bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the impact of retraction on the citation of randomized controlled trial reports: an interrupted time-series analysis
Authors: Mott Andrew , Fairhurst Caroline , Torgerson David 
Published: September 2018

Objectives To assess the impact of retraction on the citation of randomized controlled trials. Methods We used an interrupted time-series with matched controls. PubMed, CINHAL, Google and the Retraction Watch Database were searched. We identified retracted publications reporting the results of randomized controlled trials involving human participants with two years of available data before and after retraction. We obtained monthly citation counts across all articles for the 24 months before and after retraction, from Web of Science. We used a Poisson segmented regression to detect changes in the level and trend of citation following retraction. We also undertook a matched control analysis of unretracted randomized controlled trials and a sensitivity analysis to account for cases of large-scale, well-advertised fraud. Results We identified 387 retracted randomized controlled trial reports, of which 218 (56.3%) were included in the interrupted time-series analysis. A reduction of 22.9% (95% CI 4.0% to 38.2%, p = 0.02) was observed in the number of citations in the month after retraction, and a further reduction of 1.9% (95% CI 0.4% to 3.5%, p = 0.02) per month in the following 24 months, relative to the expected trend. There was no evidence of a statistically significant reduction among the matched controls. Authors with a large number of retractions saw a 48.2% reduction at the time of retraction (95% CI 17.7% to 67.3%, p = 0.01). Other cases had a more gradual reduction with no change at the time of retraction and a 1.8% reduction per month in the following 24 months (95% CI 0.2% to 3.4%, p = 0.03). Conclusions Retractions of randomized controlled trial reports can be effective in reducing citations. Other factors, such as the scale of the retractions and media attention, may play a role in the effectiveness of the reduction.
An Exploratory Correlational Study in the Use of Mobile Technology Among Adult Kidney Transplant Recipients
Authors: O’Brien Tara , Russell Cynthia L. , Tan Alai , Washington Mallory , Hathaway Donna 
Published: September 2018

Introduction: Rapidly growing use of mobile technology provides a platform for self-management of care support for those with chronic conditions. Few studies have explored the characteristics or access patterns of kidney transplant recipients who use mHealth applications (apps) for self-management of care. Research Questions: The primary aim of this study was to describe demographics, use, barriers, and perceptions of mobile apps for self-management of care among adult kidney transplants recipients. The secondary aim was to compare blood urea nitrogen, glomerular filtration rate, and number of hospitalizations among mHealth app users, other app users, and non-app users. Methods: A cross-sectional design was used to administer the Mobile Application Use among Kidney Transplant Recipients Questionnaire. Descriptive statistics, χ2 statistics, and analysis of variance were used for the primary aim and linear regression was used for the secondary aim. Results: The sample included mostly African American males (n = 123, 75.5%) with a mean age of 50 (13.2) years. Knowledge was the greatest barrier reported by the non-app users (mHealth app users 9%, other app users 12%, non-app users, 49%, P < .001). Significantly fewer hospitalizations were found in the mHealth app users compared to other app users (regression coefficient b = −1.2, standard error [SE] = 0.5) and non-app users ( b = −0.9, SE = 0.6), adjusting for patient demographic and clinical characteristics. Discussion: Findings suggest a relationship may exist between mHealth app use and a decrease in the number of hospitalizations following kidney transplantation.
Putting the Applied in Applied Psychology: Experiential Learning Projects in the HFE Classroom
Authors: Lum Heather C. , Hancock Gabriella M. , Waldfogle Grace E. , Scholcover Federico , Kelling Nicholas 
Published: September 2018

The objective of this panel is to open a dialog about how experiential learning is being represented within the human factors and ergonomic classroom. The panel will start by Heather Lum briefly giving an overview and the precipice for this discussion panel. The panelists will then provide their views and experiences regarding this topic. Gabriella Hancock will discuss how she prepares her students for ‘publish or perish’ through a hands-on assignment. Grace Waldfogle will discuss how her undergraduate applied project prepared her for graduate education in human factors. Federico Scholcover will share his experiences with a semester long design project and how he uses what he learned there in a job setting. Finally, Nicholas Kelling will discuss the industry-academia collaborative process and how it prepares students for life beyond the classroom. The specific theme of this discussion panel is focused on the differing perspectives that one might face rom either the instructor and student perspectives. Dr. Lum will foster discussion among the panelists and questions from the general audience. Discussion time: 90 minutes.
Electrical stimulation devices for the prevention of venous thromboembolism: Preliminary studies of physiological efficacy and user satisfaction
Authors: Badger James , Taylor Paul , Papworth Neil , Swain Ian 
Published: September 2018

Introduction Electrical stimulation could provide an alternative method for preventing venous thromboembolism in stroke patients. The purpose of this preliminary study was to explore the effects of electrical stimulation and intermittent pneumatic compression on enhancing lower limb venous return in healthy and chronic stroke patients and also to evaluate patient and nurse satisfaction. Methods We investigated the effectiveness of two electrical stimulation devices: Geko (Firstkind Ltd, High Wycombe, UK) and Orthopaedic Microstim 2V2 (Odstock Medical Ltd, Salisbury, UK); and one intermittent pneumatic compression device: Huntleigh Flowstron Universal (Huntleigh Healthcare Ltd, Cardiff, UK). We recruited 12 healthy and 5 chronic stroke participants. The devices were fitted sequentially, and Doppler ultrasound measurements were taken. Eight patients and nurses were also recruited for a separate usability evaluation. Results The electrical stimulation devices emulated the blood flow characteristics of intermittent pneumatic compression in both healthy and stroke participants provided that the intensity of electrical stimulation was sufficient. Patients and nurses also felt that the electrical stimulation devices were acceptable. Conclusions Electrical stimulation may offer benefit as an alternative method for venous thromboembolism prevention in stroke patients. The apparent benefit is sufficient to warrant further investigation in a full powered randomised controlled trial.
Increased acute care utilization in a prospective cohort of adults with sickle cell disease
Authors: Lanzkron Sophie , Little Jane , Field Joshua , Shows Joseph Ryan , Wang Hang , Seufert Rebecca , Brooks Jasmine , Varadhan Ravi , Haywood Carlton , Saheed Mustapha , Huang Chiung Yu , Griffin Brandi , Frymark Steven , Piehet Allie , Robertson Derek , Proudford Marc , Kincaid Adrienne , Green Charles , Burgess Lorri , Wallace Marcus , Segal Jodi 
Published: September 2018

Abstract
The ESCAPED (Examining Sickle Cell Acute Pain in the Emergency vs Day Hospital) trial is an ongoing prospective study comparing outcomes of people with sickle cell disease (SCD) seeking care for acute pain management in either an emergency department or specialty infusion clinic. The objective of this paper is to describe the baseline characteristics and health care utilization of patients in the trial. This is a multicenter study across 4 US cities that enrolled all adults with SCD living within 60 miles (96.6 km) of a study site who were expected to have acute care utilization over the study period. Twenty-one percent of participants had no acute care visits in the first 12 months of follow-up. Using negative binomial regression, we describe subject characteristics that predict acute care utilization. Three hundred ninety-one subjects have completed 12 months of follow-up with a mean age of 34.5 years (standard deviation, 11.4), 60% are female. Fifty-four percent of subjects with hemoglobin SS disease and 46% with hemoglobin SC disease had 3 or more acute visits over the study period. The prevalence of chronic pain in this cohort was 68%. Predictors of higher rates of acute care utilization included being unemployed, having chronic pain, being on chronic transfusion therapy, having a history of stroke, and being on disability or on Medicaid. This is the first prospective cohort in the modern era, and it demonstrates much higher rates of acute care utilization than reported in the Cooperative Study of Sickle Cell Disease.
Snail promotes metastasis of nasopharyngeal carcinoma partly by down‐regulating TEL2
Authors: Sang Yi , Cheng Chun , Zeng Yi‐Xin , Kang Tiebang 
Published: September 2018

AbstractBackgroundMetastasis is the major cause of treatment failure in patients with nasopharyngeal carcinoma (NPC). We previously reported that TEL2, a negative regulator of SERPINE1, could inhibit NPC metastasis to lymph nodes.MethodA series of in vivo and in vitro assays were performed to elucidate the regulation between Snail and TEL2. TEL2 expression was analyzed in three representative NPC cell lines expressing low levels of Snail (S26, 6‐10B, HK1) and two cell lines expressing high levels of Snail (S18, 5‐8F). Luciferase and chromatin immunoprecipitation assays were used to analyze the interaction between Snail and TEL2. The roles of the Snail/TEL2 pathway in cell migration and invasion of NPC cells were examined using transwell assays. Metastasis to the lungs was examined using nude mouse receiving NPC cells injection through the tail vein.ResultsEctopic Snail expression down‐regulated TEL2 at the mRNA and protein levels, whereas knockdown of Snail using short hairpin RNA up‐regulated TEL2. Luciferase and chromatin immunoprecipitation assays indicated that Snail binds directly to the TEL2 promoter. Ectopic Snail expression enhanced migration and invasion of NPC cells, and such effects were mitigated by TEL2 overexpression. TEL2 overexpression also attenuated hypoxia‐induced cell migration and invasion, and increased the number of metastatic pulmonary nodules. Snail overexpression reduced the number of metastatic pulmonary nodules.ConclusionsTEL2 is a novel target of Snail and suppresses Snail‐induced migration, invasion and metastasis in NPC.
Chinese expert consensus on clinical prevention and treatment of scar+
Authors: Lv Kaiyang , Xia Zhaofan ,   On behalf of the Chinese consensus panel on the prevention and treatment of scars
Published: September 2018

Abstract
Following injury, Asian skin has a tendency toward hyperpigmentation and scar formation than Caucasians. A standardized algorithm tailored to Asian patients, especially Chinese patients, is in great demand. Twelve independent, self-selected academic and military physicians from the department of burn/trauma, plastic surgery and dermatology with extensive experience in treating scars were assembled on January 17, 2015, establishing the consensus panel. This consensus was then appraised, drafted, reviewed, and finalized during the following 3 years, aiming to standardize and improve scar prevention and treatment in China. Hopefully, it may also provide some advices and references for the management of scarring in Asian patients.
Individual placement and support for vocational recovery in first-episode psychosis: randomised controlled trial
Authors: Killackey Eóin , Allott Kelly , Jackson Henry J. , Scutella Rosanna , Tseng Yi-Ping , Borland Jeff , Proffitt Tina-Marie , Hunt Sally , Kay-Lambkin Frances , Chinnery Gina , Baksheev Gennady , Alvarez-Jimenez Mario , McGorry Patrick D. , Cotton Susan M. 
Published: September 2018

BackgroundHigh unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).AimsTo examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370).MethodYoung people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations.ResultsAt the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17–9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes.ConclusionsThis is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.Declaration of interestNone.
Hospitalization and hospital discharge destinations after chemotherapy: Using the Oncology Care Model (OCM) methodology in 2012–2015 Medicare data.
Authors: Peng Yi , Liu Jiannong , Raskin Leon , Kelsh Michael Anthony , Zaha Rebecca , Hernandez Rohini K. , Henry David , Lyman Gary H. 
Published: September 2018

113 Background: The Medicare OCM gives financial incentives for efficient, high-quality care. Hospitalizations of cancer patients receiving chemotherapy substantially increases costs. We assessed reasons for hospitalization and hospitalization discharge destinations after chemotherapy in cancer patients. Methods: We applied OCM methodology in a Medicare fee-for-service 20% sample data to estimate 6-month patient episodes triggered by chemotherapy from 2012 to 2015. We summarized the most frequent reasons for hospitalization (using ICD-9-CM codes in the first 5 positions of hospital claims) and the discharge destinations among all episodes and by cancer type. Results: Of 485,186 6-month episodes in 255,229 patients, 121,886 (25%) episodes had ≥1 hospitalization. The most frequent reasons for hospitalization were infection (13%), anemia (7%), dehydration (5%), and congestive heart failure (CHF; 3%; Table). Most hospitalized patients were discharged to home (71%) or a skilled nursing facility (SNF; 13%); some died in the hospital (6%) or went to hospice (5%). Reasons for hospitalization and discharge destination varied by cancer type. Patients with lung cancer had the highest rates of infection and anemia and higher proportions of death and hospice discharge compared with other cancers. Conclusions: Among Medicare beneficiaries receiving chemotherapy, hospitalizations most often occurred as a result of infection or anemia. Patients were most often discharged to home or SNF. Variations across cancer types in the reasons for hospitalization, as well as discharge destinations, should be considered when evaluating OCM practice performance. [Table: see text]
Health system stakeholder perceptions of financial assistance programs at a comprehensive cancer center.
Authors: Spencer Jennifer , Manning Michelle L. , Rosenstein Donald L. , Samuel Cleo A. , Reeder-Hayes Katherine Elizabeth , Sellers Jean , Wheeler Stephanie B. 
Published: September 2018

114 Background: Cancer-related financial burden is a growing problem that has been linked to psychosocial distress, treatment delays and non-adherence, and excess mortality risk. Comprehensive cancer centers often provide financial support resources to mitigate financial burden, but the scope of these services and the processes involved are poorly understood. We conducted an in-depth qualitative analysis of key health system stakeholders to understand these processes and identify areas for improvement. Methods: Semi-structured interviews were conducted with 12 stakeholders involved in the financial assistance process at a public comprehensive cancer center. Interviews elicited descriptions of programs, perceived strengths and weakness, and the stakeholders' roles in helping patients obtain financial assistance. A codebook was developed inductively and interviews were coded in duplicate, with codes added as new themes emerged. Coded data were used to develop and revise a system-wide process map of financial support resources. Results: Stakeholders described numerous resources for financial assistance, both internal (e.g., Charity Care) and external (e.g., manufacturer assistance). Although participants described feeling pride at helping patients obtain assistance, numerous barriers were identified, including delays in processing applications, duplicative processes, insufficient time to address patients' concerns, lack of dedicated staff to address the complexity of navigating resources, and perception that existing resources are inadequate to meet patient needs. Conclusions: Processes required to obtain financial support for cancer patients often place a high administrative burden on patients who must proactively seek resources, understand complex eligibility criteria and complete multiple, often overlapping applications, even within comprehensive cancer center environments. Dedicated financial navigators may assist patients in accessing existing available resources, and health systems should consider moving beyond patient-activated pathways of access to financial support to avoid exacerbating disparities for the most vulnerable patients.
The challenges of implementing the CMS oncology care model (OCM) in a large multi-center community oncology practice.
Authors: Brown John , King Kelly , Hunis Brian 
Published: September 2018

115 Background: Our oncology practice has participated in the OCM program since July 2016. The purpose was to build improvement in quality care delivery and create methodology to reduce costs. We peered our work with ten cancer centers from ten states along the east coast. Methods: For all performance periods, we focused on building our strengths via five teams: Access, Care Mgmt., Post-acute transition, Finance, and Reporting. A registry was created in Epic. Data was collated and categorized as “OCM Eligible” and “OCM patients.” The Care Team worked with IT to create beneficiary identifications, discrete chart elements, financial estimations, and reports. Results: From Oct. to Dec. 2017 (latest quarter review), 589 patients were attributable. Our black and Hispanic population was +72.9% and +413.3% v. OCM (+76.6% and +381.2% v. all). We were categorized as high risk in the hierarchal condition category: +14% v. OCM, +17.7% v. all at the 25th percentile; +21.6% and +32.6% at the 50th percentile, +14.2% and +17.5 % at the 75th percentile respectively. Our dually enrolled, Medicare / Medicaid was 29% (+113% v. OCM). ED visit utilization was +2.6% (not leading to admits or observations (Obs). IP admits were utilized at a rate of 27.3 per 100 beneficiaries v. 25.8 for OCM (+5.9%) and 26.1 for all (+4.9%). Those that resulted from ED visits only were 15.8 v. 16.2 (-2.5%). Those resulted from Obs were 0.8 v. 0.3 OCM (+142.4%). Unplanned readmits within 30 days were 6.4 (per 100) v. 5.7 OCM (+13.9%). Imaging utilization was -35.2% v. OCM and -38.5% v. all. Hospice use was 3.7% v. a 5% median OCM rate. Home health was +26% v. OCM and +15.8% v. all. Risk-adjusted four Qtr. avg. expenditures were +14.5% per beneficiary v. OCM (Jan. – Dec. 2017); however, mortality rates were -10.9% v. OCM. Conclusions: Our practice data led us to identify and prioritize PI initiatives, helped us engage providers, and educate stakeholders. While certain costs were lower, drug utilization remains high. The ED and IP admits from Obs have been a challenge, even with phone triage assistance developed previously as participants of the ASCO Quality Training Program. Our PI plan is to develop oncology expanded care clinics to reduce ED and Obs utilization.
Impact of a comprehensive copay assistance and drug recovery system in a community cancer center.
Authors: Siegel Robert D. , Standifer Theresa , Spann Terra , Borron Michael , Slough Richard , Pringle Dionne , Helms Bonnie , Stoeppler-Biege Kristina 
Published: September 2018

121 Background: The cost of oncology drugs has escalated rapidly while rollbacks in health care coverage and the emergence of high deductible and limited policies have made these drugs unaffordable for many. Many pharmaceutical companies offer drug replacement for those uninsured or for whom coverage is inadequate. Previously Bon Secours St. Francis Cancer Center (BSSFCC) had contracted with a third-party to recover replacement drug from these pharmaceutical programs. In 2017, we opted to suspend that third-party contract and take the process internally. Methods: BSSFCC is located in Greenville, SC. Nearly1500 new cases of cancer were diagnosed in 2016, of which, 3.5% are uninsured. We hired 2.5 FTE's to manage our drug recovery program. After clearance with legal and compliance officers, limited power of attorney was obtained to pursue these efforts on the patients’ behalf. Patients who had no drug coverage, inadequate coverage, or off-label denials were identified at the time of chemotherapy education, pre-authorization, or by after-the-fact processing of claims. Our efforts at drug recovery are noted below. Results: We recovered drug for 71 patients during fiscal 2017. The total cost of those recovered drugs was $3.25 million. This compared with $389,000 recovered by our third-party vendor (pre-commission) in FY 2016. $842,000 of drug replacement were for off-label use in insured patients, while $587,000 represented use in the uninsured. The remainder represented replacement drug for those with inadequate drug coverage and an ipilimumab replacement program for adjuvant therapy for melanoma. Conclusions: Embedding a process within a community cancer center to manage drug recovery for the un- and underinsured proved to have a substantial return on investment. The drug expenses which had to be written off were decreased substantially but most importantly, our ability to replace drug with some reliability allowed many of our patients to receive effective therapy that otherwise would have been cost prohibitive. Although the ability to recover drugs in this fashion is both helpful and appreciated, our program does nothing to rein in the unsustainable rise in the cost of cancer care.