bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of autologous adipose-derived mesenchymal stem cell therapy in the treatment of acromioclavicular joint osteoarthritis
Authors: Freitag Julien , Wickham James , Shah Kiran , Tenen Abi 
Published: February 2019

The aim of this case report is to evaluate the efficacy of mesenchymal stem cell (MSC) therapy in the treatment of small joint osteoarthritis (OA). Acromio-clavicular (AC) joint OA is an under-diagnosed and yet frequent source of shoulder pain. MSCs have shown evidence of benefit in the treatment of knee OA. This is the first report to describe the use of MSC therapy in OA of the upper limb. A 43-year-old patient presents with painful AC joint OA and undergoes MSC therapy. The patient reported pain and functional improvement as assessed by the Disability of Arm, Shoulder and Hand Score and Numeric Pain Rating Scale. Imaging at 12 months showed structural improvement with reduction in subchondral oedema, synovitis and subchondral cysts. This case is the first to show the benefit of MSC therapy in the treatment of small joint arthropathy and also of the upper limb.Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12617000638336).
Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study
Authors: Izawa Junichi , Komukai Sho , Gibo Koichiro , Okubo Masashi , Kiyohara Kosuke , Nishiyama Chika , Kiguchi Takeyuki , Matsuyama Tasuku , Kawamura Takashi , Iwami Taku , Callaway Clifton W , Kitamura Tetsuhisa 
Published: February 2019

Abstract

Objective
To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest.

Design
Cohort study between January 2014 and December 2016.

Setting
Nationwide, population based registry in Japan (All-Japan Utstein Registry).

Participants
Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first documented electrocardiographic rhythm: shockable (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable (pulseless electrical activity or asystole). Patients who received AAM during cardiopulmonary resuscitation were sequentially matched with patients at risk of AAM within the same minute on the basis of time dependent propensity scores.

Main outcome measures
Survival at one month or at hospital discharge within one month.

Results
Of the 310 620 patients eligible, 8459 (41.2%) of 20 516 in the shockable cohort and 121 890 (42.0%) of 290 104 in the non-shockable cohort received AAM during cardiopulmonary resuscitation. After time dependent propensity score sequential matching, 16 114 patients in the shockable cohort and 236 042 in the non-shockable cohort were matched at the same minute. In the shockable cohort, survival did not differ between patients with AAM and those with no AAM: 1546/8057 (19.2%) versus 1500/8057 (18.6%) (adjusted risk ratio 1.00, 95% confidence interval 0.93 to 1.07). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35).

Conclusions
In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.
Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines
Authors: Pouwels Koen B , Hopkins Susan , Llewelyn Martin J , Walker Ann Sarah , McNulty Cliodna AM , Robotham Julie V 
Published: February 2019

AbstractObjectiveTo evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.DesignCross sectional study.SettingGeneral practices contributing to The Health Improvement Network database, 2013-15.Participants931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.Main outcome measuresThe main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.ResultsThe most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6% of the included consultations), acute sore throat (239 231, 25.7%), acute otitis media (83 054, 8.9%), and acute sinusitis (76 683, 8.2%). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80% or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6% (95% confidence interval 9.4% to 9.9%) of prescriptions exceeded seven days and acute sore throat where only 2.1% (2.0% to 2.1%) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6%, 54.1% to 55.0%). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.ConclusionFor most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.
The costs of diabetes treatment in low- and middle-income countries: a systematic review
Authors: Moucheraud Corrina , Lenz Cosima , Latkovic Michaella , Wirtz Veronika J 
Published: February 2019

IntroductionThe rising burden of diabetes in low- and middle-income countries may cause financial strain on individuals and health systems. This paper presents a systematic review of direct medical costs for diabetes (types 1 and 2) in low- and middle-income countries.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (PubMed, International Bibliography of Social Science, EconLit) were searched for publications reporting direct medical costs of type 1 and 2 diabetes. Data were extracted from all peer-reviewed papers meeting inclusion criteria, and were standardised into per-patient-visit, per-patient-year and/or per-complication-case costs (2016 US$).ResultsThe search yielded 584 abstracts, and 52 publications were included in the analysis. Most articles were from Asia and Latin America, and most focused on type 2 diabetes. Per-visit outpatient costs ranged from under $5 to over $40 (median: $7); annual inpatient costs ranged from approximately $10 to over $1000 (median: $290); annual laboratory costs ranged from under $5 to over $100 (median: $25); and annual medication costs ranged from $15 to over $500 (median: $177), with particularly wide variation found for insulin. Care for complications was generally high-cost, but varied widely across countries and complication types.ConclusionThis review identified substantial variation in diabetes treatment costs; some heterogeneity could be mitigated through improved methods for collecting, analysing and reporting data. Diabetes is a costly disease to manage in low- and middle-income countriesand should be a priority for the global health community seeking to achieve Universal Health Coverage.
Integrating community health workers into the formal health system to improve performance: a qualitative study on the role of on-site supervision in the South African programme
Authors: Tseng Yu-hwei , Griffiths Frances , de Kadt Julia , Nxumalo Nonhlanhla , Rwafa Teurai , Malatji Hlologelo , Goudge Jane 
Published: February 2019

ObjectivesTo explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses.DesignA case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117).SettingSouth Africa where a national CHW programme is being implemented with on-site supervision.ParticipantsCHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients.ResultsEffective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs’ daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In contrast, teams with only junior supervisors, or based in the community, had less engagement with clinic staff, and were less able to ensure necessary care for patients, resulting in lower levels of trust from clients.ConclusionSenior supervisors raised CHW skills, and successfully negotiated a place for CHWs in the health system. Collaboration with clinic staff reduced CHWs’ marginalisation and increased motivation. Despite being clinic-based, teams without senior supervisors had lower skill levels and were less integrated into the health system.
Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review
Authors: Wright Kathleen M , Dono Joanne , Brownbill Aimee L , Pearson (nee Gibson) Odette , Bowden Jacqueline , Wycherley Thomas P , Keech Wendy , O’Dea Kerin , Roder David , Avery Jodie C , Miller Caroline L 
Published: February 2019

ObjectivesSugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities.MethodsPubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population’s SSB consumption or an intervention that focused on reducing SSB consumption in this population.DesignSystematic scoping review.Results59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy).ConclusionsThere was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
Computerised memory specificity training (c-MeST) for the treatment of major depression: a study protocol for a randomised controlled trial
Authors: Hallford David J , Austin David W , Raes Filip , Takano Keisuke 
Published: February 2019

IntroductionMajor depression is a prevalent and debilitating disorder, but many sufferers do not receive support or respond to current treatments. The development of easily accessible and low-intensity treatments that have clear cognitive mechanisms of change is indicated. Memory specificity training (MeST) is an intervention for depression that targets deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial will assess the efficacy of an online, computerised version of MeST (c-MeST).Methods and analysisAdults aged 18 and over with a current major depressive episode (MDE) will be recruited and randomised to have access to the seven session, online c-MeST programme for 2 weeks, or to a wait-list control group. The primary outcomes will be diagnostic status of MDE and self-reported depressive symptoms at postintervention. One-month and three-month follow-ups will be collected. Increases in autobiographical memory specificity will be assessed as a mediator of change, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance.Ethics and disseminationEthics approval has been granted by the Deakin University Human Research Ethics Committee to conduct the study (ID: 2017_168). The findings will be disseminated through scholarly publications and workshops and will inform future trials, such as with an active comparator or as an adjunct treatment.Trial registration numberACTRN12618000257268; Pre-results.
Delay in patients suspected of transient ischaemic attack: a cross-sectional study
Authors: Dolmans L Servaas , Kappelle L Jaap , Bartelink Marie-Louise EL , Hoes Arno W , Rutten Frans H 
Published: February 2019

ObjectivesSuspected transient ischaemic attack (TIA) necessitates an urgent neurological consultation and a rapid start of antiplatelet therapy to reduce the risk of early ischaemic stroke following a TIA. Guidelines for general practitioners (GPs) emphasise the urgency to install preventive treatment as soon as possible. We aimed to give a contemporary overview of both patient and physician delay.MethodsA survey at two rapid-access TIA outpatient clinics in Utrecht, the Netherlands. All patients suspected of TIA were interviewed to assess time delay to diagnosis and treatment, including the time from symptom onset to (1) the first contact with a medical service (patient delay), (2) consultation of the GP and (3) assessment at the TIA outpatient clinic. We used the diagnosis of the consulting neurologist as reference.ResultsOf 93 included patients, 43 (46.2%) received a definite, 13 (14.0%) a probable, 11 (11.8%) a possible and 26 (28.0%) no diagnosis of TIA. The median time from symptom onset to the visit to the TIA service was 114.5 (IQR 44.0–316.6) hours. Median patient delay was 17.5 (IQR 0.8–66.4) hours, with a delay of more than 24 hours in 36 (38.7%) patients. The GP was first contacted in 76 (81.7%) patients, and median time from first contact with the GP practice to the actual GP consultation was 2.8 (0.5–18.5) hours. Median time from GP consultation to TIA service visit was 40.8 (IQR 23.1–140.7) hours. Of the 62 patients naïve to antithrombotic medication who consulted their GP, 27 (43.5%) received antiplatelet therapy.ConclusionsThere is substantial patient and physician delay in the process of getting a confirmed TIA diagnosis, resulting in suboptimal prevention of an early ischaemic stroke.
High kinesin family member 11 expression predicts poor prognosis in patients with clear cell renal cell carcinoma
Authors: Jin Qin , Dai Yanfeng , Wang Yan , Zhang Shu , Liu Gang 
Published: February 2019

AimsKinesin family member 11 (Kif11) is a member of the kinesin family motor proteins, which is associated with spindle formation and tumour genesis. In this study, we investigated the relationship between Kif11 expression and clear cell renal cell carcinoma (CCRCC) development.MethodsThe relationship between Kif11 expression and CCRCC development was analysed by quantitative real-time (qRT)-PCR analyses, and tissue immunohistochemistry. The prognostic significance of Kif11 expression was explored by univariable and multivariable survival analyses of 143 included patients. Furthermore, SB743921 was used as a specific Kif11 inhibitor to treat 786-O cells with the epithelial to mesenchymal transition (EMT) process analysed by qRT-PCR, and cell survival rates analysed with Annexin V-FITC/PI staining followed by flow cytometric analyses. Disease-free survival curves of Kif11 with different cancers and the relationships between Kif11 and the von Hippel-Lindau disease tumour suppressor gene (VHL), and proliferating cell nuclear antigen (PCNA) in kidney cancer were further analysed using the GEPIA database.ResultsThe levels ofKif11mRNA were significantly higher in CCRCC tissues compared with corresponding non-cancerous tissues. The results of immunohistochemistry demonstrated that the expression of Kif11 protein was significantly associated with clinicopathologial parameters, including nuclear grade and TNM stage. The Kaplan-Meier survival curve indicated that high Kif11 expression, nuclear grade and TNM stage were independent factors to predict poor prognosis in patients with CCRCC. In addition, inhibition of Kif11 expression by SB743921 suppressed cell proliferation, migration and the EMT process with increased apoptosis rate.ConclusionsThese results combined with bioinformation analyses suggest that high Kif11 expression was associated with unfavourable prognosis in CCRCC and could be used as a potential prognostic marker in the clinical diagnosis of CCRCC.
Genotype–phenotype correlations in ataxia telangiectasia patients with ATM c.3576G>A and c.8147T>C mutations
Authors: van Os Nienke J H , Chessa Luciana , Weemaes Corry M R , van Deuren Marcel , Fiévet Alice , van Gaalen Judith , Mahlaoui Nizar , Roeleveld Nel , Schrader Christoph , Schindler Detlev , Taylor Alexander M R , Van de Warrenburg Bart P C , Dörk Thilo , Willemsen Michèl A A P 
Published: February 2019

BackgroundAtaxia telangiectasia (A-T) is a neurodegenerative disorder. While patients with classic A-T generally die in their 20s, some patients with variant A-T, who have residual ataxia-telangiectasia mutated (ATM) kinase activity, have a milder phenotype. We noticed two commonly occurring ATM mutations that appeared to be associated with prolonged survival and decided to study patients carrying one of these mutations.MethodsData were retrospectively collected from the Dutch, Italian, German and French A-T cohorts. To supplement these data, we searched the literature for patients with identical genotypes.ResultsThis study included 35 patients who were homozygous or compound heterozygous for the ATM c.3576G>A; p.(Ser1135_Lys1192del58) mutation and 24 patients who were compound heterozygous for the ATM c.8147T>C; p.(Val2716Ala) mutation. Compared with 51 patients with classic A-T from the Dutch cohort, patients with ATM c.3576G>A had a longer survival and were less likely to develop cancer, respiratory disease or immunodeficiency. This was also true for patients with ATM c.8147T>C, who additionally became wheelchair users later in life and had fewer telangiectasias. The oldest patient with A-T reported so far was a 78-year-old patient who was compound heterozygous for ATM c.8147T>C. ATM kinase activity was demonstrated in cells from all patients tested with the ATM c.8147T>C mutant protein and only at a low level in some patients with ATM c.3576G>A.ConclusionCompared with classic A-T, the presence of ATM c.3576G>A results in a milder classic phenotype. Patients with ATM c.8147T>C have a variant phenotype with prolonged survival, which in exceptional cases may approach a near-normal lifespan.
Determinants of walking fitness in patients with heart failure attending cardiac rehabilitation
Authors: Doherty Patrick , Harrison Alexander Stephen , Hossain Rashed 
Published: February 2019

IntroductionPatients with heart failure (HF) attending cardiac rehabilitation (CR) benefit in terms of improved quality of life, physical fitness and reduced hospital admissions. Too few patients with HF attend CR and little data exist on the characteristics of those who do especially in respect of physical fitness. This study evaluates the extent by which clinical and demographic factors determine walking fitness in patients with a primary diagnosis of HF.MethodsClinical data from the British Heart Foundation National Audit of Cardiac Rehabilitation identified 1519 patients with HF who completed an incremental shuttle walk test (ISWT). Stepwise regression accounting for age, gender and multiple potential confounders assessed their contribution to total walking distance.ResultsMean age was 64.5 (SD 12.70) years with a range of ISWT distances across gender and associated comorbidities from 215 to 282 m. Walking distance reduced by 4.9 m for each year increase in age above mean age (p<0.001). After accounting for confounders, females walked 42.1 m less than males (p≤ 0.001). Pulmonary disease and the existence of depression was associated with a 39.3 and 52.2 m reduction in walking distance, respectively. Body mass index >30 was associated with 28.5 m reduction in walking distance (p<0.001). HF severity failed to improve the regression model fit or achieve significance in the analysisConclusionsAge, gender and the presence of pulmonary disease or depression were highly significant factors in predicting walking fitness in patients with HF. The study also produced a set of reference values based on these four factors to aid the interpretation of walking fitness in patients with HF.