bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision-making for people with dementia and advanced kidney disease: a secondary qualitative analysis of interviews from the Conservative Kidney Management Assessment of Practice Patterns Study
Authors: Scott Jemima , Owen-Smith Amanda , Tonkin-Crine Sarah , Rayner Hugh , Roderick Paul , Okamoto Ikumi , Leydon Geraldine , Caskey Fergus , Methven Shona 
Published: November 2018

ObjectiveTo explore dialysis decision-making for adults who lack capacity due to cognitive impairment, a common and under-recognised condition in those with advanced chronic kidney disease (CKD).DesignSecondary analysis of qualitative data collected during the Conservative Kidney Management Assessment of Practice Patterns Study programme of research was performed. Sixty semistructured interviews were conducted with multiprofessional team members from UK renal centres. Staff were asked about local facilities, the value of conservative kidney management (CKM), when and with whom CKM was discussed and how CKM could be improved. Thematic analysis was employed to identify, characterise and report on themes that emerged from the data, focused on the specific issues experienced by people with dementia.SettingA purposive sample of nine UK renal centres differing in the scale of their CKM programmes.ParticipantsClinical directors of renal centres identified staff involved in CKM. Staff were asked to participate if they had experience of low clearance clinics or of caring for patients with advanced CKD (estimated glomerular filtration rate <20mL/min/1.732or >65 years with end-stage kidney disease).ResultsTwo overarching themes were identified: factors taken into consideration during decision-making, and the process of decision-making itself. Comorbidity, social support, quality of life and the feasibility of dialysis were reported as factors pertinent to clinicians’ decisions regarding suitability. The majority of renal centres practised multidisciplinary ‘best interests’ decision-making for those without capacity. Attitudes to advance care planning were divided.ConclusionsIn view of the prevalence of cognitive impairment among those with advanced CKD, we suggest consideration of routine assessment of cognition and capacity. In the UK, dialysis is initiated and continued for individuals with dementia and services should be adapted to meet the needs of this population.
Effects of a mindfulness-based intervention (MYmind) for children with ADHD and their parents: protocol for a randomised controlled trial
Authors: Chan Stanley Kam Chung , Zhang Dexing , Bögels Susan M , Chan Christian Shaunlyn , Lai Kelly Yee Ching , Lo Herman Hay Ming , Yip Benjamin Hon Kei , Lau Elsa Ngar Sze , Gao Tiffany Ting , Wong Samuel Yeung Shan 
Published: November 2018

IntroductionMindfulness is one of the potential alternative interventions for children with attention-deficit hyperactivity disorder (ADHD). Some evidence suggests that mindfulness is related to changes in brain regions associated with ADHD. The potential benefits of mindfulness on children with ADHD, as well as the feasibility of this intervention approach, are warranted through prior local and foreign studies. This study aims to evaluate the effect of mindfulness-based group intervention for children with ADHD and their respective parents through a robust research design.Methods and analysisThis study will adopt a randomised controlled trial design including 140 children aged 8–12 years with ADHD together with one of their parents (n=140). These families will be randomised into intervention group (n=70) who will be offered the MYmind programme delivered by trained healthcare professionals, and an active control group (n=70) who will be offered the CBT programme. The intervention includes 8 weekly 90 min group sessions for children with ADHD (aged 8–12 years) and their respective parents. The primary and secondary outcomes will include children’s attention, ADHD-related symptoms, behaviours, executive function and mindfulness levels measured by validated objective measures and parent’s reported instruments. Parents’ parental stress, parenting styles, ADHD related symptoms, well-being, rumination level and mindfulness levels will also be measured. Analysis is by intention to treat. The effects of intervention will be evaluated by comparing outcomes between the two arms, as well as comparing outcomes within subject through comparing measurements at baseline (T0), immediately after the 8 week intervention (T1) and at 3 (T2) and 6 (T3) months postintervention.Ethics and disseminationEthics approval has been granted by the Joint Chinese University of Hong Kong – New Territories East Cluster Clinical Research Ethics Committee (The Joint CUHK-NTEC CREC). Participants will be required to sign informed consent form from both parents and children. Findings will be reported in conferences and peer-reviewed publications in accordance with recommendations of Consolidated Standards of Reporting Trials.Trial registration numberChiCTR1800014741; Pre-results.
Qualitative cross-country comparison of whether, when and how people diagnosed with lung cancer talk about cigarette smoking in narrative interviews
Authors: Hajdarevic Senada , Rasmussen Birgit H , Overgaard Hasle Trine L , Ziebland Sue 
Published: November 2018

ObjectivesTo compare and examine whether, when and how patients with lung cancer in three countries, with different survival rates, talk about cigarette smoking and its relationship with help-seeking.DesignA qualitative cross-country comparison with analysis of narrative interviews.SettingParticipants in Sweden, Denmark and England were interviewed during 2015–2016. Interviews, using a narrative approach, were conducted in participants’ home by trained and experienced qualitative researchers.ParticipantsSeventy-two men and women diagnosed with lung cancer were interviewed within 6 months of their diagnosis.ResultsThe English participants, regardless of their own smoking status, typically raised the topic of smoking early in their interviews. Smoking was mentioned in relation to symptom appraisal and interactions with others, including health professionals. Participants in all three countries interpreted their symptoms in relation to their smoking status, but in Sweden (unlike England) there was no suggestion that this deterred them from seeking care. English participants, but not Swedish or Danish, recounted reluctance to consult healthcare professionals with their symptoms while they were still smoking, some gave up shortly before consulting. Some English patients described defensive strategies to challenge stigma or pre-empt other people’s assumptions about their culpability for the disease. A quarter of the Danish and 40% of the Swedish participants did not raise the topic of smoking at any point in their interview.ConclusionThe causal relationship between smoking and lung cancer is well known in all three countries, yet this comparative analysis suggests that the links between a sense of responsibility, stigma and reluctance to consult are not inevitable. These findings help illuminate why English patients with lung cancer tend to be diagnosed at a later stage than their Swedish counterparts.
Cardiac biomarkers predict mortality in emergency patients presenting with atrial fibrillation
Authors: Niederdöckl Jan , Simon Alexander , Schnaubelt Sebastian , Schuetz Nikola , Laggner Roberta , Sulzgruber Patrick , Spiel Alexander O , Herkner Harald , Laggner Anton N , Domanovits Hans 
Published: November 2018

ObjectivesTo assess the predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive troponin T (hs-TnT) serum levels for mid-term mortality in patients presenting with symptomatic atrial fibrillation (AF) to an emergency department.MethodsNon-interventional cohort/follow-up study, including consecutive patients presenting to a tertiary care university emergency department due to symptomatic AF between 2012 and 2016. Multivariable Cox proportional hazard regression models were used to estimate the mortality rates and hazards per 100 patient-years (pry) for NT-proBNP and hs-TnT serum levels in quintiles.Results2574 episodes of 1754 patients (age 68 (IQR 58–75) years, female gender 1199 (44%), CHA2DS2-VASc 3 (IQR 1–4)) were recorded. Following the exclusion of incomplete datasets, 1780 episodes were available for analysis. 162 patients deceased during the mid-term follow-up (median 23 (IQR 4–38) months); the mortality rate was 4.72/100 pry. Hazard for death increased with every quintile of NT-proBNP by 1.53 (HR; 95% CI 1.27 to 1.83; p<0.001) and by 1.31 (HR; 95% CI 1.10 to 1.55; p=0.002) with every quintile of hs-TnT in multivariate Cox-regression analysis. No interaction between NT-proBNP and hs-TnT levels could be observed.ConclusionElevated NT-proBNP and hs-TnT levels are independently associated with increased mid-term mortality in patients presenting to an emergency department due to symptomatic AF.Trial registration numberNCT03272620; Results.
Long-term outcome after atrial correction for transposition of the great arteries
Authors: Couperus Lotte E , Vliegen Hubert W , Zandstra Tjitske E , Kiès Philippine , Jongbloed Monique R M , Holman Eduard R , Zeppenfeld Katja , Hazekamp Mark G , Schalij Martin J , Scherptong Roderick W C 
Published: November 2018

ObjectiveThis study assessed adult survival and morbidity patterns in patients who underwent atrial correction according to Mustard or Senning for transposition of the great arteries (TGA).MethodsIn 76 adult patients with TGA (59% male) after atrial correction, long-term survival and morbidity were investigated in three periods: early (<15 years postoperatively), midterm (15–30 years postoperatively) and late (>30 years postoperatively).ResultsThe Mustard technique was performed in 41 (54%) patients, and the Senning technique was performed in 35 (46%) patients aged 3.1 (IQR: 2.1–3.8) and 1.0 (IQR: 0.6–3.1; p<0.01) years, respectively. Adult survival was 82% at 39.7 (IQR: 35.9–42.4) years postoperatively and exceeded 50 years in four patients. Supraventricular tachycardia (SVT) occurred in 51% of patients. The incidences of ventricular arrhythmia (0%, 8% and 13%; p<0.01), heart failure (0%, 5% and 19%; p<0.01) and surgical reinterventions (0%, 5% and 11%; p=0.01) increased from early to late follow-up. At last follow-up, RV function was depressed in 31 (46%) patients, and New York Heart Association functional class was ≥2 in 34 (48%) patients. Bradyarrhythmia, SVT and ventricular arrhythmia were associated with depressed RV function (OR: 4.47, 95% CI 1.50 to 13.28, p<0.01; OR: 3.74, 95% CI 1.26 to 11.14, p=0.02; OR: 14.40, 95% CI 2.80 to 74.07, p<0.01, respectively) and worse functional capacity (OR: 2.10, 95% CI 0.75 to 5.82, p=0.16; OR: 2.87, 95% CI 1.06 to 7.81, p=0.04; OR: 8.47, 95% CI 1.70 to 42.10, p<0.01, respectively).ConclusionsIn adult patients with TGA, survival was 82% at 39.7 (IQR: 35.9–42.4) years after atrial correction. Morbidity was high and included SVT as most frequent adverse event. Ventricular arrhythmias, heart failure and surgical reinterventions were common during late follow-up. Adverse events were associated with depressed right ventricle function and reduced functional class.
Challenges in outlier surgeon assessment in the era of public reporting
Authors: Mao Jialin , Resnic Frederic Scott , Girardi Leonard N , Gaudino Mario Fl , Sedrakyan Art 
Published: November 2018

ObjectiveTo assess the effect of various evaluation and reporting strategies in determining outlier surgeons, defined by having worse-than-expected mortality after cardiac surgery.MethodsOur study included 33 394 isolated coronary artery bypass graft (CABG) procedures performed by 136 surgeons and 12 172 surgical aortic valve replacement (SAVR) procedures performed by 113 surgeons between 2010 and 2014. Three current methodologies based on the framework of comparing observed and expected (O/E ratio) mortality, with different distributional assumptions, were examined. We further assessed the consistency of outliers detected by these three methods and the impact of using different time windows and aggregating data of CABG and SAVR procedures.ResultsThe three methods were consistent and detected same outliers, with the least conservative method detecting additional outliers (outliers detected for methods 1, 2 and 3: CABG 3 (2.2%), 2 (1.5%) and 8 (5.9%); SAVR 1 (0.9%), 0 (0.0%) and 11 (9.7%)). When numbers of cases recorded were low and events were rare, the two more conservative methods were unlikely to detect outliers unless the O/E ratios were extremely high. However, these two methods were more consistent in detecting the same surgeons as outliers across different time windows for assessment. Of the surgeons who performed both CABG and SAVR, none was an outlier for both procedures when assessed separately. Aggregating data from CABG and SAVR may lead to results to be dominated by the procedure that had a higher caseload.ConclusionsThe choices of outlier assessment method, time window for assessment and data aggregation have an intertwined impact on detecting outlier surgeons, often representing different value assumptions toward patient protection and provider penalty. It is desirable to use different methods as sensitivity analyses, avoid aggregating procedures and avoid rare-event endpoints if possible.
Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting
Authors: Beaton Andrea , Okello Emmy , Scheel Amy , DeWyer Alyssa , Ssembatya Renny , Baaka Olivia , Namisanvu Henrietor , Njeri Angela , Matovu Alphons , Namagembe Imelda , Mccarter Robert , Carapetis Jonathan , DeStigter Kristen , Sable Craig 
Published: November 2018

BackgroundThe burden of pre-existing cardiovascular disease and the contribution to adverse pregnancy outcomes are not robustly quantified, particularly in low-income countries. We aimed to determine both the prevalence of maternal heart disease through active case finding and its attributable risk to adverse pregnancy outcomes.MethodsWe conducted a 24-month prospective longitudinal investigation in three Ugandan health centres, using echocardiography for active case finding during antenatal care. Women with and without heart disease were followed to 6 weeks post partum to determine pregnancy outcomes. Prevalence of heart disease was calculated. Per cent attributable risk estimates were generated for maternal, fetal and neonatal mortality.ResultsScreening echocardiography was performed in 3506 women. The prevalence of heart disease was 17 per 1000 women (95% CI 13 to 21); 15 per 1000 was rheumatic heart disease. Only 3.4% of women (2/58) had prior diagnosis. Cardiovascular complications occurred in 51% of women with heart disease, most commonly heart failure. Per cent attributable risk of heart disease on maternal mortality was 88.6% in the exposed population and 10.8% in the overall population. Population attributable risk of heart disease on fetal death was 1.1% and 6.0% for neonatal mortalityConclusionsOccult maternal heart disease may be responsible for a substantial proportion of adverse pregnancy outcomes in low-resource settings. Rheumatic heart disease is, by far, the most common condition, urging global prioritisation of this neglected cardiovascular disease.
Nebulised recombinant activated factor VII (rFVIIa) does not attenuate the haemorrhagic effects of blast lung injury
Authors: Smith Jason E , Watts S , Spear A M , Wilson C , Kirkman E 
Published: November 2018

IntroductionPrimary blast lung injury causes intrapulmonary haemorrhage. A number of case reports have suggested the efficacy of recombinant activated factor VII (rFVIIa) in the treatment of diffuse alveolar haemorrhage from a range of medical causes, but its efficacy in blast lung is unknown. The aim of this study was to investigate whether nebulised rFVIIa attenuates the haemorrhagic effects of blast lung injury in an animal model.MethodsTerminally anaesthetised rabbits subjected to blast lung injury were randomised to receive either rFVIIa or placebo via a nebuliser. The primary outcome was the level of blood iron–transferrin complex, a marker of the extent of blast lung injury, analysed using low temperature electron paramagnetic resonance spectroscopy.ResultsBlast exposure led to a significant fall in iron-bound transferrin in both groups of animals (p<0.001), which remained depressed during the study. There were no significant differences in iron–transferrin between the rFVIIa and placebo treatment groups over the duration of the study (p=0.081), and there was no trend towards elevated iron–transferrin in the rFVIIa-treated group once drug treatment had started. There was suggestive evidence of systemic absorption of rFVIIa given via the inhaled route.ConclusionA single dose of nebulised rFVIIa did not attenuate pulmonary haemorrhage in a rabbit model of blast lung injury. As there was some evidence of systemic absorption, the inhaled route does not avoid the concern about potential thromboembolic complications from administration of rFVIIa.
Effect of low anisotropy and supernova constraints on cosmological models
Authors: Terohid S. A. A. , Hossienkhani H. , Yousefi H. 
Published: November 2018

The 194 supernova Ia data and the effect of anisotropy are combined to reconstruct the dark energy equation of state parameter [Formula: see text] and the deceleration parameter [Formula: see text]. Using the supernovae type Ia data, we evaluate the anisotropy effects (although low) on dark energy parametrization [Formula: see text] and we compare the results with [Formula: see text]CDM model. Present supernova observations are analyzed using a standard [Formula: see text] method and the minimal [Formula: see text] values obtained for each model are compared. We confirm the difficulty of discriminating between these models using present SNIa data only. By means of the maximum likelihood method, we find that the best-fit dynamical [Formula: see text] and [Formula: see text] parameters [Formula: see text] are obtained from the SNIa dataset. In particular, we find the best-fit values of [Formula: see text]CDM model ([Formula: see text] = 0.013, [Formula: see text] = 197.559) for [Formula: see text] = 0.3 and ([Formula: see text] = 0.02, [Formula: see text] = 196.983) for [Formula: see text] = 0.27. Finally, we found that the presence of anisotropy is confirmed in mentioned models via SNIa dataset.
The magnetic properties and domain structures of nanocrystalline Ce–Fe–B magnets with enhanced maximum energy products
Authors: Pan Minxiang , Xu Hui , Li Zhong , Tan Xiaohua , Hou Xueling , Gu Yong , Zhang Pengyue 
Published: November 2018

Optimizing of alloy composition and heat-treatment for rapidly solidified Ce–Fe–B magnets can lead nanocrystalline products with enhanced magnetic properties. In this work, the magnetic properties and domain structures of the nanocrystalline Ce[Formula: see text]Fe[Formula: see text]Co1Zr[Formula: see text]B6 have been investigated. The results show that hard Ce2Fe[Formula: see text]B magnetic phase and paramagnetic CeFe2 phase are crystallized for the heat treated alloys, while the volume fraction and grain size of Ce2Fe[Formula: see text]B and CeFe2 phases change significantly with the increase of annealing temperature. The enhanced coercivity H[Formula: see text] of 6.32 kOe and maximum energy products (BH)[Formula: see text] of 5.52 MGOe have been observed for the Ce[Formula: see text]Fe[Formula: see text]Co1Zr[Formula: see text]B6 ribbons at the optimal annealing temperature of 520[Formula: see text]C and 580[Formula: see text]C, respectively. Meanwhile, the magnetization reversal behaviors and the nucleation field of the annealed sample were discussed in detail. The domain structures analysis provides more information on the characteristic of the domain width W as well as the exchange interactions.
Tolerance of Chromosomal Instability in Cancer: Mechanisms and Therapeutic Opportunities
Authors: Gronroos Eva , López-García Carlos 
Published: November 2018

AbstractChromosomal instability (CIN) is the result of ongoing changes in the number (aneuploidy) and structure of chromosomes. CIN is induced by chromosome missegregation in mitosis and leads to karyotypic diversity within the cancer cell population, thereby adding to intratumor heterogeneity. Regardless of the overall pro-oncogenic function of CIN, its onset is typically detrimental for cell fitness and thus tumors must develop CIN-tolerance mechanisms in order to propagate. There is overwhelming genetic and functional evidence linking mutations in the tumor suppressor TP53 with CIN-tolerance. However, the pathways leading to p53 activation following chromosome missegregation remain controversial. Recently, additional mechanisms have been identified in CIN-surveillance, resulting in a more complex network of pathways acting independently or in cooperation with p53. Tolerance might also be achieved by modifying aspects of the cancer cell physiology in order to attenuate CIN or by adaptation to the consequences of aneuploid karyotypes. In this review, we summarize the current knowledge about p53-dependent and -independent mechanisms of CIN-tolerance in cancer, the adaptations observed in CIN cells buffering CIN levels, its consequences for cellular homeostasis, and the potential of exploiting these adaptations in order to design new cancer therapies.
Typification of Cyperus exaltatus (Cyperaceae) and notes on its identity
Authors: MALLICK TANMOY , NASKAR SAIKAT , GHOSH ASOK 
Published: November 2018

The name Cyperus exaltatus is here lectotypified. This species is highly variable as revealed from its potential type material and sometimes the species treated as synonymous with C. imbricatus and C. fastigiatus. This issue has been discussed. Keywords: C. imbricatus, C. fastigiatus, König, lectotype, Retzius
The genus Hylaeus Fabricius in Central Asia (Hymenoptera: Apoidea: Colletidae)
Authors: DATHE HOLGER H. , PROSHCHALYKIN MAXIM YU. 
Published: November 2018

All presently available information about bees of the genus Hylaeus F. in Central Asia is summarized. Seventy species are currently known from this area. Ten new species are described: Hylaeus gissariensis Dathe & Proshchalykin, sp. nov. (Tajikistan), H. karagandicus Dathe & Proshchalykin, sp. nov. (Kazakhstan), H. kirgisicus Dathe & Proshchalykin, sp. nov. (Kyrgyzstan), H. klausnitzeri Dathe & Proshchalykin, sp. nov. (Kyrgyzstan), H. michaelis Dathe & Proshchalykin, sp. nov. (Kyrgyzstan), H. murgabensis Dathe & Proshchalykin, sp. nov. (Tajikistan), H. pamirensis Dathe & Proshchalykin, sp. nov. (Tajikistan), H. petzi Dathe & Proshchalykin, sp. nov. (Tajikistan), H. piotris Dathe & Proshchalykin, sp. nov. (Uzbekistan, Kyrgyzstan, Turkmenistan, Tajikistan), and H. rushanicus Dathe & Proshchalykin, sp. nov. (Uzbekistan, Tajikistan). In addition, the male of H. punctiventris Morawitz, 1876 is described for the first time.—Twenty species are newly recorded from Central Asia: Hylaeus alexandrinus (Warncke, 1992), H. annulatus (Linnaeus, 1758), H. araxanus (Warncke, 1981), H. brevicornis Nylander, 1852, H. cardioscapus Cockerell, 1924, H. dorni Dathe, 1986, H. gredleri Förster, 1871, H. kozlovi Dathe & Proshchalykin, 2016, H. leleji Proshchalykin & Dathe, 2016, H. lineolatus (Schenck, 1861), H. longimaculus (Alfken, 1936), H. mellon Dathe & Proshchalykin, 2016, H. meridionalis Förster, 1871, H. moricei (Friese, 1898), H. nimbatus Dathe, 1986, H. paulus Bridwell, 1919, H. pesenkoi Proshchalykin & Dathe, 2016, H. rugicollis Morawitz, 1874, H. stubbei Dathe, 1986 and H. tsingtauensis (Strand, 1915).—New synonymy has been established for Hylaeus arenarius Morawitz, 1876 (= Prosopis cinerea Warncke, 1992, syn. nov.), Hylaeus ferghanicus Morawitz, 1876 (= H. kuhlmanni Dathe, 2010, syn. nov.) and Hylaeus punctiventris Morawitz, 1876 (= H. atrocallosus Morawitz, 1893, syn. nov.). Hylaeus (Nesoprosopis) alexandrinus (Warncke, 1992) and Hylaeus (Prosopis) stellatus (Warncke, 1992) are introduced as new combinations.—Keys to most species known from Central Asia are provided.