bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness Of Routine Physiotherapy With And Without Neuromobilization In Patients With Shoulder Impingement Syndrome On Pain And Functional Disability; A Randomized Control Clinical Trial
Authors: Akhtar Muhammad , Kirimi Hossein , Gilani Syed Amir , Ahmad Ashfaq , Raza Asim 
Published: December 2019

Abstract
Background: Neuromobilization (NM) includes neurophysiological parameters that vary between clinicians. This randomized controlled trial aimed to investigate the NM on the outcomes of participants with shoulder impingement syndrome (SIS) following treatment sessions (base line to follow up). Study design: Single blinded randomized control clinical trial. Methods: Patients (80) with shoulder impingement syndrome (SIS) were asked to participate in this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and functional disability score were evaluated on baseline, post treatment and after follow up. Pain was considered as primary out come and functional disability score as secondary outcome. Improvement was evaluated at post treatment and follow up. Differences in outcome between groups were evaluated with clinical improvement. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P ˂ 0.001 and Partial ƞ2=0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference ,5.62; 95%CI,(4.32-6.92); P˂ 0.001 and Partial ƞ2=0.49. Over all pain and functional disability score were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization leads to significantly different outcomes in participants than in control group. Studies are still required to explore the mechanisms underlying neuromobilization effects. Trial registration: IRCT20190121042445N1, Registered 19 February 2019. Key words: shoulder impingement, neuromobilization, functional disability.
Intrauterine transplantation of autologous menstrual blood stem cells in the treatment of refractory intrauterine adhesion: a prospective cohort study
Authors: Ma Hailan , Liu Mengting , Wu Dongcheng , Li Yufeng , Wang Wei , Yang Keqin , Lu Lanying , He Mei , Deng Taoran , Li Meiling , Wang Wei 
Published: December 2019

Abstract
Background: The loss of endometrial stem cells has been associated with intrauterine adhesion caused by miscarriage, repeated improper intrauterine operation or infection. Cell-based therapies are promising in regenerative medicine. However, the effects of menstrual blood stem cells (MenSCs) therapy on impaired endometrium need to be explored and validated. This study evaluates the effects of intrauterine transplantation of MenSCs on endometrial thickness and pregnancy outcomes in patients with refractory intrauterine adhesion. Methods: This study included a group of infertile women (n=12, age 22-40 years), with refractory intrauterine adhesion (Grade III – IV). Autologous MenSCs isolated from the women’ menstrual blood were expanded in vitro and transplanted into their uteruses, followed by hormone replacement therapy. Transvaginal ultrasound examination was performed to assess the endometrial thickness. Transabdominal ultrasound was conducted to detect pregnancy outcome. Results: Autologous MenSCs were successfully isolated and expanded from menstrual blood and transplanted into the uterus of each patient. A significant improvement of the endometrial thickness was observed (from 3.9±0.9 mm pre-treatment to 7.5±0.6 mm post-treatment (P<0.001)). No adverse reaction was observed. The duration of menstruation was increased (from 2.4±0.7 days pre-treatment to 5.3±0.6 days post-treatment (P<0.001)). Five out of 12 patients achieved clinical pregnancy. Conclusions: Intrauterine transplantation of autologous MenSCs results in regeneration of endometrium, a prolongation of menstrual duration and an increase rate of pregnancy in patients with refractory intrauterine adhesion.
Swedish Translation and Validation of the Pediatric Insomnia Severity Index
Authors: Angelhoff Charlotte , Johansson Peter , Svensson Erland , Sundell Anna Lena 
Published: December 2019

Abstract
Background: To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aim of this study was to present a Swedish version of the Pediatric Insomnia Severity Index (PISI), analyse the structure, test the validity and reliability of the instrument. Methods: The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed Results: In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors influenced all KIDSCREEN-27 dimensions. Conclusions: The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep. It is also relevant in research and for evaluation of treatment. Keywords: Child; Child, Preschool; Health Promotion; Sleep; Translations; Pediatrics; Validation Studies; Quality of Life
Maternal Subclinical Hypothyroidism in the first trimester is not Associated with Gestational Diabetes Mellitus
Authors: Li Ping , Chen Xinjuan , Cui Jinhui , Meng Zhaoran , Fan Jianhui , Lin Shuo 
Published: December 2019

Abstract
Background: To explore the association between subclinical hypothyroidism (SCH) during the first trimester and gestational diabetes mellitus (GDM) that was happened later on in our cohort. Methods: A total of 6530 pregnant women who first visited before 13 +6 gestational weeks and accepted routinely prenatal services in the third affiliated hospital of Sun Yat-Sen University from January 2015 to September 2018 were finally met the inclusion criteria and recruited. Thyroid functions (TSH, free T4 (FT4) and TPOAb) were performed at the first visit and a 2h 75-g oral glucose tolerance test was performed between 24-28 weeks. Chi-square test and multivariate logistic regression were used to evaluate the association between SCH and GDM. Results: Though SCH group was divided into subgroups according TPOAb status and TSH levels, the incidence of GDM was no change when compared with the normal group (all P > 0.05). No matter adjusting or not for maternal age, maternal pregestational body max index, parity and educational level, the results showed elevated TSH was not associated GDM (all P > 0.05). TPOAb status also had no effect on the incidence of GDM either before or after adjustment ( P > 0.05). Conclusion: Maternal SCH in the first trimester was not associated with GDM, regardless of the TPOAb status or the TSH levels.
Culture of porcine Vascular Wall - Mesenchymal Stem Cells on 3D biodegradable highly porous mineral doped Poly (α-hydroxy) acids scaffolds
Authors: Forni Monica , Bernardini Chiara , Zamparini Fausto , Zannoni Augusta , Salaroli Roberta , Ventrella Domenico , Esposti Micaela Degli , Fabbri Paola , Fava Fabio , Prati Carlo , Gandolfi Maria Giovanna 
Published: December 2019

Abstract
Background Vascularization is a crucial factor when approaching any engineered tissue. Hybrid biomaterials composed of biodegradable synthetic polymers and inorganic materials showed suitable properties for biomedical application. Being Vascular Wall – Mesenchymal Stem Cells derived from pig thoracic aorta (pVW-MSCs) an excellent in vitro model to study vascular remodelling due to their strong angiogenic attitude, the aim of the present study was to demonstrate the angiogenic potential of experimental highly porous scaffolds based on polylactic acid (PLA) or poly-e-caprolactone (PCL) doped with calcium silicates (CaSi) and dicalcium phosphate dehydrated (DCPD), namely PLA-10CaSi-10DCPD and PCL-10CaSi-10DCPD. Results The results obtained clearly demonstrated that the cells colonized the scaffolds and were metabolically active. Moreover cells, grown in these 3D systems, showed the typical gene expression profile they have in control 2D culture, although with some main quantitative differences. DAPI staining and immunofluorescence assay confirmed cellular presence on both scaffolds, however pVW-MSCs cultured in PLA-10CaSi-10DCPD showed an individual cellular growth, in contrast, in PCL-10CaSi-10DCPD scaffolds pVW-MSCs grew in spherical clusters. Conclusion In conclusion, the property of the experimental scaffolds demonstrated the suitability of the scaffolds to be colonized by vascular stem cells for new vessels formation and a potential application in tissue regeneration for biomedical purpose.
Effects of Lactobacillus plantarum on intestinal integrity and immune responses of chickens infected with Clostridium perfringens under the free-range or the specific pathogen free environment
Authors: Xu Tianyue , Chen Yan , Yu Longfei , Wang Jun , Huang Mingxing , Zhu Nianhua 
Published: December 2019

Abstract
Background Necrotic enteritis, which is caused by Clostridium perfringens, has resulted in more than $2 billion losses in the poultry industry every year. Due to the ban of antibiotics in feed industry, alternatives like environment improvement and probiotics have been found to be effective as well. In our study, we aim to explore the protective effect of Lactobacillus plantarum on CP infected chickens in two environments. Results The results showed that the Clostridium perfringens administration led to visible and histomorphological gut lesions. In the specific pathogen free or free-range system environment, dietary supplementation with LP obvious increased the ratio of intestinal villus height to crypt depth and the expression of MUC2 mRNA in ileum mucosa, then reduced the mRNA expression level of TNF-α gene in the ileum mucosa. LP treatment significantly reduced the contents of total protein, total superoxide dismutase and glutamic oxaloacetic transaminase in serum of the chickens. Conclusions The specific pathogen free environment contributed to the recovery of pre-inflammation of the chickens, and free-range system environment contributed to the repair of damage in the later stages of chicken inflammation. Supplementation of LP in FRS environment was more conducive to the recovery of CP infected in chickens.
Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study
Authors: Cheng Jingbo , Feng Mingli , Cao Guanglei , Li Zheng , An Shuai , Lu Shibao 
Published: December 2019

Abstract
Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into two groups (ages 60–80; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees. We also recorded perioperative complications and long-term complications. Result:130 patients (139 knees) between the ages of 60 and 80 (Group 1) and 65 patients (70 knees) over 80 years old (Group 2) were included in the study. The mean follow-up was 22.04 ± 11.04 and 21.76 ± 10.20 months in Group 1 and 2, respectively. At last follow-up, the patients in Group 2 showed lower function scores, but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients. Conclusion: Oxford UKA showed validity and safety for elderly patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is well restored, but the function is still poor compared with the younger patients.
Do we need to adjust for interim analyses in a Bayesian adaptive trial design?
Authors: Ryan Elizabeth , Brock Kristian , Gates Simon , Slade Daniel 
Published: December 2019

Abstract
Background Bayesian adaptive methods are increasingly being used to design clinical trials and offer a number of advantages over traditional approaches. Decisions at analysis points are usually based on the posterior distribution of the parameter of interest. However, there is some confusion amongst statisticians and trialists as to whether control of type I error is required for Bayesian adaptive designs as this is a frequentist concept. Methods We discuss the arguments for and against adjusting for multiplicities in Bayesian trials with interim analyses. We present two case studies demonstrating the effect on type I/II error rates of including interim analyses in Bayesian clinical trials. We propose alternative approaches to adjusting stopping boundaries to control type I error, and also alternative methods for decision-making in Bayesian clinical trials. Results In both case studies we found that the type I error was inflated in the Bayesian adaptive designs through incorporation of interim analyses that allowed early stopping for efficacy and do not make adjustments to account for multiplicity. Incorporation of early stopping for efficacy also increased the power in some instances. An increase in the number of interim analyses that only allowed early stopping for futility decreased the type I error, but also decreased power. An increase in the number of interim analyses that allowed for either early stopping for efficacy or futility generally increased type I error and decreased power. Conclusions If one wishes to demonstrate control of type I error in Bayesian adaptive designs then adjustments to the stopping boundaries are usually required for designs that allow for early stopping for efficacy as the number of analyses increase. If the designs only allow for early stopping for futility then adjustments to the stopping boundaries are not needed to control type I error, but may be required to ensure adequate power. If one instead uses a strict Bayesian approach then type I errors could be ignored and the designs could instead focus on the posterior probabilities of treatment effects of particular values.
Type I Error Control for Cluster Randomized Trials Under Varying Small Sample Structures
Authors: Nugent Joshua , Kleinman Ken 
Published: December 2019

Abstract
Background: Linear mixed models (LMM) are a common approach to analyzing data from cluster randomized trials (CRTs). Inference on parameters can be performed via Wald tests or likelihood ratio tests (LRT), but both approaches may give incorrect Type I error rates in common finite sample settings. The impact of interactions of cluster size, number of clusters, intraclass correlation coefficient (ICC), and analysis approach on Type I error rates have not been well studied. Reviews of published CRTs find that small sample sizes are not uncommon, so the performance of different inferential approaches in these settings can guide data analysts to the best choices. Methods: Using a random-intercept LMM stucture, we use simulations to study Type I error rates with the LRT and Wald test with different degrees of freedom (DF) choices across different combinations of cluster size, number of clusters, and ICC.Results: Our simulations show that the LRT can be anti-conservative when the ICC is large and the number of clusters is small, with the effect most pronouced when the cluster size is relatively large. Wald tests with the Between-Within DF method or the Satterthwaite DF approximation maintain Type I error control at the stated level, though they are conservative when the number of clusters, the cluster size, and the ICC are small. Conclusions: Depending on the structure of the CRT, analysts should choose a hypothesis testing approach that will maintain the appropriate Type I error rate for their data. Wald tests with the Satterthwaite DF approximation work well in many circumstances, but in other cases the LRT may have Type I error rates closer to the nominal level.
Two-step transurethral resection of bladder tumor improves surgical quality and decreases disease recurrence: a retrospective study
Authors: Huang Wei-Lun , Huang Chao-Yuan , Huang Kuo-How , Pu Yeong-Shiau , Chang Hong-Chiang , Chow Po-Ming 
Published: December 2019

Abstract
Background: Two-step transurethral resection of bladder tumor (TURBT) is a method of TURBT that is performed in two steps- exophytic tumors first and tumor bases second. The purpose is to improve tumor clearance. In current study, we evaluated outcomes of two-step TURBT in patients with non-muscle invasive bladder cancer (NMIBC). Methods: We retrospectively reviewed a prospective database. Patients who had newly diagnosed NMIBC with at least a 2-year follow-up period during Jan. 1, 2012 and Dec. 31, 2017 were enrolled. Patients with concomitant or subsequent upper urinary tract urothelial carcinoma (UTUC) were excluded. Patients were categorized into the two-step TURBT (TR) group and the conventional TURBT (CR) group. The primary endpoints were the recurrence rate and the progression rate. The secondary endpoints were the recurrence-free survival (RFS), the progression-free survival (PFS), and the detrusor muscle sampling rate. Results: A total of 205 patients were included, with 151 patients in the TR group and 54 patients in the CR group. The median follow-up period was 40.5 months. There were lower recurrence rate (29.8% vs 48.1%, P = 0.015), higher detrusor muscle sampling rate (70.7% vs 55.6%, P = 0.043), and longer RFS ( P= 0.007) in the TR group. TR was also associated with longer RFS in both univariate (HR=0.524, p =0.009) and multivariate (HR=0.426, p =0.003) analysis. Conclusions: Two-step TURBT results in lower recurrence rate and longer RFS for NMIBC, especially for Ta disease. Two-step TURBT also improves detrusor muscle sampling rate, which is essential for adequate resection and accurate staging.
Does urethral length affect continence outcomes following robot assisted laparoscopic radical prostatectomy (RALP)?
Authors: Lin Diwei , O'Callaghan Michael E , David Rowan , Fuller Andrew , Wells Richard , Sutherland Peter , Foreman Darren 
Published: December 2019

Abstract
Purpose Post-operative urinary incontinence is a significant concern for patients choosing to undergo a radical prostatectomy (RP) for treatment of prostate cancer. The aim of our study was to determine the effect of pre-operative MUL on 12 month continence outcomes in men having robot-assisted laparoscopic prostatectomy (RALP).Methods We use the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database, to identify 602 patients who had undergone RALP by a high volume surgeon. Only patients who received an assessment and education by a specialist pelvic floor physiotherapist, had completed EPIC questionnaires before treatment and did not have radiotherapy treatment within 12 months of surgery were included. MUL measurements were taken from pre-operative magnetic resonance imaging (MRI) scans. The short-form version of the Expanded Prostate Cancer Index Composite (EPIC-26) was used to measure continence outcomes. Continence was defined as 100/100 in the EPIC-26 Urinary Continence domain score.Results The observed median MUL in this study was 14.6mm. There was no association between MUL and baseline continence. MUL was associated with continence at 12 months post RALP (OR 1.13, 95% CI 1.03-1.21, p=0.0098). In men who were continent before surgery, MUL was associated with return to continence at 12 months after RALP (OR 1.15, 1.05-1.28, p=0.006). MUL was also associated with change in continence after surgery (β=1.22, p=0.002).Conclusions MUL had no effect on baseline continence but had a positive and significant association with continence outcomes over 12 months post RALP.
Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital
Authors: Lyra Divaldo Pereira de , Alcântara Thaciana dos Santos , Neto Fernando Castro de Araújo , Lima Helena Ferreira , Araújo Dyego Carlos S. Anacleto de , Sanchez Júlia Mirão , Junior Divaldo P. de Lyra 
Published: December 2019

Abstract

Background: Children are more susceptible to medication errors and adverse reactions. In addition, variation in body mass and medication discrepancies are the major causes of medication errors, which pose a risk of harm to children. When unresolved, these issues can lead to longer hospital stays, increased hospital readmissions, and emergency room care that burden the healthcare system. Many organizations have struggled to implement medication reconciliation. In this context, studies demonstrated that reliability and improvement science methods can be used to implement a successful and sustained medication reconciliation process. One of the initial steps involved in medication reconciliation process is determining the sector for implementation. Therefore, the aim of this study was to determine the prevalence of medication discrepancies occurring throughout the course of a hospital stay and describe the types of discrepancies and medications most commonly involved in pediatric cases. Methods: A cross-sectional study was carried out from July 2017 to March 2018 in the pediatric department of a high-complexity public hospital in Brazil. Data collection consisted of: collection of sociodemographic data, clinical interview with the patient's caregiver, registration of patient prescriptions, and evaluation of medical records. Discrepancies were classified as intentional or unintentional and included omission of medication, therapeutic duplicity, different dose, frequency, route of administration than prescribed. Study approved by the Research Ethics Committee (CAAE: 36927014.4.0000.5546). Results: During care transitions, 114 children were followed. Patients presented unintentional discrepancies, of which 16 (14.0%) presented discrepancies at hospital admission, 42 (36.8%) during ward transfer, and 52 (45.6%) during discharge. Omission represented 74% (n=20) ofthe errors at admission, 38% (n=26) at ward transfer, and 100% (n=80) at discharge. The most frequent discrepancies in the three transitions were related to antimicrobials, representing 43.3% of discrepancies at admission, 38.8% at internal transfer, and 61.2% during discharge. Conclusion: The results demonstrated that the main transition levels when unintentional discrepancies occurred in children in this hospital were during internal transfer and discharge and indicated difficulties in interprofessional communication and poor documentation. Evaluation of all transition points is essential for determining the most critical point in the quality of care provided at hospitals.