bluuebunny/crossref_metadata_2025_split huggingface dataset:
Behavioral economic insights to improve medication adherence in adults with chronic conditions: a scoping review protocol
Authors: Roseleur Jacqueline , Harvey Gillian , Stocks Nigel , Karnon Jonathan 
Published: May 2019

ABSTRACT

Objective:
The objective of this review is to map the evidence on the use of behavioral economic insights to improve medication adherence in adults with chronic conditions.

Introduction:
Medication non-adherence is a barrier to effectively managing chronic conditions, leading to poorer patient outcomes and placing an additional financial burden on healthcare systems. As the population ages and the prevalence of chronic disease increases, new ways to influence patient behavior are needed. Approaches that use insights from behavioral economics may help improve medication adherence, thus reducing morbidity, mortality and financial costs of unmanaged chronic diseases.

Inclusion criteria:
Eligible studies will include adults taking medication for a chronic condition. All interventions relevant to high-income settings using insights from behavioral economics to improve medication adherence in adults will be considered. Contexts may include, but are not limited to, primary health care, corporate wellness programs and health insurance schemes. Any study design published in English will be considered. Studies in facilities where medication is administered to patients will be excluded.

Methods:
PubMed, Embase, Scopus, PsycINFO, EconLit and CINAHL will be searched from database inception to present. Gray literature will be searched using Google Scholar, OpenGrey and the Grey Literature Report. One reviewer will review titles, and then two reviewers will independently review abstracts to identify eligible studies. One reviewer will extract data on study characteristics, study design and study outcomes. A second reviewer will validate 25% of the extracted information. The results of the data extraction will be presented in a table, and a narrative summary will be presented.
Repetitive transcranial magnetic stimulation recovers cortical map plasticity induced by sensory deprivation due to deafferentiation
Authors: Kloosterboer Ellen , Funke Klaus 
Published: May 2019

Key points
Partial sensory deprivation (deafferentation) by removing whiskers from the rat snout resulted in a reduced responsiveness of related cortical representations.
Repetitive transcranial magnetic stimulation (three blocks of intermittent theta‐burst) applied for 5 days in combination with sensory exploration restored the normal responsiveness level of the deafferented barrel cortex.
However, intracortical inhibition (lateral and recurrent) appeared to be reduced after repetitive transcranial magnetic stimulation, probably as the cause of improved responsiveness.
Repetitive transcranial magnetic stimulation also reduced the asymmetry of the lateral spread of sensory activity.
AbstractRepetitive transcranial magnetic stimulation (rTMS) modulates human cortical excitability. It has the potential to support recovery to normal cortical function when the excitation–inhibition balance is altered (e.g. after a stroke or loss of sensory input). We tested cortical map plasticity on the basis of sensory responses (local field potentials, LFPs) and expression of neuronal activity marker proteins within the barrel cortex of rats receiving either active or sham rTMS after selective unilateral deafferentation by whiskers plucking. Rats received daily rTMS [intermittent theta‐burst (iTBS), active or sham] for 5 days before exploring an enriched environment. Our previous studies indicated a disinhibitory effect of iTBS on cortical activity. Therefore, we also expected disinhibitory effects if deafferentation causes depression of sensory responses. Deafferentation resulted in an acute general reduction of sensory responsiveness and enhanced expression of inhibitory activity markers (GAD67, parvalbumin) in the deafferented hemisphere. Active but not sham‐iTBS‐rTMS normalized these measures. The stronger caudal‐to‐frontal horizontal spread of activity across barrels was reduced after deafferentation but not restored after active iTBS, despite generally increased responses. Fitting the LFP data with a computational model of different strengths and types of excitatory and inhibitory connections further revealed an iTBS‐induced reduction of lateral and recurrent inhibition as the most probable scenario. Whether the disinhibitory effect of iTBS for the restoration of normal cortical function in the acute phase of depression after deafferentiation is also beneficial in humans remains to be demonstrated. As recently discussed, disinhibition appears to be required to open a window for neuronal plasticity.
Medical assessment of potential concussion in elite football: video analysis of the 2016 UEFA European championship
Authors: Abraham Karan Joshua , Casey Julia , Subotic Arsenije , Tarzi Christopher , Zhu Alice , Cusimano Michael D 
Published: May 2019

ObjectiveThe objective is to determine if suspected concussions in elite football are medically assessed according to the International Conferences on Concussion in Sport consensus statement recommendations.SettingMen’s Union of European Football Association (UEFA) Football Championship.ParticipantsAll professional football players in the UEFA 2016 Championship Tournament.DesignObservational study.Outcome measuresPotential concussive events (PCEs) were defined as direct head collision incidents resulting in the athlete being unable to immediately resume play following impact. PCEs identified and description of PCE assessment and outcome were accomplished through direct standardised observation of video footage by trained observers in 51 games played in the Men’s UEFA European Championship (10 June–10 July 2016).ResultsSixty-nine total PCEs (1.35 per match) were identified in 51 games played during the 2016 Men’s UEFA European Championship. Forty-eight PCEs (69.6%) resulted in two observable signs of concussion, 13 (18.8%) resulted in three signs and 1 (1.4%) resulted in four signs in the injured athletes. Nineteen (27.5%) PCEs were medically assessed by sideline healthcare personnel while 50 (72.5%) were not. Of the 50 PCEs that were not medically assessed, 44 (88%) PCEs resulted in two or more signs of concussion among injured athletes. Of the 19 medically assessed PCEs, 8 resulted in 3 signs of concussion, and 1 resulted in 4 signs; all assessments concluded in the same-game return for the injured athletes.ConclusionsPCEs were frequent events in the 2016 UEFA Euro championship, but were rarely assessed concordant with the International Conferences on Concussion in Sport consensus statement recommendations. There is an imperative need to improve the assessment and management of players suspected of concussion in elite football.
Effects of yoga on well-being and healthy ageing: study protocol for a randomised controlled trial (FitForAge)
Authors: Östh Josefine , Diwan Vinod , Jirwe Maria , Diwan Vishal , Choudhary Anita , Mahadik Vijay Khanderao , Pascoe Michaela , Hallgren Mats 
Published: May 2019

IntroductionDue to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults.Methods and analysisThree group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65–85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling.Ethics and disseminationThis study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles.Trial registration numberDRKS00015093, U1111-1217-4248
Comparison of the safety and efficacy between linear stapler and circular stapler in totally laparoscopic total gastrectomy: protocol for a systematic review and meta-analysis
Authors: Liao Tianyou , Deng Leilei , Yao Xueqing , Ouyang Manzhao 
Published: May 2019

IntroductionTotal gastrectomy is often recommended for upper body gastric cancer, and totally laparoscopic total gastrectomy (TLTG) is deemed to be a promising surgical method with the well-known advantages such as less invasion and fast recovery. However, the anastomosis between oesophagus and jejunum is the difficulty of TLTG. Although staplers have promoted the development of TLTG, the choice of suitable staplers to complete oesophagojejunostomy is controversial and unclear. Therefore, a higher level of research evidence is needed to compare the two types of staplers in terms of safety and efficacy for oesophagojejunostomy in TLTG among patients with gastric cancer.Methods and analysisPubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Databases will be comprehensively searched from January 1990 to July 2019. All eligible randomised controlled trials (RCTs), non-RCTs or observational studies comparing the two types of staplers will be included. A meta-analysis will be performed using Review Manager V.5.3 software to compare the safety and efficacy of linear and circular staplers for oesophagojejunostomy in TLTG. The primary outcomes are anastomotic leakage, anastomotic stricture, anastomotic haemorrhage. The secondary outcomes include time to first instance of passing gas after surgery, first feeding time, total operation time, reconstruction time, estimated blood loss. The heterogeneity of this study will be assessed by p values and I2statistic. Subgroup analyses and sensitivity analyses will be used to explore and explain the heterogeneity. The risk of bias will be assessed using the Cochrane tool or the Newcastle-Ottawa Quality Assessment Scale.Ethics and disseminationEthical approval will not be required because this proposed systematic review and meta-analysis is based on previously published data, which does not include intervention data on patients. The findings of this study will be submitted to a peer-reviewed journal and will be presented at a relevant congress.PROSPERO registration numberCRD42018111680.
Initiation and completion rates of isoniazid preventive therapy among people living with HIV in Far-Western Region of Nepal: a retrospective cohort study
Authors: Dhungana Govinda Prasad , Thekkur Pruthu , Chinnakali Palanivel , Bhatta Usha , Pandey Basudev , Zhang Wei-Hong 
Published: May 2019

ObjectivesIsoniazid preventive therapy (IPT), for people living with HIV (PLHIV) is the proven and recommended intervention to avert tuberculosis (TB). In 2015, Nepal implemented 6 months of IPT for all PLHIV registered for HIV care in antiretroviral therapy (ART) centres. After programmatic implementation, there has been no systematic assessment of IPT initiation and completion rates among PLHIV. We aimed to assess IPT initiation and completion rates in the Far-Western Region (FWR) of Nepal.DesignWe conducted a retrospective cohort study using secondary data extracted from registers maintained at ART centres.SettingAll 11 ART centres in the FWR of Nepal.ParticipantsAll PLHIV registered for care between January 2016 and December 2017 in 11 ART centres.Primary outcome measuresIPT initiation and completion rates were summarised as percentages with 95% CI. Independent association between patient characteristics and non-initiation of IPT was assessed using cluster-adjusted generalised linear model (log binomial regression) and adjusted relative risk (RR) with 95% CI was calculated.ResultOf the 492 PLHIV included, 477 (97.0%) did not have active TB at registration. Among 477 without active TB, 141 (29.8%, 95% CI 25.7% to 34.1%) had been initiated on IPT and 85 (17.8%) were initiated within 3 months of registration. Of 141 initiated on IPT, 133 (94.3%, 95% CI 89.1% to 97.5%) had completed 6 months of IPT. Being more than 60 years of age (RR-1.3, 95% CI 1.1 to 1.7), migrant worker (RR-1.3, 95% CI 1.1 to 1.4) and not being initiated on ART (RR-1.4, 95% CI 1.1 to 1.8) were significantly associated with IPT initiation.ConclusionsIn FWR of Nepal, three out of 10 eligible PLHIV had received IPT. Among those who have received IPT, the completion rate was good. The HIV care programme needs to explore the potential reasons for this low coverage and take context specific corrective action to fix this gap.
Health costs and efficiencies of patient-specific and single-use instrumentation in total knee arthroplasty: a randomised controlled trial
Authors: Attard Andre , Tawy Gwenllian Fflur , Simons Michiel , Riches Philip , Rowe Philip , Biant Leela C 
Published: May 2019

AimTo investigate whether patient-specific instrumentation (PSI) and single-use instrumentation (SUI) improve operating room efficiency in terms of time and cost to the healthcare provider over conventional/reusable instrumentation (CVR) when performing total knee arthroplasty (TKA).Patients and methodsPatients requiring TKA were randomised into one of four surgical groups: CVR, CVS (conventional/SUI), PSR (PSI/reusable) and PSS (PSI/SUI). All surgical procedures were video recorded to determine specific surgical time intervals. Other variables reported included the number of instrument trays used, missing equipment, direct instrument costs and the weight of the instruments the staff had to handle. Oxford Knee Score (OKS), estimated blood loss and lengths of hospital stay were also recorded as markers of patient experience.ResultsPSR was significantly quicker in all the recorded time intervals, used less trays, experienced less missing equipment and resulted in lower blood loss and shorter hospital stays. SUI reported significantly slower operating room times and resulted in higher blood loss, but SUI was 88% lighter and 20% cheaper on average when compared with their reusable counterparts. Despite the economic advantages of PSI and SUI, the patients who reported greatest improvements in OKS were those allocated to the CVR group, but no clinically meaningful difference in OKS was found at any time point.ConclusionsPSI and SUI for TKA have the potential of reducing operating room times over conventional, reusable sets. This reduction will benefit theatre personnel ergonomically, while presenting the healthcare provider with potential cost-saving benefits in terms of reduced sterilisation costs and surgical times.
Disrupting activities in quality improvement initiatives: a qualitative case study of the QuICR Door-To-Needle initiative
Authors: Huq Jo-Louise , Woiceshyn Jaana 
Published: May 2019

BackgroundHealthcare quality improvement (QI) efforts are ongoing but often create modest improvement. While knowledge about factors, tools and processes that encourage QI is growing, research has not attended to the need to disrupt established ways of working to facilitate QI efforts.ObjectiveTo examine how a QI initiative can disrupt professionals’ established way of working through a study of the Alberta Stroke Quality Improvement and Clinical Research (QuICR) Door-to-Needle Initiative.DesignA multisite, qualitative case study, with data collected through semistructured interviews and focus groups. Inductive data analysis allowed findings to emerge from the data and supported the generation of new insights.FindingsIn stroke centres where improvements were realised, professionals’ established understanding of the clinical problem and their belief in the adequacy of existing treatment approaches shifted—they no longer believed that their established understanding and treating the clinical problem were appropriate. This shift occurred as participants engaged in specific activities to improve quality. We identify these activities as ones that create urgency, draw professionals away from regular work and encourage questioning about established processes. These activities constituted disrupting action in which both clinical and non-clinical persons were engaged.ConclusionsDisrupting action is an important yet understudied element of QI. Disrupting action can be used to create gaps in established ways of working and may help encourage professionals’ involvement and support of QI efforts. While non-clinical professionals can be involved in disrupting action, it needs to engage clinical professionals on their own terms.
Periprocedural complications of second-generation flow diverter treatment using Pipeline Flex for unruptured intracranial aneurysms: a systematic review and meta-analysis
Authors: Bhatia Kartik Dev , Kortman Hans , Orru Emanuele , Klostranec Jesse M , Pereira Vitor M , Krings Timo 
Published: May 2019

BackgroundFlow diverters are a breakthrough treatment for large and giant intracranial aneurysms but carry a risk of periprocedural death or major stroke. Pipeline Flex is a second-generation device that is thought to have lower complication rates because of improvements in the delivery system as well as increased operator experience. Our objective was to analyze the risk of periprocedural death or major complications using Pipeline Flex for unruptured intracranial aneurysms.MethodsA systematic search of three databases was performed for studies of ≥10 treatments using Pipeline Flex for unruptured intracranial aneurysms (2014–2019) using PRISMA guidelines. Random effects meta-analysis was used to pool the rates of periprocedural (<30 days) death, major ischemic stroke, symptomatic intracranial hemorrhage, and minor stroke/transient ischemic attack.ResultsWe included eight studies reporting 901 treatments in 879 patients. Periprocedural mortality (<30 days) was 0.8% (5/901; 95% CI 0.4% to 1.5%; I2=0%). Rate of major complications (death, major ischemic stroke, or symptomatic intracranial hemorrhage) was 1.8% (14/901; 95% CI 1.0% to 2.7%; I2=0%). Aneurysm size ≥10 mm was a statistically significant predictor of a major complication (OR 6.4; 95% CI 2.0 to 20.7; p=0.002). Risk of a major complication in aneurysms <10 mm was 0.9% (95% CI 0.3% to 1.7%; I2=0%). The meta-analysis was limited by the predominance of anterior circulation aneurysms.ConclusionTreatment of unruptured intracranial aneurysms using the Pipeline Flex flow diverter has a low periprocedural risk of death (0.8%) or major complication (1.8%). The risk of a major complication is significantly higher for large/giant aneurysms (4.4%) and is very low for aneurysms <10 mm (0.9%).
Changes to the littered cigarette pack environment in New York City between 2011 and 2015
Authors: Farley Shannon M , Jasek John P , Sacks Rachel , Schroth Kevin , Davis Kevin 
Published: May 2019

IntroductionImposing policies that increase tobacco prices is a key strategy for reducing smoking prevalence, although it may result in more cigarette trafficking. In 2013, New York City (NYC) passed the Sensible Tobacco Enforcement (STE) law requiring cigarettes be sold for a minimum price of $10.50 per pack. To evaluate whether cigarette price increases changed patterns of behaviour related to cigarette tax evasion, we examined littered pack study data from 2011 and 2015.MethodsLittered cigarette packs were collected from a random sample of NYC census tracts in 2011 and 2015. The proportions of cigarette packs with proper local, known non-local, foreign or unknown, and no tax stamp were calculated. Changes in volume, source and consumption of domestically trafficked cigarettes over time were estimated.ResultsIn 2011, 255 packs with cellophane were collected; in 2015, 226 packs with cellophane were collected. Packs without proper local stamp increased from 60.7% in 2011 to 76.3% in 2015 (p<0.05) and those with foreign or unknown stamp increased from 11.6% in 2011 to 31.4% in 2015 (p<0.05). The percentage of domestically sourced packs attributed to domestic trafficking increased significantly from a range of 47.9% to 52.8% in 2011 to a range of 59.4% to 63.2% in 2015.ConclusionWhile the trafficking rate among domestically sourced cigarettes increased between 2011 and 2015 (before and after the STE minimum price floor on cigarette packs was in place), there was a decline in total consumption of domestically trafficked cigarettes due to a significant increase in consumption of foreign-sourced cigarettes. Jurisdictions considering price measures should bolster monitoring and enforcement efforts to maximise public health impact. Given the interstate nature of cigarette trafficking in the USA, Federal intervention would be optimal.
Automatic Fact-Checking Using Context and Discourse Information
Authors: Atanasova Pepa , Nakov Preslav , Màrquez Lluís , Barrón-Cedeño Alberto , Karadzhov Georgi , Mihaylova Tsvetomila , Mohtarami Mitra , Glass James 
Published: May 2019

We study the problem of automatic fact-checking, paying special attention to the impact of contextual and discourse information. We address two related tasks: (
i
) detecting check-worthy claims and (
ii
) fact-checking claims. We develop supervised systems based on neural networks, kernel-based support vector machines, and combinations thereof, which make use of rich input representations in terms of discourse cues and contextual features. For the check-worthiness estimation task, we focus on political debates, and we model the target claim in the context of the full intervention of a participant and the previous and following turns in the debate, taking into account contextual meta information. For the fact-checking task, we focus on answer verification in a community forum, and we model the veracity of the answer with respect to the entire question–answer thread in which it occurs as well as with respect to other related posts from the entire forum. We develop annotated datasets for both tasks and we run extensive experimental evaluation, confirming that both types of information—but especially contextual features—play an important role.
Viola Moderna: considerações sobre quatro violeiros contemporâneos
Authors: Cury Pedro Pereira 
Published: May 2019

Neste trabalho busco refletir sobre a estética da viola instrumental no Brasil nas últimas décadas. Essa reflexão parte da identificação de elementos que foram incorporados nesse universo, apontando para um processo acentuado de modernização pelo qual passa o instrumento desde entornos dos anos 1980. O trabalho edifica a fundação de uma linguagem renovada da viola sobre a obra de quatro violeiros compositores tidos como referência: Almir Sater, Tavinho Moura, Ivan Vilela e Heraldo do Monte. Abordo também algumas questões históricas uma vez que esse movimento recente de retomada da viola nos meios urbanos é também um processo importante da trajetória do instrumento desde sua chegada no Brasil, ainda no século XVI.