bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children—protocol of a register-based retrospective observational study
Authors: Feldman Inna , Eurenius Eva , Häggström Jenny , Sampaio Filipa , Lindkvist Marie , Pulkki-Brännström Anni-Maria , Ivarsson Anneli 
Published: August 2016

IntroductionThere is inadequate evidence for the effectiveness and cost-effectiveness of health promotion interventions. The Salut Programme aims to reach all parents and children in the Västerbotten County of Sweden with a combination of health promotion interventions initiated during pregnancy and continued over the childhood period. This study protocol describes an effectiveness study and an economic evaluation study, where the ongoing Salut Programme is compared to care-as-usual over the periods of pregnancy, delivery and the child's first 2 years of life.MethodsA register-based retrospective observational study design will be used with existing data sources with respect to exposures and outcomes. Outcomes of interest are clustered at 3 points: around the child's birth, 1 month after the child's birth and 2 years after the child's birth. We will simulate an experiment by retrospectively identifying and comparing children and their parents in the geographical areas where the Salut Programme was implemented since 2006 and onwards, and the areas where the Programme was not implemented before 2009. Outcomes will be analysed and compared for the premeasure period, and the postmeasure period for both groups. Our analysis combines difference-in-difference estimation with matching. A complementary analysis will be carried out on the longitudinal subsample of mothers who gave birth at least once during each of the time periods. The economic evaluation aims to capture the wider societal costs and benefits of the Salut Programme for the first 2 years of the children's lives. Incremental costs will be compared with incremental health gains and the results will be presented as a cost-consequence analysis.Ethics and disseminationThe Regional Ethical Review Board in Umeå has given clearance for the Salut Programme research (2010-63-31M). No individual's identity will be revealed when presenting results. This study will provide information that can guide decision-makers to allocate resources optimally.
Study design for a randomised controlled trial to explore the modality and mechanism of Tai Chi in the pulmonary rehabilitation of chronic obstructive pulmonary disease
Authors: Fu Juan-Juan , Min Jie , Yu Peng-Ming , McDonald Vanessa M , Mao Bing 
Published: August 2016

IntroductionAlthough pulmonary rehabilitation (PR) is associated with significant clinical benefits in chronic obstructive pulmonary disease (COPD) and has been recommended by guidelines, PR with conventional exercise training has not been widely applied in the clinic because of its inherent limitations. Alternative exercise such as Tai Chi has been investigated and the results are promising. However, the strengths and weaknesses of the exercise modality of Tai Chi, conventional PR and a combination of Tai Chi and conventional PR and the possible mechanisms underlying Tai Chi exercise remain unclear. This study aims to address the above research gaps in a well-designed clinical trial.Methods and analysisThis study is a single-blind, randomised controlled trial. Participants with stable COPD will be recruited and randomly assigned to one of four groups receiving Tai Chi exercise, conventional PR using a total body recumbent stepper (TBRS), combined Tai Chi and TBRS, or usual care (control) in a 1:1:1:1 ratio. Participants will perform 30 min of supervised exercise three times a week for 8 weeks; they will receive sequential follow-ups until 12 months after recruitment. The primary outcome will be health-related quality of life as measured by the St George's Respiratory Questionnaire. Secondary outcomes will include 6 min walking distance, pulmonary function, the modified Medical Research Council Dyspnoea Scale, the COPD Assessment Test, the Hospital Anxiety and Depression Scale, the Berg Balance Scale, exacerbation frequency during the study period, and systemic inflammatory and immune markers.Ethics and disseminationEthics approval has been granted by the Clinical Trial and Biomedical Ethics Committee of West China Hospital of Sichuan University (No TCM-2015-82). Written informed consent will be obtained from each participant before any procedures are performed. The study findings will be published in peer-reviewed journals and presented at national and international conferences.Trial registration numberChiCTR-IOR-15006874; Pre-results.
Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK
Authors: Oakland Kathryn , Guy Richard , Uberoi Raman , Seeney Frances , Collins Gary , Grant-Casey John , Mortensen Neil , Murphy Mike , Jairath Vipul 
Published: August 2016

IntroductionAcute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes.Methods and analysisThe UK Lower Gastrointestinal Bleeding Audit is a large nationwide audit of adult patients acutely admitted with LGIB or those who develop LGIB while hospitalised for another reason. Consecutive, unselected presentations with LGIB will be enrolled prospectively over a 2-month period at the end of 2015 and detailed data will be collected on patient characteristics, comorbidities, use of anticoagulants, transfusion, timing and modalities of diagnostic and therapeutic procedures, clinical outcome, length of stay and mortality. These will be audited against predefined minimum standards of care for LGIB. It is anticipated that over 80% of all acute hospitals in England and some hospitals in Scotland, Wales and Northern Ireland will participate. Data will be collected on the availability and organisation of care, provision of diagnostic and therapeutic GI endoscopy, interventional radiology, surgery and transfusion protocols.Ethics and disseminationThis audit will be conducted as part of the national comparative audit programme of blood transfusion through collaboration with specialists in gastroenterology, surgery and interventional radiology. Individual reports will be provided to each participant site as well as an overall report and disseminated through specialist societies. Results will also be published in peer-reviewed journals. The study has been funded by National Health Services (NHS) Blood and Transplant and the Bowel Disease Research Foundation and endorsed by the Association of Coloproctology of Great Britain and Ireland.
The Intratumoral Balance between Metabolic and Immunologic Gene Expression Is Associated with Anti–PD-1 Response in Patients with Renal Cell Carcinoma
Authors: Ascierto Maria Libera , McMiller Tracee L. , Berger Alan E. , Danilova Ludmila , Anders Robert A. , Netto George J. , Xu Haiying , Pritchard Theresa S. , Fan Jinshui , Cheadle Chris , Cope Leslie , Drake Charles G. , Pardoll Drew M. , Taube Janis M. , Topalian Suzanne L. 
Published: August 2016

AbstractPretreatment tumor PD-L1 expression has been shown to correlate with response to anti–PD-1/PD-L1 therapies. Yet, most patients with PD-L1+ tumors do not respond to treatment. The current study was undertaken to investigate mechanisms underlying the failure of PD-1–targeted therapies in patients with advanced renal cell carcinoma (RCC) whose tumors express PD-L1. Formalin-fixed, paraffin-embedded pretreatment tumor biopsies expressing PD-L1 were derived from 13 RCC patients. RNA was isolated from PD-L1+ regions and subjected to whole genome microarray and multiplex quantitative (q)RT-PCR gene expression analysis. A balance between gene expression profiles reflecting metabolic pathways and immune functions was associated with clinical outcomes following anti–PD-1 therapy. In particular, the expression of genes involved in metabolic and solute transport functions such as UGT1A family members, also found in kidney cancer cell lines, was associated with treatment failure in patients with PD-L1+ RCC. Conversely, tumors from responding patients overexpressed immune markers such as BACH2, a regulator of CD4+ T-cell differentiation, and CCL3 involved in leukocyte migration. These findings suggest that tumor cell–intrinsic metabolic factors may contribute to treatment resistance in RCC, thus serving as predictive markers for treatment outcomes and potential new targets for combination therapy regimens with anti–PD-1. Cancer Immunol Res; 4(9); 726–33. ©2016 AACR.See related Spotlight by Ohashi, p. 719.
Aortic Stiffness and the Risk of Incident Mild Cognitive Impairment and Dementia
Authors: Pase Matthew P. , Beiser Alexa , Himali Jayandra J. , Tsao Connie , Satizabal Claudia L. , Vasan Ramachandran S. , Seshadri Sudha , Mitchell Gary F. 
Published: August 2016

Background and Purpose—
Aortic stiffening increases the transfers of high pressure and flow pulsatility to small cerebral vessels potentially causing the accumulation of vascular brain injury. Our aim was to investigate the prospective association of aortic stiffness with the risks of incident mild cognitive impairment and dementia.

Methods—
We studied 1101 dementia-free Framingham Offspring study participants (mean age, 69±6 years; 54% women). Aortic stiffness was measured as carotid–femoral pulse wave velocity using applanation tonometry and modeled as a linear variable and the top 2 quintiles (>11.4 m/s). Outcomes were the 10-year risk of incident mild cognitive impairment and dementia, including clinically characterized Alzheimer disease. We observed 106, 77, and 59 events of mild cognitive impairment, all-cause dementia, and clinical Alzheimer disease, respectively.

Results—
After adjustment for age and sex, higher continuous aortic stiffness predicted an increased risk of mild cognitive impairment (hazard ratio, 1.40 [95% confidence interval, 1.13–1.73]), all-cause dementia (hazard ratio, 1.45 [95% confidence interval, 1.13–1.87]), and Alzheimer disease (hazard ratio, 1.41 [95% confidence interval, 1.06–1.87]). In risk factor–adjusted statistical models, aortic stiffness remained a significant predictor of mild cognitive impairment but not incident dementia. In nondiabetic patients, the top 2 quintiles of aortic stiffness were associated with a higher risk of incident all-cause dementia across all statistical models.

Conclusions—
Aortic stiffness was an independent predictor of incident mild cognitive impairment in the whole sample and with incident dementia in nondiabetic patients. Our findings suggest aortic stiffness as a potentially modifiable risk factor for clinical cognitive impairment and dementia.
Early Land Plants Today: Index of Liverworts &amp; Hornworts 2013–2014
Authors: SÖDERSTRÖM LARS , HAGBORG ANDERS , VON KONRAT MATT 
Published: August 2016

A widely accessible list of known plant species is a fundamental requirement for plant conservation and has vast applications. An index of published names of liverworts and hornworts between 2013 and 2014 is provided as part of a continued effort in working toward producing a world checklist of this group. The list includes 50 higher taxa, 361 species, 82 infraspecific taxa, and 50 infraspecific autonyms for 2013 and 2014. Three of them are fossils. Five older names not included in the earlier indices are included. Three illegitimate and 13 invalid names are also included. New to science are 105 species and 22 infraspecific taxa.
Toward a User-Centered Design of a Weather Forecasting Decision-Support Tool
Authors: Argyle Elizabeth M. , Gourley Jonathan J. , Flamig Zachary L. , Hansen Tracy , Manross Kevin 
Published: August 2016

ABSTRACT
Hazard Services is a software toolkit that integrates information management, hazard alerting, and communication functions into a single user interface. When complete, National Weather Service forecasters across the United States will use Hazard Services for operational issuance of weather and hydrologic alerts, making the system an instrumental part of the threat management process. As a new decision-support tool, incorporating an understanding of user requirements and behavior is an important part of building a system that is usable, allowing users to perform work-related tasks efficiently and effectively. This paper discusses the Hazard Services system and findings from a usability evaluation with a sample of end users. Usability evaluations are frequently used to support software and website development and can provide feedback on a system’s efficiency of use, effectiveness, and learnability. In the present study, a user-testing evaluation assessed task performance in terms of error rates, error types, response time, and subjective feedback from a questionnaire. A series of design recommendations was developed based on the evaluation’s findings. The recommendations not only further the design of Hazard Services, but they may also inform the designs of other decision-support tools used in weather and hydrologic forecasting.
Incorporating usability evaluation into the iterative design of decision-support tools, such as Hazard Services, can improve system efficiency, effectiveness, and user experience.
Flash Flood–Producing Storm Properties in a Small Urban Watershed
Authors: Smith Brianne K. , Smith James , Baeck Mary Lynn 
Published: August 2016

Abstract
The structure and evolution of flash flood–producing storms over a small urban watershed in the mid-Atlantic United States with a prototypical flash flood response is examined. Lagrangian storm properties are investigated through analyses of the 32 storms that produced the largest peak discharges in Moores Run between January 2000 and May 2014. The Thunderstorm Identification, Tracking, Analysis, and Nowcasting (TITAN) algorithm is used to track storm characteristics over their life cycle with a focus on storm size, movement, intensity, and location. First, the 13 June 2003 and 1 June 2006 storms, which produced the two largest peak discharges for the study period, are analyzed. Heavy rainfall for the 13 June 2003 and 1 June 2006 storms were caused by a collapsing thunderstorm cell and a slow-moving, low-echo centroid storm. Analyses of the 32 storms show that collapsing storm cells play an important role in peak rainfall rate production and flash flooding. Storm motion is predominantly southwest-to-northeast, and approximately half of the storms exhibited some linear organization. Mean storm total rainfall for the 32 storms displayed an asymmetric distribution around Moores Run, with sharply decreasing gradients southwest of the watershed (upwind and into the city) and increased rainfall to the northeast (downwind and away from the city). Results indicate urban modification of rainfall in flash flood–producing storms. There was no evidence that the storms split around Baltimore. Flood-producing rainfall was highly concentrated in time; on average, approximately 21% of the storm total rainfall fell within 15 min.
Short-term effects of goal-setting focusing on the life goal concept on subjective well-being and treatment engagement in subacute inpatients: a quasi-randomized controlled trial
Authors: Ogawa Tatsuya , Omon Kyohei , Yuda Tomohisa , Ishigaki Tomoya , Imai Ryota , Ohmatsu Satoko , Morioka Shu 
Published: August 2016

Objective: To investigate the short-term effects of the life goal concept on subjective well-being and treatment engagement, and to determine the sample size required for a larger trial. Design: A quasi-randomized controlled trial that was not blinded. Setting: A subacute rehabilitation ward. Subjects: A total of 66 patients were randomized to a goal-setting intervention group with the life goal concept (Life Goal), a standard rehabilitation group with no goal-setting intervention (Control 1), or a goal-setting intervention group without the life goal concept (Control 2). Interventions: The goal-setting intervention in the Life Goal and Control 2 was Goal Attainment Scaling. The Life Goal patients were assessed in terms of their life goals, and the hierarchy of goals was explained. The intervention duration was four weeks. Main measures: Patients were assessed pre- and post-intervention. The outcome measures were the Hospital Anxiety and Depression Scale, 12-item General Health Questionnaire, Pittsburgh Rehabilitation Participation Scale, and Functional Independence Measure. Results: Of the 296 potential participants, 66 were enrolled; Life Goal ( n = 22), Control 1 ( n = 22) and Control 2 ( n = 22). Anxiety was significantly lower in the Life Goal (4.1 ±3.0) than in Control 1 (6.7 ±3.4), but treatment engagement was significantly higher in the Life Goal (5.3 ±0.4) compared with both the Control 1 (4.8 ±0.6) and Control 2 (4.9 ±0.5). Conclusions: The life goal concept had a short-term effect on treatment engagement. A sample of 31 patients per group would be required for a fully powered clinical trial.
What is the evidence for conducting palliative care family meetings? A systematic review
Authors: Cahill Philippa J , Lobb Elizabeth A , Sanderson Christine , Phillips Jane L 
Published: August 2016

Background: Structured family meeting procedures and guidelines suggest that these forums enhance family–patient–team communication in the palliative care inpatient setting. However, the vulnerability of palliative patients and the resources required to implement family meetings in accordance with recommended guidelines make better understanding about the effectiveness of this type of intervention an important priority. Aim and design: This systematic review examines the evidence supporting family meetings as a strategy to address the needs of palliative patients and their families. The review conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Data sources: Six medical and psychosocial databases and “CareSearch,” a palliative care–specific database, were used to identify studies reporting empirical data, published in English in peer-reviewed journals from 1980 to March 2015. Book chapters, expert opinion, and gray literature were excluded. The Cochrane Collaboration Tool assessed risk of bias. Results: Of the 5051 articles identified, 13 met the inclusion criteria: 10 quantitative and 3 qualitative studies. There was low-level evidence to support family meetings. Only two quantitative pre- and post-studies used a validated palliative care family outcome measure with both studies reporting significant results post-family meetings. Four other quantitative studies reported significant results using non-validated measures. Conclusion: Despite the existence of consensus-based family meeting guidelines, there is a paucity of evidence to support family meetings in the inpatient palliative care setting. Further research using more robust designs, validated outcome measures, and an economic analysis are required to build the family meeting evidence before they are routinely adopted into clinical practice.
A survey exploring the knowledge and perceptions of senior medical students in Nepal toward generic medicines
Authors: Gyawali Sudesh , Hassali Mohamed Azmi , Saha Archana 
Published: August 2016

Background: The accurate knowledge of generic medicine issues among future prescribers will enhance the prescribing of cost-effective medicines. This study aimed to explore the knowledge and perception of senior medical students about the generic medicines. Methodology: A cross-sectional study was conducted among 237 senior medical students (final year students and interns) using a validated self-administered questionnaire. The collected data were analyzed using Statistical Package for the Social Sciences version 20 for windows and comparison of difference was done using linear by linear association. A p value of less than 0.05 was taken as statistically significant. Results: The average age (standard deviation) of the respondents was 23.54 (1.39) years. Almost 5% of respondents correctly answered the question regarding the regulatory limits for bioequivalence. Almost two-thirds of respondents correctly agreed that generic medicine is bioequivalent to a brand-name medicine, and 79.3% and 72.5% of respondents correctly agreed that the medicine should be present in the same dosage form and same dose, respectively, as the brand-name medicines. However, almost half of the respondents had impression that brand-name medicines are required to meet higher safety standard than generic medicines. Almost 90% of respondents felt that advertisement by the drug companies would influence the use of brand-name medicine and they need more information about generic medicine. Conclusion: This study highlights the negative perception and knowledge deficit among the respondents. The students’ responses to almost all the statements were almost similar to the respondents’ academic year (final year students and interns), gender and nationality.
Transarterial embolization for management of severe postcoital bleeding
Authors: Eskandari Armen , Mukherjee Ashis , McHugh John 
Published: August 2016

Objectives: Postcoital bleeding is an uncommon cause of gynecologic hemorrhage; however, it can be severe in a majority of cases necessitating surgical management. Methods: We report a case of severe postcoital bleeding in a young woman requiring blood transfusion. Results: Hemostasis was achieved using subselective embolization of cervical artery by metallic coils. Conclusion: Our case demonstrates a minimally invasive treatment for control of non-obstetric hemorrhage.
Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study
Authors: Nadif Rachel , Siroux Valérie , Boudier Anne , le Moual Nicole , Just Jocelyne , Gormand Frederic , Pison Christophe , Matran Regis , Pin Isabelle 
Published: August 2016

To what extent blood granulocyte patterns may predict asthma control remains under-studied. Our aim was to study associations between blood neutrophilia and eosinophilia and asthma control outcomes in adults.Analyses were conducted in 474 asthmatics from the first follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2), including 242 asthmatics who were adults a decade earlier (EGEA1). At EGEA2, asthma control was assessed using the Global Initiative for Asthma definition (2015), and asthma exacerbations by use of urgent care or courses of oral corticosteroids in the past year. Blood EOSlo/EOShiwas defined as </≥250 eosinophils·mm−3, respectively, and NEUlo/NEUhias </≥5000 neutrophils·mm−3, respectively. Estimates were adjusted for age, sex and smoking.At EGEA2, NEUhiwas associated with asthma exacerbations and poor asthma control (OR >2.10). EOShiwas associated with higher bronchial hyperresponsiveness (BHR) (OR (95% CI) 2.21 (1.24–3.97)), poor lung function (p=0.02) and higher total IgE level (p=0.002). Almost 50% of asthmatics had a persistent pattern between surveys. Persistent NEUhiwas associated with poor asthma control at EGEA2 (OR (95% CI) 3.09 (1.18–7.05)). EOShiat EGEA1 and persistent EOShiwere associated with higher BHR (OR (95% CI) 2.36 (1.10–5.07) and 3.85 (1.11–13.34), respectively), poor lung function (p<0.06) and higher immunoglobulin E level (p<10−4) at EGEA2.Granulocyte patterns were differently associated with asthma outcomes, suggesting specific roles for each one, which could be tested as predictive signatures.