bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin K deficiency bleeding in Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study
Authors: Zurynski Yvonne , Grover Cameron J , Jalaludin Bin , Elliott Elizabeth J 
Published: September 2019

ObjectiveTo undertake surveillance of vitamin K deficiency bleeding (VKDB) in Australia from 1993 to 2017, during a time of change to national recommendations and available vitamin K formulations.MethodsPaediatricians reported cases of VKDB in infants aged <6 months and provided demographic, clinical and biochemical information via the Australian Paediatric Surveillance Unit.Results58 cases were reported, of which 5 (9%) were early, 11 (19%) classic and 42 (72%) late VKDB. 53 (91%) were exclusively breast fed. Seven (12%) received oral prophylaxis, the majority (86%) of whom did not receive all three recommended doses. The overall reported incidence was 0.84 per 100 000 live births (95% CI: 0.64 to 1.08) and the incidence of late VKDB was 0.61 per 100 000 live births (95% CI: 0.44 to 0.82), which are similar to rates reported by other countries where intramuscular vitamin K is recommended. VKDB rates were significantly higher (2.46 per 100 000 live births; 95% CI: 1.06 to 4.85) between 1993 and March 1994 when oral prophylaxis was recommended (p<0.05). Vitamin K was not given to 33 (57%) cases, primarily due to parental refusal, and the number of parental refusals increased significantly after 2006 (p<0.05). There were six deaths, all due to intracranial haemorrhage, and three associated with home delivery and parental refusal of vitamin K.ConclusionsIncidence rates of VKDB in Australia are among the lowest in the world; however, we have identified an increasing trend of parental refusal. Ongoing surveillance and educational campaigns for health professionals and parents are needed to prevent VKDB.
Upside-down position leads to choroidal expansion and anterior chamber shallowing: OCT study
Authors: Li Fei , Li Hao , Yang Jianlong , Liu Jiang , Aung Tin , Zhang Xiulan 
Published: September 2019

BackgroundTo determine whether dynamic changes in choroidal thickness (CT) cause shallowing of the anterior chamber.Methods34 healthy volunteers were enrolled. The participants in our study adopted the upside-down position for 1.5 min, which was the model we used to study the dynamic changes in CT. Intraocular pressure (IOP) elevation, optical coherence tomography images of the choroid and anterior chamber were obtained at baseline, after being in an upside-down position in an inversion machine and after 15 min of rest. The changes in IOP, anterior chamber and choroidal blood flow between the baseline and the upside-down position were compared.ResultsSixty-eight eyes from 34 subjects were analysed. After being in upside-down position for 1.5 min, there was a significant increase in CT from 226.39±52.44 µm to 238.34±54.84 µm (p<0.001). Choroidal flow index decreased from 0.3357±0.0251 to 0.3004±0.0190 in upside-down position, and there was a decrease in anterior chamber depth (3.21±0.22 mm to 3.13±0.21 mm, p<0.001) and angle opening distance at 500 µm from the scleral spur (0.65±0.24 mm to 0.58±0.20 mm, p=0.007). Pearson correlation analysis showed that the increase in CT was positively related with CT at baseline CT (p=0.001).ConclusionWhen the body position changed from sitting to upside-down position, there was choroidal thickening, anterior chamber shallowing and IOP elevation with reduced choroidal blood flow. The data provide evidence about the relationship between choroid expansion and shallowing of the anterior chamber, which may be of relevance for the pathogenesis of angle closure.
Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study
Authors: Jin Yinghui , Li Zimeng , Han Fei , Huang Di , Huang Qiao , Cao Yue , Weng Hong , Zeng Xian-Tao , Wang Xinghuan , Shang Hong-Cai 
Published: September 2019

ObjectivesThe aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.DesignMixed-method research study to collect and analyse both quantitative and qualitative data.SettingClass A tertiary hospitals in China.ParticipantsThe inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital.MethodsQuestionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners.ResultsA total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on ‘lack of access’, ‘less convenient’, ‘lack of applicability’ and ‘lack of evidence from Chinese sample’. Higher frequency and higher ranking of enablers converged on ‘Short formats presentation’, ‘Utilisation of various media’, ‘Information visualisation’ and ‘Linking to patient electronic medical records’. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous.ConclusionOur findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future.
Analgesic efficacy and safety of ketamine after total knee or hip arthroplasty: a meta-analysis of randomised placebo-controlled studies
Authors: Xu Bei , Wang Yilun , Zeng Chao , Wei Jie , Li Jiatian , Wu Ziying , He Hongyi , Lei Guanghua , Xie Dongxing , Ding Xiang 
Published: September 2019

ObjectiveTo examine the analgesic efficacy and safety of ketamine after total knee or hip arthroplasty.DesignSystematic review and meta-analysis.Data sourcesPubMed, EMBASE and Cochrane Library from inception to 22 May 2019.Eligibility criteria for selecting studiesRandomised controlled trials comparing the efficacy and safety of ketamine with placebo for postoperative pain relief in patients undergoing total knee or hip arthroplasty.Data extraction and synthesisData (ie, pain intensity, morphine consumption, gastrointestinal and psychotic adverse effects) were extracted by two reviewers independently. The Cochrane Collaboration’s recommended tool was used to determine the methodological quality of included studies.ResultsA total of 10 studies were included. One of them was rated as low quality. Compared with placebo, intravenous ketamine was effective for pain relief during 0–8-hour (weighted mean difference (WMD) −1.21, 95% CI −1.45 to −0.98, p<0.001; three studies, 149 participants) but not during 8–24-hour postoperative periods, and effective for reduction of cumulative morphine consumption during both 0–24-hour (WMD −17.76, 95% CI −31.25 to −4.27, p=0.01; five studies, 366 participants) and 0–48-hour (WMD −21.79, 95% CI −25.46 to −18.11, p<0.001; four studies, 252 participants) postoperative periods, without increasing risks of gastrointestinal or psychotic adverse effects. The limited data available for intra-articular (WMD −0.49, 95% CI −0.70 to −0.29, p<0.001; two studies, 83 participants) and epidural (WMD −2.10, 95% CI −3.30 to −0.90, p<0.001; one study, 20 participants) ketamine pointed to a significant reduction in pain intensity during 8–24-hour postoperative period.ConclusionsIntravenous administration of ketamine is effective and safe for postoperative pain relief in patients undergoing total knee or hip arthroplasty. Nevertheless, the analgesic efficacy and safety of ketamine in such patients seem to vary by different administration routes and still warrant further studies to explore.
Study protocol for a randomised controlled trial assessing the clinical and cost-effectiveness of the Journeying through Dementia (JtD) intervention compared to usual care
Authors: Wright Jessica , Foster Alexis , Cooper Cindy , Sprange Kirsty , Walters Stephen , Berry Katherine , Moniz-Cook Esme , Loban Amanda , Young Tracey Anne , Craig Claire , Dening Tom , Lee Ellen , Beresford-Dent Julie , Thompson Benjamin John , Young Emma , Thomas Benjamin David , Mountain Gail 
Published: September 2019

IntroductionServices are being encouraged to provide postdiagnostic treatment to those with dementia but the availability of evidence-based interventions following diagnosis has not kept pace with increase in demand. To address this need, the Journeying through Dementia (JtD) intervention was created. A randomised controlled trial (RCT), based on a pilot study, is in progress.Methods and analysisThe RCT is a pragmatic, two-arm, parallel group trial designed to test the clinical and cost-effectiveness of JtD compared with usual care. Recruitment will be through NHS services, third sector organisations and Join Dementia Research. The sample size is 486 randomised (243 to usual care and 243 to the intervention usual care). Participants can choose to ask a friend or relative (supporter) to become involved in the study. The primary outcome measure for participants is Dementia-Related Quality of Life (DEMQOL), collected at baseline and at 8 months’ postrandomisation. Secondary outcome measures will be collected from participants and supporters at those visits. Participants will also be followed up at 12 months’ postrandomisation with a reduced set of measures. A process evaluation will be conducted through qualitative and fidelity substudies. Analyses will compare the two arms of the trial on an intention to treat as allocated basis. The primary analyses will compare the mean DEMQOL scores of the participants at 8 months between the two study arms. A cost-effectiveness analysis will consider the incremental cost per Quality Adjusted Life Years of the intervention compared with usual care. Qualitative and fidelity substudies will be analysed through framework analysis and fidelity assessment tools respectively.Ethics and disseminationREC and HRA approval were obtained. A Data Monitoring and Ethics Committee has been constituted. Dissemination will be via publications, conferences and social media. Intervention materials will be made open access.Trial registration numberISRCTN17993825.
A qualitative exploratory study of UK first-time fathers’ experiences, mental health and wellbeing needs during their transition to fatherhood
Authors: Baldwin Sharin , Malone Mary , Sandall Jane , Bick Debra 
Published: September 2019

ObjectivesTo develop an understanding of men’s experiences of first-time fatherhood, their mental health and wellbeing needs.DesignA qualitative study using semi-structured interviews. Data were analysed using framework analysis.SettingTwo large National Health Service integrated care trusts covering four London (UK) local authority boroughs.ParticipantsFirst-time fathers with children under 12 months of age were included. Maximum variation sampling was used, with 21 fathers recruited. Ten of these men described their ethnic background as Indian, seven as White British, one as Spanish, one as Black African, one as Black Caribbean and one as Pakistani. Participants’ ages ranged from 20 to over 60 years; completion of full-time education ranged from high school certificate to doctorate level; and annual income ranged from £15 000 to over £61 000. Non-English speaking fathers, those experiencing bereavement following neonatal death, stillbirth, pregnancy loss, sudden infant death, and fathers with existing severe mental illnesses were excluded.ResultsNine major categories were identified: ‘preparation for fatherhood’, ‘rollercoaster of feelings’, ‘new identity’, ‘challenges and impact’, ‘changed relationship: we’re in a different place’, ‘coping and support’, ‘health professionals and services: experience, provision and support’, ‘barriers to accessing support’, and ‘men’s perceived needs: what fathers want’. Resident (residing with their partner and baby) and non-resident fathers in this study highlighted broadly similar needs, as did fathers for whom English was their first language and those for whom it was not. A key finding of this study relates to men’s own perceived needs and how they would like to be supported during the perinatal period, contributing to the current evidence.ConclusionsThis study provides insight into first-time fathers’ experiences during their transition to fatherhood, with important implications for healthcare policy makers, service providers and professionals for how perinatal and early years services are planned and provided for both new parents.
What are the patient factors that impact on decisions to progress to total knee replacement? A qualitative study involving patients with knee osteoarthritis
Authors: O'Brien Penny , Bunzli Samantha , Ayton Darshini , Dowsey Michelle M , Gunn Jane , Manski-Nankervis Jo-Anne 
Published: September 2019

ObjectivesGeneral practitioners (GPs) are often the first health professionals to assess patients with osteoarthritis (OA). Despite clinical guideline recommendations for non-surgical intervention as first-line therapies, the most frequent referral from a GP for a person with knee OA is to an orthopaedic surgeon. The aim of our study was to explore patient factors that impact on the decision to progress to total knee replacement (TKR), including the experience of patients in general practice, their perceptions of their condition, and their access and use of community-based allied health interventions.DesignQualitative investigation using semi-structured interviews. The Candidacy framework was selected as a lens to examine the factors driving healthcare access. Data were analysed using a thematic analysis approach. Codes identified in the data were mapped to the seven Candidacy domains. Themes corresponding to each domain were described.SettingA public hospital in Melbourne, Australia.Participants27 patients with knee OA who were on a waiting list to undergo TKR.ResultsTen themes described factors influencing access and use of non-surgical interventions and decision-making for undergoing TKR: (1) History of knee problems, change in symptoms; (2) Physical and psychosocial functioning (Identification of Candidacy); (3) GP and social networks as information sources, access to care (Navigation); (4) Referral pathways (Permeability of services); (5) Communication of impact (Appearances at health services); (6) GP-Surgeon as the predominant referral pathway (Adjudications); (7) Physical activity as painful; (8) Beliefs about effectiveness of non-surgical interventions (Offers and resistance); (9) Familiarity with local system; and (10) Availability (Operating conditions and local production of Candidacy).ConclusionsUsing the Candidacy framework to analyse patients’ experiences when deciding to progress to TKR highlighted missed opportunities in general practice to orient patients to first try non-surgical interventions. Patients with knee OA also require improved support to navigate allied health services.
Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial
Authors: Borges Flavia K , Devereaux P J , Cuerden Meaghan , Bhandari Mohit , Guerra-Farfán Ernesto , Patel Ameen , Sigamani Alben , Umer Masood , Neary John , Tiboni Maria , Tandon Vikas , Ramokgopa Mmampapatla Thomas , Sancheti Parag , John Bobby , Lawendy AbdelRahman , Balaguer-Castro Mariano , Jenkinson Richard , Ślęczka Paweł , Nabi Nur Aamer , Wood Gavin C A , Feibel Robert , McMahon John Stephen , Sigamani Alen , Biccard Bruce M , Landoni Giovanni , Szczeklik Wojciech , Wang Chew Yin , Tomas-Hernandez Jordi , Abraham Valsa , Vincent Jessica , Harvey Valerie , Pettit Shirley , Sontrop Jessica , Garg Amit X 
Published: September 2019

IntroductionInflammation, dehydration, hypotension and bleeding may all contribute to the development of acute kidney injury (AKI). Accelerated surgery after a hip fracture can decrease the exposure time to such contributors and may reduce the risk of AKI.Methods and analysisHip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) is a multicentre, international, parallel-group randomised controlled trial (RCT). Patients who suffer a hip fracture are randomly allocated to either accelerated medical assessment and surgical repair with a goal of surgery within 6 hours of diagnosis or standard care where a repair typically occurs 24 to 48 hours after diagnosis. The primary outcome of this substudy is the development of AKI within 7 days of randomisation. We anticipate at least 1998 patients will participate in this substudy.Ethics and disseminationWe obtained ethics approval for additional serum creatinine recordings in consecutive patients enrolled at 70 participating centres. All patients provide consent before randomisation. We anticipate reporting substudy results by 2021.Trial registration numberNCT02027896; Pre-results.
CDK12 inhibition mediates DNA damage and is synergistic with sorafenib treatment in hepatocellular carcinoma
Authors: Wang Cun , Wang Hui , Lieftink Cor , du Chatinier Aimee , Gao Dongmei , Jin Guangzhi , Jin Haojie , Beijersbergen Roderick L , Qin Wenxin , Bernards René 
Published: September 2019

ObjectivesHepatocellular carcinoma (HCC) is one of the most frequent malignancies and a major leading cause of cancer-related deaths worldwide. Several therapeutic options like sorafenib and regorafenib provide only modest survival benefit to patients with HCC. This study aims to identify novel druggable candidate genes for patients with HCC.DesignA non-biased CRISPR (clustered regularly interspaced short palindromic repeats) loss-of-function genetic screen targeting all known human kinases was performed to identify vulnerabilities of HCC cells. Whole-transcriptome sequencing (RNA-Seq) and bioinformatics analyses were performed to explore the mechanisms of the action of a cyclin-dependent kinase 12 (CDK12) inhibitor in HCC cells. Multiple in vitro and in vivo assays were used to study the synergistic effects of the combination of CDK12 inhibition and sorafenib.ResultsWe identify CDK12 as critically required for most HCC cell lines. Suppression of CDK12 using short hairpin RNAs (shRNAs) or its inhibition by the covalent small molecule inhibitor THZ531 leads to robust proliferation inhibition. THZ531 preferentially suppresses the expression of DNA repair-related genes and induces strong DNA damage response in HCC cell lines. The combination of THZ531 and sorafenib shows striking synergy by inducing apoptosis or senescence in HCC cells. The synergy between THZ531 and sorafenib may derive from the notion that THZ531 impairs the adaptive responses of HCC cells induced by sorafenib treatment.ConclusionOur data highlight the potential of CDK12 as a drug target for patients with HCC. The striking synergy of THZ531 and sorafenib suggests a potential combination therapy for this difficult to treat cancer.
Energy loss of heavy quarks in the isotropic collisional hot QCD medium
Authors: Jamal M. Yousuf , Chandra Vinod 
Published: September 2019

Abstract
The collisional energy loss of heavy partons (charm and bottom quarks) has been determined within the framework of semi-classical transport theory implying the Bhatnagar–Gross–Krook (BGK) collisional kernel. Hot QCD medium effects have been incorporated while employing a quasi-particle description of the medium in terms of effective gluons, quarks and antiquarks with respective temperature dependent effective fugacities. The momentum dependence of the energy loss for the charm and the bottom quark has been investigated. It is observed that with the increase in momentum of the heavy quarks, the loss increases sharply for the smaller values and reaches saturation later. Furthermore, as compared to the charm quark, the bottom quark loses less energy at a particular momentum and collisional frequency. The energy loss is seen to increase with increasing collisional frequency. We also provide a comparative study of the results obtained using the BGK kernel rather than those using the relaxation time approximation (RTA) kernel and found them to be consistent with each other. The medium effects in all the situations are seen to play a quite significant role.
meso-Tetraphenylporphine as a prochiral solvating agent (pro-CSA): A physicochemical study
Authors: Labuta Jan , Ishihara Shinsuke , Hill Jonathan P. 
Published: September 2019

Meso-tetraphenylporphine (TPP) can be used as a prochiral chiral solvating agent (pro-CSA) for NMR detection of enantiomeric excess (ee) of chiral organic acids, in this study 2-phenoxypropionic acid (PPA). The pro-CSA sensing mechanism is unique in that it does not depend on formation of diastereomers. Here we discuss the factors affecting construction of the calibration curves ([Formula: see text] observed linearity between induced chemical shift non-equivalency and ee) including temperature, guest exchange rate and binding strength. We have employed various NMR techniques including variable temperature NMR, titration experiments and analyses of NMR spectral line shapes. It is confirmed that optimization of ee sensing conditions is required for each TPP/acid guest pair. For the TPP/PPA host–guest system, an optimum operating temperature is -32[Formula: see text] C with an acceptable range from -28[Formula: see text] C to -50[Formula: see text] C. The upper bound is due to complete diprotonation of TPP by PPA and the lower bound is due to the limit of PPA guest exchange rate at TPP’s binding site [Formula: see text] s[Formula: see text]. These findings, typical for porphyrin-type diprotonated pro-CSAs, yields valuable insight for design of the next generation of ee sensing molecules.