bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peer review comments on drug trials submitted to medical journals differ depending on sponsorship, results and acceptance: a retrospective cohort study
Authors: van Lent Marlies , IntHout Joanna , Out Henk Jan 
Published: October 2015

ObjectiveDuring peer review, submitted manuscripts are scrutinised by independent experts to assist journal editors in their decision-making and to help improve the quality of articles. In this retrospective cohort study, peer review comments for drug trials submitted to medical journals were analysed to investigate whether there is a relation between the content of these comments and sponsorship, direction of results and decision about acceptance.Design/settingDescriptive content analysis of reviewer comments made on manuscripts on drug trials submitted to eight medical journals (January 2010–April 2012). For each manuscript, the number of reviewers, decision about acceptance, sponsorship and direction of results were extracted. Reviewer comments were classified using a predefined checklist.ResultsReviewer reports for 246 manuscripts were assessed. Industry-sponsored trials were more likely to receive comments about lack of novelty (8.9%) than industry-supported (2.5%) and non-industry trials (6.1%, overall p=0.038). Non-industry trials more often received comments about poor experimental design (69.7%) than industry-supported (58.8%) and industry-sponsored trials (52.9%, overall p=0.019). Non-industry trials were also more likely to receive comments regarding inappropriate statistical analyses (28.4%) than industry-supported (23.5%) and industry-sponsored trials (15.1%, overall p=0.006). Manuscripts with negative results were more likely to receive comments about inappropriate conclusions (29.3%) than those with positive results (18.9%, p=0.010). Rejected manuscripts had more often received comments on the research question not being clinically relevant (7.8%) than accepted manuscripts (1.6%, p=0.002), and also on lack of novelty (8.3% vs 2.6%, p=0.008) and poor experimental design (68.6% vs 50.5%, p<0.001).ConclusionsReviewers identified fewer shortcomings regarding design and statistical analyses in industry-related trials, but commented more often on a lack of novelty in industry-sponsored trials. Negative trial results did not significantly influence the nature of comments other than appropriateness of the conclusion. Manuscript acceptance was primarily related to the research question and methodological robustness of studies.
Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews
Authors: Johnson Mark J , May Carl R 
Published: October 2015

ObjectivesTranslating research evidence into routine clinical practice is notoriously difficult. Behavioural interventions are often used to change practice, although their success is variable and the characteristics of more successful interventions are unclear. We aimed to establish the characteristics of successful behaviour change interventions in healthcare.DesignWe carried out a systematic overview of systematic reviews on the effectiveness of behaviour change interventions with a theory-led analysis using the constructs of normalisation process theory (NPT). MEDLINE, CINAHL, PsychINFO and the Cochrane Library were searched electronically from inception to July 2015.SettingPrimary and secondary care.ParticipantsParticipants were any patients and healthcare professionals in systematic reviews who met the inclusion criteria of having examined the effectiveness of professional interventions in improving professional practice and/or patient outcomes.InterventionsProfessional interventions as defined by the Cochrane Effective Practice and Organisation of Care Review Group.Primary and secondary outcome measuresSuccess of each intervention in changing practice or patient outcomes, and their mechanisms of action. Reviews were coded as to the interventions included, how successful they had been and which NPT constructs its component interventions covered.ResultsSearches identified 4724 articles, 67 of which met the inclusion criteria. Interventions fell into three main categories: persuasive; educational and informational; and action and monitoring. Interventions focusing on action or education (eg, Audit and Feedback, Reminders, Educational Outreach) acted on the NPT constructs of Collective Action and Reflexive Monitoring, and reviews using them tended to report more positive outcomes.ConclusionsThis theory-led analysis suggests that interventions which contribute to normative restructuring of practice, modifying peer group norms and expectations (eg, educational outreach) and relational restructuring, reinforcing modified peer group norms by emphasising the expectations of an external reference group (eg, Reminders, Audit and Feedback), offer the best chances of success. Combining such interventions is most likely to change behaviour.
Reporting, handling and assessing the risk of bias associated with missing participant data in systematic reviews: a methodological survey
Authors: Akl Elie A , Carrasco-Labra Alonso , Brignardello-Petersen Romina , Neumann Ignacio , Johnston Bradley C , Sun Xin , Briel Matthias , Busse Jason W , Ebrahim Shanil , Granados Carlos E , Iorio Alfonso , Irfan Affan , Martínez García Laura , Mustafa Reem A , Ramírez-Morera Anggie , Selva Anna , Solà Ivan , Sanabria Andrea Juliana , Tikkinen Kari A O , Vandvik Per O , Vernooij Robin W M , Zazueta Oscar E , Zhou Qi , Guyatt Gordon H , Alonso-Coello Pablo 
Published: October 2015

ObjectivesTo describe how systematic reviewers are reporting missing data for dichotomous outcomes, handling them in the analysis and assessing the risk of associated bias.MethodsWe searched MEDLINE and theCochrane Database of Systematic Reviewsfor systematic reviews of randomised trials published in 2010, and reporting a meta-analysis of a dichotomous outcome. We randomly selected 98 Cochrane and 104 non-Cochrane systematic reviews. Teams of 2 reviewers selected eligible studies and abstracted data independently and in duplicate using standardised, piloted forms with accompanying instructions. We conducted regression analyses to explore factors associated with using complete case analysis and with judging the risk of bias associated with missing participant data.ResultsOf Cochrane and non-Cochrane reviews, 47% and 7% (p<0.0001), respectively, reported on the number of participants with missing data, and 41% and 9% reported a plan for handling missing categorical data. The 2 most reported approaches for handling missing data were complete case analysis (8.5%, out of the 202 reviews) and assuming no participants with missing data had the event (4%). The use of complete case analysis was associated only with Cochrane reviews (relative to non-Cochrane: OR=7.25; 95% CI 1.58 to 33.3, p=0.01). 65% of reviews assessed risk of bias associated with missing data; this was associated with Cochrane reviews (relative to non-Cochrane: OR=6.63; 95% CI 2.50 to 17.57, p=0.0001), and the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology (OR=5.02; 95% CI 1.02 to 24.75, p=0.047).ConclusionsThough Cochrane reviews are somewhat less problematic, most Cochrane and non-Cochrane systematic reviews fail to adequately report and handle missing data, potentially resulting in misleading judgements regarding risk of bias.
The diverse impact of advance care planning: a long-term follow-up study on patients’ and relatives’ experiences
Authors: Andreassen Pernille , Neergaard Mette Asbjørn , Brogaard Trine , Skorstengaard Marianne Hjorth , Jensen Anders Bonde 
Published: October 2015

BackgroundAdvance care planning (ACP) is a process of discussing and recording patients’ preferences for future care, aiming to guide healthcare decisions at the end of life (EOL).AimTo explore nuances in the long-term impact of ACP by studying patient and relative experiences.DesignA qualitative follow-up interview study. Interviews were recorded, transcribed and analysed using thematic synthesis.Setting/participants3 patients with a life-limiting disease (lung or heart disease), affiliated with a major Danish hospital, and 7 relatives were interviewed 1 year after participating in an ACP discussion.ResultsThe experiences were diverse. Some patients and relatives felt ‘relieved’, ‘more secure’ and more in control due to ACP. To some, ACP had led to open communication rather than ‘beating around the bush’, and to spending more quality time together. However, others perceived ACP as irrelevant. Some stated that the patient's wishes had not been met regardless of ACP. Others felt that EOL questions cannot be realistically considered until ‘you're in the middle of it’, because many factors are involved. In one case, participating in ACP led to a patient-relative conflict, resulting in EOL issues being ‘tucked away’.ConclusionsThe study reveals great diversity in patient and relative experiences of ACP. The study challenges previous research which mainly emphasises ACP as a valuable tool to optimise EOL care. This study stresses the importance of awareness of the highly individual nature of preferences and needs of patients and relatives regarding information, involvement and communication about EOL care.
Developing a system to monitor family planning and HIV service integration: results from a pilot test of indicators
Authors: Adamchak Susan E , Okello Francis O , Kaboré Inoussa 
Published: October 2015

ObjectivesTo determine the feasibility of collecting data to calculate six indicators of family planning (FP) and HIV integration using existing health information systems (HIS); obtain information to refine indicators; and identify changes needed in existing HIS to calculate indicators.DesignData abstraction from HIS in a purposive sample of 39 health facilities in Ethiopia, Rwanda, Tanzania and Uganda to analyse data availability and quality undertaken between November 2010 and March 2011.MethodsTeams reviewed patient record cards, registers, monthly and quarterly reports for the most recent complete month. Teams recorded all possible sources for each data element, indicated whether data are collated monthly, and whether disaggregation by age, sex and originating service was possible.ResultsWith the exception of Uganda, all countries were able to report the proportion of service delivery points offering integrated services. Ethiopia was able to calculate the indicator for fixed sites but not for home-based care services. In most cases we were able to calculate the proportion of HIV clients receiving FP services or referral, and the proportion of FP clients receiving an HIV test or referral. It is feasible to collect data for these indicators under current circumstances in some countries.ConclusionsSeveral actions are proposed for national health systems, including adopting a system of unique client identifiers. Age group reporting bands should be aligned across services. More accurate counts of daily and active client loads are needed to provide programme managers with information to inform programme monitoring.
Datix
Authors: Sarlis Dimitrios , Papailiou Nikolaos , Konstantinou Ioannis , Smaragdakis Georgios , Koziris Nectarios 
Published: October 2015

The ever-increasing Internet traffic poses challenges to network operators and administrators that have to analyze large network datasets in a timely manner to make decisions regarding network routing, dimensioning, accountability and security. Network datasets collected at large networks such as Internet Service Providers (ISPs) or Internet Exchange Points (IXPs) can be in the order of Terabytes per hour. Unfortunately, most of the current network analysis approaches are ad-hoc and centralized, and thus not scalable.
In this paper, we present Datix, a fully decentralized, open-source analytics system for network traffic data that relies on smart partitioning storage schemes to support fast join algorithms and efficient execution of filtering queries. We outline the architecture and design of Datix and we present the evaluation of Datix using real traces from an operational IXP. Datix is a system that deals with an important problem in the intersection of data management and network monitoring while utilizing state-of-the-art distributed processing engines. In brief, Datix manages to efficiently answer queries within minutes compared to more than 24 hours processing when executing existing Python based code in single node setups. Datix also achieves nearly 70% speedup compared to baseline query implementations of popular big data analytics engines such as Hive and Shark.
CCR 20th Anniversary Commentary: Bevacizumab in the Treatment of Glioblastoma—The Progress and the Limitations
Authors: Mar Nataliya , Desjardins Annick , Vredenburgh James J. 
Published: October 2015

Abstract
Vredenburgh and colleagues conducted the first phase II study of bevacizumab plus irinotecan in recurrent malignant glioma, confirming the safety and efficacy of bevacizumab. This study, which was published in the February 15, 2007, issue of Clinical Cancer Research, was a stepping stone for subsequent research, leading to regulatory approval of bevacizumab for recurrent glioblastoma. Clin Cancer Res; 21(19); 4248–50. ©2015 AACR.
See related article by Vredenburgh et al., Clin Cancer Res 2007;13(4) February 15, 2007;1253–9
The IL-15-Based ALT-803 Complex Enhances FcγRIIIa-Triggered NK Cell Responses and In Vivo Clearance of B Cell Lymphomas
Authors: Rosario Maximillian , Liu Bai , Kong Lin , Collins Lynne I. , Schneider Stephanie E. , Chen Xiaoyue , Han Kaiping , Jeng Emily K. , Rhode Peter R. , Leong Jeffrey W. , Schappe Timothy , Jewell Brea A. , Keppel Catherine R. , Shah Keval , Hess Brian , Romee Rizwan , Piwnica-Worms David R. , Cashen Amanda F. , Bartlett Nancy L. , Wong Hing C. , Fehniger Todd A. 
Published: October 2015

Abstract
Purpose: Anti-CD20 monoclonal antibodies (mAb) are an important immunotherapy for B-cell lymphoma, and provide evidence that the immune system may be harnessed as an effective lymphoma treatment approach. ALT-803 is a superagonist IL-15 mutant and IL-15Rα–Fc fusion complex that activates the IL-15 receptor constitutively expressed on natural killer (NK) cells. We hypothesized that ALT-803 would enhance anti–CD20 mAb-directed NK-cell responses and antibody-dependent cellular cytotoxicity (ADCC).
Experimental Design: We tested this hypothesis by adding ALT-803 immunostimulation to anti-CD20 mAb triggering of NK cells in vitro and in vivo. Cell lines and primary human lymphoma cells were utilized as targets for primary human NK cells. Two complementary in vivo mouse models were used, which included human NK-cell xenografts in NOD/SCID-γc−/− mice.
Results: We demonstrate that short-term ALT-803 stimulation significantly increased degranulation, IFNγ production, and ADCC by human NK cells against B-cell lymphoma cell lines or primary follicular lymphoma cells. ALT-803 augmented cytotoxicity and the expression of granzyme B and perforin, providing one potential mechanism for this enhanced functionality. Moreover, in two distinct in vivo B-cell lymphoma models, the addition of ALT-803 to anti-CD20 mAb therapy resulted in significantly reduced tumor cell burden and increased survival. Long-term ALT-803 stimulation of human NK cells induced proliferation and NK-cell subset changes with preserved ADCC.
Conclusions: ALT-803 represents a novel immunostimulatory drug that enhances NK-cell antilymphoma responses in vitro and in vivo, thereby supporting the clinical investigation of ALT-803 plus anti-CD20 mAbs in patients with indolent B-cell lymphoma. Clin Cancer Res; 22(3); 596–608. ©2015 AACR.
Influence of Input Hardware and Work Surface Angle on Upper Limb Posture in a Hybrid Computer Workstation
Authors: Kingston David C. , Riddell Maureen F. , McKinnon Colin D. , Gallagher Kaitlin M. , Callaghan Jack P. 
Published: October 2015

Objective: We evaluated the effect of work surface angle and input hardware on upper-limb posture when using a hybrid computer workstation. Background: Offices use sit-stand and/or tablet workstations to increase worker mobility. These workstations may have negative effects on upper-limb joints by increasing time spent in non-neutral postures, but a hybrid standing workstation may improve working postures. Method: Fourteen participants completed office tasks in four workstation configurations: a horizontal or sloped 15° working surface with computer or tablet hardware. Three-dimensional right upper-limb postures were recorded during three tasks: reading, form filling, and writing e-mails. Amplitude probability distribution functions determined the median and range of upper-limb postures. Results: The sloped-surface tablet workstation decreased wrist ulnar deviation by 5° when compared to the horizontal-surface computer when reading. When using computer input devices (keyboard and mouse), the shoulder, elbow, and wrist were closest to neutral joint postures when working on a horizontal work surface. The elbow was 23° and 15° more extended, whereas the wrist was 6° less ulnar deviated, when reading compared to typing forms or e-mails. Conclusion: We recommend that the horizontal-surface computer configuration be used for typing and the sloped-surface tablet configuration be used for intermittent reading tasks in this hybrid workstation. Application: Offices with mobile employees could use this workstation for alternating their upper-extremity postures; however, other aspects of the device need further investigation.
The Diagnostic and Therapeutic Impact of Point-of-Care Ultrasonography in the Intensive Care Unit
Authors: Bernier-Jean Amélie , Albert Martin , Shiloh Ariel L. , Eisen Lewis A. , Williamson David , Beaulieu Yanick 
Published: October 2015

Purpose: In light of point-of-care ultrasonography’s (POCUS) recent rise in popularity, assessment of its impact on diagnosis and treatment in the intensive care unit (ICU) is of key importance. Methods: Ultrasound examinations were collected through an ultrasound reporting software in 6 multidisciplinary ICU units from 3 university hospitals in Canada and the United States. This database included a self-reporting questionnaire to assess the impact of the ultrasound findings on diagnosis and treatment. We retrieved the results of these questionnaires and analyzed them in relation to which organs were assessed during the ultrasound examination. Results: One thousand two hundred and fifteen ultrasound studies were performed on 968 patients. Intensivists considered the image quality of cardiac ultrasound to be adequate in 94.7% compared to 99.7% for general ultrasound ( P < .001). The median duration of a cardiac examination was 10 (interquartile range [IQR] 10) minutes compared to 5 (IQR 8) minutes for a general examination ( P < .001). Overall, ultrasound findings led to a change in diagnosis in 302 studies (24.9%) and to a change in management in 534 studies (44.0%). A change in diagnosis or management was reported more frequently for cardiac ultrasound than for general ultrasound (108 [37.1%] vs 127 [16.5%], P < .001) and (170 [58.4%] vs 270 [35.1%], P < .001). Assessment of the inferior vena cava for fluid status emerged as the critical care ultrasound application associated with the greatest impact on management. Conclusion: Point-of-care ultrasonography has the potential to optimize care of the critically ill patients when added to the clinical armamentarium of the intensive care physician.
Community Palliative Care Nurses’ Challenges and Coping Strategies on Delivering Home-Based Pediatric Palliative Care
Authors: Chong LeeAi , Abdullah Adina 
Published: October 2015

Objective: The aim of this study was to explore the experience of community palliative care nurses providing home care to children. Method: A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports. Conclusions: These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.
Health economic modeling of the potential cost saving effects of Neurally Adjusted Ventilator Assist
Authors: Hjelmgren Jonas , Bruce Wirta Sara , Huetson Pernilla , Myrén Karl-Johan , Göthberg Sylvia 
Published: October 2015

Objectives: Asynchrony between patient and ventilator breaths is associated with increased duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) controls MV through an esophageal reading of diaphragm electrical activity via a nasogastric tube mounted with electrode rings. NAVA has been shown to decrease asynchrony in comparison to pressure support ventilation (PSV). The objective of this study was to conduct a health economic evaluation of NAVA compared with PSV. Methods: We developed a model based on an indirect link between improved synchrony with NAVA versus PSV and fewer days spent on MV in synchronous patients. Unit costs for MV were obtained from the Swedish intensive care unit register, and used in the model along with NAVA-specific costs. The importance of each parameter (proportion of asynchronous patients, costs, and average MV duration) for the overall results was evaluated through sensitivity analyses. Results: Base case results showed that 21% of patients ventilated with NAVA were asynchronous versus 52% of patients receiving PSV. This equals an absolute difference of 31% and an average of 1.7 days less on MV and a total cost saving of US$7886 (including NAVA catheter costs). A breakeven analysis suggested that NAVA was cost effective compared with PSV given an absolute difference in the proportion of asynchronous patients greater than 2.5% (49.5% versus 52% asynchronous patients with NAVA and PSV, respectively). The base case results were stable to changes in parameters, such as difference in asynchrony, duration of ventilation and daily intensive care unit costs. Conclusion: This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV.