bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human immunodeficiency virus 1 dual‐target nucleic acid technology improves blood safety: 5 years of experience of the German Red Cross blood donor service Baden‐Württemberg–Hessen
Authors: Hourfar Kai , Eberle Josef , Müller Markus , Micha Nübling C , Chudy Michael , Kress Julia , Gürtler Lutz , Mayr‐Wohlfart Uschi , Schrezenmeier Hubert , Hellmann Inke , Luhm Jürgen , Kraas Sabine , Ringwald Jürgen , Gubbe Knut , Frank Kerstin , Karl Andreas , Tonn Torsten , Jaeger Maike , Sireis Walid , Seifried Erhard , Schmidt Michael 
Published: October 2018

BACKGROUNDRNA viruses are associated with a high frequency of mutations because of the missing proofreading function of polymerases, such as reverse transcriptase. Between 2007 and 2010, six blood donations with false‐negative nucleic acid technology (NAT) results were reported in Germany. Therefore, NAT screening in two viral genome regions was introduced by our blood donation service in 2010 on a voluntary basis and became mandatory in Germany since the beginning of 2015.STUDY DESIGN AND METHODSBlood donor screening was done using, in parallel, the German Red Cross (GRC) HIV‐1 CE long terminate repeats (LTR) PCR kit and the GRC HIV‐1 gag CE PCR kit. In total, 7 million blood donations were screened during the study period from 2010 to 2014 with the GRC dual‐target human immunodeficiency virus 1 (HIV‐1) NAT system. Additionally, three suspicious specimens were analyzed by four monotargeted NAT assays and by five dual‐target NAT assays.RESULTSThree of 7 million donations tested negative using the 5’LTR–polymerase chain reaction, but they were positive if amplification was performed in the gag region. HIV antibodies were detected in all three donations. Nucleic acid sequence analysis identified a deletion of 22 bases within the 5’LTR probe binding region. Three different ltr‐based monotargeted assays missed two donations, except for a low‐reactive result obtained by one of the assays. In total, the detection rates for HIV‐1–positive donations were 37.5% (3/8) for monotargeted assays and 100% (10/10) for dual‐target assays.CONCLUSIONThe current data demonstrate that dual‐target NAT systems reduce the risk of false‐negative HIV‐1 NAT screening results.
Platelet concentrate supernatants alter endothelial cell mRNA and protein expression patterns as a function of storage length
Authors: Sut Caroline , Hamzeh‐Cognasse Hind , Arthaud Charles‐Antoine , Eyraud Marie‐Ange , Chettab Kamel , Dumontet Charles , Laradi Sandrine , Burnouf Thierry , Garraud Olivier , Cognasse Fabrice 
Published: October 2018

BACKGROUNDPlatelet transfusions are safe but can nevertheless cause serious adverse reactions (SARs). This study investigated the effects of platelet biological response modifiers (BRMs) that accumulate during storage and are commonly associated with transfusion adverse reactions.STUDY DESIGN AND METHODSEndothelial cells (ECs), that is, EA.hy926, were exposed in vitro to supernatants of platelet components (PCs) that had been either implicated or not in SARs. The EC Biology RT2 Profiler PCR Array was used at the same time to study 84 genes related to functions of ECs. Soluble cytokines and surface expression of EC markers were determined by Luminex/enzyme‐linked immunosorbent assay technology and flow cytometry, respectively. Apoptosis and scratch wound assays were performed using IncuCyte technology.RESULTSIn vitro exposure of EA.hy926 monolayers with Day 0, 1‐2, and 3‐4 stored PC supernatants resulted in decreases in surface expression of markers of ECs. There was differential production of soluble BRMs in the tested cell line. Exposure to the supernatants of PCs that had been implicated in SARs showed a significant difference in the expression of the EC surface markers. EC mediators also responded differently when exposed to PC supernatants of different storage times and PCs involved in SARs.CONCLUSIONPC supernatants collected at Day 1‐2 activate fewer cell lines of ECs compared with supernatants collected at Day 3‐4. Moreover, PC supernatants involved in SARs appear to alter EC activation compared with the control and storage length.
Five-year single-centre experience of carcinoma of the oesophagus from Blantyre, Malawi
Authors: Chetwood John David , Finch Peter J , Kankwatira Anstead , Mallewa Jane , Gordon Melita A , Masamba Leo 
Published: October 2018

BackgroundOesophageal squamous cell carcinoma (OSCC) is increasing worldwide and has an exceptionally high prevalence in certain distinct geographical locations such as the African oesophageal SCC corridor. Despite this, there is a paucity of evidence to characterise the disease particularly in the Malawian context.MethodWe retrospectively audited our endoscopy database over 5 years, including for patient demographics, endoscopy findings, therapeutic intervention and recommendations for treatment.Results1586 patients with oesophageal cancer were identified from a total of 5882 endoscopy records from 2013 to 2017. Our cohort showed a larger proportion of oesophageal cancers found higher in the oesophagus compared with other African studies and a female preponderance in this upper-oesophagus disease subset though a male preponderance overall. 39% of patients with oesophageal cancer underwent bougie dilatation and 11% underwent palliative stent placement, which likely reflects local availability of resources.ConclusionThis study validates the observation that OSCC predominates in sub-Saharan Africa in Malawi over other forms of oesophageal carcinoma, though our cohort appears to have subtly distinct demographics and disease-specific data. This highlights the need to prioritise preventative and therapeutic strategies for OSCC in this and similar settings.
Free contraception and behavioural nudges in the postpartum period: evidence from a randomised control trial in Nairobi, Kenya
Authors: McConnell Margaret , Rothschild Claire Watt , Ettenger Allison , Muigai Faith , Cohen Jessica 
Published: October 2018

BackgroundShort birth intervals are a major risk factor for poor maternal and newborn outcomes. Utilisation of modern contraceptive methods during the postpartum period can reduce risky birth intervals but contraceptive coverage during this critical period remains low.MethodsWe conducted a randomised controlled experiment to test whether vouchers for free contraception, provided with and without behavioural ‘nudges’, could increase modern contraceptive use in the postpartum period. 686 pregnant women attending antenatal care in two private maternity hospitals in Nairobi, Kenya, were enrolled in the study. The primary outcomes were the use of modern contraceptive methods at nearly 3 months and 6 months after expected delivery date (EDD). We tested the impact of a standard voucher that could be redeemed for free modern contraception, a deadline voucher that expired 2 months after delivery and both types of vouchers with and without a short message service (SMS) reminder, relative to a control group that received no voucher and no SMS reminder.ResultsBy nearly 6 months after EDD, we find that the combination of the standard voucher with an SMS reminder increased the probability of reporting utilisation of a modern contraceptive method by 25 percentage points (pp) (95% CI 6 pp to 44 pp) compared with the control group. Estimated impacts in other treatment arms were not statistically significantly different from the control group.ConclusionsReducing financial barriers to postpartum contraception alone may not be enough to encourage take-up. Programmes targeting the postpartum period should consider addressing behavioural barriers to take-up.
Protocol for the STRONG trial: stereotactic body radiation therapy following chemotherapy for unresectable perihilar cholangiocarcinoma, a phase I feasibility study
Authors: Koedijk Merel S , Heijmen Ben J M , Groot Koerkamp Bas , Eskens Ferry A L M , Sprengers Dave , Poley Jan-Werner , van Gent Dik C , van der Laan Luc J W , van der Holt Bronno , Willemssen François E J A , Méndez Romero Alejandra 
Published: October 2018

IntroductionFor patients with perihilar cholangiocarcinoma (CCA), surgery is the only treatment modality that can result in cure. Unfortunately, in the majority of these patients, the tumours are found to be unresectable at presentation due to either local invasive tumour growth or the presence of distant metastases. For patients with unresectable CCA, palliative chemotherapy is the standard treatment yielding an estimated median overall survival (OS) of 12–15.2 months. There is no evidence from randomised trials to support the use of stereotactic body radiation therapy (SBRT) for CCA. However, small and most often retrospective studies combining chemotherapy with SBRT have shown promising results with OS reaching up to 33–35 months.Methods and analysisThis study has been designed as a single-centre phase I feasibility trial and will investigate the addition of SBRT after standard chemotherapy in patients with unresectable perihilar CCA (T1-4 N0-1 M0). A total of six patients will be included. SBRT will be delivered in 15 fractions of 3–4.5 Gy (risk adapted). The primary objective of this study is to determine feasibility and toxicity. Secondary outcomes include local tumour control, progression-free survival (PFS), OS and quality of life. Length of follow-up will be 2 years. As an ancillary study, the personalised effects of radiotherapy will be measured in vitro, in patient-derived tumour and bile duct organoid cultures.Ethics and disseminationEthics approval for the STRONG trial has been granted by the Medical Ethics Committee of Erasmus MC Rotterdam, the Netherlands. It is estimated that all patients will be included between October 2017 and October 2018. The results of this study will be published in a peer-reviewed journal, and presented at national and international conferences.Trial registration numberNCT03307538; Pre-results.
Ten-year risk prediction models of complications and mortality of Chinese patients with diabetes mellitus in primary care in Hong Kong: a study protocol
Authors: Wan Eric Yuk Fai , Yu Esther Yee Tak , Chin Weng Yee , Fung Colman Siu Cheung , Kwok Ruby Lai Ping , Chao David Vai Kiong , Chan King Hong , Hui Eric Ming-Tung , Tsui Wendy Wing Sze , Tan Kathryn Choon Beng , Fong Daniel Yee Tak , Lam Cindy Lo Kuen 
Published: October 2018

IntroductionDiabetes mellitus (DM) is a major disease burden worldwide because it is associated with disabling and lethal complications. DM complication risk assessment and stratification is key to cost-effective management and tertiary prevention for patients with diabetes in primary care. Existing risk prediction functions were found to be inaccurate in Chinese patients with diabetes in primary care. This study aims to develop 10-year risk prediction models for total cardiovascular diseases (CVD) and all-cause mortality among Chinese patients with DM in primary care.Methods and analysisA 10-year cohort study on a population-based primary care cohort of Chinese patients with diabetes, who were receiving care in the Hospital Authority General Outpatient Clinic on or before 1 January 2008, were identified from the clinical management system database of the Hospital Authority. All patients with complete baseline risk factors will be included and followed from 1 January 2008 to 31 December 2017 for the development and validation of prediction models. The analyses will be carried out separately for men and women. Two-thirds of subjects will be randomly selected as the training sample for model development. Cox regressions will be used to develop 10-year risk prediction models of total CVD and all-cause mortality. The validity of models will be tested on the remaining one-third of subjects by Harrell’s C-statistics and calibration plot. Risk prediction models for diabetic complications specific to Chinese patients in primary care will enable accurate risk stratification, prioritisation of resources and more cost-effective interventions for patients with DM in primary care.Ethics and disseminationThe study was approved by the Institutional Review Board of the University of Hong Kong—the Hospital Authority Hong Kong West Cluster (reference number: UW 15–258).Trial registration numberNCT03299010; Pre-results.
Effects of the Namaste Care Family programme on quality of life of nursing home residents with advanced dementia and on family caregiving experiences: study protocol of a cluster-randomised controlled trial
Authors: Smaling Hanneke J A , Joling Karlijn J , van de Ven Peter M , Bosmans Judith E , Simard Joyce , Volicer Ladislav , Achterberg Wilco P , Francke Anneke L , van der Steen Jenny T 
Published: October 2018

IntroductionQuality of life of people with advanced dementia living in nursing homes is often suboptimal. Family caregivers can feel frustrated with limited contact with their relatives, which results in visits that are perceived as stressful and not very meaningful. Few psychosocial interventions are specifically developed for people with advanced dementia, and actively involve family caregivers or volunteers. Also, interventions usually stop when it becomes difficult for people to participate. The Namaste Care Family programme aims to increase the quality of life of people with advanced dementia, and improve family caregiving experiences through connecting to people and making them comfortable.Methods and analysisOur study will evaluate the effects of the Namaste Care Family programme on quality of life of people with advanced dementia living in nursing homes and family caregiving experiences using a cluster-randomised controlled trial. Longitudinal analyses will be performed taking into account clustering at the nursing home level. Both a cost-effectiveness and a cost-utility analysis from a societal perspective will be performed. We will modify the Namaste Care Family programme to increase family and volunteer involvement in ongoing and end-of-life care. Data collection involves assessments by family caregivers, nursing staff and elderly care physicians using questionnaires, and observations by the researchers at baseline and multiple times over 12 months. The last questionnaire will be sent up to month 24 after the death of the person with dementia. During semistructured interviews, the feasibility, accessibility and sustainability of the Namaste Care Family programme will be assessed.Ethics and disseminationThe study protocol is approved by the Medical Ethics Review Committee of the VU University Medical Center in Amsterdam (protocol no. 2016.399) and registered with the Nederlands Trial Register (NTR5692). The findings will be disseminated via publications in peer-reviewed journals, conference presentations and presentations for healthcare professionals where appropriate.Trial registration numberNTR5692.
Pain, agitation and delirium assessment and management in a community medical-surgical ICU: results from a prospective observational study and nurse survey
Authors: Maximous Ramez , Miller Franziska , Tan Carolyn , Camargo Mercedes , Ross Katie , Marshall Carl , Yung Priscilla , Fleming Dimitra , Law Madelyn , Tsang Jennifer L Y 
Published: October 2018

BackgroundDelirium is a common manifestation in the intensive care unit (ICU) that is associated with increased mortality and morbidity. Guidelines suggested appropriate management of pain, agitation and delirium (PAD) is crucial in improving patient outcomes. However, the practice of PAD assessment and management in community hospitals is unclear and the mechanisms contributing to the potential care gap are unknown.ObjectivesThis quality improvement initiative aimed to review the practice of PAD assessment and management in a community medical-surgical ICU (MSICU) and to explore the community MSICU nurses’ perceived comfort and satisfaction with PAD management in order to understand the mechanisms of the observed care gap and to inform subsequent quality improvement interventions.MethodsWe prospectively collected basic demographic data, clinical information and daily data on PAD process measures including PAD assessment and target Richmond Agitation-Sedation Scale (RASS) score ordered by intensivists on all patients admitted to a community MSICU for >24 hours over a 20-week period. All ICU nurses in the same community MSICU were invited to participate in an anonymous survey.ResultsWe collected data on a total of 1101 patient-days (PD). 653 PD (59%), 861 PD (78%) and 439 PD (39%) had PAD assessment performed, respectively. Target RASS was ordered by the intensivists on 515 PD (47%). Our nurse survey revealed that 88%, 85% and 41% of nurses were comfortable with PAD assessment, respectively.ConclusionsDelirium assessment was not routinely performed. This is partly explained by the discomfort nurses felt towards conducting delirium assessment. Our results suggested that improvement in nurse comfort with delirium assessment and management is needed in the community MSICU setting.
Prevention of musculoskeletal injuries in recreational field hockey: the systematic development of an intervention and its feasibility
Authors: Gouttebarge Vincent , Zuidema Victor 
Published: October 2018

ObjectiveThis article describes the systematic development of an intervention for the prevention of lower extremity injuries in field hockey and the assessment of its feasibility.MethodsThe intervention was developed according to the first four steps of the intervention mapping and knowledge transfer scheme processes, mostly based on focus group interviews with experts in field hockey and injury prevention (needs assessment; objective and target groups; content selection; development). Subsequently, a quasi-experimental research (one-group post-test design) was conducted among 35 young field hockey players and 7 coaches. Participants were asked to use the intervention for 3 weeks, and the degrees of relevancy, suitability, satisfaction and usability of the intervention were assessed by means of a questionnaire and a group interview.ResultsFirst, the needs assessment conducted among the main actors within recreational field hockey revealed that an injury prevention intervention was needed, ideally delivered through videos via an application for smartphone/tablet or website. Second, the objective and target groups of the intervention were defined, namely to prevent or reduce the occurrence of lower extremity injuries among both young and adult recreational field hockey players. Third, warming-up exercises were selected as preventive measures and strategies (eg, core stability, strength, coordination). Last, the ‘Warming-Up Hockey’ intervention was developed, consisting of a warm-up programme (delivered by coaches including more than 50 unique exercises). The relevancy, satisfaction and usability of ‘Warming-Up Hockey’ were positively evaluated, but two main alterations were made: the duration of the ‘Warming-up Hockey’ was reduced from 16 to 12  min and a match-specific warm-up was added.ConclusionThe feasibility of ‘Warming-Up Hockey’ was positively assessed by players and coaches. Prior to its nationwide implementation, the effectiveness of the intervention on injury reduction among field hockey players should be conducted.
Can simulation-based team resource management training help students to pass entrustable professional activities 13?
Authors: Ko Tung-Wen , Hung Sheng-Hui , Wu Yung-Lung , Lee Hui-Chen , Lein Heng-Hui , Wang Pa-Chun 
Published: October 2018

ObjectiveSimulation technology has been integrated into team resource management (TRM) training in many hospitals. We designed a simulation-based TRM training scenario (SBTRM) aiming to help post graduate year (PGY) physicians to fulfil the requirements of the entrustable professional activities 13 (EPA 13). In this study, we investigate and report the SBTRM effectiveness.MethodsA total of 61 physicians received the SBTRM from March to November 2017. The SBTRM covers the core contents of teamwork skills. The trainees were evaluated with qualified clinical instructors after SBTRM training. The evaluation form is a 15-item questionnaire that evaluates the communication, situation monitoring, attitudes and clinical treatment of trainee behaviour.ResultsA total of 75% of trainees agreed that the simulation is close to the usual care behaviour and helpful in thinking about changes in the surrounding conditions. More than 80% of trainees can actively communicate the care process; 82% of trainees can provide appropriate clinical treatment for patients. We found that physicians did not pay enough attention to the definition of ‘nursing work’. 75% of the overall performance of teamwork and patient safety reached only ‘good’ level.ConclusionsCurrent medical education is increasingly using simulation to learn teamwork skills, with the hope that trainees use systematic thinking to carry out the care process. In this study, we designed a SBTRM and evaluation form that meets the requirements of EPA 13 for trainees. This training should improve physicians’ safety awareness in the first post-graduate year.
A new method to statistically describe microcatheter tip position in patient-specific aneurysm models
Authors: Nawka Marie Teresa , Buhk Jan-Hendrik , Gellissen Susanne , Sedlacik Jan , Fiehler Jens , Frölich Andreas Maximilian 
Published: October 2018

Background and purposeEvidence on how to select microcatheters to facilitate aneurysm catheterization during coil embolization is sparse. We developed a new method to define microcatheter tip location inside a patient-specific aneurysm model as a 3-dimensional probability map. We hypothesized that precision and accuracy of microcatheter tip positioning depend on catheter tip shape and aneurysmal geometry.Materials and methodsUnder fluoroscopic guidance two to three operators introduced differently shaped microcatheters (straight, 45°, 90°) into eight aneurysm models targeting the anatomic center of the aneurysm. Each microcatheter position was recorded with flat-panel CT, and 3-dimensional probability maps of the microcatheter tip positions were generated. Maps were assessed with histogram analyses and compared between tip shapes, aneurysm locations and operators.ResultsAmong a total of 530 microcatheter insertions, the precision (mean distance between catheter positions) and accuracy (mean distance to target position) were significantly higher for the 45° tip (1.10±0.64 mm, 3.81±1.41 mm, respectively) than for the 90° tip (1.27±0.57 mm, p=0.010; 4.21±1.60 mm p=0.014, respectively). Accuracy was significantly higher in posterior communicating artery aneurysms (3.38±1.20 mm) than in aneurysms of the internal carotid artery (4.56±1.54 mm, p<0.001).ConclusionOur method can be used tostatistically describe statistically microcatheter behavior in patient-specific anatomy, which may improve the available evidence guiding microcatheter shape selection. Experience increases the ability to reach the intended position with a microcatheter (accuracy) that is also dependent on the aneurysm location, whereas catheter tip choice determines the variability of catheter tip placements versus each other (precision). Clinical validation is required.