bluuebunny/crossref_metadata_2025_split huggingface dataset:
GP retention in the UK: a worsening crisis. Findings from a cross-sectional survey
Authors: Owen Katherine , Hopkins Thomas , Shortland Thomas , Dale Jeremy 
Published: February 2019

ObjectiveTo investigate how recent national policy-led workforce interventions are affecting intentions to remain working as a general practitioner (GP).DesignOnline questionnaire survey with qualitative and quantitative questions.Setting and participantsAll GPs (1697) in Wessex region, an area in England for which previous GP career intention data from 2014 is available.Results929 (54.7%) participated. 59.4% reported that morale had reduced over the past two years, and 48.5% said they had brought forward their plans to leave general practice. Intention to leave/retire in the next 2 years increased from 13% in the 2014 survey to 18% in October/November 2017 (p=0.02), while intention to continue working for at least the next 5 years dropped from 63.9% to 48.5% (p<0.0001). Age, length of service and lower job satisfaction were associated with intention to leave. Work intensity and amount were the most common reasons given for intention to leave sooner than previously planned; 51.0% participants reported working more hours than 2 years previously, predominantly due to increased workload.GPs suggested increased funding, more GPs, better education of the public and expanding non-clinical and support staff as interventions to improve GP retention.National initiatives that aligned with these priorities, such as funding to expand practice nursing were viewed positively, but low numbers of GPs had seen evidence of their roll-out. Conversely, national initiatives that did not align, such as video consulting, were viewed negatively.ConclusionWhile recent initiatives may be having an impact on targeted areas, most GPs are experiencing little effect. This may be contributing to further lowering of morale and bringing forward intentions to leave. More urgent action appears to be needed to stem the growing workforce crisis.
Risk perception, beliefs about medicines and medical adherence among pregnant and breastfeeding women with migraine: findings from a cross-sectional study in Norway
Authors: Amundsen Siri , Øvrebø Torunn Gudmestad , Amble Netta Marie Skretteberg , Poole Anne Christine , Nordeng Hedvig 
Published: February 2019

ObjectivesTo examine risk perception, beliefs about migraine medications and medical adherence among pregnant and breastfeeding women with migraine.Design and settingCross-sectional study conducted in Norway from October 2013 to February 2014. Data were collected via an anonymous, electronic questionnaire.ParticipantsWomen with migraine, either pregnant or having delivered within the previous 18 months.Main outcomesWomen’s perception of teratogenic risk (numeric rating scale 0–10) was obtained for 14 different drugs/substances, including medications commonly used in the acute treatment of migraine. Women’s perspectives on migraine drug therapy were assessed by 10 statements from the Beliefs about Medicines Questionnaire (BMQ-Specific) and six pregnancy/breastfeeding-specific statements. Adherence to migraine treatment during pregnancy and breastfeeding period was assessed by maternal self-report.ResultsThe study population included 401 women with migraine, of which 140 were pregnant and 261 were new mothers. More than 70% of the women reported use of migraine medications during pregnancy. Still, the majority severely overestimated the risk associated with migraine medications and were concerned about using medications to manage their migraine during pregnancy and breastfeeding. Almost 9 out of 10 women had at some point deliberately avoided using migraine medications during their pregnancy. Women reporting use of migraine medications, however, were more positive and overestimated to a lesser extent the risks of using such medications in pregnancy compared with their counterparts.ConclusionsWomen with migraine severely overestimated the risk associated with migraine pharmacotherapy in pregnancy. The majority of women were concerned about use of migraine medications during pregnancy and breastfeeding and reported non-adherence to needed treatment. More attention should be focused on women’s beliefs and concerns regarding migraine pharmacotherapy during pregnancy and breastfeeding in order to improve management of disease, reduce unfounded concerns and enhance adherence to needed treatment.
Haematologists and palliative care: a multicentric qualitative study
Authors: Tricou Colombe , Munier Sophie , Phan-Hoang Nicolas , Albarracin Dolores , Perceau-Chambard Élise , Filbet Marilene 
Published: February 2019

ObjectivesEarly palliative care leads to meaningful improvements in physical and psychosocial symptoms, as well as quality of life, in patients with advanced cancer. Patients with haematological malignancies, despite a high level of distress, continue to have less access to palliative care services. The aim of this study was to identify haematologists’ perceptions of palliative care, as well as barriers to patient referral.MethodsWe used a qualitative grounded theory methodology. Twenty-four medical haematologists involved in clinical practice from two French centres in Lyon—the Lyon Sud University Hospital and the Léon Bérard Cancer Center—were included. The interview guide questions aimed to establish the clinical situations which triggered referral to palliative care and how participants perceived palliative care.ResultsData saturation was reached after 14 interviews. The data analysis highlighted four themes. The aim of palliative care was clearly identified as alleviating severe suffering. Palliative care was identified as a separate specialty, and respondents expressed the need for collaboration. Early intervention was perceived as beneficial to avoid certain situations such as hospitalisation or emergency department visits at the end of life. The main barrier to palliative care referral remained the negative connotations associated with the term ‘palliative’, which was overwhelmingly associated with the end of life.Significance of resultsOur results suggest that the principal barrier to palliative care referral is the term ‘palliative care’; haematologists would prefer ‘supportive care’ instead.
Multicentre randomised controlled trial comparing standard and high resolution optical technologies in colorectal cancer screening
Authors: Di Caro Simona , Fini Lucia , Vega Roser , Fragkos Konstantinos C , Dolwani Sunil , Green John , Smith Lesley-Ann , Beckett Conrad , Cameron Ewen , Banks Matthew 
Published: February 2019

Background and objectivesThe UK bowel cancer screening programme (BCSP) has been established for the early detection of colorectal cancer offering colonoscopy to patients screened positive by faecal occult blood tests. In this multisite, prospective, randomised controlled trial, we aimed to compare the performance of Standard Definition Olympus Lucera (SD-OL) with Scope Guide and the High Definition Pentax HiLine (HD-PHL).Patients and methodsSubjects undergoing a colonoscopy as part of the UK National BCSP at four UK sites were randomised to an endoscopy list run using either SD-OL or HD-PHL. Primary endpoints were polyp and adenoma detection rate (PDR and ADR, respectively) as well as polyp size, morphology and histology characteristics.Results262 subjects (168 males, mean age 66.3±4.3 years) were colonoscoped (133 patients with HD-PHL while 129 with SD-OL). PDR and ADR were comparable within the two optical systems. The HD-PHL group resulted in a PDR 55.6% and ADR 43.6%; the SD-OL group had PDR 56.6% and ADR 45.7%. HD-PHL was significantly superior to SD-OL in detection of flat adenomas (18.6% vs 5.2%, p<0.001), but not detection of pedunculated or sessile polyps. Patient comfort, use of sedation and endoscopist perception of procedural difficulty resulted similar despite the use of Scope Guide with SD-OL.ConclusionPDR and ADR were not significantly different between devices. The high-resolution colonoscopy system HD-PHL may improve polyp detection as compared with standard resolution technology in detecting flat adenomas. This advantage may have clinically significant implications for missed lesion rates and post-colonoscopy interval colorectal cancer rates.
European Stroke Organisation (ESO) - European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischemic Stroke
Authors: Turc Guillaume , Bhogal Pervinder , Fischer Urs , Khatri Pooja , Lobotesis Kyriakos , Mazighi Mikaël , Schellinger Peter D. , Toni Danilo , de Vries Joost , White Philip , Fiehler Jens 
Published: February 2019

BackgroundMechanical thrombectomy (MT) has become the cornerstone of acute ischemic stroke management in patients with large vessel occlusion (LVO).ObjectiveTo assist physicians in their clinical decisions with regard toMT.MethodsThese guidelines were developed based on the standard operating procedure of the European Stroke Organisation and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. An interdisciplinary working group identified 15 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach.ResultsWe found high-quality evidence to recommend MT plus best medical management (BMM, including intravenous thrombolysis whenever indicated) to improve functional outcome in patients with LVO-related acute ischemic stroke within 6 hours after symptom onset. We found moderate quality of evidence to recommend MT plus BMM in the 6–24h time window in patients meeting the eligibility criteria of published randomized trials. These guidelinesdetails aspects of prehospital management, patient selection based on clinical and imaging characteristics, and treatment modalities.ConclusionsMT is the standard of care in patients with LVO-related acute stroke. Appropriate patient selection and timely reperfusion are crucial. Further randomized trials are needed to inform clinical decision-making with regard tothe mothership and drip-and-ship approaches, anesthaesia modalities during MT, and to determine whether MT is beneficial in patients with low stroke severity or large infarct volume.
Efficacy and reliability of active robotic-assisted total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis
Authors: Ren Yi , Cao Shiliang , Wu Jinxuan , Weng Xisheng , Feng Bin 
Published: February 2019

AbstractBackgroundIn the field of prosthetics, the ultimate goal is to improve the clinical outcome by using a technique that prolongs the longevity of prosthesis. Active robotic-assisted total knee arthroplasty (TKA) is one such technique that is capable of providing accurate implant position and restoring mechanical alignment. Although relevant studies have been carried out, the differences in the efficacy and reliability between active robotic-assisted TKA and conventional arthroplasty have not yet been adequately discussed.MethodsWe referenced articles, including randomised controlled trials and comparative retrospective research, from PubMed, Embase, Cochrane Library and Web of Science, in order to compare active robotic-assisted TKA with the conventional technique. Data extraction and quality assessment were conducted for each study. Statistical analysis was performed using Revman V. 5.3.ResultsSeven studies with a total of 517 knees undergoing TKA were included. Compared with conventional surgery, active robotic TKA showed better outcomes in precise mechanical alignment (mean difference, MD: − 0.82, 95% CI: −1.15 to − 0.49, p &lt; 0.05) and implant position, with lower outliers (p &lt; 0.05), better functional score (Western Ontario and McMaster University, Knee Society Score functional score) and less drainage (MD: − 293.28, 95% CI: − 417.77 to − 168.79, p &lt; 0.05). No significant differences were observed when comparing the operation time, range of motion and complication rates.ConclusionThe current research demonstrates that active robotic-assisted TKA surgeries are more capable of improving mechanical alignment and prosthesis implantation when compared with conventional surgery. Further studies are required to investigate the potential benefits and long-term clinical outcomes of active robotic-assisted TKA.
Mechanical stress-induced mast cell degranulation activates TGF-β1 signalling pathway in pulmonary fibrosis
Authors: Shimbori Chiko , Upagupta Chandak , Bellaye Pierre-Simon , Ayaub Ehab A , Sato Seidai , Yanagihara Toyoshi , Zhou Quan , Ognjanovic Alexander , Ask Kjetil , Gauldie Jack , Forsythe Paul , Kolb Martin R J 
Published: February 2019

BackgroundThe role of mast cells accumulating in idiopathic pulmonary fibrosis (IPF) lungs is unknown.ObjectivesWe investigated the effect of fibrotic extracellular matrix (ECM) on mast cells in experimental and human pulmonary fibrosis.ResultsIn IPF lungs, mast cell numbers were increased and correlated with disease severity (control vs 60%<FVC<90%, mean difference=-222.7, 95% CI −386.3 to −59.2, p=0.004; control vs FVC<60%, mean difference=−301.7, 95% CI of difference −474.1 to −129.34, p=0.0001; FVC>90% vs 60%<FVC<90%, mean difference=−189.6, 95% CI of difference −353.1 to −26.03, p=0.017; FVC>90% vs FVC<60%, mean difference=−268.6, 95% CI of difference −441.0 to −96.17, p=0.0007). Plasma tryptase levels were increased in IPF and negatively correlated with FVC (control vs FVC<60%, mean difference=−17.12, 95% CI of difference −30.02 to −4.22, p=0.006: correlation curves R=−0.045, p=0.025). In a transforming growth factor (TGF)-β1-induced pulmonary fibrosis model, chymase-positive and tryptase-positive mast cells accumulated in fibrotic lung. Lung tissue was decellularised and reseeded with bone marrow or peritoneum-derived mast cells; cells on fibrotic ECM released more TGF-β1 compared with normal ECM (active TGF-β1: bone marrow-derived mast cell (BMMC)-DL vs BMMC-TGF-β1 p=0.0005, peritoneal mast cell (PMC)-DL vs PMC-TGF-β1 p=0.0003, total TGF-β1: BMMC-DL vs BMMC-TGF-β1 p=0.013, PMC-DL vs PMC-TGF-β1 p=0.001). Mechanical stretch of lungs caused mast cell degranulation; mast cell stabilisers inhibited degranulation (histamine: cont vs doxantrazole p=0.004, β-hexosaminidase: cont vs doxantrazole, mean difference=1.007, 95% CI of difference 0.2700 to 1.744, p=0.007) and TGF-β1 activation (pSmad2/Smad2: cont vs dox p=0.006). Cromoglycate attenuated pulmonary fibrosis in rats (collagen: phosphate-buffered saline (PBS) vs cromoglycate p=0.036, fibrotic area: PBS vs cromoglycate p=0.031).ConclusionThis study suggests that mast cells may contribute to the progression of pulmonary fibrosis.
Electrochemotherapy as treatment for generalised squamous cell carcinoma in a dog
Authors: Boncea Ana Maria , Cristea Anca , Bourdeau Patrick 
Published: February 2019

Canine squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm in dogs. Treatment options are limited. Electrochemotherapy (ECT) has been proposed as an alternative treatment for many types of tumours. To describe the use of ECT as treatment for generalised cSCC. An adult dog (four years old) was diagnosed with generalised cSCC. There were 24 tumours with the size range of 0.3–3 cm. The biopsy revealed an infiltrate rich in epithelial squamous cells, associated with pyogranulomatous inflammation. ECT was elected as treatment of choice. Cisplatin was injected intratumorously. After five minutes, the electric pulses were applied. The complete tumour regression was noted four weeks after. The dog was still in complete remission, 20 months later. This is the first case reporting a complete long‐term remission using ECT for generalised cSCC.
Ab initiostudy of electronic and optical properties of nitrogen-doped rutile TiO2
Authors: Olayinka A. S. , Adetunji B. I. , Idiodi J. O. A. , Aghemelon U. 
Published: February 2019

Ab initio study has been carried out to investigate the band structure, density of state and optical dielectric function of pure and Nitrogen (N)-doped rutile phase of TiO2. The band structure obtained with the inclusion of U parameter of 8.5 eV compared favorably with experimental result. Bandgap of N-doped rutile decreases with respect to pure rutile which is traceable to 2p state of the Nitrogen dopant as revealed in partial density of state (PDOS). The optical properties calculated revealed that N-doped rutile has at least one optical peak in the visible light region of the electromagnetic spectrum which suggests it to be a potential material for photovoltaic application than pure rutile. Our results suggest that optical properties of rutile can be adapted by doping with Nitrogen at different concentration which enhances its potential as photocatalyst.
Stress and frequency analysis of silicon diaphragm of MEMS based piezoresistive pressure sensor
Authors: Samridhi  , Kumar Manish , Dhariwal Sachin , Singh Kulwant , Alvi P. A. 
Published: February 2019

This paper reports the stress and frequency analysis of dynamic silicon diaphragm during the simulation of micro-electro-mechanical-systems (MEMS) based piezoresistive pressure sensor with the help of finite element method (FEM) within the frame work of COMSOL software. Vibrational modes of rectangular diaphragm of piezoresistive pressure sensor have been determined at different frequencies for different pressure ranges. Optimal frequency range for particular applications for any diaphragm is a very important so that MEMS sensors performance should not degrade during the dynamic environment. Therefore, for the MEMS pressure sensor having applications in dynamic environment, the diaphragm frequency of 280 KHz has been optimized for the diaphragm thickness of 50 [Formula: see text]m and hence this frequency can be considered for showing the better piezoresistive effect and high sensitivity. Moreover, the designed pressure sensor shows the high linearity and enhanced sensitivity of the order of ([Formula: see text]0.5066 mV/psi).
Development of a microchip based on LIGA technology for bacterial inactivation
Authors: Li Hua , Yun Hongmei , Jiang Liuxiu , Zeng Ruosheng , Chen Yanlin , Deng Minchao , Liu Chunhua , Xiao Wenxiang , Jiang Yongrong , Chen Zhencheng 
Published: February 2019

We designed and fabricated a new micro-needle-column discharge chip by Lithographie, Galvanoformung and Abformung technology to meet sterilization requirements. The dimensions of the chip are 11.6 mm × 11.7 mm × 3 mm. The micro-discharge structure is composed of a needle electrode and two cylinder electrodes. We employed a needle with a tip diameter of 20 [Formula: see text]m and a thickness of 20 [Formula: see text]m as the discharge cathode. We used a cylinder with a thickness of 1 mm and diameter of 0.4 mm as the anode. We carried out the gas discharge experiments in ambient air and at room temperature, without external air flow. In the experiments, a corona and glow discharge with applied voltages of −2.1 kV and −3.8 kV were realized. We carried out the sterilization experiments for six different discharge times (15, 30, 60, 90, 120 and 180 s) with an applied voltage of −3.8 kV. The inactivation efficiency of Escherichia coli and Staphylococcus aureus reached 100% for sterilization times of 120 s and 180 s. This indicates that the micro-needle-column discharge chip may be suitable as a portable sterilizer.
Response of Middle Jurassic shallow-marine environments to syn-depositional block tilting: Isles of Skye and Raasay, NW Scotland
Authors: Archer Stuart G. , Steel Ronald J. , Mellere Donatella , Blackwood Stuart , Cullen Brian 
Published: February 2019

The Hebridean Province of NW Scotland provides insight into the interaction between tectonics and shallow-marine and tidal strait depositional environments in the Sea of the Hebrides and Inner Hebrides basins. The study tests the influence of syn-depositional block tilting on gross thickness, sand to mud ratio and the distribution of shallow-marine facies in the resulting succession. New Middle Jurassic palaeogeographical maps and stratigraphic correlations are presented that integrate both outcrop and well data and illustrate the evolution of the deltaic sedimentary system in a broad, semi-regional context.
Results show that distance from the sediment entry point and the syn-rift tectonic geomorphology were the critical controls on gross thickness, sand to mud ratios and facies types. The impact of relative sea-level change is hard to detect in locations proximal to the Scottish hinterland, where sediment supply was large relative to accommodation (Ss > Ac), but becomes more influential in distal locations where eustasy and tectonic subsidence convolved to increase the influence of accommodation over sediment supply (Ac > Ss).

Supplementary material:
An outcrop to well log correlation exercise is available at
https://doi.org/10.6084/m9.figshare.c.4397858
Hexedriocystis
, an aberrant echinoderm from the Upper Ordovician of Morocco
Authors: Zamora Samuel , Sumrall Colin D. 
Published: February 2019

Abstract

Hexedriocystis
is a very unusual echinoderm with a puzzling combination of morphological features. The two described species
H. inexpectatus
and
H. mimus
occur in Upper Ordovician siliciclastic rocks from Morocco, North Africa. They show a striking combination of isorophid edrioasteroid, paedomorphic crinoid and blastozoan characteristics including a domed thecal shape with a peripheral rim-like attachment structure, imbricate thecal plates. However, both species developed feeding appendages covered by large peristomial cover plates and six oral plates.
Hexedriocystis
lived intimately associated with edrioasteroid colonies and its strange morphology is probably the result of convergence with isorophid edrioasteroid.
Biomaterial Scaffolds Recruit an Aggressive Population of Metastatic Tumor Cells In Vivo
Authors: Bushnell Grace G. , Hardas Tejaswini P. , Hartfield Rachel M. , Zhang Yining , Oakes Robert S. , Ronquist Scott , Chen Haiming , Rajapakse Indika , Wicha Max S. , Jeruss Jacqueline S. , Shea Lonnie D. 
Published: February 2019

Abstract

For most cancers, metastasis is the point at which clinical treatment shifts from curative intent to extending survival. Biomaterial implants acting as a synthetic premetastatic niche recruit metastatic cancer cells and provide a survival advantage, and their use as a diagnostic platform requires assessing their relevance to disease progression. Here, we showed that scaffold-captured tumor cells (SCAF) were 30 times more metastatic to the lung than primary tumor (PT) cells, similar to cells derived from lung micrometastases (LUNG). SCAF cells were more aggressive in vitro, demonstrated higher levels of migration, invasion, and mammosphere formation, and had a greater proportion of cancer stem cells than PT. SCAF cells were highly enriched for gene expression signatures associated with metastasis and had associated genomic structural changes, including globally enhanced entropy. Collectively, our findings demonstrate that SCAF cells are distinct from PT and more closely resemble LUNG, indicating that tumor cells retrieved from scaffolds are reflective of cells at metastatic sites.

Significance:
These findings suggest that metastatic tumor cells captured by a biomaterial scaffold may serve as a diagnostic for molecular staging of metastasis.