bluuebunny/crossref_metadata_2025_split huggingface dataset:
Communication and patient participation influencing patient recall of treatment discussions
Authors: Richard Claude , Glaser Emma , Lussier Marie‐Thérèse 
Published: November 2016

AbstractContextPatient recall of treatment information is a key variable towards chronic disease (CD) management. It is unclear what communication and patient participation characteristics predict recall.ObjectivesTo assess what aspects of doctor‐patient communication predict patient recall of medication information. To describe lifestyle treatment recall, in CD primary care patients.DesignObservational study within a RCT.Setting & participantsCommunity‐based primary care (PC) practices. Family physicians (n=18): practicing >5 years, with a CD patient caseload. Patients (n=159): >40 years old, English speaking, computer literate, off‐target hypertension, type II diabetes and/or dyslipidaemia.Main variablesPatient characteristics: age, education, number of CDs. Information characteristics: length of encounter, medication status, medication class. Communication variables: socio‐emotional utterances, physician dominance and communication control scores and PACE (ask, check and express) utterances, measured by RIAS. Number of medication themes, dialogue and initiative measured by MEDICODE.Main outcome measuresRecall of CD, lifestyle treatment and medication information.ResultsFrequency of lifestyle discussions varied by topic. Patients recalled 43% (alcohol), 52% (diet) to 70% (exercise) of discussions. Two and a half of six possible medication themes were broached per medication discussion. Less than one was recalled. Discussing more themes, greater dialogue and patient initiative were significant predictors of improved medication information recall.DiscussionCritical treatment information is infrequently exchanged. Active patient engagement and explicit conversations about medications are associated with improved treatment information recall in off‐target CD patients followed in PC.ConclusionProviders cannot take for granted that long‐term off‐target CD patients recall information. They need to encourage patient participation to improve recall of treatment information.
Encapsulation of probiotic Lactobacillus acidophilus by ionic gelation with electrostatic extrusion for enhancement of survival under simulated gastric conditions and during refrigerated storage
Authors: Kim Jeong Un , Kim Bomi , Shahbaz Hafiz Muhammad , Lee Sung Hyun , Park Daseul , Park Jiyong 
Published: November 2016

SummaryThe probiotic Lactobacillus acidophilus was encapsulated in biodegradable and biocompatible capsules prepared by ionic gelation between phytic acid (PA) and chitosan (CS) with an electrostatic extrusion method. Calcium carbonate (CaCO3) and starch were used as co‐encapsulants for improvement of capsule stability. Capsules were characterised and evaluated for survival of encapsulated L. acidophilus cells in simulated gastric fluid (SGF) and during refrigerated storage. Loading capacity values of PA‐CS capsules, PA‐CS‐starch capsules and PA‐CS‐CaCO3 capsules were 8.20, 8.12 and 7.81 log CFU g−1 of wet capsule, respectively. Capsules showed particle sizes of 1.3–1.5 mm and a uniform spherical shape. PA‐CS‐CaCO3 capsules were the most stable vehicles for the protection of probiotic cells against acidic damage, particularly at pH 1.5 and pH 2. L. acidophilus cells from PA‐CS‐CaCO3 capsules showed only a 0.64 log CFU reduction in numbers after 2 h in pH 1.5 SGF conditions. The numbers of L. acidophilus encapsulated in PA‐CS‐CaCO3 capsules were decreased by only 0.69 log CFU g−1, while PA‐CS capsules and PA‐CS‐starch capsule numbers were reduced by more than 1.45 log CFU g−1 after 4 weeks at 4 °C. Addition of calcium carbonate to PA‐CS capsules provided protection against acid injury via antacid and buffering effects for encapsulation of L. acidophilus.
A single‐arm trial indirect comparison investigation: a proof‐of‐concept method to predict venous leg ulcer healing time for a new acellular synthetic matrix matched to standard care control
Authors: Shannon Ronald , Nelson Andrea 
Published: November 2016

AbstractTo compare data on time to healing from two separate cohorts: one treated with a new acellular synthetic matrix plus standard care (SC) and one matched from four largeUKpragmatic, randomised controlled trials [venous leg ulcer (VLU) evidence network]. We introduce a new proof‐of‐concept strategy to aVLUclinical evidence network, propensity score matching and sensitivity analysis to predict the feasibility of the new acellular synthetic matrix plusSCfor success in future randomised, controlled clinical trials. Prospective data on chronicVLUsfrom a safety and effectiveness study on an acellular synthetic matrix conducted in one wound centre in theUK(17 patients) and three wound centres in Australia (36 patients) were compared retrospectively to propensity score‐matched data from patients with comparable leg ulcer disease aetiology, age, baseline ulcer area, ulcer duration, multi‐layer compression bandaging and majority of care completed in specialist wound centres (average of 1 visit per week), with the outcome measures at comparable follow‐up periods from patients enrolled in four prospective, multicentre, pragmatic, randomised studies of venous ulcers in theUK(the comparison group;VLUevidence network). Analysis using Kaplan–Meier survival curves showed a mean healing time of 73·1 days forASMplusSC(ASM) treated ulcers in comparison with 83·5 days for comparison group ulcers treated withSCalone (Log rank test,χ25·779,P = 0·016) within 12 weeks. Sensitivity analysis indicates that an unobserved covariate would have to change the odds of healing forSCby a factor of 1·1 to impact the baseline results. Results from this study predict a significant effect on healing time when using a newASMas an adjunct toSCin the treatment of non‐healing venous ulcers in theUK, but results are sensitive to unobserved covariates that may be important in healing time comparison.
Medical Spending and Hospital Inpatient Care in England: An Analysis over Time
Authors: Aragón María José , Chalkley Martin , Rice Nigel 
Published: November 2016

AbstractHealth care in England is predominantly provided free at the point of service through the publicly‐funded National Health Service (NHS). Total NHS expenditure, which has risen in real terms by an average of 3.7 per cent per annum since the inception of the NHS in 1948, constituted 7.9 per cent of GDP in 2012. This paper presents a summary of the trends in medical expenditure in England together with, using detailed administrative data, an analysis of the growth over 15 years of expenditure and activity in hospital inpatient health care, which represents around 20–25 per cent of all NHS expenditure. We document the coincidence of observed trends in expenditure with reported activity, morbidity and the proximity of individuals to death. We find that: (i) expenditure for both elective and emergency inpatient care broadly follows activity, so that expenditure is mostly driven by activity rather than unit costs; (ii) expenditure is concentrated in individuals with multiple diseases, so that the prevalence and identification of complex medical conditions are important drivers of expenditure; and (iii) health care activity rises substantially for individuals in the period before death, so that expenditure is driven substantially by mortality in the population. Taken together, these findings indicate that this element of health care expenditure in England has been substantially driven by the underlying morbidity and age of the population in conjunction with improving health care technology.
Medical Spending in France: Concentration, Persistence and Evolution before Death
Authors: Gastaldi‐Ménager Christelle , Geoffard Pierre‐Yves , de Lagasnerie Grégoire 
Published: November 2016

AbstractThis paper studies medical spending in France from three perspectives: concentration, persistence, and evolution before death. We use claims data from a representative sample of over 500,000 individuals covered by the National Health insurance scheme, from 2008 to 2013. These data contain individual‐level information (gender, age, date of death), some clinical information and detailed information on each medical treatment (inpatient, outpatient, drugs). Medical spending in France is highly concentrated. In 2013, 10 per cent of the population accounted for 62 per cent of all health care spending. In addition, the concentration of medical expenditure increased between 2008 and 2013. The concentration of insurance reimbursement, however, is even greater, indicating that French social health insurance redistributes income from the healthy to the unhealthy. The serial correlation of health care expenditures appears relatively high between adjacent years, but not surprisingly decreases over time. Decedents have high medical expenditures – on average, eight times those of survivors – and resources devoted to health care in the last three years of life represent, on average, 22 per cent of lifetime medical spending. Decedents’ expenditures decrease with age after 55 years old.
Out‐of‐Pocket Medical Expenditures in the United States: Evidence from the Health and Retirement Study
Authors: Fahle Sean , McGarry Kathleen , Skinner Jonathan 
Published: November 2016

AbstractWe use data from the Health and Retirement Study (HRS) to document the distribution of out‐of‐pocket medical spending among individuals aged 55 and over in the US. The HRS data permit us to examine out‐of‐pocket spending close to the end of life and to analyse the components of spending in more detail than has been done in previous studies. We find that spending risk rises sharply at older ages and near the end of life. While the median individual spent $6,328 out‐of‐pocket in the last year of life, 5 per cent were reported to have spent over $62,040. Our results also indicate that out‐of‐pocket spending is highly concentrated, with the top 10 per cent of spenders accounting for 42 per cent of all spending, and persistent, even over periods spanning many years. Finally, while certain categories of spending are very responsive to income and wealth, we do not find overall spending to be highly concentrated along these dimensions. Viewed within the international context, our results suggest that the fraction of households facing very high out‐of‐pocket spending is substantially greater in the US than in other developed countries.
Medical Spending around the Developed World
Authors: French Eric , Kelly Elaine 
Published: November 2016

AbstractWe bring together estimates of patterns of medical spending in all nine countries considered in this issue – Canada, Denmark, England, France, Germany, Japan, the Netherlands, Taiwan and the United States. Comparing estimates across countries reveals three principal findings. First, medical spending in the calendar year of death accounts for 5–10 per cent of aggregate medical spending for the whole population and 9–20 per cent for those aged 65 and over. Spending in Taiwan is a little higher, at 16 per cent for the whole population and 29 per cent for the over‐65s. Second, there is a mostly negative correlation between patient income and medical spending within all countries, except Japan and Taiwan for the over‐65s and Taiwan and the US for the under‐25s. Third, medical spending in all countries is concentrated in a small share of the population and is persistent over time, although the degree of concentration and persistence varies across countries.
Renal dysfunction in patients taking fumaric acid esters – a retrospective cross‐sectional study
Authors: Menzies S. , Ismail N. , Abdalla A. , Collins P. , Kirby B. , Holian J. , Lally A. 
Published: November 2016

AbstractBackgroundFumaric acid esters (FAE) have been used for over 30 years in the management of psoriasis. There have been a number of case reports linking the use of FAE with nephrotoxicity, including acute renal injury and Fanconi syndrome. However, one large multicentre retrospective trial showed no evidence of renal dysfunction with FAE.Objectives/aimsThe aim of this study was to determine the number of patients in our institution being treated with FAE who developed significant proteinuria or renal dysfunction.MethodsThis was a single‐centre retrospective study assessing all patients on FAE who attended for follow‐up during an 18‐week period between February and June 2015. Demographics, comorbidities, duration and dose of treatment with FAE, proteinuria, renal function and other biochemical serum abnormalities were recorded.ResultsOne hundred and twenty‐seven patients were included in the study. Eighty‐two patients had proteinuria detected at some stage during treatment with FAE, and 18 of these had persistent proteinuria (positive in at least three consecutive specimens, 12 weeks apart). Six patients (five female) developed proximal tubular dysfunction (PTD). The risk factors for the development of PTD appear to be lower bodyweight (P = 0.03), higher dose per weight (P = 0.03) and longer duration of treatment (P = 0.03). Renal dysfunction improved on discontinuation or dose reduction in FAE.ConclusionFumaric acid esters are frequently associated with transient or persistent proteinuria. Significant renal dysfunction is rare and usually reversible on dose reduction or discontinuation of FAE. This study highlights the importance of screening for proteinuria. Higher doses per weight of treatment and longer duration of FAE therapy are likely risk factors for PTD.
Comparative treatment effectiveness of direct acting antiviral regimens for hepatitis C: Data from the Veterans administration
Authors: Fox D Steven , McGinnis Justin J , Tonnu‐Mihara Ivy Q , McCombs Jeffrey S 
Published: November 2016

AbstractBackground and AimsData addressing real world effectiveness of direct acting antiviral agents in hepatitis C infected patients are now emerging. This study compared the sustained virologic response rates achieved 12 weeks post‐treatment in patients treated with three such agents by the Veterans Health Administration.MethodsA retrospective cohort study was conducted using patients who terminated treatment by July 1, 2015. Data were retrieved from the Veterans Health Administration electronic medical records system. Patients were included if sufficient viral load laboratory data were available to determine sustained virologic response. Applying an intention to treat approach and logistic regression analysis, the sustained virologic response rates achieved were compared across drug regimens.ResultsA total of 11 464 patients met study selection criteria. Without controlling for other risk factors, sustained virologic response at least 12 weeks post treatment was achieved in 92% of ledipasvir/ sofosbuvir, 86% of ombitasvir/paritaprevir/ritonavir/dasabuvir, and 83% of simeprevir/sofosbuvir patients. After adjusting for patient characteristics, simeprevir/sofosbuvir (93.3%) and ledipasvir/sofosbuvir (96.2%) patients were statistically more likely than ombitasvir/paritaprevir/ritonavir/dasabuvir (91.8%) patients to demonstrate sustained virologic response. Human immunodeficiency virus, hepatitis B infection, diabetes, obesity, previous treatment history and augmentation therapy using ribavirin did not impact sustained virologic response rates. Sustained virologic response rates were lower for patients under age 65, with cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, indications of fibrosis, or a non‐genotype 1 infection. Women and Caucasian patients were more likely to achieve a sustained virologic response.ConclusionsAll three direct acting antiviral regimens appear highly effective in achieving sustained virologic response.
Peroxiredoxin‐2 up‐regulation in inflammatory bowel disease: Friend or foe?
Authors: Senhaji Nezha , Zaid Younes , El Khalfi Bouchra , Fahimi Mina , Martin Javier , Badre Wafaa , Nadifi Sellama , Soukri Abdelaziz 
Published: November 2016

AbstractBackgroundInflammatory bowel diseases (IBD) are chronic multi‐factorial inflammatory disorders. Accumulating investigations have provided compelling evidence that describe the interplay of a complex genetic landscape and inappropriate inflammatory response to intestinal microbes in disease etiopathogenesis but still pose challenges in diagnostic practices.MethodIn this study, comparative proteomic analysis was conducted to identify disease specific proteins underlying IBD pathogenetic mechanisms. Total blood proteins of the IBD patients and healthy subjects were analyzed with one‐dimensional electrophoresis; differentially expressed bands were excised and subjected to matrix‐assisted laser desorption ionization–time of flight mass spectrometry along with nanoflow liquid chromatography electrospray ionization‐tandem mass spectrometry analysis. Presence of glycosylation, hydroxylation, and phosphorylation post‐translational modifications was further investigated by immunoprecipitation.ResultsPeroxiredoxin‐2 (PRDX2) and hemoglobin‐subunits proteins, which are closely involved in the response to oxidative stress, were identified. PRDX2 was selected for further validation using western blot and reverse transcription–polymerase chain reaction. PRDX2 overexpression was restricted to the protein level within the membrane fraction. Immunoprecipitation identified PRDX2 to be post‐translationally glycosylated and phosphorylated.ConclusionOur findings demonstrate the implication of PRDX2 in IBD. Future studies are required to establish its functional role and to determine the clinical utility.
Determinants of health‐related quality of life in anti‐MAG neuropathy: a cross‐sectional multicentre European study
Authors: Delmont Emilien , Hiew Fu Liong , Cassereau Julien , Aubé‐Nathier Anne‐Catherine , Grapperon Aude‐Marie , Attarian Shahram , Rajabally Yusuf A. 
Published: November 2016

AbstractOur objective was to assess determinants of quality of life (QoL) in anti‐myelin associated glycoprotein antibody (MAG) neuropathy. The SF‐36 questionnaire was assessed in 55 patients, from Marseille, Angers (France) and Birmingham (UK). Routine clinical evaluations included Medical Research Council (MRC) sum score, inflammatory neuropathy cause and treatment (INCAT) sensory score, inflammatory Rasch‐built overall disability score (I‐RODS), ataxia score, Jamar grip dynamometry, timed 10‐m walk, neuropathic pain symptom inventory (NPSI) score, and fatigue severity score (FSS). Physical component summary (PCS) and mental component summary (MCS) of the SF36 questionnaire were significantly lower than in reported normal subjects of both countries (p < 0.001). All SF‐36 domains correlated with I‐RODS, except MCS for which significance was, however, approached (p = 0.056). PCS correlated with MRC sum score, ataxia score, timed 10‐m walk, tremor, Jamar grip dynamometry, NPSI pain score, FSS and level of social support. MCS correlated exclusively with FSS and level of social support. In multivariate regression, PCS was associated independently with I‐RODS (p < 0.001) and NPSI pain score (p = 0.011), whereas MCS was associated independently with FSS (p = 0.022). QoL is accurately predicted in anti‐MAG neuropathy by the I‐RODS and FSS, lending support to their use in clinical and research settings. Effective measures to improve QoL should include tremor and neuropathic pain treatment, fatigue management, and improved social support.
Does Local Ibandronate and/or Pamidronate Delivery Enhance Osseointegration? A Systematic Review
Authors: Kellesarian Sergio Varela , Abduljabbar Tariq , Vohra Fahim , Gholamiazizi Elham , Malmstrom Hans , Romanos Georgios E. , Javed Fawad 
Published: November 2016

AbstractPurposeTo our knowledge from indexed literature, the present study is the first one to systematically review the influence of local delivery of pamidronate (PAM) and/or ibandronate (IBA) on osseointegration enhancement. The aim of the present systematic review was to assess the efficacy of IBA and/or PAM local delivery (topically or coating on implants surfaces) in promoting osseointegration.Materials and MethodsTo address the focused question, “Does local IBA and/or PAM delivery enhances osseointegration?,” indexed databases were searched without time or language restrictions up to and including May 2016 using various combinations of the following keywords: “pamidronate,” “ibandronate,” “bisphosphonates,” “osseointegration,” and “topical administration.” Letters to the Editor, historic reviews, commentaries, case series, and case reports were excluded.ResultsFifteen studies were included. Fourteen studies were performed in animals and 2 were clinical trials. One study reported an experimental model and a clinical trial in the same publication. Results from 12 experimental studies and 2 clinical studies reported improved biomechanical properties and/or osseointegration around implants with PAM and/or IBA. Two experimental studies showed that PAM and/or IBA did not improve osseointegration.ConclusionsOn experimental grounds, local IBA and/or PAM delivery seems to enhance osseointegration; however, from a clinical perspective, further randomized control trials are needed to assess the effectiveness of IBA and PAM in promoting osseointegration around dental implants.
Effect of dietary calcium level and source on mineral utilisation by piglets fed diets containing exogenous phytase
Authors: Schlegel P. , Gutzwiller A. 
Published: November 2016

SummaryCalcium and phosphorus are essential minerals, closely linked in digestive processes and metabolism. With widespread use of low P diets containing exogenous phytase, the optimal dietary Ca level was verified. The 40‐day study evaluated the effects of Ca level (4, 7 and 10 g/kg diet) and Ca source (Ca from CaCO3 and from Lithothamnium calcareum) on mineral utilisation in 72 piglets (7.9 ± 1.0 kg BW) fed an exogenous phytase containing diet with 2.9 g digestible P/kg. Measured parameters were growth performance, stomach mineral solubility, bone breaking strength and urinary, serum and bone mineral concentration. The apparent total tract digestibility of minerals was also assessed in the two diets with 7 g Ca/kg, using 12 additional pigs. Regardless of Ca source, increasing dietary Ca impaired feed conversion ratio, increased urinary pH, increased serum and urinary Ca, decreased serum and urinary P, decreased serum Mg and increased urinary Mg, increased serum AP activity, decreased bone Mg increased bone Zn. Bone breaking strength was improved with 7 compared to 4 g Ca/kg. Compared to CaCO3, Ca from Lithothamnium calcareum increased serum Mg and with, 10 g Ca/kg, it limited body weight gain. The dose response of Ca in a diet with 2.9 g digestible P/kg and including exogenous phytase indicated that: (i) a low dietary Ca was beneficial for piglet growth, but was limiting the metabolic use of P; (ii) a high dietary Ca level impaired P utilisation; (iii) the optimal P utilisation and bone breaking strength was obtained with a dietary Ca‐to‐digestible P ratio of 2.1 to 2.4:1; (iv). Increasing dietary Ca reduced Mg utilisation, but not Zn status, when fed at adequate level. Finally, Ca from Lithothamnium calcareum had similar effects on Ca and P metabolism as CaCO3, but impaired growth when fed at the highest inclusion level.