bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of competence training for the minimally trained health worker in type 2 diabetes
Authors: Gudlavalleti Anirudh Gaurang , Babu Giridhara R. , van Schayck Onno C.P. , Schaper Nicolaas C. , Lewis Melissa Glenda , Murthy G.V.S. 
Published: October 2020

AbstractIntroduction:Type 2 diabetes mellitus is responsible for high mortality and morbidity globally and in India. India has high prevalence of the condition and the burden is set to increase exponentially in the next decade. Indians traditionally reside in rural or semi-urban areas with limited access to healthcare facilities. To overcome this, the government has introduced a cadre of health workers called Accredited Social Health Activists (ASHA) for such areas. These workers were initially trained to provide maternal & infant care but now need improved competence training to improve type 2 diabetes screening & management in these locations. The objective of the study is to assess the competence training provided to ASHA workers at the chosen study sites.Methodology:A cluster randomized control trial has been designed. It will be conducted across 8 centers in Hyderabad & Rangareddy districts of Telangana, India. The training will be provided to ASHA workers. The tool used for training will be developed from existing sources with an emphasis on topics which require training. The training will be delivered across 6 months at each center as a classroom training. Each participant's baseline competence will be recorded using a questionnaire tool and a practical evaluation by trained public health experts. The same experts will use the same tools to assess the training post the intervention.Discussion:This trial will evaluate the use of health worker training as a tool for improving the clinical competence in relation to type 2 diabetes mellitus. We anticipate that the module will provide a greater understanding of type 2 diabetes mellitus, the importance of screening of both disease and complications and improved skills for the same. The study has received the ethical approval form the Institutional Ethics Committee of the Indian Institute of Public Health Hyderabad. The registration number is: IIPHH/TRCIEC/218/2020. The trial has also been registered under the Clinical trial registry of India (CTRI) on 27thJuly 2020. The registration number of the trial is: CTRI/2020/07/026828. The URL of the registry trial is: http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=45342&EncHid=&userName=CTRI/2020/07/026828.
Continuous epileptic negative myoclonus as the first seizure type in atypical benign epilepsy with centrotemporal spikes
Authors: Yang Li , Su Quanping , Xu Na , Xu Liyun , Zhao Juan , Fan Chao , Li Yufen , Li Baomin 
Published: October 2020

Abstract
To figure out which diagnosis is more suitable and which antiepileptic drugs are more sensitive to epileptic negative myoclonus (ENM) as the first seizure type in atypical benign epilepsy with centrotemporal spikes.
We reviewed the electroencephalogram (EEG) database of Linyi People's Hospital Affiliated to Shandong University and medical records of patients with ENM onset. The characteristics of epileptic seizures, onset age, treatment process, growth and development history, past disease history, family history, degree of mental deterioration, cranial imaging, and video-EEG were studied retrospectively and followed up.
There were 4 cases with ENM onset and 1 with continuous ENM, 3 males and 1 female. The onset age was from 2 years 3 months to 8 years 7 months. The cranial magnetic resonance imaging (MRI) and developmental quotient, as well as the family, personal, and past disease history, were normal. Frequent falls and drops were the main clinical manifestations. Five months after the onset of ENM, case 1 had focal seizures in sleep. ENM was the first and only manifestation in all the other 3 children. Discharges of interictal EEG were in bilateral rolandic areas, especially in midline areas (Cz, Pz), electrical status epilepticus in sleep was found in 3 cases. One child was sensitive to levetiracetam, the other 3 were sensitive to clonazepam.
ENM can affect the upper or lower extremities. ENM as the first or only symptom was a special phenomenon in benign epilepsy with centrotemporal spikes (BECTS) variants. Ignorance of midline spikes mainly in Cz or Pz in BECTS might lead to missed diagnosis of ENM. Whether benzodiazepines are viable as a choice of BECTS variants with electrical status epilepticus in sleep when ENM is the first symptom still needs a large sample evidence-based observation.
Relationship of alignment in the lower extremity with early degeneration of articular cartilage after resection of the medial meniscus
Authors: Nakagawa Shuji , Arai Yuji , Inoue Hiroaki , Fujii Yuta , Kaihara Kenta , Mikami Yasuo 
Published: October 2020

Abstract
The objective of this study was to examine the relationship between cartilage degeneration early after partial medial meniscectomy and abnormal alignment in the lower extremity.
The subjects were 34 patients (37 knees) with medial meniscal tear who underwent arthroscopic partial meniscectomy. MRI was performed before and 6 months after surgery. T2 mapping images in sagittal sections of medial femoral condyle were produced and 10 regions of interest were set at intervals of 10° in the articular cartilage in the femur. Subjects with an increase in T2 of ≥6% at a flexion angle of 30° were assigned to the degeneration group. Patient background, hip-knee-ankle (HKA) angle, and total resection of meniscal segments were compared between this group and the other patients to identify factors involved in degeneration of articular cartilage.
T2 values 6 months after surgery in 3 ROIs at flexion angles of 30° to 50° were significantly longer than those before surgery. The preoperative HKA angle was significantly higher in the degeneration group. T2 values in articular cartilage of the femoral condyle increased earlier after meniscectomy with abnormal alignment in the lower extremity.
Meniscectomy in cases with abnormal alignment may have a risk of early onset of osteoarthritis.
Level of evidence: Level IV
Chinese herbal medicines for the treatment of cough in idiopathic pulmonary fibrosis
Authors: Xiao Siyao , Yu Yang , Xiong Yimin , Sun Fang , Liu Xiaoyu , Yan Jiaxin , Zhang Shunan 
Published: October 2020

Abstract

Background:
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease with unknown etiology and hidden onset, which causes major health problems worldwide. Cough is a typical manifestation of IPF, which is usually characterized by cough without phlegm, and seriously affects the quality of life (QOL) of patients. At present, the treatment of IPF is mainly focused on prolonging survival time and improving lung function, such as pirfenidone, nintedanib, and N-acetylcysteine (NAC), but lack of effective measures to improve the QOL. Chinese herbal medicines (CHMs) is widely used in the clinical treatment of IPF. The adjuvant treatment of CHMs can effectively reduce the clinical symptoms of patients. Therefore, we designed this study to evaluate the role of CHMs in the treatment of cough in IPF.

Method:
This systematic review and meta-analysis will extract all randomized controlled trials (RCTs) related to the treatment of IPF from the following electronic database without date or language restrictions: PubMed, EMBASE, Cochrane CENTRAL, CNKI, VIP, CBM, and Wanfang database. The primary outcomes will be cough frequency and QOL, while secondary outcomes will include safety events. The methodologic quality of RCTs will be assessed using the Cochrane risk assessment tool. The I2 test will be used to identify the extent of heterogeneity, and funnel plot analysis will be used to test the publication deviation (the number of studies included >10). We will use RevMan5.3 software for data synthesis and analysis.

Result:
This review evaluates the efficacy and safety of CHMs in combination therapy on cough frequency, the quality of life, adverse reactions and safety incidents in patients with IPF.

Conclusion:
This study protocol will be used to evaluate the efficacy and safety of CHMs in combination with conventional therapy in treatment of cough in IPF.

OSF Registration DOI:
10.17605/OSF.IO/JKQYV.
Ju Re Ba Du therapy for Postherpetic neuralgia
Authors: Huang Shijie , Pan Zhengqi , Li Zimeng , Zhu Xinyun , Ma Tingting , Wu Jie 
Published: October 2020

Abstract

Introduction:
Postherpetic neuralgia (PHN) is one of the most common types of chronic neuropathic pain, which seriously affects quality of the life because of pain severity and poor response to the currently available treatments. Ju Re Ba Du therapy as a form of acupuncture therapy which is proved to be effective in RCTs and very suitable for patients, has been used in Postherpetic neuralgia in patients for a long time, therefore a systematic review is necessary to provide available evidence for further study.

Methods and analysis:
The following databases will be searched from their inception to October 2020: Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, Nature, Science online, VIP medicine information, and CNKI (China National Knowledge Infrastructure). Primary outcome: pain intensity assessed on a visual analogue scale (VAS); Additional outcomes:
Data will be extracted by two researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0.

Results:
The results of this study will systematically evaluate the effectiveness and safety of Ju Re Ba Du therapy intervention for people with Postherpetic neuralgia.

Conclusion:
The systematic review of this study will summarize the current published evidence of Ju Re Ba Du therapy for the treatment of Postherpetic neuralgia, which can further guide the promotion and application of it.

Ethics and dissemination:
This study is a systematic review, the outcomes are based on the published evidence, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations.

OSF registration number:
September 29, 2020 osf.io/r6y9b. (https://osf.io/r6y9b)
Full-endoscopic decompression for thoracic ossification of ligamentum flavum: surgical techniques and clinical outcomes
Authors: Li Wenyi , Gao Shangju , Zhang Long , Cao Can , Wei Jingchao 
Published: October 2020

Abstract

Background:
Many complications are associated with thoracic open decompression surgery, such as dural tears and neurological deficits. The clinical outcomes are also not satisfactory. Full-endoscopic decompression of the lumbar spinal canal has achieved satisfactory results for the treatment of lumbar spinal stenosis. This surgery may be used for the treatment of thoracic ossification of the ligamentum flavum (OLF) under local anesthesia. The aim of our study is to introduce the surgical techniques used for full-endoscopic decompression for thoracic OLF and to evaluate its safety and efficacy.

Methods:
Fourteen patients with thoracic OLF (4 combined with dural ossification) underwent full-endoscopic decompression surgery. An interlaminar approach was performed. The anchoring method was used to establish the working passage. Spinal cord exposure began at a space between the ossification and the spinal cord, and dorsal and contralateral decompression were performed with the “Over the Top” technique. The modified Japanese Orthopedic Association score (11 points) was used to evaluate the efficacy during follow-up. At the same time, the visual analogue scale score for assessing back pain before and after the operation was evaluated.

Results:
The average operation time was 159.73 ± 62.09 minutes, and the hospitalization time was 7.43 ± 1.79 days. The follow-up period ranged from 8 to 22 months. Neurological function was improved. There were no serious complications. Dural tears occurred in 5 patients, intraoperative neurological deterioration occurred in 1 patient, and intraoperative headache and neck pain occurred in 1 patient.

Conclusion:
Full-endoscopic decompression is an effective, safe surgical technique for thoracic OLF even the cases combined with dural ossification.
Introduction and Validation of a Novel Acute Pancreatitis Digital Tool
Authors: Paragomi Pedram , Spagnolo Daniel M. , Breze Cameron R. , Gougol Amir , Talukdar Rupjyoti , Kochhar Rakesh , Goenka Mahesh Kumar , Gulla Aiste , Gonzalez Jose A. , Singh Vikesh K. , Ferreira Miguel , Stevens Tyler , Barbu Sorin T. , Nawaz Haq , Gutierrez Silvia C. , Zarnescu Narcis O. , Archibugi Livia , Easler Jeffrey J. , Triantafyllou Konstantinos , Pelaez-Luna Mario , Thakkar Shyam , Ocampo Carlos , de-Madaria Enrique , Cote Gregory A. , Wu Bechien U. , Pothoulakis Ioannis , Haupt Mark , Whitcomb David C. , Papachristou Georgios I. 
Published: October 2020

ObjectivesAcute pancreatitis (AP) is a sudden onset, rapidly evolving inflammatory response with systemic inflammation and multiorgan failure (MOF) in a subset of patients. New highly accurate clinical decision support tools are needed to allow local doctors to provide expert care.MethodsAriel Dynamic Acute Pancreatitis Tracker (ADAPT) is a digital tool to guide physicians in ordering standard tests, evaluate test results and model progression using available data, propose emergent therapies. The accuracy of the severity score calculators was tested using 2 prospectively ascertained Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience cohorts (pilot University of Pittsburgh Medical Center, n = 163; international, n = 1544).ResultsThe ADAPT and post hoc expert-calculated AP severity scores were 100% concordant in both pilot and international cohorts. High-risk criteria of all 4 severity scores at admission were associated with moderately-severe or severe AP and MOF (bothP< 0.0001) and prediction of no MOF was 97.8% to 98.9%. The positive predictive value for MOF was 7.5% to 14.9%.ConclusionsThe ADAPT tool showed 100% accuracy with AP predictive metrics. Prospective evaluation of ADAPT features is needed to determine if additional data can accurately predict and mitigate severe AP and MOF.
Nonopioid drug combinations for cancer pain: protocol for a systematic review
Authors: Sohi Gursharan , Caraceni Augusto , Moulin Dwight E. , Zimmermann Camilla , Herx Leonie , Gilron Ian 
Published: October 2020

Abstract

Introduction:
Pain related to cancer, and its treatment, is common, may severely impair quality of life, and imposes a burden on patients, their families and caregivers, and society. Cancer-related pain is often challenging to manage, with limitations of analgesic drugs including incomplete efficacy and dose-related adverse effects.

Objectives:
Given problems with, and limitations of, opioid use for cancer-related pain, the identification of nonopioid treatment strategies that could improve cancer pain care is an attractive concept. The hypothesis that combinations of mechanistically distinct analgesic drugs could provide superior analgesia and/or fewer adverse effects has been tested in several pain conditions, including in cancer-related pain. Here, we propose to review trials of nonopioid analgesic combinations for cancer-related pain.

Methods:
Using a predefined literature search strategy, trials—comparing the combination of 2 or more nonopioid analgesics with at least one of the combination's individual components—will be searched on the PubMed and EMBASE databases from their inception until the date the searches are run. Outcomes will include pain intensity or relief, adverse effects, and concomitant opioid consumption.

Results/Conclusions:
This review is expected to synthesize available evidence describing the efficacy and safety of nonopioid analgesic combinations for cancer-related pain. Furthermore, a review of this literature will serve to identify future research goals that would advance our knowledge in this area.
Adverse childhood experiences in parents of youth with chronic pain: prevalence and comparison with a community-based sample
Authors: Beveridge Jaimie K. , Dobson Keith S. , Madigan Sheri , Yeates Keith O. , Stone Amanda L. , Wilson Anna C. , Salberg Sabrina , Mychasiuk Richelle , Noel Melanie 
Published: October 2020

Abstract

Introduction:
Adverse childhood experiences (ACEs) are common occurrences that are related to poor health outcomes, including chronic pain, in youth and adults. Research suggests that children of parents exposed to ACEs are also at risk of poor outcomes. However, little is known about the risk that ACEs confer for chronic pain across generations. Parent ACEs may play an important role in pediatric chronic pain, given their association with key parent factors (eg, mental and physical health).

Objectives:
This study evaluated the prevalence of ACEs in parents of youth with chronic pain and compared these rates to a community-based sample.

Methods:
One hundred seventy parents of youth (aged 10–18 years) with chronic pain, recruited from a tertiary-level chronic pain program at a pediatric hospital in Canada, completed a self-report measure of ACEs. A comparison sample (n = 3914) was drawn from a local, community-based study that examined ACEs among adults in primary care.

Results:
Among parents of youth with chronic pain, 67.6% reported ≥1 ACE and 23.5% reported ≥4 ACEs. Controlling for sociodemographic factors, ACEs were similar across samples, except parents of youth with chronic pain reported significantly higher rates of physical neglect (odds ratio = 2.14; 95% confidence interval = 1.35–3.40) than the community-based sample.

Conclusion:
Adverse childhood experiences are prevalent among parents of youth with chronic pain, with physical neglect reported more frequently than the community-based sample. Further research that examines the association between parent ACEs and child chronic pain, as well as neurobiological and psychosocial factors that may mediate this potential relation, is needed.
Relationship Between Performance in the Timed Up & Go and Foot Clearances During Obstacle Crossing in Older Women
Authors: Ceccon Fernando G. , Guadagnin Eliane C. , da Rocha Emmanuel S. , Priario Liver A. A. , Kunzler Marcos R. , Carpes Felipe P. 
Published: October 2020

Objective:
To verify whether Timed Up & Go (TUG) performance correlates with foot clearances in different conditions of obstacle crossing.

Methods:
Thirty older women were assigned to a group with or without risk of falls classified by TUG. Three-dimensional kinematics of walking with obstacles was recorded.

Results:
For those without risk, TUG did not correlate with foot clearances. Among those with risk of falls, a moderate inverse correlation was found between TUG and heel clearance.

Conclusion:
Timed Up & Go did not differentiate older women with or without risk of falls regarding foot clearances during obstacle crossing.
The Occiput-Wall Distance Was Related to the Physical/Mental Outcomes in the Elders With Severe Flexed Posture, But Not the Dual Digital Inclinometer Thoracic Kyphosis
Authors: Balki Selvin , Özyonar Ayişe 
Published: October 2020

Purpose:
To examine the usefulness of the dual digital inclinometer thoracic kyphosis and the occiput-wall distance (OWD) measures as a marker of the mental/physical status in older adults with severe flexed posture (FP).

Method:
The study was conducted with 16 nursing home-dwelling older adults (13 male/3 female) with severe FP (OWD > 8.0).

Results:
The OWD was correlated with the severity of fear of falling, cognitive function, depression, mobility, 10-m gait speed, and anterior trunk flexibility at moderate and good levels (v < .05).

Conclusions:
The OWD may be useful as a marker of the mental/physical status in older adults.
Nonlinear self-dual network equations: modulation instability, interactions of higher-order discrete vector rational solitons and dynamical behaviours
Authors: Wen Xiao-Yong , Yan Zhenya , Zhang Guoqiang 
Published: October 2020

The nonlinear self-dual network equations that describe the propagations of electrical signals in nonlinear LC self-dual circuits are explored. We firstly analyse the modulation instability of the constant amplitude waves. Secondly, a novel generalized perturbation (
M
,
N
−
M
)-fold Darboux transform (DT) is proposed for the lattice system by means of the Taylor expansion and a parameter limit procedure. Thirdly, the obtained perturbation (1,
N
− 1)-fold DT is used to find its new higher-order rational solitons (RSs) in terms of determinants. These higher-order RSs differ from those known results in terms of hyperbolic functions. The abundant wave structures of the first-, second-, third- and fourth-order RSs are exhibited in detail. Their dynamical behaviours and stabilities are numerically simulated. These results may be useful for understanding the wave propagations of electrical signals.
Real-world, Prospective, and Multicenter Validation of a microRNA-based Thyroid Molecular Classifier
Authors: dos Santos Marcos Tadeu , Rodrigues Bruna Moretto , Shizukuda Satye , Alves Figueiredo David Livingstone , de Melo Giulianno Molina , da Silva Rubens Adão , Fainstein Claudio , dos Reis Gerson Felisbino , Corbo Rossana , Ramos Helton Estrela , Vaisman Fernanda , Vaisman Mário 
Published: October 2020

ABSTRACTBackgroundThe diagnosis of cancer in thyroid nodules with indeterminate cytology (Bethesda III/IV) is challenging as fine-needle aspiration (FNA), the gold standard method, has limitations, and these cases usually require diagnostic surgery. As approximately 77% of these nodules are not malignant, a diagnostic test accurately identifying benign thyroid nodules can reduce surgery rates. We have previously reported the development and validation of a microRNA-based thyroid molecular classifier for precision endocrinology (mir-THYpe) with high sensitivity and specificity, which could be performed directly from readily available cytological smear slides without the need for a new dedicated FNA. We sought to evaluate whether the use of this test in real-world clinical routine can reduce the rates of surgeries for Bethesda III/IV thyroid nodules and analyze the test performance.MethodsWe designed a real-world, prospective, multicenter cohort study. Molecular tests were performed in a real-world clinical routine with samples (FNA smear slides) prepared at 128 cytopathology laboratories. Patients were followed-up from March 2018 until surgery or until March 2020 (for those patients not recommended for surgery). The final diagnosis of thyroid tissue samples was retrieved from postsurgical anatomopathological reports.ResultsAfter applying the exclusion criteria, 435 patients (440 nodules) classified as Bethesda III/IV were followed-up. The rate of avoided surgeries was 52.5% for all surgeries and 74.6% for “potentially unnecessary” surgeries. After the statistical treatment of non-resected test-negative samples, the test achieved 89.3% sensitivity (95% CI 82–94.3), 81.65% specificity (95% CI 76.6–86), 66.2% positive predictive value (95% CI 60.3–71.7), and 95% negative predictive value (95% CI 91.7–97) at 28.7% (95% CI 24.3–33.5) cancer prevalence. The test influenced 92.3% of clinical decisions.ConclusionsThe reported data demonstrate that the use of the microRNA-based classifier in the real-world can reduce the rate of thyroid surgery with robust performance and significantly influence clinical decision-making.