bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life in Asian patients with breast cancer: a systematic review
Authors: Ho Peh Joo , Gernaat Sofie A M , Hartman Mikael , Verkooijen Helena M 
Published: April 2018

ObjectiveTo summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer.DesignSystematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468).MethodsAccording to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies.ResultsFifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being.ConclusionsIn Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients’ HRQL.
Cohort profile: the Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS), a multicentre cohort for socioeconomic inequalities in health monitoring
Authors: Caranci Nicola , Di Girolamo Chiara , Giorgi Rossi Paolo , Spadea Teresa , Pacelli Barbara , Broccoli Serena , Ballotari Paola , Costa Giuseppe , Zengarini Nicolás , Agabiti Nera , Bargagli Anna Maria , Cacciani Laura , Canova Cristina , Cestari Laura , Biggeri Annibale , Grisotto Laura , Terni Gianna , Costanzo Gianfranco , Mirisola Concetta , Petrelli Alessio 
Published: April 2018

PurposeThe Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS) is a system of integrated data on health outcomes, demographic and socioeconomic information, and represents a powerful tool to study health inequalities.ParticipantsIN-LiMeS is a multicentre and multipurpose pool of metropolitan population cohorts enrolled in nine Italian cities: Turin, Venice, Reggio Emilia, Modena, Bologna, Florence, Leghorn, Prato and Rome. Data come from record linkage of municipal population registries, the 2001 population census, mortality registers and hospital discharge archives. Depending on the source of enrolment, cohorts can be closed or open. The census-based closed cohort design includes subjects resident in any of the nine cities at the 2001 census day; 4 466 655 individuals were enrolled in 2001 in the nine closed cohorts. The open cohort design includes subjects resident in 2001 or subsequently registered by birth or immigration until the latest available follow-up (currently 31 December 2013). The open cohort design is available for Turin, Venice, Reggio Emilia, Modena, Bologna, Prato and Rome. Detailed socioeconomic data are available for subjects enrolled in the census-based cohorts; information on demographic characteristics, education and citizenship is available from population registries.Findings to dateThe first IN-LiMeS application was the study of differentials in mortality between immigrants and Italians. Either using a closed cohort design (nine cities) or an open one (Turin and Reggio Emilia), individuals from high migration pressure countries generally showed a lower mortality risk. However, a certain heterogeneity between the nine cities was noted, especially among men, and an excess mortality risk was reported for some macroareas of origin and specific causes of death.Future plansWe are currently working on the linkage of the 2011 population census data, the expansion of geographical coverage and the implementation of the open design in all the participating cohorts.
Older patients’ perception of deprescribing in resource-limited settings: a cross-sectional study in an Ethiopia university hospital
Authors: Tegegn Henok Getachew , Tefera Yonas Getaye , Erku Daniel Asfaw , Haile Kaleab Taye , Abebe Tamrat Befekadu , Chekol Fasil , Azanaw Yonas , Ayele Asnakew Achaw 
Published: April 2018

ObjectiveTo assess older patients’ attitude towards deprescribing of inappropriate medications.DesignThis was an institutional-based, quantitative, cross-sectional survey.SettingOutpatient clinics of the University of Gondar Referral and Teaching Hospital in Ethiopia.ParticipantsPatients aged 65 or older with at least one medication were enrolled in the study from 1 March to 30 June 2017. Excluded patients were those who had severe physical or psychological problems and who refused to participate.Main outcome measuresOlder patients’ attitude towards deprescribing was measured using a validated instrument, ‘the revised Patients’ Attitudes towards Deprescribing’ (rPATD) tool for older patients. Data were collected on sociodemographic characteristics and clinical data such as comorbidity and polypharmacy, and the main outcome was older patients’ willingness to deprescribe inappropriate medications.ResultsOf the 351 eligible participants, 316 patients completed the survey. Of the 316 patients, 54.7% were men and were taking a median of 3 (IQR: 2–4) medications daily. Overall, most of the participants (92.1%; 95% CI 89% to 95%) were satisfied with the medications they were taking; however, still a significant number of participants (81.6%; 95% CI 77% to 86%) were willing to stop one or more of their medications if possible and agreed by their doctors. This willingness was correlated with seven items of the rPATD, including a strong correlation with the overall satisfaction of patients with the medications taken.ConclusionMany older patients have shown their willingness to reduce one or more of their medications if their doctors said it was possible. Healthcare providers should be proactive in discussing and evaluating potentially inappropriate medications for better clinical decision making.
Prescribing and deprescribing antihypertensive medication in older people by Dutch general practitioners: a qualitative study
Authors: van Middelaar Tessa , Ivens Sophie D , van Peet Petra G , Poortvliet Rosalinde K E , Richard Edo , Pols A Jeannette , Moll van Charante Eric P. 
Published: April 2018

ObjectivesTo explore general practitioners’ (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support.DesignSemistructured interviews.SettingDutch general practice.ParticipantsFifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached.ResultsGPs appeared reluctant to start AHM, especially in patient >80 years. High systolic blood pressure and history of cardiovascular disease or diabetes were enablers to start or intensify treatment. Reasons to refrain from this were frailty and patient preference. GPs described a tendency to continue AHM regimens unchanged, influenced by daily time constraints, automated prescription routines and anticipating discomfort when disturbing patients’ delicate balance. GPs were only inclined to deprescribe AHM in terminally ill patients or after prolonged achievement of target levels in combination with side effects or patient preference. Deprescription was facilitated when GPs had experience with patients showing increased quality of life after deprescription and was withheld by anticipated regret (ie, GPs’ fear of a stroke after deprescribing). GPs felt insufficient guidance from current guidelines, especially on deprescription.ConclusionsGPs are reluctant to start or deprescribe AHM in older people and have a propensity to continue AHM within a daily routine that insufficiently supports critical medication review. (De)prescription is influenced by patient preferences and anticipated regret and current guidelines provide insufficient guidance.
Clinicians’ and researchers’ perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study
Authors: Tong Allison , Crowe Sally , Gill John S , Harris Tess , Hemmelgarn Brenda R , Manns Braden , Pecoits-Filho Roberto , Tugwell Peter , van Biesen Wim , Wang Angela Yee Moon , Wheeler David C , Winkelmayer Wolfgang C , Gutman Talia , Ju Angela , O’Lone Emma , Sautenet Benedicte , Viecelli Andrea , Craig Jonathan C 
Published: April 2018

ObjectivesTo describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact.DesignFace-to-face, semistructured interviews; thematic analysis.StettingTwenty-seven centres across nine countries.ParticipantsFifty-eight nephrologists (42 (72%) who were also triallists).ResultsWe identified six themes:reflecting direct patient relevance and impact(survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus);amenable and responsive to interventions(realistic and possible to intervene on, differentiating between treatments);reflective of economic burden on healthcare; feasibility of implementation(clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions);authoritative inducement and directive(endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake);instituting patient-centredness(explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life).ConclusionsNephrologists emphasised that core outcomes should be relevant to patients, amenable to change, feasible to implement and supported by stakeholder organisations. They expected core outcomes would improve patient-centred care and outcomes.
Can exercise delay transition to active therapy in men with low-grade prostate cancer? A multicentre randomised controlled trial
Authors: Galvão Daniel A , Hayne Dickon , Frydenberg Mark , Chambers Suzanne K , Taaffe Dennis R , Spry Nigel , Scuffham Paul A , Ware Robert S , Hart Nicolas H , Newton Robert U 
Published: April 2018

IntroductionActive surveillance is a strategy for managing low-risk, localised prostate cancer, where men are observed with serial prostate-specific antigen assessments to identify signs of disease progression. Currently, there are no strategies to support active surveillance compliance nor are there interventions that can prevent or slow disease progression, ultimately delaying transition to active treatment before it is clinically required. Recently, we proposed that exercise may have a therapeutic potential in delaying the need for active treatment in men on active surveillance.Methods and analysisA single-blinded, two arm, multicentre randomised controlled trial will be undertaken with 168 patients randomly allocated in a ratio of 1:1 to exercise or usual care. Exercise will consist of supervised resistance and aerobic exercise performed three times per week for the first 6 months in an exercise clinical setting, and during months 7–12, a progressive stepped down approach will be used with men transitioning to once a week supervised training. Thereafter, for months 13 to 36, the men will self-manage their exercise programme. The primary endpoint will be the time until the patients begin active therapy. Secondary endpoints include disease progression (prostate specific antigen), body composition and muscle density, quality of life, distress and anxiety and an economic analysis will be performed. Measurements will be undertaken at 6 and 12 months (postintervention) and at 24 and 36 months follow-up. The primary outcome (time to initiation of curative therapy) will be analysed using Cox proportional hazards regression. Outcomes measured repeatedly will be analysed using mixed effects models to examine between-group differences. Data will be analysed using an intention-to-treat approach.Ethics and disseminationOutcomes from the study will be published in peer-reviewed academic journals and presented in scientific, consumer and clinical meetings.Trial registration numberACTRN12618000225213.
Using videos in a smartphone app logbook to aid obstetricians and gynaecologists with reflection following critical events
Authors: Gray Thomas G , Li Weiguang , Farrell Tom 
Published: April 2018

IntroductionReflection is essential for continuous professional development. Many opportunities to reflect during training in obstetrics and gynaecology are not utilised. A Smartphone App (Healthcare Supervision Logbook), allows doctors training in obstetrics and gynaecology to view videos to aid reflection. The App incorporates a comprehensive logbook of practical skills. A self-facilitated reflective process, prompted by offering the viewing of a video when logging an event such as a shoulder dystocia, has been integrated into the logbook. The objective of this study was to evaluate how this function aids reflection.MethodsForty doctors training in obstetrics and gynaecology undertook a shoulder dystocia drill as part of a mock examination. After completing the drill, participants scored their performance on a proforma, before watching a video of simulated standard management for shoulder dystocia on a Smartphone. Participants then re-scored themselves before completing a survey. This assessed their agreement with three statements on a five-point Likert scale.Results50% of participants marked themselves lower after watching the video. 100% agreed or strongly agreed that watching the video helped them reflect on the shoulder dystocia drill. 80% agreed or strongly agreed that they would feel more prepared to deal with shoulder dystocia as a result of using the video to reflect. 93% agreed or strongly agreed that they would be willing to use a Smartphone App with videos to aid reflection following critical events. Student’s t test showed that viewing the standardised video clip on the App resulted in a significant down-marking (P<0.0005).ConclusionsMany emergency scenarios in obstetrics and gynaecology unfold quickly and are rapidly resolved, doctors-in-training need to use opportunities for self-directed reflection. Using the video self-reflection function integrated into Healthcare Supervision Logbook Smartphone App could help to prompt this process, which could be utilised in other specialities and disciplines.
The burden of neurothrombectomy call: a multicenter prospective study
Authors: Williams Michelle M , Wilson Taylor A , Leslie-Mazwi Thabele , Hirsch Joshua A , Kellogg Ryan T , Spiotta Alejandro M , De Leacy Reade , Mocco J , Albuquerque Felipe C , Ducruet Andrew F , Arthur Adam , Srinivasan Visish M , Kan Peter , Mokin Maxim , Dumont Travis M , Reeves Alan , Singh Jasmeet , Wolfe Stacey Q , Fargen Kyle M 
Published: April 2018

IntroductionNeurothrombectomy frequency is increasing, and a better understanding of the neurothrombectomy call burden is needed.MethodsNeurointerventional physicians at nine participating stroke centers prospectively recorded time requirements for all neurothrombectomy (NT) consultations over 30 consecutive 24 hour call periods.ResultsData were collected from a total of 270 days of call. 214 NT consultations were reported (mean 0.79 per day), including 130 ‘false positive’ consultations that ultimately did not lead to thrombectomy (mean 0.48 per day). 84 NT procedures were performed at the nine centers (0.32 per day, or 1 every 3 days). Most (59.8%) consultations occurred between 5pm and 7am. 30% of thrombectomy procedures resulted in delays in scheduled cases; treating physicians had to emergently travel to the hospital for 51.2% of these cases. A median of 27 min was spent on each false positive consultation and 171 min on each thrombectomy. Overall, the median physician time spent on NT responsibilities per 24 hour call period was 69 min (mean 85 min; IQR 16–135 min).ConclusionsNT consultations are frequent and often disrupt physician schedules, requiring physicians to commute in from home after hours in the majority of cases. As procedural and consultation volumes increase, it is crucial to understand the significant burden of call on neurointerventional physicians and develop strategies that reduce the potential for burnout. Importantly, this study was performed prior to the completion of the DAWN and DEFUSE3 trials; NT consultations are expected to continue to increase in the future.
Infections and Risk of Peripartum Stroke During Delivery Admissions
Authors: Miller Eliza C. , Gallo Marisa , Kulick Erin R. , Friedman Alexander M. , Elkind Mitchell S.V. , Boehme Amelia K. 
Published: April 2018

Background and Purpose—
Peripartum strokes during delivery admissions are rare but have high maternal morbidity. Infections have been proposed as a possible stroke trigger. We hypothesized that women who had infections diagnosed at the time of delivery admission would have higher risk of stroke during their delivery hospitalization.

Methods—
We conducted a case–control study using state inpatient administrative databases for California (2007–2011), Florida (2009–2011), and New York (2009–2011). Women whose admission included a vaginal or cesarean delivery, with a new diagnosis of stroke during the admission, were considered cases and were randomly matched to 3 in-state controls by age/admission year and presence and severity of hypertensive disorders of pregnancy. The primary exposure of interest was infection of any type present on admission. Secondary exposures included race/ethnicity, payer status, delivery method, and known vascular risk factors such as chronic hypertension, diabetes mellitus, smoking, alcohol abuse, hypercoagulable states, coagulopathies, and renal disease. We used multivariable conditional logistic regression to estimate the odds ratios and 95% confidence intervals for the association of infections and known vascular risk factors with stroke risk.

Results—
A total of 455 cases (mean age, 29.8), of whom 195 (42.9%) had hypertensive disorders of pregnancy, were matched with 1365 controls. Infection of any type present on admission increased the odds of stroke diagnosis during the admission (adjusted odds ratio, 1.74; 95% confidence interval, 1.29–2.35). Risk was higher for genitourinary infections (adjusted odds ratio, 2.56; 95% confidence interval, 1.25–5.24) and sepsis (adjusted odds ratio, 10.4; 95% confidence interval, 2.15–20.0). The association between infection and stroke during delivery admission did not differ by the presence of hypertensive disorders of pregnancy.

Conclusions—
Infections present on admission increased stroke risk during delivery admissions in women with and without hypertensive disorders of pregnancy. The results were driven by genitourinary infections and sepsis. Infections may be an underrecognized precipitant of peripartum stroke.
Paradigmatic Possibilities as Perspective for Absolute Constructions
Authors: Kruijer Mike , la Roi Ezra 
Published: April 2018

AbstractCompared to Greek genitive absolutes, Latin ablative absolutes are of two types. The first have agents that are non-coreferential with the subject of the main clause. The second have agents thatarecoreferential with the subject of the main clause. The first type strongly resemble Greek genitive absolutes because of their high frequency of animate subject complements and the similar way in which they articulate referential coherence. The second type, which always contains a perfect passive participle, from a comparative perspective can be seen as a paradigmatic filler, which is a Latin alternative to an anterior active participle. Their subject complements are less frequently animate and in the word order (iconically) placed close to the subject of the main clause that is also the agent of the ablative absolute. However, paradigmatic differences have only minor consequences for the preferred sentence position of the absolute constructions and their internal complexity.
Cerebellum size is positively correlated with geographic distribution range in anurans
Authors: Zhao Chun Lin , Jin Long , Zhong Mao Jun , Xie Feng , Jiang Jian Ping , Li Da Yong , Liao Wen Bo 
Published: April 2018

Abstract
The ‘cognitive buffer’ hypothesis predicts that the costs of relatively large brains are compensated for later in life by the increased benefits of large brains providing a higher chance of survival under changing environments through flexible behaviors in the animal kingdom. Thus, animals that live in a larger range (with a higher probability of environmental variation) are expected to have larger brains than those that live in a restricted geographic range. Here, to test the prediction of the ‘cognitive buffer’ hypothesis that larger brains should be expected to occur in species living in geographic ranges of larger size, we analyzed the relationship between the size of the geographic range and brain size and the size of various brain regions among 42 species of anurans using phylogenetic comparative methods. The results show that there is no correlation between relative brain size and size of the species’ geographic range when correcting for phylogenetic effects and body size. Our findings suggest that the effects of the cognitive buffer and the energetic constraints on brains result in non-significant variation in overall brain size. However, the geographic range is positively correlated with cerebellum size, but not with optic tecta, suggesting that species distributed in a wider geographic range do not exhibit larger optic tecta which would provide behavioral flexibility to allow for an early escape from potential predators and discovery of new food resources in unpredictable environments.
Regulatory Challenges of Data Mining Practices: The Case of the Never-ending Lifecycles of ‘Health Data’
Authors: Comandè Giovanni , Schneider Giulia 
Published: April 2018

Abstract
Health data are the most special of the ‘special categories’ of data under Art. 9 of the General Data Protection Regulation (GDPR). The same Art. 9 GDPR prohibits, with broad exceptions, the processing of ‘data concerning health’. Our thesis is that, through data mining technologies, health data have progressively undergone a process of distancing from the healthcare sphere as far as the generation, the processing and the uses are concerned. The case study aims thus to test the endurance of the ‘special category’ of health data in the face of data mining technologies and the never-ending lifecycles of health data they feed. At a more general level of analysis, the case of health data shows that data mining techniques challenge core data protection notions, such as the distinction between sensitive and non-sensitive personal data, requiring a shift in terms of systemic perspectives that the GDPR only partly addresses.