bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives of mild asthma patients on maintenance versus as-needed preventer treatment regimens: a qualitative study
Authors: Foster Juliet , Beasley Richard , Braithwaite Irene , Harrison Tim , Holliday Mark , Pavord Ian , Reddel Helen 
Published: January 2022

ObjectivesAs-needed low-dose combination budesonide-formoterol is recommended by asthma guidelines in many countries as an alternative to maintenance inhaled corticosteroids (ICS) for treatment of mild asthma, but there are few data on patient attitudes toward these regimens. This study explored the comparative implementation experiences and future treatment preferences of mild asthma patients who had experienced these two treatment regimens.SettingA subgroup of adults randomised to maintenance ICS or as-needed ICS-formoterol in a multinational, 52-week open-label randomised controlled trial (NovelSTART) in mild asthma patients were interviewed to explore their motivations for treatment use during the study and their preferences for future treatment.ParticipantsSemistructured interviews were conducted with 74 participants (Maintenance group: n=39, As-needed group n=35, mean age 38 (range 19–69)) and thematically analysed from transcribed audiorecordings.ResultsEmergent themes from analysis comprised: ‘How much my asthma affects me’ (how their asthma’s impact affected their self-management motivation); ‘What I know about asthma’ (limited knowledge impeded appropriate self-management decision making); ‘How much effort this treatment regimen involves for me’ (treatment complexity and/or difficulty establishing a medication routine impeded implementation, particularly in the Maintenance group); and ‘My beliefs about the benefits and risks of this treatment’ (patients who considered their treatment as ineffective, eg, limited difference in symptoms relative to salbutamol (both groups) or slower onset of relief (As-needed group) had poor motivation to use the treatment). Due to the simplicity of the as-needed combination strategy, this was the preferred future regimen, even by patients who had not yet tried it.ConclusionsKey patient perspectives on the implementation of preventer treatments for mild asthma included factors relating to perceived asthma burden, disease knowledge, treatment complexity and treatment usefulness or safety. The as-needed budesonide-formoterol regimen was preferred to maintenance ICS treatment in mild asthma though patient education is urgently needed to address implementation motivation.Trial registration numberACTRN12615000999538.
Individual readiness for transplantation medicine of laypersons and the number of deceased organ donors: a cross-sectional online survey in Japan, South Korea and Taiwan
Authors: Asai Tomoko , Taniguchi Yasuhiro , Tsukata Yukiyoshi 
Published: January 2022

ObjectivesThe gap between the numbers of organ donors and recipients is a common problem worldwide. This study was designed to investigate the importance of ‘individual readiness’, a here introduced novel concept in transplantation medicine and a measure of positive attitudes towards organ donation and transplantation.DesignA cross-sectional online survey was used to collect the research data.ParticipantsThe participants were recruited by a Japanese research company and affiliates in South Korea and Taiwan and fulfilled the following criteria: (1) laypersons aged 18–75 years, (2) residents of the countries and (3) understood the questions in their native languages.Primary outcome measuresThe survey investigated the interest and attitude of individuals regarding transplantation medicine by asking multiple choice questions. Based on answers concerning attitude, a positive group was identified as willing to be organ donors and recipients, and a non-positive group was identified as unwilling to be donors and recipients. The ratio between the positive and non-positive group, the P/N ratio, was introduced as an index of individual readiness.Results1500 samples were included in this analysis. Individuals with interest agreed more with statements on organ donation than those without interest, and the P/N ratio per country was compatible with the actual deceased organ donors rate per million population (ADODR).ConclusionsInterest in transplantation medicine was associated with positive attitudes, and positive attitudes were associated with a higher ADODR. These results support that individual readiness is an important determinant for the number of donors. The P/N ratio can be used as an index to assess individual readiness in organ transplantation, at least in countries with minor to moderate popularisation. Further studies of individual readiness using the P/N ratio should be undertaken to develop policies and initiatives for increasing organ donations.
Effect of perioperative levosimendan administration on postoperative N-terminal pro-B-type natriuretic peptide concentration in patients with increased cardiovascular risk factors undergoing non-cardiac surgery: protocol for the double-blind, randomised, placebo-controlled IMPROVE trial
Authors: Reiterer Christian , Kabon Barbara , Taschner Alexander , Adamowitsch Nikolas , Graf Alexandra , Fraunschiel Melanie , Horvath Katharina , Kuhrn Melanie , Clement Theresa , Treskatsch Sascha , Berger Christian , Fleischmann Edith 
Published: January 2022

IntroductionElevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) after non-cardiac surgery is a strong predictor for cardiovascular complications and reflects increased myocardial strain. NT-pro-BNP concentrations significantly rise after non-cardiac surgery within the first 3 days. Levosimendan is a potent inotropic drug that increases calcium sensitivity to cardiac myocytes, which results in improved cardiac contractility that last for approximately 7 days. Thus, we will test the effect of a pre-emptive perioperative administration of levosimendan on postoperative NT-pro-BNP concentration as compared with the administration of a placebo in patients undergoing moderate-risk to high-risk major abdominal surgery.Methods and analysisWe will conduct a double-blinded prospective randomised trial at the Medical University of Vienna, Vienna, Austria (and potentially a second centre in Germany), including 230 patients at-risk for cardiovascular complications undergoing moderate- to high-risk major abdominal surgery. Patients will be randomly assigned to receive a single dose of 12.5 mg levosimendan versus placebo after induction of anaesthesia. The primary outcome will be the postoperative maximum NT-pro-BNP concentration between both group within the first three postoperative days. Our secondary outcomes will be the incidence of myocardial ischaemia, myocardial injury after non-cardiac surgery and a composite of myocardial infarction and death within 30 days and 1 year after surgery between both groups. Our further secondary outcome will be stratification of NT-pro-BNP values according to previously thresholds to predict mortality of myocardial infarction after surgery.Ethics and disseminationThe study was approved by the Ethics Committee of the Medical University of Vienna on 14 July 2020 (EK 2187/2019). Written informed consent will be obtained from all patients a day before surgery. Results of this study will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT04329624.
Barriers and enablers to monitoring and deprescribing opioid analgesics for chronic non-cancer pain: a systematic review with qualitative evidence synthesis using the Theoretical Domains Framework
Authors: Cross Amanda J , Buchbinder Rachelle , Mathieson Stephanie , Bourne Allison , Maher Christopher G , Lin Chung-Wei Christine , O'Connor Denise A 
Published: January 2022

BackgroundUnderstanding barriers and enablers to monitoring and deprescribing opioids will enable the development of tailored interventions to improve both practices.ObjectiveTo perform a qualitative evidence synthesis of the barriers and enablers to monitoring ongoing appropriateness and deprescribing of opioids for chronic non-cancer pain (CNCP) and to map the findings to the Theoretical Domains Framework (TDF).MethodsWe included English-language qualitative studies that explored healthcare professional (HCP), patient, carer and the general public’s perceptions regarding monitoring and deprescribing opioids for CNCP. We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED) and PsycINFO from inception to August 2020. Two authors independently selected the studies, extracted the data, assessed the methodological quality using the Critical Appraisal Skills Programme, and assessed the confidence in the findings using GRADE CERQual (Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research). We used an inductive approach to synthesis of qualitative data and mapped identified themes to TDF domains.ResultsFrom 6948 records identified we included 21 studies, involving 209 HCPs and 330 patients. No studies involved carers or the general public. Five barrier themes were identified: limited alternatives to opioids, management of pain is top priority, patient understanding, expectations and experiences, prescriber pressures, and reluctance to change. Four enabler themes were identified: negative effects of opioids and benefits of deprescribing, clear communication and expectations for deprescribing, support for patients, and support for prescribers. 16 barrier and 12 enabler subthemes were identified; most were graded as high (n=15) or moderate (n=9) confidence. The TDF domains ‘beliefs about consequences’, ‘environmental context and resources’, ‘social influences’ and ‘emotion’ were salient for patients and HCPs. The domains ‘skills’ and ‘beliefs about capabilities’ were more salient for HCPs.ConclusionFuture implementation interventions aimed at monitoring and deprescribing opioids should target the patient and HCP barriers and enablers identified in this synthesis.PROSPERO registration numberCRD42019140784.
Comparison of radiation exposure and clinical outcomes between transradial and transfemoral diagnostic cerebral approaches: a retrospective study
Authors: Amankwah Curtis , Lombardo Lauren , Rutledge John , Sattar Ahsan , Chancellor Bree , Altschul Dorothea 
Published: January 2022

ObjectiveTo identify and compare patient and procedural variables that are associated with a high radiation dose exposure and worse clinical outcomes between transradial arterial (TRA) and transfemoral arterial (TFA) approaches.DesignThis was a retrospective analysis.SettingA community hospital during the initial phase of adopting a TRA-first approach.ParticipantsA resultant 215 subjects who only underwent diagnostic cerebral angiograms (DCA) after excluding all therapeutic procedures and patients under 18 years.InterventionsOnly DCA from 1 May 2018 to 31 January 2021.Main outcome measuresWe compared radiation exposure parameters (total fluoroscopy time (FT), total radiation dose (TD) and dose area product (DAP), number of vessels injected and Patient-Reported Global Health Physical and Mental Outcome Scores (PROGHS) at 30 days postprocedure between groups.ResultsFT was significantly greater in TRA compared with TFA (p<0.001). In addition, TRA had a significantly higher TD (p=0.002) and DAP (p=0.005) when compared with TFA. Analysis of only 6-vessel DCAs also showed that TRA had a significantly higher FT, DAP and TD in comparison to TFA. Despite observing a longer FT in TRA, results showed fewer vessels injected and a notably lower success rate in acquiring a 6-vessel DCA using the TRA. Further analysis of the effect of vessel number on FT using general linear models showed that with every increase of one vessel, the FT increases by 2.2 min for TRA (p<0.001; 95% CI 1.03 to 3.36) and by 1.3 min for TFA (p<0.001; 95% CI 0.72 to 1.83). There was no significant difference between groups in PROGHS mental and physical t-scores at 30 days postprocedure, even though our cohort showed a significantly greater percentage of TRA procedures done in the outpatient setting.ConclusionsAdopting a TRA first approach for DCAs may be initially associated with a higher radiation dose for the patient. Better strategies and devices are needed to mitigate this effect.
Mass spectra, wave functions and mixing effects of the (bcq) baryons
Authors: Li Qiang , Chang Chao-Hsi , Qin Si-Xue , Wang Guo-Li 
Published: January 2022

AbstractMass spectra and wave functions of the $$J^P=\frac{1}{2}^+$$

J
P

=

1
2

+

(bcq) baryons are calculated by the relativistic Bethe–Salpeter equation (BSE) with considering the mixing effects between the $$1^+$$

1
+

and $$0^+$$

0
+

(bc)-diquarks inside. Based on the diquark picture, the three-body problem of baryons is transformed into two two-body problems. The BSE and wave functions of the $$0^+$$

0
+

diquark are given, and then solved numerically to obtain the effective mass spectra and form factors. Also we present the wave functions at zero point for the (bc)-diquark. Considering the obtained diquark form factors, the (bcq) baryons are then described by the BSE as the bound state of a diquark and a light quark, where the interaction kernel includes the inner transitions between the $$0^+$$

0
+

and $$1^+$$

1
+

diquarks. The general wave function of the $$\frac{1}{2}^+$$

1
2

+

(bcq) baryons is constructed and solved to obtain the corresponding mass spectra. Especially, by using the obtained wave functions, the mixing effects between $$\Xi _{bc}(\Omega _{bc})$$

Ξ

bc

(

Ω

bc

)

and $$\Xi _{bc}'(\Omega '_{bc})$$

Ξ

bc

′

(

Ω

bc

′

)

in ground states are computed and determined to be small ($$\sim \!1\%$$

∼

1
%

). The numerical results indicate that it is a good choice to take $$\Xi _{bc}$$

Ξ

bc

and $$\Xi '_{bc}$$

Ξ

bc

′

as the baryon states with the inside (bc)-diquarks occupying the definite spin.
A Machine Learning Model Based on Tumor and Immune Biomarkers to Predict Undetectable MRD and Survival Outcomes in Multiple Myeloma
Authors: Guerrero Camila , Puig Noemi , Cedena Maria-Teresa , Goicoechea Ibai , Perez Cristina , Garcés Juan-José , Botta Cirino , Calasanz Maria-Jose , Gutierrez Norma C. , Martin-Ramos Maria-Luisa , Oriol Albert , Rios Rafael , Hernandez Miguel-Teodoro , Martinez-Martinez Rafael , Bargay Joan , de Arriba Felipe , Palomera Luis , Gonzalez-Rodriguez Ana Pilar , Mosquera-Orgueira Adrian , Gonzalez-Perez Marta-Sonia , Martinez-Lopez Joaquin , Lahuerta Juan-José , Rosiñol Laura , Blade Joan , Mateos Maria-Victoria , San-Miguel Jesus F. , Paiva Bruno 
Published: January 2022

Abstract

Purpose:
Undetectable measurable residual disease (MRD) is a surrogate of prolonged survival in multiple myeloma. Thus, treatment individualization based on the probability of a patient achieving undetectable MRD with a singular regimen could represent a new concept toward personalized treatment, with fast assessment of its success. This has never been investigated; therefore, we sought to define a machine learning model to predict undetectable MRD at the onset of multiple myeloma.

Experimental Design:
This study included 487 newly diagnosed patients with multiple myeloma. The training (n = 152) and internal validation cohorts (n = 149) consisted of 301 transplant-eligible patients with active multiple myeloma enrolled in the GEM2012MENOS65 trial. Two external validation cohorts were defined by 76 high-risk transplant-eligible patients with smoldering multiple myeloma enrolled in the Grupo Español de Mieloma(GEM)-CESAR trial, and 110 transplant-ineligible elderly patients enrolled in the GEM-CLARIDEX trial.

Results:
The most effective model to predict MRD status resulted from integrating cytogenetic [t(4;14) and/or del(17p13)], tumor burden (bone marrow plasma cell clonality and circulating tumor cells), and immune-related biomarkers. Accurate predictions of MRD outcomes were achieved in 71% of cases in the GEM2012MENOS65 trial (n = 214/301) and 72% in the external validation cohorts (n = 134/186). The model also predicted sustained MRD negativity from consolidation onto 2 years maintenance (GEM2014MAIN). High-confidence prediction of undetectable MRD at diagnosis identified a subgroup of patients with active multiple myeloma with 80% and 93% progression-free and overall survival rates at 5 years.

Conclusions:
It is possible to accurately predict MRD outcomes using an integrative, weighted model defined by machine learning algorithms. This is a new concept toward individualized treatment in multiple myeloma.
See related commentary by Pawlyn and Davies, p. 2482
From Refoundation to Decline: A Century of Catholic Church Hospitals in Spain (1880s–1980s)
Authors: León-Sanz Pilar 
Published: January 2022

Abstract
This paper analyses the contribution of the Catholic Church to Spanish hospitals for more than a century, from the last three decades of the nineteenth century to the 1980s, when the health system model changed and when the transfer of healthcare to Spain’s Autonomous Communities was initiated. The refoundation of Catholic Church hospitals can be observed in the last thirty years of the nineteenth century, as the result of the confiscation of Church property that took place during this century. The new hospitals incorporated contemporary scientific innovations and medical specialisation. Over time, the Catholic Church ran a substantial number of hospitals (surgical, maternity, children’s, psychiatric, shelters, etc.). This work of healthcare provision still continued into the early 1940s, when the Church hospitals were integrated into the national hospital system. Catholic Church hospitals accounted for 15 to 17 per cent of the total number of beds in the Spanish health system. The most common were surgical hospitals – each with around 100 beds – located in urban areas. The contribution of Catholic Church hospitals to psychiatric care was notable (30 per cent of all beds for this purpose in Spain). This study also analyses the ten-percentage point reduction in the number of beds and hospitals dependent on the Church that occurred in the 1980s.
Anxiety and Depression: The Moderating Effects of Attention to Emotion and Emotional Clarity
Authors: Yildirim Damla , Vives Jaume , Ballespí Sergi 
Published: January 2022

Anxiety and depression are the most common mental health problems. They often occur together and significantly affect well-being and daily functioning. However, it is unclear to what extent the two dimensions of meta-mood knowledge play a role in their comorbidity. Therefore, the aim of the current study was to examine the role of attention to emotion and emotional clarity in the relationship between anxiety and depression. A sample of 256 adults aged 32–66 years ( M = 46.21, SD = 5.53; 82.03% women) completed questionnaires on anxiety, depression, and meta-mood knowledge. Results showed that emotional clarity buffered the relationship between anxiety and depression. In addition, all combinations of attention to emotion and emotional clarity showed a significant and positive relationship with anxiety and depression symptom severity, with one exception. Interestingly, there was no statistically significant relationship between anxiety and depression when attention to emotion was low and emotional clarity was high. This last condition was interpreted as beneficial rather than detrimental, which in turn could help promote psychological resilience to better cope with emotional difficulties. Given these findings, this study highlights the role of attention to emotion and emotional clarity in assessing anxiety and risk of comorbid depression.
The Effect of Income Disparities on Influenza Vaccination Coverage in the United States
Authors: Gaskin Christeon M. , Woods Darien R. , Ghosh Subhanwita , Watson Shae , Huber Larissa R. 
Published: January 2022

Objectives: Although influenza vaccinations are widely accessible, many people in the United States do not receive them as recommended by the Centers for Disease Control and Prevention. This study examined the relationship between income and receiving the influenza vaccination among US adults. Methods: We used 2014-2018 National Health Interview Survey data (N = 138 697). Adults self-reported whether they received a shot or nasal spray vaccine within the previous 12 months and their total family income. We used multivariable logistic regression to obtain odds ratios and 95% CIs. Results: Approximately 43% of adults reported receiving the influenza vaccine in the previous 12 months. After adjustment, adults in lower-income-level categories had decreased odds of influenza vaccine receipt compared with adults with a total family income ≥$100 000. Specifically, adults with a total family income <$35 000 had 21% decreased odds of receiving the influenza vaccine (adjusted odds ratio = 0.79; 95% CI, 0.75-0.83). Conclusions: In this population of US adults, lower income levels were associated with decreased odds of influenza vaccine receipt. The relationship between income and receipt of the influenza vaccine may have important implications for future influenza vaccination efforts. Increasing influenza vaccination coverage among lower-income adults should be considered a public health priority.
The Patellar Instability Probability Calculator: A Multivariate-Based Model to Predict the Individual Risk of Recurrent Lateral Patellar Dislocation
Authors: Wierer Guido , Krabb Nicole , Kaiser Peter , Ortmaier Reinhold , Schützenberger Sebastian , Schlumberger Michael , Hiller Bernd , Ingruber Florian , Smekal Vinzenz , Attal Rene , Seitlinger Gerd 
Published: January 2022

Background: Predicting the risk of recurrence is of great interest when counseling patients after primary lateral patellar dislocation (LPD). Purpose: To investigate a multivariate model to predict the individual risk of recurrent LPD. Study Design: Case-control study; Level of evidence, 3. Methods: The study population included patients with primary LPD, knee imaging, and a minimum 2-year follow-up after nonoperative treatment. Data including patient characteristics and anatomic patellar instability risk factors were collected retrospectively from 7 national study centers. Bivariate and multivariate regression analyses were carried out to identify risk factors for recurrent LPD and to generate an accuracy-optimized model for out-of-sample prediction. Results: In total, 115 of 201 patients (57%) experienced recurrent LPD within 2 years after primary LPD. Age ≤16 years at primary LPD (odds ratio [OR], 5.0), history of contralateral instability (OR, 2.4), and trochlear dysplasia (Dejour type B-D: OR, 2.5; lateral trochlear inclination ≤12°: OR, 2.7) were significant risk factors for recurrent LPD ( P < .05). The prediction accuracy including these 3 risk factors was 79%. Patella alta, an increased tibial tubercle to trochlear groove distance, and patellar tilt had neither an association with increased recurrence rates nor an influence on prediction accuracy of recurrent LPD. Conclusion: Young age and trochlear dysplasia are major risk factors for early recurrent LPD. A multivariate model including age at primary LPD, lateral trochlear inclination, and history of contralateral LPD achieved the highest prediction accuracy. Based on these findings, the patellar instability probability calculator is proposed to estimate the individual risk of early recurrence when counseling patients after primary LPD.
Peak-Load Pricing With Quality-Differentiated Demand
Authors: Adams Charles F. 
Published: January 2022

This is the fifth in a series of teaching notes on quality-differentiated demand. With an eye on accessibility to undergraduate economics majors, the focus here is on peak-load pricing and highway tolls. Once quality considerations are accounted for, a richer set of insights is derived to guide social planners in deciding optimal levels of traffic flow and tolls. JEL Classifications: L0, D0