bluuebunny/crossref_metadata_2025_split huggingface dataset:
A concept analysis of deprescribing medications in older people
Authors: Page Amy , Clifford Rhonda , Potter Kathleen , Etherton‐Beer Christopher 
Published: March 2018

AbstractAimDeprescribing is an increasingly common term in the literature, although no specific accepted definition exists. We aimed to clarify the concept of deprescribing as used in research and clinical practice.MethodsDeprescribing was examined using the eight‐step Walker and Avant method of concept analysis that consisted of: (i) concept selection; (ii) determining the purpose of the analysis; (iii) identifying uses of the concept; (iv) determining the critical attributes; (v) identifying the model case; (vi) identifying borderline and contrary cases; (vii) identifying antecedents and consequences; and (viii) defining empirical referents. A literature search was conducted on the word de?prescri*.ResultsWe identified seven critical attributes: withdrawing medications, de‐escalation, intended outcomes, structured and iterative process, intervention, risk to benefit, and patient‐centred care. Deprescribing antecedents were identified as changing health, changing goals for health care, and polypharmacy. Deprescribing consequences identified were compliance, health outcomes, mortality and cost, and possibility for adverse drug withdrawal events to occur. We used the model case, borderline and contrary cases and empirical referents to illustrate the concept of deprescribing.ConclusionsDeprescribing is a term used with varying degrees of precision, and there is no accepted definition. In this paper, we have analysed the concept of deprescribing and identified it as a patient‐centred process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required.
Informing deprescribing decisions in older people: does the Product Information contain advice on medication use for older people and medication withdrawal?
Authors: Page Amy , Clifford Rhonda , Potter Kathleen , Etherton‐Beer Christopher 
Published: March 2018

AbstractBackgroundProduct Information (PI) details the indications for prescribing, dosage and administration, and recognised side effects and contraindications. No formal requirement exists for PI to include information on medication use in older people and what to expect while withdrawing medication (deprescribing). Deprescribing has a focus on older people, so we designed this study to evaluate how frequently the PI includes information on medication withdrawal and medication use in older people.MethodsWe identified PIs currently available from the Therapeutic Goods Administration website for medications commonly used by older people. Data were abstracted using data extraction tables for eight categories of information, including statements of possible withdrawal effects, specified advice on discontinuation strategies and specified advice for older people.ResultsWe retrieved the PI for 99 different medications. Statements of possible withdrawal effects were provided in half of the PIs (n = 57). Of these, three PIs specified scenarios that constituted clinical criteria for withdrawal of the medication from long‐term use. The majority of PIs (n = 73) did not provide specified advice on discontinuation strategies. Of these medications, 23 PIs provided specific recommendations and three PIs made a general recommendation to gradually withdraw medication.DiscussionAlmost all the PIs reviewed included information about medication use in older people, but only half included information about medication withdrawal. The inclusion of information about discontinuation effects and strategies may improve PIs.
Improving influenza vaccination among hospitalised patients in General Medicine and Emergency Short Stay units – a pharmacist‐led approach
Authors: Tong Erica Y. , Mitra Biswadev , Roman Cristina P. , Yip Gary , Olding Suzanne , Joyce Carolyn , Galbraith Kirstie , Dooley Michael J. 
Published: March 2018

AbstractAimPatients admitted to General Medical Units (GMU) and Emergency Short Stay Units (ESSU) are often elderly with multiple comorbidities and the majority are considered to be at high risk of complications from influenza. The aim of this study was to assess the practice of including a pharmacist assessment of appropriateness and charting of influenza vaccination in a partnered pharmacist charting model in a GMU and ESSU.MethodsAs part of a partnered pharmacist charting model, the pharmacist assessed each patient for suitability of receiving the influenza vaccination at admission. If it was deemed appropriate by the pharmacist and medical officer, the pharmacist charted the influenza vaccination for administration as an inpatient and this was documented in the discharge summary to the general practitioner.ResultsThere were 6595 patients admitted to the two units during the study period, of which 316 patients had partnered pharmacist charting. Among these, 52 patients were eligible for vaccination, of which 31 patients (59.6%) had their influenza vaccination charted by a pharmacist. Among the 6279 patients who had their medication charted by a medical officer only, there were no cases of influenza vaccination prescription (p < 0.01).ConclusionWe identified that initiation of the influenza vaccination as part of the partnered pharmacist charting model is feasible and effective in increasing the rates of vaccination among ESSU and GMU patients.
Pharmacist care activities: a bibliometric analysis
Authors: López José J. , Orozco José G. , Vargas‐Peláez Claudia M. 
Published: March 2018

AbstractAimTo characterise systematic reviews and meta‐analyses on pharmacist care activities (PCAs) by means of bibliometric indicators.Data sourcesTheMEDLINE,EMBASEandLILACSdatabases were consulted.Study selectionArticles describing/evaluatingPCAs in any setting (community, ambulatory or hospital) in which research design was a systematic review of the literature (SR) or a meta‐analysis (MA) were included.ResultsOf the 1180 publications retrieved from the search, 86 were included. The included papers were published between 1998 and 2014.SRs were the most frequent research design (84.9%). The most frequent settings were all‐care settings (n= 20, 23.3%), followed by community settings (n= 19, 22.1%). The most common target population included all types of population groups together (n= 53; 59.3%). None of theSR/MAs had a high quality level. The bibliometric analysis showed that theSR/MAs were carried out by an average of four authors (range 1–13) and 62.8% (54/86) of the analysedSR/MAs were written only by pharmacists. TheUSAand theUKwere the most frequent authors’ countries of origin. The 86SR/MAs were published in 49 journals, and the average impact factor was 1.172 (range: 5.827–0.109).ConclusionsThe results of this review evidenced the urgency of an agreement on aPCAclassification aiming at equating results among different studies. It is necessary to establish the minimum quality criteria for conducting studies onPC. Finally, the results showed the need for further research onPC(i) using qualitative methods and (ii) studying the paediatric population.
Prospective Examination of Early Associations of Iraq War Zone Deployment, Combat Severity, and Posttraumatic Stress Disorder with New Incident Medical Diagnoses
Authors: Brailey Kevin , Mills Mary Alice , Marx Brian P. , Proctor Susan P. , Seal Karen H. , Spiro Avron , Ulloa Erin W. , Vasterling Jennifer J. 
Published: March 2018

AbstractWar zone deployment and posttraumatic stress disorder (PTSD) have been associated with morbidity and mortality decades later. Less is known about the associations between these variables and the early emergence of medical disorders in war zone veterans. This prospective study of 862 U.S. Army soldiers (n = 569 deployed; n = 293 nondeployed) examined: (a) associations between Iraq War deployment status (deployed vs. nondeployed) and new medical diagnoses that emerged within six months after return from Iraq among all participants; and (b) associations between combat severity and PTSD symptoms, and new postdeployment medical diagnoses that emerged within 12 months after return from Iraq within deployed participants. New medical diagnoses were abstracted from diagnostic codes associated with clinical outpatient visits recorded within the Department of Defense Standard Ambulatory Data Record database. Combat severity was measured with the Combat Experiences module of the Deployment Risk and Resilience Inventory, and postdeployment posttraumatic stress disorder symptom severity was measured using the PTSD Checklist–Civilian. Neither deployment nor combat severity was associated with new medical diagnoses. However, among deployed soldiers, more severe PTSD symptoms were associated with increased risk for a new medical disorder diagnosis; every 10‐point increase in PTSD symptoms increased odds of a new diagnosis by nearly 20% (odds ratio = 1.20). Results suggest that PTSD symptoms are associated with early morbidity in Iraq War veterans.
Quantitative Evaluation of the End‐to‐End Correlation Vector and of the Mean Square Displacement of the Molecules' Center in a Telechelic Polymer under Several Shear Rates Values
Authors: Manassero Carlo , Castellano Carlo 
Published: March 2018

AbstractThe results of molecular dynamics simulations of bead and spring models of telechelic polymers of general formula AB12A at melt‐like densities, under a shear rate, are presented. The A atoms, differing from the B ones, have self‐associate properties. In this paper, the quantitative correlation between the mean square displacement of the barycenter of the molecules and the correlation of the end‐to‐end vector with respect to the time is studied, depending on different values of the A–A interactions (included the one corresponding to the homopolymer, A = B) and of the shear deformation (included the zero, corresponding to the bulk conditions).
Treatment of Langerhans cell histiocytosis with a modified risk‐adapted protocol—experience from a tertiary cancer institute in India
Authors: Narula Gaurav , Pradhan Nirmalaya D. , Arora Brijesh , Banavali Sripad D. 
Published: March 2018

AbstractBackgroundInvolvement of risk‐organs (RO+) in Langerhans cell histiocytosis (LCH) and inadequate early response identifies patients at high risk for relapse and mortality requiring intensive salvage therapy including stem cell transplant, adding cost and toxicity. To mitigate this, we used a standard induction, augmented with metronomic etoposide, and prolonged maintenance—similarly augmented for RO+, and retrospectively analyzed its impact.ProcedureLCH patients from 2009 through 2014 were included. Patients received standard vinblastine and prednisolone therapy weekly till week 25 for RO+. Single site (SS) and multisystem (MS) without risk organ involvement (RO−) received 3‐weekly pulses from week 13 till week 25. Maintenance was 3‐weekly vinblastine and 5‐day prednisolone pulses, daily 6‐mercaptopurine (60 mg/m2) and weekly methotrexate (15 mg/m2) for 18 and 9 months for RO+ and MSRO−, respectively. RO+ also received oral etoposide (50 mg/m2) for 21 of every 28‐day cycle for the first year.ResultsFifty consecutive patients were analyzed. Median age was 36 months (4–189 months). SS, MSRO−, and RO+ were 29 (58%), 12 (24%), and nine (18%), respectively. Four were lost to follow‐up and excluded from further evaluation. On response evaluation at week 6, 24 (52%) had no active disease (NAD), 17 (37%) had AD‐better (where AD is active disease), and one (2%) had AD‐worse. In RO+, eight (66.6%) had AD‐better and three (25%) had NAD. Forty‐five patients had NAD by week 12. Three patients relapsed. With median follow‐up of 39 months (8–84), 5‐year event free survival was 85.6% (RO− and SS), and 100% for RO+. One patient's death in remission from unrelated causes resulted in overall survival of 97%.ConclusionsRO+LCH receiving oral etoposide augmented induction and maintenance had early and durable responses. Prolonging maintenance lowered reactivation rates in RO+ and RO−LCH, resulting in excellent survival.
Current methods for the prediction of T‐cell epitopes
Authors: Kar Prattusha , Ruiz‐Perez Lanie , Arooj Mahreen , Mancera Ricardo L. 
Published: March 2018

AbstractT‐cell epitopes are specific peptide sequences derived from foreign or own proteins that can initiate an immune response and which are recognized by specific T‐cells when displayed on the surface of other cells. The prediction of T‐cell epitopes is of particular interest in vaccine design, disease prevention and the development of immunotherapeutics. There are two principal categories of predictive methods: peptide‐sequence based and peptide‐structure‐based. Sequence‐based methods make use of various approaches to identify likely immunogenic amino acid sequences, such as sequence motifs, decision trees, partial least squares (PLS), quantitative matrices (QM), artificial neural networks (ANN), hidden Markov models (HMM), and support vector machines (SVM). Structure‐based methods are more diverse in nature and involve approaches such as quantitative structure‐activity relationships (QSAR), molecular modelling, molecular docking and molecular dynamics simulations (MD). This review highlights the key features of all of these approaches, provides some key examples of their application, and compares and contrasts the most important methods currently in use.
Essence and definition by abstraction
Authors: Hale Bob 
Published: March 2018

AbstractWe may define words or concepts, and we may also, as Aristotle and others have thought, define the things for which words stand and of which concepts are concepts. Definitions of words or concepts may be explicit or implicit, and may seek to report preexisting synonymies, as Quine put it, but they may instead be wholly or partly stipulative. Definition by abstraction, of which Hume’s principle is a much discussed example, seek to define a term-forming operator, such as the number operator, by fixing the truth-conditions of identity-statements featuring terms formed by means of that operator. Such definitions are a species of implicit definition. They are typically at least partly stipulative. Definitions of things, or real definitions, are, by contrast, typically conceived as true or false statements about the nature or essence of their definienda, and so not stipulative. There thus appears to be an obvious and head-on clash between taking Hume’s principle as an implicit and at least partly stipultative definition of the number operator and taking it as a real definition, stating the nature or essence of cardinal numbers. This paper argues that this apparent tension can be resolved, and that resolving it sheds light on part of the epistemology or essence and necessity, showing how some of our knowledge of essence and necessity can be a priori.
Maximizing the short circuit current of organic solar cells by partial decoupling of electrical and optical properties
Authors: Qarony Wayesh , Hossain Mohammad I. , Jovanov Vladislav , Knipp Dietmar , Tsang Yuen Hong 
Published: March 2018

Abstract
The partial decoupling of electronic and optical properties of organic solar cells allows for realizing solar cells with increased short circuit current and energy conversion efficiency. The proposed device consists of an organic solar cell conformally prepared on the surface of an array of single and double textured pyramids. The device geometry allows for increasing the optical thickness of the organic solar cell, while the electrical thickness is equal to the nominal thickness of the solar cell. By increasing the optical thickness of the solar cell, the short circuit current is distinctly increased. The quantum efficiency and short circuit current are determined using finite-difference time-domain simulations of the 3D solar cell structure. The influence of different solar cell designs on the quantum efficiency and short circuit current is discussed and optimal device dimensions are proposed.
Enhancing Global Health Security: US Africa Command’s Disaster Preparedness Program
Authors: Morton Hamer Melinda J. , Reed Paul L. , Greulich Jane D. , Beadling Charles W. 
Published: March 2018

AbstractUS Africa Command’s Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizations to promote stability and security on the African continent by engaging with African Partner Nations’ (PN) civil and military authorities to improve disaster management capabilities. From 2008 to 2015, DPP conducted disaster preparedness and response programming with 17 PNs. DPP held a series of engagements with each, including workshops, strategic planning, developing preparedness and response plans, tabletop exercises, and prioritizing disaster management capability gaps identified through the engagements. DPP partners collected data for each PN to further capacity building efforts. Thus far, 9 countries have completed military pandemic plans, 10 have developed national pandemic influenza plans, 9 have developed military support to civil authorities plans, and 11 have developed disaster management strategic work plans. There have been 20 national exercises conducted since 2009. DPP was cited as key in implementation of Ebola response plans in PNs, facilitated development of disaster management agencies in DPP PNs, and trained nearly 800 individuals. DPP enhanced PNs’ ability to prepare and respond to crises, fostering relationships between international agencies, and improving civil-military coordination through both national and regional capacity building. (Disaster Med Public Health Preparedness. 2019;13:319–329)
Evaluation and Gap Analysis of Pediatric Disaster Preparedness Resources
Authors: Koeffler Tessa J. , Demeter Natalie E. , Kysh Lynn , Reeb Jeffrey , Stayton Alix , Spears Robert , Burke Rita V. 
Published: March 2018

AbstractThe goal of this research was to identify, summarize, and evaluate pediatric disaster preparedness resources in the United States and to identify areas that need improvement or further development. Using standard literature, gray literature and website reviews, relevant resources were identified and the 50 most relevant resources were studied in depth. Each resource was given a grade of A, B, or C based on content, format, quality, and thoroughness. These resources were divided into 3 categories: (1) hospital resources, (2) school resources, and (3) training/education resources. Half of the 50 resources (25) were given a grade of A, indicating the highest level of quality and thoroughness, with pertinent information presented in a clear format. Sixteen of the resources were given a rating of B, while 9 of the resources were given a rating of C. Over 60% of the resources did not contain culturally sensitive information and more than 60% of the resources did not contain preparedness information for children with disabilities. Resources specific to hospitals and schools were limited in number and quality available, while training/education resources were widely available. In addition, 60% of resources were not specific to schools, children’s hospitals, or to certain occupations (ie, nurses, doctors, teachers, principals). Based on these results, gaps in cultural sensitivity were identified and limitations in resources for children with disabilities and for schools and hospitals currently exist. All these areas require further development in the field of pediatric disaster preparedness (Disaster Med Public Health Preparedness. 2019;13:330–337)
A SPEAR ‘LIKE A BALL’: A NOTE ON SOPHOCLES, FR. 781
Authors: Corthals Bob 
Published: March 2018

Etymologicum Magnum s.v. ἔγχος (313, 3):ὁ δὲ Σοφοκλῆς τὴν σφαῖραν ἔγχος κέκληκεν, οἶον ‘τὸ δ’ ἔγχος ἐν ποσὶ κυλίνδεται’.Sophocles has called a ball egkhos (‘spear’), as in ‘and the egkhos rolls to (someone's) feet’.
The quoted fragment is generally assigned to Sophocles' Nausicaa (or Plyntriai). This suggestion dates back to nineteenth-century scholarship, is found in the editions of Pearson and Radt, and has been accepted by LSJ (s.v. ἔγχος II. ‘of Nausicaa's ball’). Certainly, the Nausicaa will have included a version of the famous scene in which the Phaeacian princess and her maidens enjoy a game of ball. Pearson thought it probable that the words are part of Odysseus' speech at the court of Alcinous (cf. Od. 7.290), in which he would have recalled Nausicaa's misdirected cast (cf. 6.115). The feet, on this view, are Odysseus' own. According to Welcker, Odysseus calls the ball an ἔγχος, ‘because it reached him like a missile’. This is awkward: an ἔγχος is properly a thrusting spear and, at any rate, the quality of being thrown does not enter into the immediate image, as the fragment's object is said to reach someone's feet rolling.
Setting up a parathyroid multidisciplinary team meeting: one year's experience, outcomes and learning points
Authors: Hancox S H , Sinnott J D , Kirkland P , Lipscomb D , Owens E , Howlett D C 
Published: March 2018

AbstractObjective:A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology.Methods:Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness.Results:Seventy-nine new referrals were discussed throughout the year; 43 per cent were recommended for surgery, 41 per cent had a trial of conservative or medical management before re-discussion, and 16 per cent required further imaging. Ninety-two per cent of patients underwent an ultrasound, single-photon emission computed tomography/computed tomography or nuclear medicine (sestamibi) scan prior to the meeting. All ultrasound scans were performed by a consultant radiologist.Conclusion:The multidisciplinary team meeting has been successful, with perceived benefits for patients, improved imaging evaluation and efficiency of referral pathways, leading to more appropriate patient management.
Russia and the Liberal World Order
Authors: Clunan Anne L. 
Published: March 2018

AbstractWhile Russian leaders are clearly dissatisfied with the United States and the European Union, they are not inherently opposed to a liberal world order. The question of Russia's desire to change a liberal international order hangs on the type of liberalism embedded in that order. Despite some calls from within for it to create a new, post-liberal order premised on conservative nationalism and geopolitics, Russia is unlikely to fare well in such a world.
A Post-Western Europe: Strange Identities in a Less Liberal World Order
Authors: Wæver Ole 
Published: March 2018

AbstractDebates on “rising powers” and a possible end to the liberal international order mostly focus on two kinds of actors: the hegemon (the United States), privileged by the power distribution of yesteryear, and rising powers (notably China). Europe's curious position brings to light some intriguing dynamics of the emerging world order—nuances needed to capture a more differentiated future. This essay traces the threats and opportunities to Europe presented by the emerging order in four domains. In terms of overall power (polarity) and economics, far-reaching change registers but is rarely designated as threatening. In contrast, change regarding values (human rights and democracy especially) triggers more alarm. Finally, in the domain of institutions, change elicited a relative lack of concern prior to 2016, but worries have grown since then. For Europe, peaceful change primarily demands that rising powers rearticulate rather than confront classical Western values because, in contrast to the United States, there is little sense of loss in Europe in relation to the global structures of power and economics.