stool Listeria was detectable.
Tumors were assessed by scan using RECIST criteria. At the end of the study 5 patients had progressive disease, 7 patients were stable, and one patient demonstrated a PR by objective criteria. Of the 7 stable patients, 3 demonstrated tumor reductions of approximately 20%. The PR, who was IVb at dosing, was subsequently given 6 courses of chemotherapy and a radical hysterectomy. At the time of this writing she is tumor free, with normal hematology, and all labs WNL.
It is concluded that Lovaxin C is safe to use therapeutically.