bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of valganciclovir prophylaxis in high‐risk (D+/R−) renal transplant recipients experiencing delayed graft function
Authors: Freedman Sari R. , Ravichandran Bharath R. , Masters Brian M. , Bromberg Jonathan S. , Haririan Abdolreza , Saharia Kapil K. , Heil Emily L. , Sparkes Tracy 
Published: June 2019

AbstractBackgroundCytomegalovirus (CMV) outcomes with valganciclovir prophylaxis in renal transplant recipients experiencing delayed graft function (DGF) are unclear.MethodsThis single center, retrospective, cohort study of CMV high‐risk (D+/R− with alemtuzumab induction) deceased donor renal transplant recipients receiving valganciclovir prophylaxis assessed CMV outcomes in patients experiencing DGF (n = 72) versus those with immediate graft function (IGF; n = 66).ResultsCytomegalovirus viremia by 12 months occurred at similar rates in the IGF and DGF groups (30.3% vs 26.4%, respectively, P = 0.71) with 89.7% (35/39) of all cases classified as CMV disease. The median time to CMV viremia post transplant was day 141 and 138 in the IGF and DGF groups, respectively (P = 0.30). The incidence of biopsy‐proven acute rejection (BPAR) was higher in the DGF group (18.1% vs 4.6%, P = 0.02) with BPAR preceding CMV in only 1 patient. There was no significant difference in graft loss (1.5% vs 4.2%, P = 0.62) or patient survival (98.5% vs 95.8%, P = 0.62) at 1 year between the IGF and DGF groups, respectively.ConclusionValganciclovir prophylaxis in patients experiencing DGF yielded similar CMV outcomes up to 1‐year post transplant when compared to use in patients with IGF.
3-D seismic images of an extensive igneous sill in the lower crust
Authors: Wrona T. , Magee C. , Fossen H. , Gawthorpe R.L. , Bell R.E. , Jackson C.A.-L. , Faleide J.I. 
Published: June 2019

AbstractWhen continents rift, magmatism can produce large volumes of melt that migrate upwards from deep below the Earth’s surface. To understand how magmatism impacts rifting, it is critical to understand how much melt is generated and how it transits the crust. Estimating melt volumes and pathways is difficult, however, particularly in the lower crust where the resolution of geophysical techniques is limited. New broadband seismic reflection data allow us to image the three-dimensional (3-D) geometry of magma crystallized in the lower crust (17.5–22 km depth) of the northern North Sea, in an area previously considered a magma-poor rift. The subhorizontal igneous sill is ∼97 km long (north-south), ∼62 km wide (east-west), and 180 ± 40 m thick. We estimate that 472 ± 161 km3 of magma was emplaced within this intrusion, suggesting that the northern North Sea contains a higher volume of igneous intrusions than previously thought. The significant areal extent of the intrusion (∼2700 km2), as well as the presence of intrusive steps, indicate that sills can facilitate widespread lateral magma transport in the lower crust.
High-resolution correlations of strata within a sand-rich clinothem using grain fabric data, offshore New Jersey, USA
Authors: Cosgrove Grace I.E. , Hodgson David M. , Mountney Nigel P. , McCaffrey William D. 
Published: June 2019

AbstractTrajectories of successive clinoform rollovers are widely applied to predict patterns of spatio-temporal sand distribution. However, the detailed internal architecture of individual clinothems is rarely documented. Understanding the textural complexities of complete topset-foreset-bottomset clinothem sequences is a key factor in understanding how and when sediment is transferred basinward. This study used high-resolution, core-based analyses of 267 samples from three research boreholes from quasi-coeval topset, foreset, and bottomset deposits of a single Miocene intrashelf clinothem recovered during Integrated Ocean Drilling Program (IODP) Expedition 313, offshore New Jersey, USA. Topset deposits were subdivided into three sedimentary packages based on grain character and facies analysis, consisting of upper and lower river-dominated topset process-regime packages separated by a middle wave- and storm-dominated process-regime package. Temporal variability in topset process regime exerts a quantifiable effect on grain character across the complete depositional profile, which was used here to correlate topset deposits with time-equivalent sedimentary packages in foreset and bottomset positions. River-dominated sedimentary packages have higher sand-to-mud ratios; however, the grain character of river-dominated sedimentary packages is texturally less mature than that of wave- and storm-dominated deposits. Differences in grain character between packages dominated by different process regimes increase basinward. The novel use of quantitative grain-character data allows intraclinothem time lines to be established at a higher resolution than is possible using chronostratigraphic techniques. Additionally, stratigraphic changes in grain character were used to refine the placement of the basal sequence boundary. These results challenge the idea that clinoform trajectories and stacking patterns are sufficient to describe spatio-temporal sand-body evolution across successive clinothems.
Effect of power outages on the use of maternal health services: evidence from Maharashtra, India
Authors: Koroglu Mustafa , Irwin Bridget R , Grépin Karen A 
Published: June 2019

IntroductionElectricity outages are common in low/middle-income countries and have been shown to adversely affect the operation of health facilities; however, little is known about the effect of outages on the utilisation of health services.MethodsUsing data from the 2015–2016 India Demographic Health Survey, combined with information on electricity outages as reported by the state electricity provider, we explore the associations between outage duration and frequency and delivery in an institution, skilled birth attendance, and caesarean section delivery in Maharashtra State, India. We employ multivariable logistic regression, adjusting for individual and household-level covariates as well as month and district-level fixed effects.ResultsPower outage frequency was associated with a significantly lower odds of delivering in an institution (OR 0.98; 95% CI 0.96 to 0.99), and the average number of 8.5 electricity interruptions per month was found to yield a 2.08% lower likelihood of delivering in a facility, which translates to an almost 18% increase in home births. Both power outage frequency and duration were associated with a significantly lower odds of skilled birth attendance (OR 0.97; 95% CI 0.95 to 0.99, and OR 0.99; 95% CI 0.992 to 0.999, respectively), while neither power outage frequency nor duration was a significant predictor of caesarean section delivery.ConclusionPower outage frequency and duration are important determinants of maternal health service usage in Maharashtra State, India. Improving electricity services may lead to improved maternal and newborn health outcomes.
Cost-effectiveness of scaling up of hepatitis C screening and treatment: a modelling study in South Korea
Authors: Kim Jungyeon , Haacker Markus , Keshavjee Salmaan , Atun Rifat 
Published: June 2019

BackgroundThe prices and the coverage of effective direct-acting antivirals (DAAs) to treat hepatitis C vary across countries. South Korea expanded DAAs coverage through national health insurance. This study aims to analyse the cost-effectiveness of scale-up of hepatitis C screening and treatment with DAAs in South Korea, a high-income country.MethodsThis study uses a compartmental age–sex structured model of progression of hepatitis C to analyse effects of different policy choices for the scale up of screening and treatment with DAAs on hepatitis C disease burden and costs from 2017 to 2050. Policy scenarios considered in our study are (1) no treatment, (2) status quo, (3) screening population aged over 60 years, (4) screening population over 40 years and (5) screening population aged over 20 years.ResultsThe continuation of current policy with the expansion of DAAs coverage is estimated to reduce the prevalence of hepatitis C antibody from 0.6% in 2015 to 0.25% in 2050 of the adult population. Status quo policy, screening from age 60, screening from age 40 and screening from age 20 are cost-effective in terms of averted infection at estimated incremental cost-effective ratio of US$101 208, US$111 770, US$107 909 and US$229 604.ConclusionsThe expansion of DAAs coverage by the national health insurance is highly effective in alleviating hepatitis C disease burden. The scale-up of screening and treatment with DAAs for targeted adult population with high prevalence of hepatitis C is cost-effective. This study provides a case for policy-makers to invest in rapid expansion of hepatitis C comprehensive screening and treatment with DAAs.
Is self-esteem associated with self-rated health among French college students? A longitudinal epidemiological study: the i-Share cohort
Authors: Arsandaux Julie , Michel Grégory , Tournier Marie , Tzourio Christophe , Galéra Cédric 
Published: June 2019

ObjectivesThe aim of the study was to estimate the association between self-esteem and subsequent self-rated health during college years, taking into account a wide range of potential confounders.DesignProspective longitudinal study.SettingThe French i-Share cohort.ParticipantsThe sample consisted of 1011 college students.Primary and secondary outcome measuresThe association between self-esteem and later self-rated health was evaluated using multivariate modelling.Data regarding self-rated health, global self-esteem and demographic, educational, social, behavioural, environmental and financial characteristics were collected through an internet-based questionnaire.ResultsThe 1011 participants had a median age of 21.9 years and 79% (795/1011) were females. Self-rated health was assessed a median of 8 months after the self-esteem measurement. Twenty per cent of the students declared average to very poor health (203/1011). Students with higher levels of self-esteem were more likely to declare good or very good self-rated health (adjusted OR=1.40, 95% CI 1.15 to 1.72, p value=0.001). Other factors associated with good or very good self-rated health were low body mass index, a comfortable financial situation during childhood and three personality traits (low persistence and harm avoidance and high cooperativeness).ConclusionsThis study offers novel findings on the impact of self-esteem on self-rated health among college students. Interventions targeting self-esteem should be experimented during university years in order to improve health outcomes.
Single-centre, triple-blinded, randomised, 1-year, parallel-group, superiority study to compare the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function in subjects with morbid obesity: a protocol for the Obesitysurgery in Tønsberg(Oseberg) study
Authors: Borgeraas Heidi , Hjelmesæth Jøran , Birkeland Kåre Inge , Fatima Farhat , Grimnes John Olav , Gulseth Hanne L , Halvorsen Erling , Hertel Jens Kristoffer , Hillestad Tor Olav Widerøe , Johnson Line Kristin , Karlsen Tor-Ivar , Kolotkin Ronette L , Kvan Nils Petter , Lindberg Morten , Lorentzen Jolanta , Nordstrand Njord , Sandbu Rune , Seeberg Kathrine Aagelen , Seip Birgitte , Svanevik Marius , Valderhaug Tone Gretland , Hofsø Dag 
Published: June 2019

IntroductionBariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function.Methods and analysisSingle-centre, randomised, triple-blinded, two-armed superiority trial carried out at the Morbid Obesity Centre at Vestfold Hospital Trust in Norway. Eligible patients with type 2 diabetes and obesity were randomly allocated in a 1:1 ratio to either gastric bypass or sleeve gastrectomy. The primary outcome measures are (1) the proportion of participants with complete remission of type 2 diabetes (HbA1c≤6.0% in the absence of blood glucose-lowering pharmacologic therapy) and (2) β-cell function expressed by the disposition index (calculated using the frequently sampled intravenous glucose tolerance test with minimal model analysis) 1 year after surgery.Ethics and disseminationThe protocol of the current study was reviewed and approved by the regional ethics committee on 12 September 2012 (ref: 2012/1427/REK sør-øst B). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. Participants will receive a summary of the main findings.Trial registration numberNCT01778738;Pre-results.
Improving smoking cessation care in pregnancy at Aboriginal Medical Services: ‘ICAN QUIT in Pregnancy’ step-wedge cluster randomised study
Authors: Bar-Zeev Yael , Bovill Michelle , Bonevski Billie , Gruppetta Maree , Oldmeadow Christopher , Palazzi Kerrin , Atkins Louise , Reath Jennifer , Gould Gillian Sandra 
Published: June 2019

ObjectivesThis study aimed to examine the impact of the ‘ICAN QUIT in Pregnancy’ intervention on individual health providers (HPs) smoking cessation care (SCC) knowledge, attitudes and practices in general, and specifically regarding nicotine replacement therapy (NRT) prescription.DesignStep-wedge clustered randomised controlled study. HPs answered a preintervention and 1–6 months postintervention survey.SettingSix Aboriginal Medical Services (AMSs) in three states of Australia.ParticipantsAll HPs were invited to participate. Of 93 eligible, 50 consented (54%), 45 completed the presurvey (90%) and 20 the post (40%).InterventionIncluded three 1-hour webinar sessions, educational resource package and free oral NRT.OutcomesHPs knowledge was measured using two composite scores—one from all 24 true/false statements, and one from 12 NRT-specific statements. Self-assessment of 22 attitudes to providing SCC were measured using a five-point Likert scale (Strongly disagree to Strongly agree). Two composite mean scores were calculated—one for 15 general SCC attitudes, and one for 7 NRT-specific attitudes. Self-reported provision of SCC components was measured on a five-point Likert scale (Never to Always). Feasibility outcomes, and data collected on the service and patient level are reported elsewhere.ResultsMean knowledge composite scores improved from pre to post (78% vs 84% correct, difference 5.95, 95% CI 1.57 to 10.32). Mean NRT-specific knowledge composite score also improved (68% vs 79% correct, difference 9.9, 95% CI 3.66 to 16.14). Mean attitude composite score improved (3.65 (SD 0.4) to 3.87 (SD 0.4), difference 0.23, 95% CI 0.05 to 0.41). Mean NRT-specific attitudes composite score also improved (3.37 (SD 0.6) to 3.64 (SD 0.7), difference 0.36, 95% CI 0.13 to 0.6). Self-reported practices were unchanged, including prescribing NRT.ConclusionsA multicomponent culturally sensitive intervention in AMSs was feasible, and might improve HPs provision of SCC to pregnant Aboriginal women. Changes in NRT prescription rates may require additional intensive measures.Trial registration numberACTRN 12616001603404; Results.
The intermediate care unit as a cost-reducing critical care facility in tertiary referral hospitals: a single-centre observational study
Authors: Plate Joost D J , Peelen Linda M , Leenen Luke P H , Hietbrink Falco 
Published: June 2019

ObjectivesTo determine whether and to what extent the surgical intermediate care unit (IMCU) reduces healthcare costs.DesignRetrospective cohort study.SettingThe mixed-surgical IMCU of a tertiary academic referral hospital.ParticipantsAll admissions (n=2577) from 2012 to 2015.Primary and secondary outcome measuresThe outcome measure was the hypothetical cost savings due to the presence of the IMCU. For this, each admission day was classified as either low-acuity or high-acuity, based on the Therapeutic Intervention Scoring System-28, the required specific nursing interventions and the indication for admission at the IMCU. Costs (2018) used were €463 per hospital ward, €1307 per IMCU and €2224 per intensive care unit (ICU) admission day. Savings were calculated by subtracting the actual IMCU costs from the hypothetical costs in the absence of the IMCU.ResultsThere were 9037 admission days (n=2577 admissions) at the IMCU. The proportion of high-acuity admissions was 87.6%. Total costs at the IMCU were €11.808 888. Total hypothetical costs in absence of the IMCU were €18.115 284. Total cost savings were thus €6.306 395, or €1.576 599, per year.ConclusionsThe surgical IMCU may substantially reduce societal healthcare costs, making it a cost saving alternative to ICU care. Constant adequate triage is essential to optimise its potential.
Randomised controlled trial of a novel online cognitive rehabilitation programme for children with cerebral palsy: a study protocol
Authors: Wotherspoon Jane , Whittingham Koa , Boyd Roslyn N , Sheffield Jeanie 
Published: June 2019

IntroductionCerebral palsy (CP) is the most common cause of physical disability in children, with an estimated 600–700 infants born with CP in Australia each year. CP is typically associated with motor impairments, but nearly half of all children with CP also experience cognitive impairment, potentially impacting educational and vocational achievement. This paper reports the protocol for a randomised controlled trial of a computerised cognitive training intervention based on behavioural principles: Strengthening Mental Abilities through Relational Training (SMART). The study aims to investigate SMART’s effect on fluid reasoning, executive function and academic achievement in children with CP.Methods and analysisSixty children with mild to moderate CP (Gross Motor Function Classification Scale I–IV) aged between 8 years and 12 years will be recruited. Participants will be randomly allocated to two groups: SMART cognitive training and waitlist control. Families will access the programme at home over a 4-month period. Assessments will be administered at baseline, 20 weeks and at 40 week follow-up for retention. The primary outcome will be fluid intelligence, while academic achievement, executive function and social and emotional well-being will be secondary outcomes.Ethics and disseminationThis study has approval from the Children’s Health Queensland Hospital and Health Service Research Ethics Committee (HREC/14/QRCH/377) and The University of Queensland (2017001806). If the computerised cognitive training programme is found to be effective, dissemination of these findings would assist children with CP by providing an accessible, cost-effective intervention that can be completed at home at the individual’s own pace.Registration detailsThe study was registered prospectively on 10 November 2017 to present. Recruitment is now under way, and we aim to complete recruitment by June 2019, with data collection finalised by March 2020.Trial registration numberACTRN12617001550392; Pre-results.
How do residents perceive and narrate stories about communication challenges in patient encounters? A narrative study
Authors: Møller Jane Ege , Brøgger Matilde Nisbeth 
Published: June 2019

ObjectiveThis article investigated residents’ narratives to gain their understandings of which patterns are challenging in doctor–patient conversations.DesignQualitative narratological framework.ParticipantsWe analysed 259 narratives from 138 residents’ oral recounts of communication with patients in which they had felt challenged.ResultsThe analysis identified an ideal narrative for the doctor–patient encounter with the resident as protagonist pursuing the object of helping the patient with his health problem. Disruptions of this ideal narrative were at play when challenges occurred. Regardless of medical setting, challenges were often related to the establishment of a common object, and the communication actants had to go through negotiations, disagreements or even battles when trying to reach a common object. Challenges also occurred when actants which in the ideal narrative should act as helpers become opponents. We find narratives where patients, relatives and colleagues become opponents.ConclusionsOur study showed that communication challenges were the result of disruptions of the perceived ideal narrative. Residents found it especially challenging to establish a common object, and dealing with helpers turned opponents. Patient communication is thus a challenge in the transition phase from student to doctor, and doctor–patient communication is complex in nature and continuously perceived to be so by residents, despite pregraduate training.
Familial bilateral cryptorchidism is caused by recessive variants inRXFP2
Authors: Ayers Katie , Kumar Rakesh , Robevska Gorjana , Bruell Shoni , Bell Katrina , Malik Muneer A , Bathgate Ross A , Sinclair Andrew 
Published: June 2019

BackgroundCryptorchidism or failure of testicular descent is the most common genitourinary birth defect in males. While both the insulin-like peptide 3 (INSL3) and its receptor, relaxin family peptide receptor 2 (RXFP2), have been demonstrated to control testicular descent in mice, their link to human cryptorchidism is weak, with no clear cause–effect demonstrated.ObjectiveTo identify the genetic cause of a case of familial cryptorchidism.MethodsWe recruited a family in which four boys had isolated bilateral cryptorchidism. A fourth-degree consanguineous union in the family was reported. Whole exome sequencing was carried out for the four affected boys and their parents, and variants that segregated with the disorder and had a link to testis development/descent were analysed. Functional analysis of aRXFP2variant in cell culture included receptor localisation, ligand binding and cyclic AMP (cAMP) pathway activation.ResultsGenomic analysis revealed a homozygous missense variant in theRXFP2gene (c.1496G>A .p.Gly499Glu) in all four affected boys and heterozygous in both parents. No other variant with a link to testis biology was found. TheRXFP2variant is rare in genomic databases and predicted to be damaging. It has not been previously reported. Functional analysis demonstrated that the variant protein had poor cell surface expression and failed to bind INSL3 or respond to the ligand with cAMP signalling.ConclusionThis is the first reported genomic analysis of a family with multiple individuals affected with cryptorchidism. It demonstrates that recessive variants in theRXFP2gene underlie familial cryptorchidism and solidifies the link between this gene and testicular descent in humans.