bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis
Authors: Yang Chuang , Li Zhibo , Xue Xin , fei yu 
Published: December 2019

Abstract
Background Class III anti-arrhythmic drugs (AADs) are used to control heart rhythm or rate in the management of atrial fibrillation (AF). In this study, we evaluated the most effective and safe class III AADs used to treat patients with AF. Methods We searched the PubMed, Cochrane Library, Web of Science, Embase, WanFang databases, as well as the China National Knowledge Infrastructure from 2014 to 2019 to identify studies that reported the use of class III ADDs to treat AF. Results We identified 31 articles (24 Chinese and 7 English), that included 2,894 AF patients (treatment group = 1,498, control group = 1,396) for our analysis. Several class III AADs showed significant treatment effects in AF patients compared to conventional treatment. The ADDs were ranked in terms of efficacy from good to bad as follows: vernakalant (relative risk (RR) =2.7, 95% confidence interval (CI):1.9-3.7), ibutilide (RR=2.0, 95% CI:1.7-2.4), nifekalant (RR=1.5, 95% CI:1.2-2.0), and amiodarone (RR=1.4,95% CI:1.3-1.5). There were no significant differences in the incidence of adverse reactions among the different class III AADs. These ADDs were ranked from least to most adverse reactions as follows: vernakalant(RR=0.46, 95% CI:0.20-1.0), sotalol (RR=0.52, 95% CI:0.25-1.0), ibutilide (RR=0.64, 95% CI:0.33-1.2), amiodarone (RR=0.79, 95% CI:0.58-1.1), and nifekalant (RR=1.0, 95% CI:0.44-2.5). Conclusion Our network meta-analysis shows that different class III AADs can be used to treat patients with AF both safely and effectively. Vernakalant appears to offer optimal therapeutic effect with minimal adverse reactions.
Comparison of three dimensional reconstruction and conventional computer tomography angiography in patients undergoing zero-ischemia laparoscopic partial nephrectomy
Authors: Wu Xiaorong , Jiang Chen , Wu Guangyu , Shen Chao , Fu Qibo , Chen Yonghui , Liu Dongming , Xue Wei 
Published: December 2019

Abstract
Background: Advances in the three dimensional (3D) reconstruction and printing technology have fueled a rapidly growing interest in its applications in the field of urology. To our knowledge, the experience on the use of 3D reconstruction to facilitate zero-ischemia partial nephrectomy (PN) remains sparse and the role of 3D reconstruction is still needed to be defined. This study aimed to assess the role of three-dimensional (3D) reconstruction and conventional computer tomography angiography (CTA) in zero-ischemia laparoscopic partial nephrectomy (LPN). Methods: A total of 60 consecutive patients undergoing zero-ischemia LPN between October 2017 and March 2018 underwent CTA (CTA group including 30 patients) and 3D reconstruction (3D group including the remaining 30 patients) were included. 3D reconstruction and CTA images were prepared which were used to demonstrate the number and spatial interrelationships of the location of renal tumors and tumor feeding arteries. These radiology findings were directly correlated with intraoperative surgical findings at laparoscopy. Demographics, perioperative characteristics and renal function were compared between groups. Results: CTA and 3D reconstruction were successfully performed without any related complications. All the procedures were performed successfully without conversion to main renal artery clamping. Preoperative 3D reconstruction identified that 15 patients had only one tumor feeding artery, 12 had two, and another 3 had three, while the conventional CTA revealed that 22 patients had one tumor feeding artery, 8 had two (P>0.05). The mean operation time was shorter and estimated blood loss was less in the 3D group (P<0.05). 3D reconstruction group resulted in more accurate dissection of tumor artery (91.7%) as compared to conventional CTA (84.2%). There were no statistical differences in the baseline characteristics and renal function outcomes between two groups. Conclusions: 3D reconstruction can provide comprehensive information for the preoperative evaluation and intraoperative orientation that may facilitate tumor resection during zero-ischemia LPN for renal tumors.
Physical activity intervention for non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials
Authors: Wang Shu-ting , Zheng Jing , Peng He-wei , Cai Xiao-lin , Pan Xin-ting , Li Hui-quan , Hong Qi-zhu , Peng Xian-E 
Published: December 2019

Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease. Diet and lifestyle changes have dramatically increased its prevalence worldwide. This meta-analysis was performed to investigate the efficacy of physical activity intervention on liver-specific endpoints in the NAFLD population, namely hepatic enzyme levels, serum lipid levels, and glucose metabolism. Methods: PubMed and China National Knowledge Infrastructure (CNKI) databases were searched for randomized clinical trials of physical activity intervention on patients with NAFLD through to April 20, 2019. Effect sizes were reported as the standardized mean differences (SMD) and 95% confidence intervals (CI). The quality of the included studies was assessed using the Cochrane risk of bias tool. Meta-analyses were conducted using random-effect or fixed-effect models depending on the significance of heterogeneity. Clinical variability was investigated using subgroup analyses according to physical activity type and duration. Results: Eleven studies with a cumulative total of 1000 participants met the selection criteria. Physical activity was associated with small reductions in three hepatic enzyme parameters: alanine aminotransferase, (SMD: -0.17, 95% CI: -0.29 to -0.05), aspartate aminotransferase, (SMD: -0.25, 95% CI: -0.37, -0.13), and γ-glutamyl transferase (SMD: -0.21, 95% CI: -0.35, -0.08). Significant small improvements were also found for total cholesterol (SMD: -0.22, 95% CI: -0.34, -0.09), triglycerides (SMD: -0.20, 95% CI: -0.32 to -0.07), and low-density lipoprotein cholesterol (SMD: -0.26, 95% CI: -0.39 to -0.13). Physical activity also slightly improved two glucose metabolism parameters: fasting glucose (SMD: -0.25, 95% CI: -0.37 to -0.12) and homeostasis model assessment of insulin resistance (SMD: -0.38, 95% CI: -0.52, -0.24). High-density lipoprotein cholesterol and fasting insulin between the physical intervention group and control group were not significantly different. Subgroup analysis suggested that both aerobic exercise alone and resistance exercise alone could improve most liver function and glucose metabolism outcomes and that longer exercise duration generally had better improvement effects. The difference between all subgroups was not significant, except for the TG subgroups categorized by physical activity type. Conclusions: Our findings suggest that physical activity alone can only slightly improve hepatic enzyme levels, serum lipid levels, and glucose metabolism in patients with NAFLD.
Conditions for successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses
Authors: Nilsen Per , Seing Ida , Ericsson Carin , Birken Sarah A. , Schildmeijer Kristina 
Published: December 2019

Abstract

Background: Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful. Methods: The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis. Results: The analysis yielded three categories concerning conditions for successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients.Conclusions: Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients. Keywords: Organizational change, Implementation, Influence, Preparedness, Patient benefit
Knowledge of physiotherapists on the use of Muscle Energy Technique in the management of Non-Specific Low Back Pain
Authors: Ahmed Usman Abba , Maharaj SONILL Sooknunan , Thaya Nadasan , Kaka Bashir , Akodu Ashiyat Kahinde 
Published: December 2019

Abstract
Objective: The relevance and use of Muscle Energy Technique (MET) as a mode of treatment for Non-specific low back pain (NSLBP) over the last two decades has increased among physiotherapists and other health professionals. This supports the clinical relevance and efficacy of this technique. However, there are no studies to determine the level of MET knowledge among Nigerian physiotherapists. This study was designed to determine the MET knowledge among Nigerian physiotherapists.Method: A total of one hundred and twenty physiotherapists were recruited from the database of the Nigerian Society of Physiotherapy and participated in the study. They completed a semi-structured questionnaire containing 46-items. This was divided into four sections which sourced information on sociodemographic characteristics, work-profile, treatment activities and the knowledge of MET for the management of NSLBP. Data were analyzed using descriptive statistics for mean, frequency and percentages. Inferential statistics of Chi-square, Pearson Correlation, independent t-test and ANOVA were used to determine the significant difference with significance set at p<0.05.Result: The study revealed that 16.7% of the participants had knowledge of the application of MET in the management for NSLBP. Age, educational level, practice setting, area of specialization such as musculoskeletal therapy, ergonomics and additional training of low back pain (LBP) were factors that influenced respondents’ MET knowledge (p<0.05). However, gender, university of training, number of years of experience and the practice of managing of LBP in the physiotherapy department did not influence knowledge of MET for the management of NSLBP (p >0.05).Conclusion: This study showed that a small number of participants had knowledge of MET application in the management of NSLBP and certain factors influenced this knowledge. Keywords: Non-specific low back pain, Muscle Energy Technique, Physiotherapists knowledge, Nigeria
The Adoption Level of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes
Authors: Kose Ilker , Rayner John , Birinci Suayip , Ulgu Mustafa Mahir , Yilmaz Ismayil , Guner Seyma 
Published: December 2019

Abstract
Background Considering the benefits of using electronic health records (EHR) for maintaining the overall quality of clinical care, the nationwide adoption of EHR in hospitals has become a policy priority. The electronic medical record maturity model (EMRAM) is one of the most popular survey tools developed by the Healthcare Information and Management Systems Society (HIMSS) that measures the level of adoption for EHR functions in a hospital or a secondary care setting. This study aims to measure the digital capacity of public hospitals in Turkey and criticize the relation between adoption and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) public hospitals of Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated.Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which is better than the results of Korean hospitals of 2017 but still lower than the USA hospitals of 2015 (1)[1]and 2017. Our findings suggest that small hospitals are better than larger hospitals at adopting certain EHR functions. Conclusion Measuring the overall adoption level of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all public hospitals in a country by using EMRAM. The results are used by MoH of Turkey to disseminate the benefits of EHR functions overall in the country.
Typology of residential long-term care units in Germany: An explorative hierarchical clustering on principal components analysis
Authors: Bergmann Johannes Michael , Ströbel Armin Michael , Holle Bernhard , Palm Rebecca 
Published: December 2019

Abstract
Background Organizational health care research focuses on describing structures and processes in organizations and investigating their impact on the quality of health care. In the setting of residential long-term care, this effort includes the examination and description of structural differences among the organizations (e.g., nursing homes). The objective of the analysis is to develop an empirical typology of living units in nursing homes that differ in their structural characteristics. Methods Data from the DemenzMonitor Study were used. The DemenzMonitor is an observational study carried out in a convenience sample of 103 living units in 51 nursing homes spread over 11 German federal states. Characteristics of living units were measured by 19 variables related to staffing, work organization, building characteristics and meal preparation. Multiple correspondence analysis (MCA) and agglomerative hierarchical cluster analysis (AHC) are suitable to create a typology of living units. Both methods are multivariate and explorative. We present a comparison with a previous typology (created by a nonexplorative and nonmultivariate process) of the living units derived from the same data set. Results The MCA revealed differences among the living units, which are defined in particular by the size of the living unit (number of beds), the additional qualifications of the head nurse, the living concept and the presence of additional financing through a separate benefit agreement. Three clusters could be identified; these clusters occur significantly with a certain combination of characteristics. In terms of content, the three clusters can be defined as "house community", "dementia special care units” and "usual care". Conclusion The typology of living units allows to identify more suitable outcomes and to develop more tailor-made interventions. Furthermore, the development of a typology is useful to gain a deeper understanding of the differences in the care structures of residential long-term care organizations. The intended theory development on the subject of different types of living units and the subsequent definition of these units will enable the long-term evaluation of their influence in further health care research.
Panfungal PCR assays using fresh frozen paraffin embedded tissue specimens for fungal species identification and the detection of azole-resistance mutations in the A. fumigatus cyp51A gene at a South Korean hospital
Authors: Jung In Young , Lee Youn-Jung , Shim Hyo Sup , Lee Woon Ji , Kim Jun Hyoung , Seong Hye , Kim Jung Ho , Ahn Jin Young , Jeong Su Jin , Ku Nam Su , Park Yoon Soo , Yeom Joon Sup , Kim Young Keun , Kim Hyo Youl , Choi Jun Yong 
Published: December 2019

Abstract
Background: With rising concerns about changing fungal epidemiology and azole resistance in Aspergillus species, identifying fungal species and susceptibility patterns of mucorales and aspergillosis are crucial in the management of these diseases. The objectives of this study were to evaluate performance of panfungal PCR assays on formalin-fixed paraffin embedded (FFPE) samples for fungal species identification, and the detection of azole-resistance mutations in the Aspergillus fumigatus ( A.fumigatus ) cyp51A gene at a South Korean hospital. Methods: A total of 75 FFPE specimens with a histopathological diagnosis of aspergillosis or mucormycosis were identified during the 10-year study period (2006-2015). After deparaffinization and DNA extraction, panfungal PCR assays were conducted on FFPE samples for fungal species identification. The identified fungal species were compared with histopathological diagnosis. On samples identified as A.fumigatus , sequencings to identify frequent mutations in the cyp51A gene (tandem repeat 46 [TR46], L98H, and M220 alterations) that confer azole resistance were performed. Results: Specific fungal DNA was identified in 31 (41.3%) FFPE samples, and of these, 16 samples of specific fungal DNA were in accord with histopathological diagnosis of aspergillosis or mucormycosis. 15 samples had discordant histopathology and PCR results. No azole-mediating cyp51A gene mutation was revealed among nine cases of A. fumigatus . Moreover, no cyp51A mutations were identified among three cases with history of prior azole use. Conclusion: The pan-fungal PCR assay with FFPE sample may provide additional information on fungal species identification. No azole-resistance mediating mutations in the A. fumigatus cyp51A gene were identified among FFPE samples during study period.
Hepatitis E virus truncated capsid protein as a potential carrier of exogenous antigens for the development of chimeric virus-like particle vaccines
Authors: LU Tianyu , BEHLOUL Nouredine , ZHOU Yi , BAHA Sarra , LIU Zhenzhen , WEI Wenjuan , SHI Ruihua , Meng Jihong 
Published: December 2019

Abstract
Background: Virus like particle (VLP), a multiprotein structure which is assembled automatically, can stimulate robust immune responses due to an appropriate size, repetitive epitopes, and a structure similar to native virions. Utilizing VLPs as vaccine carriers to present exogenous antigens is a promising and challenging field in vaccine design. Hence, this study aims to investigate the potential of Hepatitis E virus (HEV) truncated capsid protein as a VLP carrier presenting foreign antigens in vaccine design.Results: S and M domains of HEV ORF2 protein (aa112-455) were selected as an optimal carrier (CaSM). The exogenous antigen Seq8 containing three immunogenic domains from three different foot-and-mouth disease virus (FMDV) strains was linked to the C-terminal of CaSM to construct a chimeric VLP vaccine candidate (CaSM-Seq8). Morphological analysis showed that CaSM-Seq8 self-assembled into VLPs with a diameter of approximately 26 nm, similar to the VLPs of CaSM alone but smaller than native HEV virions. Further, the thermal stability and the proteolysis resistance of Seq8 were enhanced when carried by CaSM. The antigenicity analysis revealed a more robust reactivity against anti-FMDV specific antibodies when Seq8 was presented on the CaSM particles. Upon injection into mice, anti-FMDV IgGs induced by CaSM-Seq8 appeared earlier, increased faster, and maintained higher levels for a longer time than those induced by Seq8 antigen alone or a commercial inactivated FMDV vaccine.Conclusions: This study demonstrates the potential of the HEV truncated capsid protein VLPs as a presenting-platform of exogenous antigens in vaccine design and promising preliminary results on chimeric VLP vaccine against foot-and-mouth disease.
Spatial Models for Infants HIV/AIDS Incidence Using an Integrated Nested Laplace Approximation Approach
Authors: Mutua Susan Nzula 
Published: December 2019

Abstract
Background Kenya has made significant progress in the elimination of mother to child transmission of HIV through increasing access to HIV treatment and improving the health and well-being of women and children living with HIV. Despite this progress, broad geographical inequalities in infant HIV outcomes still exist. This study aimed at assessing the spatial distribution of HIV amongst infants, areas of abnormally high risk and associated risk factors for mother to child transmission of HIV using INLA and SPDE approach. Methods Data were obtained from the Early infant diagnosis (EID) database that is routinely collected for infants under one year for the year 2017. We performed both areal and point-reference analysis. Bayesian hierarchical Poisson models with spatially structured random effects were fitted to the data to examine the effects of the covariates on infant HIV risk. Spatial random effects were modelled using Conditional autoregressive model (CAR) and stochastic partial differential equations (SPDEs). Inference was done using Integrated Nested Laplace Approximation. Posterior probabilities for exceedance were produced to assess areas where the risk exceeds 1. The Deviance Information Criteria (DIC) selection was used for model comparison and selection. Results CAR model outperformed similar competing models in modeling and mapping HIV Relative Risk in Kenya. It had a smaller DIC among the rest (DIC = 306.36)) The SPDE model outperformed the spatial GLM model based on the DIC statistic. Highly active antiretroviral therapy (HAART) and breastfeeding were found to be negatively and positively associated with infant HIV positivity respectively [-0.125, 95% Credible Interval (Cred. Int.)= -0.348, -0.102], [0.178, 95% Cred. Int. -0.051, 0.412].Conclusion The study provides relevant strategic information required to make investment decisions for targeted high impact interventions to reduce HIV infections among infants in Kenya.