bluuebunny/crossref_metadata_2025_split huggingface dataset:
Floor and Ceiling Effects, Time to Completion, and Question Burden of PROMIS CAT Domains Among Shoulder and Knee Patients Undergoing Nonoperative and Operative Treatment
Authors: Gulledge Caleb M. , Smith D. Grace , Ziedas Alexander , Muh Stephanie J. , Moutzouros Vasilios , Makhni Eric C. 
Published: December 2019

Background:
The Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) have emerged as an efficient technique for measuring patient-reported outcomes among orthopaedic patients. The purpose of this study was to investigate the floor and ceiling (F/C) effects, time to completion (TTC), and question burden of PROMIS CATs administered to patients presenting to a shoulder and sports medicine orthopaedic clinic.

Methods:
Patients prospectively completed PROMIS CATs including the physical function (PROMIS-PF) or upper-extremity function (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) domains at their initial encounter and were retrospectively included in this study. Adult patients indicating a single problem involving either the shoulder or knee were included. Patients were also grouped as either preoperative or nonoperative. F/C effects were defined as the proportion of respondents scoring the highest (ceiling) or lowest (floor) possible score across a given domain.

Results:
Included were 2,952 patients (average age, 51.0 ± 16.9 years). The PROMIS-UE, PROMIS-PF, and PROMIS-PI demonstrated negligible F/C effects across all shoulder and knee patients (<2%). The PROMIS-D displayed moderate to significant floor effects (13.9% to 18.9%) and a 0% ceiling effect in all main patient groups. The mean TTC and mean question burden of the PROMIS-UE, PROMIS-PF, and PROMIS-PI ranged from 45.3 to 54.4 seconds and 4.1 to 4.9 questions for all patient groups, while the PROMIS-D exhibited a TTC ranging from 20.9 to 38.6 seconds for all groups and a question burden that ranged from 6.2 to 6.7 questions.

Conclusions:
The PROMIS-PF, PROMIS-UE, and PROMIS-PI demonstrated favorable F/C effects, TTC, and question burden among both nonoperative and preoperative patients. These findings justify consideration of the PROMIS-PF, PROMIS-UE, and PROMIS-PI for clinical and research applications involving shoulder and knee sports medicine patients. Additionally, we found moderate to significant floor effects for the PROMIS-D in all patient groups, which may be multifactorial in nature and may not be unexpected in patients with an isolated joint concern.

Clinical Relevance:
This study highlights the psychometric properties of PROMIS CAT forms for knee and shoulder patients. Understanding these basic properties is important in considering the adoption of PROMIS CAT forms for patients with musculoskeletal conditions.
Macular and peripapillary vessel density measurement in the evaluation of Non-proliferative Diabetic Retinopathy
Authors: Yang Dawei , Cao Dan , Yu Honghua , Yang Xiaohong , Huang Zhongning , Zeng Yunkao , Zhuang Xuenan , Wu Qiaowei , Liu Baoyi , Zhang Liang 
Published: December 2019

Abstract
Purpose: To compare vessel density in macular and peripapillary area between control subjects and patients with non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography angiography (OCTA) and to evaluate the association between RNFL thickness and different stage of diabetic retinopathy. Methods: A total of 170 eyes (normal control, 43; mild NPDR, 43; moderate NPDR, 42; severe NPDR, 42) underwent OCTA imaging. Optical coherence tomography angiographic parameters were vessel densities of superficial capillary plexus (SCP), deep capillary plexus (DCP) in macular area and peripapillary area. Results: Vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were 53.13%±3.03%, 52.07%±2.28%, 53.78%±3.66% and 128.86μm±11.32μm, respectively, in control subjects; 50.24%±3.81%, 47.40%±45.02%, 46.50%±6.03% and 124μm±13.97μm, respectively, in mild NPDR; 46.80%±5.23%; 44.39%±3.99%; 44.64%±4.23%; 121.02μm±20.86μm, respectively, in moderate NPDR; 42.82%±5.46%, 42.34%±5.14%, 43.16%±4.47%, 118.60μm±21.91μm in severe NPDR. The reduction of vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were correlated with increasing severity of DR. Vessel density of SCP and DCP in macular area, peripapillary area and foveal density 300 (FD 300) in normal control were significantly higher than that of mild, moderate and severe NPDR groups. (all P<0.001). Vessel density of DCP shows better ability to identify the severity of DR (0.913; 95% CI=0.867-0.958; cut off value:0.75) than FD 300, vessel density of SCP in macular area and peripapillary area. Conclusion: Macular and peripapillary vessel density as well as RNFL thickness decreased as DR progresses. Vessel density in DCP could be an objective and sensitive indicator for monitoring progression of DR. OCTA might be clinically useful to evaluate microvascular and microstructural alterations in macula and optive nerve head (ONH), thus providing a new method to study the course of DR.
"Teaching:Individual" to Increase Adherence to Therapeutic Regimen in People with Hypertension and Type-2 Diabetes: Randomized Controlled Trial ENURSIN
Authors: Parra Dora Inés , Guevara Sandra Lucrecia Romero , Sánchez Lyda Zoraya Rojas 
Published: December 2019

Abstract
Background. Educational interventions with multifaceted approach have proven effective to improve adherence to the therapeutic regimen in people with chronic diseases. This study sought to evaluate the efficacy of the nursing intervention “Teaching: Individual” compared with usual care to increase adherence to therapeutic regimen and to analyze the impact of nursing interventions to decrease systolic blood pressure (SBP) and glycosylated hemoglobin (HbA1c) levels in people with hypertension and/or type-2 diabetes mellitus. Methods. This was a two-arm parallel randomized clinical trial in 200 patients from primary care programs with arterial hypertension and type-2 diabetes. The intervention was designed with a multifaceted approach and conducted individually in six sessions. For statistical analysis of SBP, a linear marginal model was used with an exchangeable correlation matrix for repeated measures, and for treatment adherence as well as generalized HbA1c estimating equations repeated measures were used with an unstructured correlation matrix, using all available data. All analyses were conducted in STATA software version 15.0. Values of p <0.05 were considered statistically significant. Results. After six months the follow up score adherence to the therapeutic regimen was higher in the “Teaching: Individual” group compared with the usual care group with a difference in the median of 0.87 points (95% CI: 0.30 to 1.44). The difference in the median of SBP between the groups was -3.79 mmHg (95% CI: -6.85 to -0.73), in favor of the group intervened. The difference in the median of HbA1c was -0.16% (95% CI: -0.41 to 0.09). The effect was not maintained at 12 months of follow up in none of the variables of interest. Conclusions. As well as in other contexts, this study determined that educational interventions with multifaceted approach leaded by nursing are effective in improving therapeutic adherence and control of tension figures in users of primary care programs with high blood pressure and type-2 diabetes. Trial Registration: ENURSIN was registered in ClinicalTrials.gov (NCT02758275) on 27 April 2016, protocol number 01. Keywords: Nursing Process; Diabetes Mellitus, Type 2; Hypertension, Patient Education as a Topic, Blood Pressure Monitoring, Ambulatory; Treatment Adherence and Compliance; Glycated Hemoglobin A.
Domain-Adaptive Service Evaluation of Mobile Health Application
Authors: Wang Xiaojia , Du Kuo , Xia Wei , Zhang Shanshan , Xu Weiqun , Guan Yuxiang 
Published: December 2019

Abstract
Background: In the context of "Internet +" medical treatment, mobile health applications provide services for people in a new way, making it possible for people to carry out health management anytime and anywhere. According to the survey data, the most powerful consumers in the field of mobile health applications are those aged 24 to 35. Thus, it can be seen, it is particularly important to study the preferences of young people for mobile health applications.Methods: This study established a domain-adaptive mobile health application evaluation model based on users’ experience, and used an interactive algorithm combining machine learning and Delphi method to calculate the weight distribution of evaluation factors. Compared with previous studies, the establishment of evaluation index based on user experience of youth groups can more comprehensively measure users' demand for mobile health application service quality. Meanwhile, the mobile health application evaluation system established in this study adopts feedback mechanism to realize dynamic evaluation of mobile health applications.Results: The cognitive level of information (weighting 52%) was only four percentage points higher than the emotional level (weighting 48%). The importance of the four criteria is content information on cognition (weighting 31%), interaction information on emotion (weighting 29%), interaction information on cognition (weighting 21%), and content information on emotion (weighting 19%) in descending order. Among 20 sub-criteria, less disruptive (weighting 17.8%), security (weighting 10.9%), utility (weighting 9.3%), reliability (weighting 8.1%), navigational (weighting 6.7%) occupy an important position.Conclusion: We find that the weights assigned to sociability, personalization, aesthetics, and interestingness accounted for a significant proportion of the total weights assigned; however, universality and learnability were poorly weighted. These results have important reference value for the development of mobile health applications.
Preparation and in vitro Evaluation of High Performance Fermented Soybean Meal using a mixture of Lactobacillus plantarum, Bacillus subtilis and Saccharomyces cerevisiae
Authors: Zhu Jiajia , Wang Shuaiyu , Gao Mingxing , Zhang Yanping , Tang Qihe , Wang Jinquan , Zhao Li , Lv Hongyu , Hao Zhihui 
Published: December 2019

Abstract
Background: Soybean meal is used in animal feeds as a protein supplement but contains significant amounts of anti-nutritional factors such as trypsin inhibitor that directly inhibit digestion, absorption and utilization of nutrients. Results: Herein, we used solid state batch fermentation of soybean meal using Lactobacillus plantarum, Bacillus subtilis and Saccharomyces cerevisiae alone and in combination to alter the content of anti-nutritional compounds in the meal. A systematic analysis identified a temperature of 40℃, water content of 40 % in a 48 h fermentation that optimized the fermentation according to our goals. The digestibility of the meal increased within 36 h and by 48 h, the free amino acid content increased while glycinin, β-conglycinin and trypsin inhibitor significantly decreased and the indigestible sugars stachyose and raffinose were reduced to undetectable levels. These processes correlated with high levels of lactic acid that were responsible for an overall pH decrease. Conclusions: Bacterial and mixed fermentations increased nutritional content while eliminating anti-nutritional factors and significantly improved the nutritional quality of the soybean meal.
Estimating the impacts of hospitals’ organisational characteristics on the adoption of health information technology in Mongolian public hospitals
Authors: Zhang Xinping , Tsagaankhuu Sarnai 
Published: December 2019

Abstract
Background The adoption of health information technology (HIT) is an important measure for improving healthcare quality and safety effected by many hospital factors, but it has not yet been estimated in the Mongolian healthcare field. This study examines how hospitals’ organisational characteristics influence the adoption of HIT in Mongolian tertiary and secondary care public hospitals. Methods А cross-sectional study involving the executive directors and quality managers at 39 hospitals. Data came from: (1) hospitals’ organisational characteristics (Mongolian Health Statistics, 2017), including hospital size, ownership type, health maintenance organisation (HMO) penetration, and hospital location; (2) questionnaires used to collect the adoption rate of HIT and HIT categories based on the Health Information and Management Systems Society’s classification (2002). The dependent variable was measured as numbers and the rate of HIT programs adopted included clinical, administrative and strategic information technologies (IT). A regression analysis was used to estimate the factors of impact on the adoption of clinical, administrative and strategic IT. Results On average, the number of HIT programs adopted reached 18, covering nine clinical IT programs, six administrative IT programs and three strategic IT programs. The adoption rate of overall HIT ranged between 29.02–38.05% with a mean of 33.29%. Regression analysis for organisational characteristics impact on HIT adoption found that the adoption of total HIT was positively associated with large hospital size (clinical IT: β=0.256, p< .001; administrative IT: β=0.3654, p< .001; strategic IT: β=0.0006, p<.001), ownership type (strategic IT: β=1995, p< .01), urban location (clinical IT: β=0.2840, p< .001, administrative IT: β=0.2256, p< .01; strategic IT: β=0.2256, p< .001), and HMO penetration (clinical IT: β=0.2560, p< .05, administrative IT: β=0.1985, p< .05; strategic IT: β=0.2236, p< .01). Conclusion Our study found that HIT adoption rate is poor, and HIT adoption is positively associated with hospitals’ organisational characteristics, such as large size, urban location, and HMO penetration. The profit ownership only positively contributes to strategic IT adoption. We concluded that hospitals with the above structural attributes conducive to more HIT adoption.
Attitudes and Comprehension of the Informed Consent Form by the Oncology Patients
Authors: Topçu İbrahim 
Published: December 2019

Abstract
The main purpose of this study was to investigate knowledge and perceptions of the informed consent form by cancer patients receiving chemotherapy. The participants were selected through a random sampling methodology. Out of 30 cancer patients, 28 volunteered to be involved in the study. They completed a sociodemographic form. The findings revealed that the informed consent form does not greatly affect patients about chemotherapy and their decisions. They mostly were not aware of the content and purpose. The factors behind that included incomprehensible language, less time, crowded clinics, and belief on the doctor. It is suggested that chemotherapy patients should obtain more accurate and memorable information about the treatment process and its side effects with informed consent
Effectiveness of probiotics for antipsychotic-induced functional bowel disorders: A single-center retrospective observational study
Authors: Nakamura Masaru , Nagamine Takahiko 
Published: December 2019

Abstract
Background Probiotics have the potential to improve functional constipation, however, evidence is lacking regarding its recommendation related to gut microbiota. Constipation is highly prevalent and a serious side-effect in antipsychotic treatment. This study was to investigate the effects of probiotics supplementation on defecation in psychiatry.Methods Subjects consisted of 31 male and 37 female inpatients who were co-administrated either of two probiotics: BIO-THREE or BIOFERMIN tablets. The medications that affect bowel movement including gastrointestinal drugs and antipsychotics in addition to their levels of chlorpromazine equivalent (CPeq) doses were compared between the two groups. Intestinal function was evaluated at baseline and one and two months using Bristol stool form scale. Sequential change of the three indices: average, constipation and diarrhea levels were compared within the group and analyzed to see any significant correlation against the CPeq levels. Results There were no significant differences in the medical treatment between the groups. In both groups, the average and constipation levels increased, and the diarrhea levels decreased at two months from baseline; in particular, the constipation levels were significantly increased at two months from baseline in the BIO-THREE group (-9.6±1.0 vs -6.5±0.9, mean±se). In the BIO-THREE group, only the diarrhea levels were significantly negatively correlated with the CPeq levels at two months (r= -0.341), while no such correlations were found in the BIOFERMIN group.Conclusions Probiotics supplementation may improve stool consistency, especially severe constipation and ameliorate diarrhea depended on antipsychotic dosage in psychiatric setting.
Beyond biomarkers and towards functional outcomes for adult persons living with HIV. A cross sectional survey in Blantyre Urban, Malawi.
Authors: Manyozo Steven Derrick , Tarimo Nesto , Kawalazira Gift , Muula Adamson Sinjani 
Published: December 2019

Abstract
Introduction Despite improvements in survival, reports indicate that people living with HIV are experiencing a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging recently termed ‘disability’. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. Methods We conducted a quantitative cross sectional study among adult persons living with HIV in Blantyre urban from March to August 2018. Participants were recruited consecutively from 5 health centers. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages and continuous variables were summarized using means and standard deviation. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated. Results Of the 277 participants enrolled in the study, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years ( std. dev 9.5 ). Impairments in mental functions were the most prevalent affecting 118 (43%) study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Impairments in the mental functions, genital urinary, reproductive, digestive, metabolic and endocrine systems were associated with higher odds of disability among the participants. Conclusions Our results indicate a high prevalence of impairments among persons living with HIV. Clinicians and rehabilitation personnel need to be proactive in identifying and managing impairments to promote health among HIV patients.
Hydraulic characteristics of stepped spillway dropshafts for urban deep tunnel drainage systems: the case study of Chengdu city
Authors: Liao Lei , An Ruidong , Li Jia , Yi Wenmin , Liu Xiaofan , Meng Wenkang , Zhu Lei 
Published: December 2019

Abstract
Cities in southwestern China experience urban drainage and overflow pollution after extreme rainfall events, which are major problems. In this study, a type of stepped spillway dropshaft suitable for drainage by deep tunnels in Chengdu was proposed and the hydraulic characteristics were investigated experimentally. The results showed that the nappe flow and strong turbulent deflected jet flow in the stepped spillway allowed the dropshaft to greatly dissipate energy. According to the distribution of the time-averaged pressure on the steps, the flow on the steps could be divided into a recirculating region, a wall-impinging region and a mixing region. The time-averaged pressure on the outside of the step was higher than that on the inside due to the centrifugal force effect of the water. The fluctuating pressure distribution of the step approximated the normal distribution. It was acceptable to calculate the minimum pressure with 3 times the root mean square (RMS). The vibration of the flow on the stepped spillway did not resonate with the step. When the outflow tunnel was under submerged outflow conditions, the aeration in the stepped spillway was exhausted through air holes and only a small amount of air entered the outflow tunnel, thereby avoiding an air explosion.
The removal of Rhodamine B by H2O2 or ClO2 combined with hydrodynamic cavitation
Authors: Wang Kun , Jin Ri-ya , Qiao Yi-na , He Zeng-di , Wang Ying , Wang Xiao-jian 
Published: December 2019

AbstractRhodamine B (RhB), widely used as an industrial dye, is a toxic organic that is hazardous to human health and can cause water pollution. In this study, the removal rate of RhB was investigated by the following methods: hydrodynamic cavitation (HC) operated individually, and HC combined with oxidants H2O2 or ClO2. The effect of different operating parameters including pressure (2–6 bar) and initial pH (2–8) on the extent of degradation was investigated using an orifice plate as the cavitation device to achieve maximum removal of RhB. Under the parameters of HC, the effect of different loadings was investigated: H2O2 (n(RhB):n(H2O2) was varied from 1:17.60 to 1:211.28) and ClO2 (n(RhB):n(ClO2) was varied from 1:8.87 to 1:177.53). A combination of cavitation and H2O2 or ClO2 resulted in degradations of 80.6% and 95.3%. The results indicated that the combination of HC and oxidants was better than the individual HC process for the degradation of RhB. When combining HC with H2O2 or ClO2, the synergistic coefficients of 62.54 and 74.79 were obtained. The combination of HC and ClO2 was proven to be more effective for the removal of RhB compared to HC alone and the hybrid process of HC and H2O2.