bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intelligent Monitoring? Assessing the ability of the Care Quality Commission's statistical surveillance tool to predict quality and prioritise NHS hospital inspections
Authors: Griffiths Alex , Beaussier Anne-Laure , Demeritt David , Rothstein Henry 
Published: January 2017

BackgroundThe Care Quality Commission (CQC) is responsible for ensuring the quality of the health and social care delivered by more than 30 000 registered providers in England. With only limited resources for conducting on-site inspections, the CQC has used statistical surveillance tools to help it identify which providers it should prioritise for inspection. In the face of planned funding cuts, the CQC plans to put more reliance on statistical surveillance tools to assess risks to quality and prioritise inspections accordingly.ObjectiveTo evaluate the ability of the CQC's latest surveillance tool,Intelligent Monitoring(IM), to predict the quality of care provided by National Health Service (NHS) hospital trusts so that those at greatest risk of providing poor-quality care can be identified and targeted for inspection.MethodsThe predictive ability of the IM tool is evaluated through regression analyses and χ2testing of the relationship between the quantitative risk score generated by the IM tool and the subsequent quality rating awarded following detailed on-site inspection by large expert teams of inspectors.ResultsFirst, the continuous risk scores generated by the CQC's IM statistical surveillance tool cannot predict inspection-based quality ratings of NHS hospital trusts (OR 0.38 (0.14 to 1.05) for Outstanding/Good, OR 0.94 (0.80 to −1.10) for Good/Requires improvement, and OR 0.90 (0.76 to 1.07) for Requires improvement/Inadequate). Second, the risk scores cannot be used more simply to distinguish the trusts performing poorly—those subsequently rated either ‘Requires improvement’ or ‘Inadequate’—from the trusts performing well—those subsequently rated either ‘Good’ or ‘Outstanding’ (OR 1.07 (0.91 to 1.26)). Classifying CQC's risk bandings 1-3 as high risk and 4-6 as low risk, 11 of the high risk trusts were performing well and 43 of the low risk trusts were performing poorly, resulting in an overall accuracy rate of 47.6%. Third, the risk scores cannot be used even more simply to distinguish the worst performing trusts—those subsequently rated ‘Inadequate’—from the remaining, better performing trusts (OR 1.11 (0.94 to 1.32)). Classifying CQC's risk banding 1 as high risk and 2-6 as low risk, the highest overall accuracy rate of 72.8% was achieved, but still only 6 of the 13 Inadequate trusts were correctly classified as being high risk.ConclusionsSince the IM statistical surveillance tool cannot predict the outcome of NHS hospital trust inspections, it cannot be used for prioritisation. A new approach to inspection planning is therefore required.
Evaluation of prediagnosis emergency department presentations in patients with active tuberculosis: the role of chest radiography, risk factors and symptoms
Authors: Appleton S C , Connell D W , Singanayagam A , Bradley P , Pan D , Sanderson F , Cleaver B , Rahman A , Kon O M 
Published: January 2017

IntroductionLondon has a high rate of tuberculosis (TB) with 2572 cases reported in 2014. Cases are more common in non-UK born, alcohol-dependent or homeless patients. The emergency department (ED) presents an opportunity for the diagnosis of TB in these patient groups. This is the first study describing the clinico-radiological characteristics of such attendances in two urban UK hospitals for pulmonary TB (PTB) and extrapulmonary TB (EPTB).MethodsWe conducted a retrospective cohort study using the London TB Register (LTBR) and hospital records to identify patients who presented to two London ED's in the 6 months prior to their ultimate TB diagnosis 2011–2012.Results397 TB cases were identified. 39% (154/397) had presented to the ED in the 6 months prior to diagnosis. In the study population, the presence of cough, weight loss, fever and night sweats only had prevalence rates of 40%, 34%, 34% and 21%, respectively. Chest radiography was performed in 76% (117/154) of patients. For cases where a new diagnosis of TB was suspected, 73% (41/56) had an abnormal radiograph, compared with 36% (35/98) of patients where it was not. There was an abnormality on a chest radiograph in 73% (55/75) of PTB cases and also in 40% (21/52) of EPTB cases where a film was requested.ConclusionsA large proportion of patients with TB present to ED. A diagnosis was more likely in the presence of an abnormal radiograph, suggesting opportunities for earlier diagnosis if risk factors, symptoms and chest radiograph findings are combined.
How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives?
Authors: Mayland Catriona Rachel , Mulholland Helen , Gambles Maureen , Ellershaw John , Stewart Kevin 
Published: January 2017

BackgroundThe National Care of the Dying Audit—Hospitals (NCDAH) is used as a method to evaluate care for dying patients in England. An additional component to the 2013/2014 audit was the Local Survey of Bereaved Relatives Views using the ‘Care Of the Dying Evaluation’ (CODE) questionnaire.AimWithin the context of the NCDAH audit, to evaluate quality of care provided to dying patients and their families in acute hospitals from the perspective of bereaved relatives.DesignPostbereavement survey to bereaved relatives.Setting/participantsFor acute hospitals wishing to participate, consecutive ‘expected’ adult deaths occurring between 1 May and 30 June 2013 were identified and the CODE questionnaire was sent to the next-of-kin.ResultsFrom 3414 eligible next-of-kin, 95 (2.8%) were excluded due to being involved in a complaint procedure and 1006 (29.5%) due to insufficient next-of-kin details. From the remaining 2313 potential participants, 858 returned a completed CODE questionnaire (37.1% response rate). Generally, symptoms were perceived to be well controlled with 769 (91%) participants reporting that either no pain was present or only there ‘some of the time’. Unmet information needs, however, was a recognised area for improvement, for example, 230 (29%) reporting having a discussion about hydration would have been beneficial.ConclusionsAdopting a postbereavement survey to NCDAH appears to be feasible, acceptable and a valuable addition. On the whole, the majority of participants reported good or excellent care. A small but significant minority, however, perceived poor quality of patient care with clear and timely communication urgently needed.
Long-term (8–10 years) outcomes after biodegradable polymer-coated biolimus-eluting stent implantation
Authors: Ohya Masanobu , Kubo Shunsuke , Kuwayama Akimune , Miura Katsuya , Shimada Takenobu , Amano Hidewo , Hyodo Yusuke , Otsuru Suguru , Habara Seiji , Tada Takeshi , Tanaka Hiroyuki , Fuku Yasushi , Katoh Harumi , Goto Tsuyoshi , Kadota Kazushige 
Published: January 2017

ObjectiveEfficacy and safety data on biodegradable polymer-coated biolimus-eluting stent (BP-BES) are currently limited to 5 years. We evaluated longer term (8–10 years) clinical and angiographic outcomes after BP-BES implantation.MethodsBetween 2005 and 2008, 243 patients (301 lesions) underwent BP-BES implantation. The primary clinical outcome measure was defined as any target lesion revascularisation (TLR). Absolute serial angiographic studies without any concomitant TLR within 2 years after the procedure were performed in 55 patients (65 lesions) at postprocedure, mid-term (within 1 year), late term (between 1 and 2 years) and very late term (beyond 2 years).ResultsThe median follow-up duration was 9.4 years (IQR 8.2–10.2 years). The 8-year cumulative incidence of any TLR was 20.3%. The increase rate was approximately 7% per year in the first 2 years, but decelerated to approximately 1.2% per year beyond 2 years after the procedure. The minimal lumen diameter significantly decreased from postprocedure (2.63±0.44 mm) to mid-term (2.43±0.59 mm, p=0.002) and from late term (2.27±0.63 mm) to very late term (1.98±0.73 mm, p=0.002). The 8-year cumulative incidences of definite or probable stent thrombosis (ST) and major bleeding (Bleeding Academic Research Consortium (BARC) ≥3) were 0.5% and 12.0%, respectively. Definite ST was none within 10 years in the entire cohort.ConclusionsThe long-term clinical outcomes after BP-BES implantation were favourable, although angiographic late progression of luminal narrowing did not reach a plateau. The incidence of ST remained notably low, whereas that of major bleeding gradually increased.
Mortalin promotes cell proliferation and epithelial mesenchymal transition of intrahepatic cholangiocarcinoma cells in vitro
Authors: Kang Qiang , Cai Jia-Bin , Dong Rui-Zhao , Liu Li-Xin , Zhang Chi , Zhang Peng-Fei , Zou Hao , Xie Nan , Zhang Lu , Zhang Xin-Yu , Song Zheng-Ji , Dong Zhao-Ru , Hu Mei-Yu , Huang Xiao-Yong , Zhang Xiao-Wen , Ke Ai-Wu , Shi Guo-Ming 
Published: January 2017

AimsThe prognosis of patients with intrahepatic cholangiocarcinoma (ICC) remains poor in terms of overall survival (OS) and recurrence rate. Mortalin, a stress chaperone, has been reported to be involved in carcinogenesis and metastasis. However, its role in ICC has not been defined.MethodsMortalin expression in tumour samples from patients with ICC was examined by Western blot and immunohistochemistry, and correlation between its expression and clinicopathological features was assessed. In addition, invasion, migration proliferation and apoptosis, and the expression of epithelial-mesenchymal transition (EMT)-related markers in ICC cells were assessed after mortalin depletion. Finally, the prognostic significance of mortalin in patients with ICC was further evaluated by Kaplan–Meier and Cox regression analysis.ResultsWe provide evidence that expression of mortalin in human ICC tissues is higher than that in matched peritumoural tissues. The interference of mortalin expression inhibited the proliferation and invasion of ICC cells in vitro. Mechanistically, inhibition of mortalin expression in ICC cells upregulated E-cadherin expression and decreased vimentin and snail expression. Clinically, a high level of mortalin in ICC samples was associated with loss of E-cadherin, and increased expression of vimentin and snail. Patients with ICC and high mortalin expression had a shorter OS and a higher recurrence rate. Multivariate analysis revealed that mortalin overexpression was an independent prognostic indicator for patients with ICC.ConclusionsMortalin may promote cell proliferation and invasion via induction of EMT of ICC cells. A high level of mortalin may be used as a prognostic biomarker and therapeutic target for patients with ICC.
Demographic, procedural and 30-day safety results from the WEB Intra-saccular Therapy Study (WEB-IT)
Authors: Fiorella David , Molyneux Andrew , Coon Alexander , Szikora Istvan , Saatci Isil , Baltacioglu Feyyaz , Sultan Ali , Arthur Adam 
Published: January 2017

IntroductionThe Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study.MethodsWEB-IT is a prospective multicenter single-arm interventional study conducted at 25 US and 6 international centers. The study enrolled 150 adults with WNBAs of the anterior and posterior intracranial circulations. All patients were intended to receive a WEB device delivered via standard endovascular neurosurgical embolization techniques. The study was conducted under Good Clinical Practices and included independent adjudication effectiveness outcomes and all adverse events.ResultsOne hundred and fifty patients enrolled at 27 investigational sites underwent attempted treatment with the WEB. Mean age was 59 years (range 29–79) and 110 (73.3%) of the patients were female. Treated aneurysms were located at the basilar apex (n=59, 39.3%), middle cerebral artery bifurcation (n=45, 30%), anterior communicating artery (n=40, 26.7%), and internal carotid artery terminus (n=6, 4%). Average aneurysm size was 6.4 mm (range 3.6–11.4) with a mean neck size of 4.8 mm (range 2.0–8.2, mean dome to neck ratio 1.34). Nine patients presented with ruptured aneurysms. Of the enrolled patients, 98.7% were treated successfully with WEB devices. Mean±SD fluoroscopy time was 30.2±15.7 min. One primary safety event (PSE) (0.7%)—a delayed parenchymal hemorrhage 22 days after treatment—occurred between the index procedure and 30-day follow-up. In addition to the single PSE, there were seven (4.7%) minor ischemic strokes (5 resolved without sequelae and 2 had a modified Rankin Scale score of 1 at 30 days), five (2.7%) transient ischemic attacks, and two (1.3%) minor subarachnoid hemorrhages, which did not meet the prospectively established criteria for PSEs.ConclusionsThe WEB device can be used to treat WNBAs with a high level of procedural safety and a high degree of technical success.Trial registration numberNCT02191618; Pre-results.
Can We Make a Cake and Eat it Too? A Discussion of ICN Security and Privacy
Authors: Ngai Edith , Ohlman Börje , Tsudik Gene , Uzun Ersin , Wählisch Matthias , Wood Christopher A. 
Published: January 2017

In recent years, Information-centric Networking (ICN) has received much attention from both academic and industry participants. ICN offers data-centric inter-networking that is radically different from today's host-based IP networks. Security and privacy features on today's Internet were originally not present and have been incrementally retrofitted over the last 35 years. As such, these issues have become increasingly important as ICN technology gradually matures towards real-world deployment. Thus, while ICN-based architectures (e.g., NDN, CCNx, etc.) are still evolving, it is both timely and important to explore ICN security and privacy issues as well as devise and assess possible mitigation techniques.
This report documents the highlights and outcomes of the Dagstuhl Seminar 16251 on ``Information-centric Networking and Security.'' The goal of which was to bring together researchers to discuss and address security and privacy issues particular to ICN-based architectures. Upon finishing the three-day workshop, the outlook of ICN is still unclear. Many unsolved and ill-addressed problems remain, such as namespace and identity management, object security and forward secrecy, and privacy. Regardless of the fate of ICN, one thing is certain: much more research and practical experience with these systems is needed to make progress towards solving these arduous problems.
Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030
Authors: Bryant Alex K. , Banegas Matthew P. , Martinez Maria Elena , Mell Loren K. , Murphy James D. 
Published: January 2017

Abstract
Background: Although the number of cancer survivors has increased substantially over the past several decades, the composition of survivors treated with radiotherapy is not well defined. Radiotherapy carries unique long-term toxicity risks for cancer survivors. This study describes the current estimates and future projections of the epidemiology of 5-year cancer survivors who receive radiation therapy.
Methods: We used cancer incidence and survival data from the Surveillance, Epidemiology, and End-Results (SEER) database linked to U.S. Census data to estimate the number of 5-year cancer survivors treated with radiation between 2000 and 2030. Future projections assumed continuing incidence and survival trends based on historical rates.
Results: In 2016, there were an estimated 3.05 million cancer survivors treated with radiation, accounting for 29% of all cancer survivors. The number of radiation-treated cancer survivors is projected to reach 3.38 million by 2020 and 4.17 million by 2030. In 2016, breast (40%) and prostate cancer (23%) composed the majority of radiation-treated survivors, followed by head and neck cancer (5.8%), lymphoma (5.6%), uterine (3.9%), and rectal cancer (3.8%). The percentage of 70 years or older radiation-treated survivors steadily increased between 2000 and 2030.
Conclusions: The next several years are projected to see a large increase in the number of cancer survivors treated with radiation.
Impact: This group of cancer survivors has unique needs given the long-term risks of radiation, and increased research and awareness are required to optimize health of this growing population. Cancer Epidemiol Biomarkers Prev; 26(6); 963–70. ©2017 AACR.
Use of Mixed Methods Research in Research on Coronary Artery Disease, Diabetes Mellitus, and Hypertension
Authors: Campbell David J.T. , Tam-Tham Helen , Dhaliwal Kirnvir K. , Manns Braden J. , Hemmelgarn Brenda R. , Sanmartin Claudia , King-Shier Kathryn 
Published: January 2017

Background—
Mixed methods research, the use of both qualitative and quantitative methods within 1 program of study, is becoming increasingly popular to allow investigators to explore patient experiences (qualitative) and also measure outcomes (quantitative). Coronary artery disease and its risk factors are some of the most studied conditions; however, the extent to which mixed methods studies are being conducted in these content areas is unknown. We sought to comprehensively describe the characteristics of published mixed methods studies on coronary artery disease and major risk factors (diabetes mellitus and hypertension).

Methods and Results—
We conducted a scoping review of the literature indexed in PubMed, Medline, EMBASE, and CINAHL. We identified 811 abstracts for screening, of which 254 articles underwent full-text review and 97 reports of 81 studies met criteria for inclusion. The majority of studies in this area were conducted in the past 10 years by nurse researchers from the United States and United Kingdom. Diabetes mellitus was the most common content area for mixed methods investigation (compared with coronary artery disease and hypertension). Most authors described their rationale for using mixed methods as complementarity and did not describe study priority or how they reconciled differences in methodological paradigms. Some mixed methods study designs were more commonly used than others, including concurrent timing and integration at the interpretation stage. Qualitative strands were most commonly descriptive studies using interviews for data collection. Quantitative strands were most commonly cross-sectional observational studies, which relied heavily on self-report data such as surveys and scales.

Conclusions—
Although mixed methods research is becoming increasingly popular in the area of coronary artery disease and its risk factors, many of the more advanced mixed methods, qualitative, and quantitative techniques have not been commonly used in these areas.
Avoiding Untimely Implantable Cardioverter/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter/Defibrillator—The PROLONG Study
Authors: Duncker David , König Thorben , Hohmann Stephan , Bauersachs Johann , Veltmann Christian 
Published: January 2017

Background

Optimal timing of implantation of an implantable cardioverter/defibrillator (
ICD
) after newly diagnosed heart failure is unclear given that late reverse remodelling may occur. We aimed to analyze left ventricular ejection fraction (
LVEF
) after diagnosis of an
LVEF
≤35% during optimization of heart failure drug therapy.

Methods and Results

One hundred fifty‐six patients with newly diagnosed
LVEF
≤35% receiving a wearable cardioverter/defibrillator (
WCD
) were analyzed.
WCD
was prescribed for 3 months until first re‐evaluation. Indications for prolongation of
WCD
wearing period instead of
ICD
implantation were: (1)
LVEF
at 3‐month visit 30% to 35%; (2) increase in
LVEF
of ≥5% compared to the last visit; and (3) nonoptimized heart failure medication. Mean
LVEF
was 24±7% at diagnosis and 39±11% at last follow‐up (mean, 12±10 months). Whereas 88 patients presented a primary preventive
ICD
indication (
LVEF
≤35%) at 3‐month follow‐up, only 58 showed a persistent primary preventive
ICD
indication at last follow‐up. This delayed improvement in
LVEF
was related to nonischemic origin of cardiomyopathy, New York Heart Association functional class at baseline, heart rate, better
LVEF
after 3 months, and higher dosages of mineralocorticoid receptor antagonist. Twelve appropriate
WCD
shocks for ventricular tachycardia/ventricular fibrillation occurred in 11 patients. Two patients suffered from ventricular tachycardia/ventricular fibrillation beyond 3 months after diagnosis.

Conclusions

A relevant proportion of patients with newly diagnosed heart failure shows recovery of
LVEF
>35% beyond 3 months after initiation of heart failure therapy. To avoid untimely
ICD
implantation, prolongation of
WCD
period should be considered in these patients to prevent sudden cardiac death while allowing left ventricular reverse remodeling during intensified drug therapy.
Revision of Recent and fossil Mixtacandona Klie 1938 (Ostracoda, Candonidae) from Italy, with description of a new species
Authors: MAZZINI ILARIA , MARRONE FEDERICO , ARCULEO MARCO , ROSSETTI GIAMPAOLO 
Published: January 2017

Although studies on ostracods dwelling in inland subterranean habitats of Italy have increased in the last decades, highlighting a considerable taxonomic diversity, available information is still far from sufficient to understand phylogenetic and biogeographic relationships. Mixtacandona Klie 1938 is one of the most common and diverse genera of ostracods in subterranean waters. Of the 20 living recognized species in the genus, all stygobiontic and restricted to the Palearctic Region, four are known for the Italian peninsula and Sardinia, one of which exclusively as fossil. Several other Recent and fossil taxa attributable to Mixtacandona, but identified at supraspecific level, have been reported from various Italian regions. Here we report Mixtacandona idrisi n. sp., collected in a cave near Palermo, the first cavernicolous ostracod from the island of Sicily; in addition, the description of material recently collected in northern Italy, consisting of M. laisi and of a putative new species that has been tentatively allocated to the same genus, is given. Mixtacandona (Trapezicandona) italica Karanovic & Pesce, 2000 is tentatively treated as a junior synonym of M. talianae Gliozzi & Mazzini, 1998. The validity of species-groups within Mixtacandona is discussed. Relying on the results of this study, the authors argue for the need of a comprehensive revision of the genus.