bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fertility response of lactating dairy cows subjected to three different breeding programs under subtropical conditions
Authors: Khalil Abdeltawab Abdelrazek Yassin 
Published: September 2019

Abstract

Background
It is comprehensively recognized that reduced reproductive efficiency represents a great economic loss to dairy producers. Ovarian cysts and anestrus syndromes are considered the greatest significant causes of low reproductive efficiency in dairy herds worldwide as they detrimentally affect the longevity and profitability of dairy herd. Pregnancy rate is the best available single deciding parameter used for assessment of the reproductive efficiency at the herd level which measures the probability that open cows become pregnant per unit of time. So, the current study was planned to evaluate the suitability of using Ovsynch plus CIDR and G6G resynchronization protocols as an efficient treatment regimen for cystic ovarian diseased cows and anestrus cows, respectively, through comparing pregnancy rates of cystic ovarian diseased cows that subjected to Ovsynch supplemented with controlled internal drug release device with the pregnancy rate of healthy cows that subjected to a Presynch-Ovsynch synchronization protocol, as well as through comparing pregnancy rates of anestrus cows that subjected to G6G treatment protocol with the pregnancy rate of healthy cows. Moreover, possible factors such as breed, parity, and season which may affect the treatment success were also evaluated.

Results
The results of the current study revealed an overall mean pregnancy rate of 36.64%. Moreover, Simmental cows recorded a greater (p < 0.01) pregnancy rate (45.16%) than that recorded for Holstein cows (34.98%). A highly significant seasonal effect was observed, as a higher (p < 0.01) pregnancy rate was recorded for cows inseminated during cold months (39.54%) compared with that recorded for cows inseminated during hot months (29.18%).

Conclusions
No significant differences were detected in the pregnancy rates among the three breeding programs; thence, the application of the G6G synchronization protocol for anestrus cows and Ovsynch-CIDR synchronization protocol for cows with ovarian cysts could be used as effective treatment regimens as they resulted in nearly the same pregnancy rates that recorded for healthy cows. In addition, the treatment response was highly influenced by cow’s breed, parity, and season of breeding.
Serious life events and post-traumatic stress disorder in the Norwegian population
Authors: Heir Trond , Bonsaksen Tore , Grimholt Tine , Ekeberg Øivind , Skogstad Laila , Lerdal Anners , Schou-Bredal Inger 
Published: September 2019

Background
It has been suggested that countries with more resources and better healthcare have populations with a higher risk of post-traumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare.

Aims
To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population.

Method
A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not.

Results
At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced.

Conclusions
High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events.

Declaration of interest
None.
MARS: Mutation-Adjusted Risk Score for Advanced Systemic Mastocytosis
Authors: Jawhar Mohamad , Schwaab Juliana , Álvarez-Twose Iván , Shoumariyeh Khalid , Naumann Nicole , Lübke Johannes , Perkins Cecelia , Muñoz-González Javier I. , Meggendorfer Manja , Kennedy Vanessa , Metzgeroth Georgia , Fabarius Alice , Pfeifer Dietmar , Sotlar Karl , Horny Hans-Peter , von Bubnoff Nikolas , Haferlach Torsten , Cross Nicholas C.P. , Hofmann Wolf-Karsten , Sperr Wolfgang R. , García-Montero Andrés C. , Valent Peter , Gotlib Jason , Orfao Alberto , Reiter Andreas 
Published: September 2019

PURPOSETo develop a risk score for patients with advanced systemic mastocytosis (AdvSM) that integrates clinical and mutation characteristics.PATIENTS AND METHODSThe study included 383 patients with AdvSM from the German Registry on Disorders of Eosinophils and Mast Cells (training set; n = 231) and several centers for mastocytosis in the United States and Europe, all within the European Competence Network on Mastocytosis (validation set; n = 152). A Cox multivariable model was used to select variables that were predictive of overall survival (OS).RESULTSIn multivariable analysis, the following risk factors were identified as being associated with OS: age greater than 60 years, anemia (hemoglobin < 10 g/dL), thrombocytopenia (platelets < 100 × 109/L), presence of one high molecular risk gene mutation (ie, in SRSF2, ASXL1, and/or RUNX1), and presence of two or more high molecular risk gene mutations. By assigning hazard ratio–weighted points to these variables, the following three risk categories were defined: low risk (median OS, not reached), intermediate risk (median OS, 3.9 years; 95% CI, 2.1 to 5.7 years), and high risk (median OS, 1.9 years; 95% CI, 1.3 to 2.6 years; P < .001). The mutation-adjusted risk score (MARS) was independent of the WHO classification and was confirmed in the independent validation set. During a median follow-up time of 2.2 years (range, 0 to 23 years), 63 (16%) of 383 patients experienced a leukemic transformation to secondary mast cell leukemia (32%) or secondary acute myeloid leukemia (68%). The MARS was also predictive for leukemia-free survival ( P < .001).CONCLUSIONThe MARS is a validated, five-parameter, WHO-independent prognostic score that defines three risk groups among patients with AdvSM and may improve up-front treatment stratification for these rare hematologic neoplasms.
Practice-Level Adoption of Conservative Management for Prostate Cancer
Authors: Modi Parth K. , Kaufman Samuel R. , Herrel Lindsey A. , Dupree James M. , Luckenbaugh Amy N. , Skolarus Ted A. , Hollenbeck Brent K. , Shahinian Vahakn B. 
Published: September 2019

PURPOSE: We describe the longitudinal adoption of conservative management (ie, the absence of treatment) for prostate cancer among urology group practices in the United States and identify group practice features that influence this adoption. METHODS: Using a 20% sample of Medicare claims, we identified men with incident prostate cancer from 2010 through 2014 and assigned each to his predominant urologist. We linked each urologist to a practice and characterized the practice’s organization (eg, solo, single specialty, multispecialty) and ownership of intensity-modulated radiation therapy. For each group, we determined the rate of conservative management within 1 year of diagnosis. We then fit mixed-effects logistic regression models to assess relationships between practice organization and the adoption of conservative management over time, adjusted for patient characteristics. RESULTS: We identified 22,178 men with newly diagnosed prostate cancer managed by 350 practices. Practices that increased use the most over time also used conservative management the most in 2010, whereas those that increased use the least used conservative management the least in 2010. Thus, the difference in average use of conservative management between highest- and lowest-use practices widened between 2010 and 2014. Urology groups increased their use of conservative management more rapidly than multispecialty groups. There was no difference in the rate of increase between intensity-modulated radiation therapy owning and nonowning groups. CONCLUSION: There is increasing variation among group practices in the use of conservative management for prostate cancer. This underscores the need for a better understanding of practice-level factors that influence prostate cancer management.
Real-World Clinical and Economic Outcomes and the Role of Bevacizumab in Patients With Non–Small-Cell Lung Cancer With Liver Metastases
Authors: Wong William B. , Wu Ning , Yang Erru , Davies Jessica , Chae Young Kwang 
Published: September 2019

PURPOSE: Liver metastases are associated with poor outcomes in patients with advanced non–small-cell lung cancer (aNSCLC). Nevertheless, the vasculature in the liver microenvironment may be conducive to the use of antiangiogenesis inhibitors to potentially improve outcomes. Limited real-world clinical and economic data are currently available for this patient subpopulation. METHODS: Two retrospective cohort analyses were conducted using data from an electronic health record (n = 14,209) and a claims database (n = 9,017). Patients with aNSCLC with and without liver metastases were identified in each database. Patients with baseline liver metastases in the electronic health record database were further categorized into two subgroups—those who had or had not received bevacizumab-containing regimens. Multivariable Cox proportional hazards regression models were used to adjust for baseline characteristics to evaluate the effect of treatment of bevacizumab. RESULTS: Liver metastases were associated with significantly poorer survival (median overall survival, 6.3 months v 10.1 months) and higher costs and health care resource utilization—total per-patient-per-month costs of $27,589 versus $19,607. Cost differences were primarily driven by inpatient costs, including a two-fold increase in hospitalizations and a 1.7-fold higher mean length of stay. Treatment with bevacizumab was associated with improved survival. Whereas overall survival improved in patients with and without baseline liver metastases who received bevacizumab, the relative survival benefit was greater in patients with liver metastases (hazard ratio, 0.63 [95% CI, 0.50 to 0.81] v hazard ratio, 0.80 [95% CI, 0.74 to 0.86]). CONCLUSION: Patients with aNSCLC with liver metastases have poorer survival and a higher cost and health care resource utilization burden. Bevacizumab was associated with a survival benefit in patients with aNSCLC with liver metastases.
Patient Navigation in Cancer: The Business Case to Support Clinical Needs
Authors: Kline Ronald M. , Rocque Gabrielle B. , Rohan Elizabeth A. , Blackley Kris A. , Cantril Cynthia A. , Pratt-Chapman Mandi L. , Burris Howard A. , Shulman Lawrence N. 
Published: September 2019

PURPOSE: Patient navigation (PN) is an increasingly recognized element of high-quality, patient-centered cancer care, yet PN in many cancer programs is absent or limited, often because of concerns of extra cost without tangible financial benefits. METHODS: Five real-world examples of PN programs are used to demonstrate that in the pure fee-for-service and the alternative payment model worlds of reimbursement, strong cases can be made to support the benefits of PN. RESULTS: In three large programs, PN resulted in increased patient retention and increased physician loyalty within the cancer programs, leading to increased revenue. In addition, in two programs, PN was associated with a reduction in unnecessary resource utilization, such as emergency department visits and hospitalizations. PN also reduces burdens on oncology providers, potentially reducing burnout, errors, and costly staff turnover. CONCLUSION: PN has resulted in improved patient outcomes and patient satisfaction and has important financial benefits for cancer programs in the fee-for-service and the alternative payment model worlds, lending support for more robust staffing of PN programs.
Optimization of Cancer Treatment in the Frequency Domain
Authors: Schulthess Pascal , Rottschäfer Vivi , Yates James W. T. , van der Graaf Piet H. 
Published: September 2019

Abstract
Thorough exploration of alternative dosing frequencies is often not performed in conventional pharmacometrics approaches. Quantitative systems pharmacology (QSP) can provide novel insights into optimal dosing regimen and drug behaviors which could add a new dimension to the design of novel treatments. However, methods for such an approach are currently lacking. Recently, we illustrated the utility of frequency-domain response analysis (FdRA), an analytical method used in control engineering, using several generic pharmacokinetic-pharmacodynamic case studies. While FdRA is not applicable to models harboring ever increasing variables such as those describing tumor growth, studying such models in the frequency domain provides valuable insight into optimal dosing frequencies. Through the analysis of three distinct tumor growth models (cell cycle-specific, metronomic, and acquired resistance), we demonstrate the application of a simulation-based analysis in the frequency domain to optimize cancer treatments. We study the response of tumor growth to dosing frequencies while simultaneously examining treatment safety, and found for all three models that above a certain dosing frequency, tumor size is insensitive to an increase in dosing frequency, e.g., for the cell cycle-specific model, one dose per 3 days, and an hourly dose yield the same reduction of tumor size to 3% of the initial size after 1 year of treatment. Additionally, we explore the effect of drug elimination rate changes on the tumor growth response. In summary, we show that the frequency-domain view of three models of tumor growth dynamics can help in optimizing drug dosing regimen to improve treatment success.
Clinical application of contrast-enhanced ultrasound after percutaneous renal tumor ablation
Authors: Guo Fang , Hu Bing , Chen Lei , Li Jia 
Published: September 2019

Objective: To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) in detecting incomplete ablation and local recurrence of renal tumors after percutaneous radiofrequency ablation (RFA). Methods: 31 patients were included for RFA treatment and underwent CEUS examination after RFA, ablation zone and contrast distribution in the ablation area were observed, CEUS images were compared with enhanced CT/MRI images to determine the residual tumors and local recurrence of renal tumors. Results: The average maximum diameters of the tumor and the ablation zone after the first RFA were 32.3 ± 14.7 mm and 35.9 ± 12.2 mm, respectively. A higher rate of complete tumor ablation was achieved if the ablation zone was larger than the primary tumor (p = 0.026). Within 1 month after RFA, contrast-enhanced CT/MRI examinations demonstrated incomplete ablation in 9 of 31 patients (29.0%), while CEUS revealed incomplete ablation in 8 of 31 patients (25.8%). The sensitivity, specificity, positive predictive value and negative predictive value of CEUS in evaluating complete ablation of renal tumors were 88.9%, 100%, 100%, 95.7%, respectively. During the follow-up period, local recurrence was reported in 2 (7.4%) of the 27 patients with complete tumor ablation. Tumor recurrence signs in the two patients were identified by both CEUS and contrast-enhanced CT/MRI. Therefore, both the sensitivity and specificity of CEUS for the evaluation of tumor recurrence were 100%. Conclusion: After percutaneous RFA of renal tumors, the effectiveness of CEUS in the follow-up assessment of residual and recurrent tumors is basically the same as that of contrast-enhanced CT/MRI. Advances in knowledge: In this study, we evaluated the effectiveness of CEUS in the follow-up assessment of residual and recurrent tumors after RFA is basically the same as that of contrast-enhanced CT/MRI. Combining multiple follow-up methods may improve the detection rate of residual or recurrent tumors.
Social and economic impacts of congenital Zika syndrome in Brazil: Study protocol and rationale for a mixed-methods study
Authors: Kuper Hannah , Lyra Tereza Maciel , Moreira Maria Elisabeth Lopes , de Albuquerque Maria do Socorro Veloso , de Araújo Thália Velho Barreto , Fernandes Silke , Jofre-Bonet Mireia , Larson Heidi , Lopes de Melo Ana Paula , Mendes Corina Helena Figueira , Moreira Martha Cristina Nunes , do Nascimento Marcos Antonio Ferreira , Penn-Kekana Loveday , Pimentel Camila , Pinto Marcia , Simas Clarissa , Valongueiro Sandra 
Published: September 2019

Global concern broke out in late 2015 as thousands of children in Brazil were born with microcephaly, which was quickly linked to congenital infection with Zika virus (ZIKV). ZIKV is now known to cause a wider spectrum of severe adverse outcomes—congenital Zika syndrome (CZS)—and also milder impairments. This study aimed to explore the social and economic impacts of CZS in Brazil. Data was collected through mixed methods across two settings: Recife City and Jaboatão dos Guararapes in Pernambuco State (the epicentre of the epidemic), and the city of Rio de Janeiro (where reports of ZIKV infection and CZS were less frequent). Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. In-depth qualitative interviews were conducted with: mothers and other carers of children with CZS (approximately 30 per setting), pregnant women (10-12 per setting), men and women of child-bearing age (16-20 per setting), and health professionals (10-12 per setting). Thematic analysis was undertaken independently by researchers from at least two research settings, and these were shared for feedback. A case-control study was undertaken to quantitatively explore social and economic differences between caregivers of a child with CZS (cases) and caregivers with an unaffected child (controls). We aimed to recruit 100 cases and 100 controls per setting, from existing studies. The primary caregiver, usually the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, stress, social support, family quality of life, health care and social service use, and costs incurred by families. Multivariable logistic regression analyses were used to compare outcomes for cases and controls. Costs incurred as a result of CZS were estimated from the perspective of the health system, families and society. Modelling was undertaken to estimate the total economic burden of CZS from those three perspectives.
Assessment and documentation of incontinence-associated dermatitis after implementation of a standardised instrument: a comparative study
Authors: Montague Mary , Karafa Matthew , Albert Nancy M. 
Published: September 2019

Objective: In this study, clinical nurses' documentation of incontinence-associated dermatitis (IAD) were compared with wound expert documentation before and after implementing a valid, reliable severity index (SI) instrument. Methods: A prospective, non-equivalent, two group comparative design within three hospital medical units. Pre- and post-implementation skin condition documentation were compared by clinician type, and post-implementation IADSI scores were assessed for agreement using standard and weighted Kappa. Results: Of 89 patients (pre-, n=48 and post-, n=38), mean (standard deviation) age was 72.4±13.7 years and 57.3% had IAD. Mean IADSI score was 13.2 (standard deviation: 10.5; range: 0–52), reflecting pink intact skin. Post-implementation, skin documentation between clinicians was more likely to match, from 35.4 to 84.2%, p<0.001. Post-implementation, after controlling for age, gender and race, the odds ration (OR) of matched documentation between clinicians was 5.80 ([95% confidence interval: 1.8, 18.6], p=0.003) compared with pre-implementation. In the post-implementation period, standard Kappas for agreement in clinical nurse-wound expert documentation in the lower back/buttocks/upper thigh areas ranged from 0.82 to 1.0, reflecting very good agreement. Weighted kappas ranged from 0.76 to 1.0, also reflecting good to very good agreement. Conclusion: Implementation of an IADSI assessment instrument improved accuracy of IAD documentation.
Prehospital use of the traction splint for suspected mid-shaft femur fractures
Authors: Howland Ian Ronald , Howard Ian Lucas , Pillay Yugan , Ludick Beverley Dawn , Castle Nicholas Raymond 
Published: September 2019

Introduction: A retrospective audit of electronic patient care records (ePCRs) highlighted the infrequent use of the traction splint for the management of femur fractures. The aim of this study was to improve the use of the traction splint for patients presenting with a mid-shaft femur fracture in the absence of contraindications, by means of introducing a purpose-designed trauma CPD training course. Methods: An intervention consisting of a simulation-based mandatory trauma CPD training session for all operational prehospital care providers was implemented over a 3-month period, supported by a pre- and post-implementation staff survey regarding staff perceptions of using a traction splint. Following the intervention period, a repeat retrospective audit of the ePCR database was conducted to identify any improvement in the use of the traction splint. Results: The use of the traction splint for a femur fracture in the pre-intervention stage was found to be underutilised (Median 16%). Following the intervention period, however, traction splint use increased significantly (Median 50%). An improvement was also noted in staff perception and understanding of the management of femur fractures. Conclusion: This study found that focused trauma training is an effective means to improve patient care. Training should be ongoing in order to maintain skills and knowledge needed for management of femur fractures.
Menière’s disease treated by grommet insertion
Authors: Kanegaonkar RG , Najuko-Mafemera A , Hone R , Tikka T 
Published: September 2019

Introduction Menière’s disease (MD) is an uncommon cause of sudden profound vertigo. A variety of medical and surgical treatments have been used to manage this condition. This study reviewed the outcomes of patients treated with grommet insertion and transtympanic steroid injection. Methods Patients diagnosed with MD between 2007 and 2017 were identified, and case notes and audiological data were retrieved for those managed by grommet (ventilation tube) insertion with and without transtympanic steroid injection. Results Thirty-three patients were identified as being diagnosed with MD. Grommet insertion resulted in cessation or improvement of attacks in 91% of cases. The mean follow-up duration was 33.8 months (median: 29 months). The mean hearing threshold across the low frequencies improved from 57.2dBHL to 49.4dBHL (p=0.031). Following the intervention, improved tinnitus was reported in 80% of cases. Twelve patients (36%) reported aural fullness prior to grommet insertion; all reported improved symptoms following the procedure. Conclusions Early grommet insertion with transtympanic steroid injection, combined with customised vestibular physiotherapy, may provide an alternative first-line strategy for MD, preventing further true MD attacks. In some patients, it may significantly improve hearing thresholds.