bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Socioeconomic Status Affect Stage at Presentation for Larynx Cancer in Canada's Universal Health Care System?
Authors: Khalil Diana , Corsten Martin J. , Holland Margaret , Balram Adele , McDonald James Ted , Johnson‐Obaseki Stephanie 
Published: September 2018

ObjectiveDiagnosis of laryngeal cancer is dependent on awareness that persistent hoarseness needs to be investigated as well as access to an otolaryngologist. This study aimed to better classify and understand 3 factors that may lead to variability in stage at presentation of laryngeal cancer: (1) socioeconomic status (SES), (2) differences in access to health care by location of residence (rural vs urban or by province), and (3) access to an otolaryngologist (by otolaryngologists per capita).Study DesignRegistry‐based multicenter cohort analysis.SettingThis was a national study across Canada, a country with a single‐payer, universal health care system.SubjectsAll persons 18 years or older who were diagnosed with laryngeal cancer from 2005 to 2013 inclusive were extracted from the Canadian Cancer Registry (CCR).MethodsOrdered logistic regression was used to determine the effect of income, age, sex, province of residence, and rural vs urban residence on stage at presentation.ResultsA total of 1550 cases were included (1280 males and 265 females). The stage at presentation was earlier in the highest income quintile (quintile 5) compared to the lower income quintiles (quintiles 1‐4) (odds ratio [OR], 0.68; P <. 05). There was a statistically significant difference in stage at presentation based on rural or urban residence within the highest income quintile (OR, 1.73; P <. 005).ConclusionThere is a relationship between SES and stage at presentation for laryngeal cancer even in the Canadian universal health care system.
The effect of abdominal contrast-enhanced CT on DNA double-strand breaks in peripheral blood lymphocytes: an in vitro and in vivo study
Authors: Tao Shu Min , Zhou Fan , Schoepf U Joseph , Johnson Addison A , Lin Zhu Xiao , Zhou Chang Sheng , Lu Guang Ming , Zhang Long Jiang 
Published: September 2018

Background As abdominal computed tomography (CT) radiation dose can be higher compared with other organ systems, monitoring the radiation exposure from this exam type is especially important. Purpose To evaluate the effect of abdominal contrast-enhanced CT (CE-CT) on levels of DNA double-strand breaks (DSBs) in peripheral blood lymphocytes. Material and Methods This study was performed in two parts: (i) an in vitro study: venous blood samples from 12 volunteers were divided into four groups. Samples in group A did not undergo radiation exposure, while groups B, C, and D received one CT scan with 1–3 times the radiation dose equivalent to abdominal CE-CT scan, respectively; and (ii) an in vivo study: blood was taken before CT and 5 min after CT in 30 patients. Lymphocytes were isolated and stained by immunofluorescence of γ-H2AX protein. DSB levels were compared by variance analysis or paired t-test. The relationship between radiation dose and γ-H2AX focus increase was analyzed using Pearson correlation analysis. Results In the in vitro study, DSBs levels in groups B, C, and D were 49.4%, 96.6%, and 149.4% higher than those in Group A, respectively (all P < 0.001). Radiation dose in the four subgroups had a linear correlation to DSB levels ( P < 0.001). In the in vivo study, the DSB level was 43.5% higher after CT ( P < 0.001). Conclusion Abdominal CE-CT significantly increased DSB levels in both in vitro and in vivo experiments. A positive linear correlation of CT radiation dose with intracellular DSBs levels was observed in the in vitro study.
Efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for vitreous floaters
Authors: Luo Jihan , An Xiaoju , Kuang Yi 
Published: September 2018

Objective To examine the efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for the treatment of vitreous floaters. Methods Consecutive adult patients with symptomatic vitreous floaters who attended Chongqing General Hospital from April to December 2016 were included in this prospective study. Patients had >3 mm between the vitreous opacity and retina/lens and acceptable quality peri-papillary Optical Coherence Tomography (OCT) images (i.e., signal strength ≥5). Those with history of glaucoma, severe cataracts, vitreous haemorrhages, retinal holes and/or macular disease were excluded from the study. Best corrected visual acuity (BCVA) and non-contact intraocular pressure (IOP) were measured before and for up to 6 months post-YAG laser vitreolysis. Anterior segment photography and peripapillary retinal nerve fibre layer (RNFL) measured by OCT were taken before and 6 months post-procedure. Questionnaires on patient satisfaction were completed 6 months post-procedure. Results No statistically significant differences in BCVA and IOP were observed before or after treatment. Anterior segment photography showed that vitreous opacities partially or completely disappeared after YAG laser treatment. The thickness of RNFL in four directions (upper, below, nasal and temporal) was not statistically significant different before or 6 months after the procedure. 75% patients reported significant improvement and 25% reported moderate improvement. Conclusion The results of this study conducted in a cohort of 30 Chinese patients showed that YAG laser vitreolysis was a well-tolerated and effective treatment for vitreous floaters. Randomised, controlled trials involving large numbers of participants monitored over an extended follow up period are required to confirm these results.
The influence of individualistic and collectivistic morality on dementia care choices
Authors: Hanssen Ingrid , Tran Phuong Thai Minh 
Published: September 2018

Background: If collectivistic-oriented family carers choose professional care for dependents with dementia, they risk being stigmatised as failing their obligation. This may influence dementia care choices. Research question: How may individualistic and collectivistic values influence choices in dementia care? Method: Qualitative design with in-depth interviews with a total of 29 nurses, 13 family members in Norway and the Balkans and 3 Norwegian dementia care coordinators. A hermeneutic content-focused analysis was used. Ethical considerations: Ethical approval was obtained from the Regional Ethics Committee for Research, South-Eastern Norway, and the nursing homes’ leadership. Findings: Family domain reasons why institutionalisation of dependents with dementia was seen as a last resort: obligation towards family members, particularly parents; worry about other family members’ reactions and inability to cope with the care for the person with dementia. Social domain reasons: feelings of shame and stigma regarding dementia, particularly in connection with institutionalisation of family members. Discussion: Children’s obligation towards their parents is an important aspect of the morality of collectivistic societies. Institutionalising parents with dementia may cause feelings of guilt and shame and worry about being stigmatised and ostracised. To avoid blame and rejection, caregiver(s) try to keep the fact that family members have dementia ‘in the family’. The decision to accept professional healthcare for dependents with severe dementia or have them admitted to a geriatric institution was postponed as long as possible. Conclusion: Family care morality may constitute a significant barrier against seeking professional help for persons with dementia, a barrier based on the expectation that the family will care for their old, even when suffering from severe dementia. Hence, stigma and shame may significantly affect the provision of care. Culturally tailored information may encourage family carers to seek professional help before the disruptive influence of the disease makes institutionalisation the only feasible option.
The Effectiveness of Interventions for Grandparents Raising Grandchildren: A Meta-Analysis
Authors: Chan Ko Ling , Chen Mengtong , Lo Kin Ming Camilla , Chen Qiqi , Kelley Susan J. , Ip Patrick 
Published: September 2018

Purpose: The research objective is to evaluate the effectiveness of intervention programs that aim to enhance the well-being of grandparent caregivers and the developmental outcomes of grandchildren and identify useful program components. Method: Relevant studies were identified via comprehensive literature searches of electronic databases. A random effects model was used to calculate effect sizes. Results: We included 20 studies published in and before April 2018. Our review indicates that interventions for grandparent caregivers have positive effects in regard to various well-being outcomes. Small to moderate effect sizes for increases in social support and parenting skills and a decrease in children’s behavioral problems were found. Supportive and educational components could contribute to a promising intervention. Conclusions: The implementation of interventions for grandparents requires ongoing research efforts to obtain high-quality evidence for program effectiveness. We suggest future research be conducted to develop tailored interventions to meet the needs of different grandparent caregivers.
Developing recommendations for the safe handling of oral anti-cancer drugs in community pharmacies: A pan-Canadian consensus approach
Authors: Vu Kathy , Emberley Philip , Brown Erika , Abbott Rick , Bates Justin , Bourrier Venetia , Djordjevic Kathryn , Greenall Julie , Leung Mova , Pasetka Mark , Paquet Louise , Logan Heather 
Published: September 2018

Purpose To create a set of consensus-based and evidence-informed recommendations to provide guidance around the safe dispensing and handling of oral anti-cancer drugs in low-volume settings unique to the community pharmacy setting. Methods A review of published and grey literature (published in non-commercial domains such as national organizations and associations) documents and nine key informant interviews were conducted and a modified Delphi approach was taken to achieve consensus. The final list of 47 candidate recommendations was reviewed by a task force and validated by multi-disciplinary stakeholders. A draft of the statements was circulated broadly within the community pharmacy community in an effort to assess relevance and implementation feasibility. Results The final report included 44 recommendations that addressed 11 key areas germane to the safe handling of oral anti-cancer drugs in community pharmacies. Mean agreement increased from 70% to 95%. Early feedback from community pharmacy leaders during the external review suggests that many of the proposed recommendations can be feasibly implemented within a reasonable timeframe when released with appropriate education and resource materials. Conclusions A modified-Delphi approach supplemented by key informant interviews and a comprehensive external review resulted in a set of evidence-informed, community-driven recommendations for community pharmacies. The recommendations address a gap in existing literature to improve understanding of the risks associated with handling and dispensing oral anti-cancer drugs for both community pharmacy staff and management and offer mitigating strategies to reduce those risks. Incorporating feasibility assessment actions early (through the key informant interviews) and late (through the external review) ensures recommendations are grounded in practicality and support broad and early knowledge translation strategies.
Efficacy of addition of nepafenac 0.1% to steroid eye drops in prevention of post-phaco macular edema in high-risk eyes
Authors: El Gharbawy Shahenda A , Darwish Essam A , Abu Eleinen Khaled G , Osman Moataz Hamed 
Published: September 2018

Purpose:To compare the efficacy of addition of nonsteroidal anti-inflammatory eye drops to steroidal eye drops with that of using postoperative steroidal anti-inflammatory eye drops alone in prevention of macular edema in high-risk patients.Setting:Cairo University Hospital.Design:This study was comparative prospective interventional randomized study.Methods:This study included 100 cataractous eyes divided into five subgroups: 20 eyes of diabetic patients, 20 uveitic eyes, 20 traumatic cataracts, 20 glaucomatous eyes on topical prostaglandin analogs, and 20 eyes with posterior capsular rupture during phacoemulsification. Each subgroup of 20 was randomized between two groups of 10 eyes, group A received postoperative topical steroids alone and group B received both steroidal and nonsteroidal anti-inflammatory eye drops.Results:There was significant increase in postoperative central foveal thickness as compared to preoperative values in both groups (60.9 ± 87.95 µ in group A and 25.52 ± 57.26 µ in group B) that was significantly more in group A (P value 0.016). There was significant difference in postoperative macular thickness between both groups (280.1 ± 86.0 µ and 246.80 ± 57.73 µ, respectively, in groups A and B) (P value = 0.012). There was no statistically significant difference between both groups in preoperative and postoperative corrected distance visual acuity and intraocular pressure.Conclusion:Addition of topical nepafenac eye drops to topical steroid drops significantly reduced the amount of pseudophakic macular edema after cataract surgery in high-risk eyes.
Efficacy and safety of inhaled low-dose methoxyflurane for acute paediatric pain: A systematic review
Authors: Hartshorn Stuart , Middleton Paul M 
Published: September 2018

Introduction Undertreatment of acute, moderate-to-severe pain in children is common, due in part to barriers to the use of opioids. Low-dose methoxyflurane is an inhaled, non-opioid analgesic widely used in Australia and recently approved in Europe for the emergency relief of acute moderate-to-severe trauma pain in adults. Methods Using an integrative review framework, we conducted a literature analysis to examine the potential utility of methoxyflurane in children with acute pain. EMBASE®, MEDLINE® and PubMed were searched (criteria included ‘methoxyflurane’ ‘child*’ or ‘adolescent’ or ‘pediatr*’ or ‘paediatr*’) from January 2000 to October 2017, along with internet-based sources to identify relevant grey literature (no predefined search criteria). A series of investigative questions were developed regarding the safety and efficacy of methoxyflurane in this setting and addressed using evidence collated from the identified studies. Results Of 366 results from the literature searches, 6 clinical trials and observational studies were identified which explored the safety and/or efficacy of inhaled methoxyflurane in individuals < 18 years in either a clinical trial or observational study. All six studies concluded that methoxyflurane provides effective and rapid analgesia for paediatric acute moderate-to-severe pain. Methoxyflurane was well tolerated and associated with good levels of patient/healthcare provider satisfaction in this setting. Conclusions While large-scale studies are needed to better inform treatment approaches for paediatric use, inhaled methoxyflurane has potential to provide easy to administer, needle-free analgesia with a rapid onset and good safety profile.
Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location
Authors: Taitt Harold Evelyn 
Published: September 2018

Although research has reported that prostate cancer (PCa) incidence and mortality rates are among the highest for African Americans, the data is inconclusive regarding PCa rates in native African men, Black men residing in other countries, and men in Asia, Europe, and the Americas. Data reveals that prostate-specific antigen (PSA) testing and disease incidence have risen significantly in developing and Asian countries, and PCa has become one of the leading male cancers in many of those nations. The objective of this study was to review published peer-reviewed studies that address PCa in different regions of the world to get a better understanding of how PCa incidence, prevalence, detection, and mortality are influenced by race, ethnicity, and geography. A secondary goal was to compare PCa data from various world regions to contextualize how disproportionate the incidence and mortality rates are among men from the African diaspora versus men of European, Hispanic, and Asian descent, as well as to highlight the need for more robust screening and treatment guidelines in developing countries. There are differences in incidence and mortality rates between men of African, Asian, Hispanic, and European ancestry, confirming the involvement of genetic factors. However, differences between men of the same race and ethnicity who live in different countries suggest that environmental factors may also be implicated. Availability and access to diagnostic and health-care services as well as recommendations regarding PCa testing vary from country to country and contribute to the variability in incidence and mortality rates.
Urinary fibrinogen is elevated in hospitalized patients undergoing angiography
Authors: Du Tian , Dong Honglin , Li Chunhong , Yan Sheng , Li Haifeng 
Published: September 2018

Objectives Previously, we found that urinary fibrinogen (Fg) levels were positively related to contrast-induced acute renal injury degree in mice. Reduction of fibrinogen in heterozygous mice can improve renal function. Here, we prospectively observed the variation in urinary Fg levels in patients undergoing angiography to determine the relationship between serum creatinine (Scr) and serum cystatin C (Cys C) levels. Methods Serum Cys C and urinary Fg levels were evaluated by ELISA before and 2, 12, and 24 h after angiography in 115 enrolled inpatients. Scr was assessed before and 24 and 48 h after angiography. Data were analyzed using ANOVA or Kruskal–Wallis ANOVA and Spearman correlation. Results Urinary Fg levels were elevated as early as 2 h after angiography and decreased thereafter before returning to baseline levels 24 h after angiography. Urinary Fg was correlated with the amount of contrast agent ( r = 0.24, p = 0.036) and the presence of diabetes and hypertension ( r = 0.31, r = 0.28, p < 0.05, respectively). Urinary Fg levels 2 h after angiography were positively related with Cys C at 12 and 24 h and Scr at 48 h after angiography ( r = 0.34, r = 0.51, r = 0.85, p < 0.05, respectively). Conclusions Our results showed that variations in urinary Fg levels are consistent with serum Cys C and Scr in patients undergoing angiography and that urinary Fg levels were the earliest parameter to become elevated. Urinary Fg should be investigated as a useful predictor for abnormal renal function after angiography.
Beyondp-values: A phase II dual-criterion design with statistical significance and clinical relevance
Authors: Roychoudhury Satrajit , Scheuer Nicolas , Neuenschwander Beat 
Published: September 2018

BackgroundWell-designed phase II trials must have acceptable error rates relative to a pre-specified success criterion, usually a statistically significant p-value. Such standard designs may not always suffice from a clinical perspective because clinical relevance may call for more. For example, proof-of-concept in phase II often requires not only statistical significance but also a sufficiently large effect estimate.PurposeWe propose dual-criterion designs to complement statistical significance with clinical relevance, discuss their methodology, and illustrate their implementation in phase II.MethodsClinical relevance requires the effect estimate to pass a clinically motivated threshold (the decision value (DV)). In contrast to standard designs, the required effect estimate is an explicit design input, whereas study power is implicit. The sample size for a dual-criterion design needs careful considerations of the study’s operating characteristics (type I error, power).ResultsDual-criterion designs are discussed for a randomized controlled and a single-arm phase II trial, including decision criteria, sample size calculations, decisions under various data scenarios, and operating characteristics. The designs facilitate GO/NO-GO decisions due to their complementary statistical–clinical criterion.LimitationsWhile conceptually simple, implementing a dual-criterion design needs care. The clinical DV must be elicited carefully in collaboration with clinicians, and understanding similarities and differences to a standard design is crucial.ConclusionTo improve evidence-based decision-making, a formal yet transparent quantitative framework is important. Dual-criterion designs offer an appealing statistical–clinical compromise, which may be preferable to standard designs if evidence against the null hypothesis alone does not suffice for an efficacy claim.
Conceptualizing Health Promotion in Relation to Outpatient Healthcare Building Design: A Scoping Review
Authors: Miedema Elke , Lindahl Göran , Elf Marie 
Published: September 2018

Objective: This review explored different conceptualizations of health promotion in the context of, and in relation to, outpatient building design. Background: Today’s healthcare organizations are implementing holistic healthcare approaches such as health promotion, while simultaneously increasing their outpatient services. These health promotion approaches, focused on empowering people to take control of their health, are expected to have implications for the outpatient healthcare building design. Yet there is limited knowledge what these may be. A review of the literature on the current state of the art is thus needed to enable and support dialog on future healthcare building design. Method: A scoping review of 4,506 papers, collected from four databases and three scientific journals in 2015, resulted in 14 papers relating health promotion to building design and outpatient healthcare. From the subsequent content analysis, multiple common themes and subthemes emerged. Results: The review reveals diverse range of health promotion interpretations, three health promotion perspectives (health behavior, health equity, and sense of coherence), associated design approaches, design objectives, health-related outcomes, building features, and solutions. Conclusions: While diverse health promotion perspectives might merely represent variations in focus, these differences become problematic when relating to building design. To support further dialogs on development of health promotion in, and in relation to, the build environment, there is a need to strengthen the health promotion vocabulary. Further research is needed to compare different design approaches and how these can be combined to minimize contradicting implications for building design.