bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mannitol and renal graft injury in patients undergoing deceased donor renal transplantation – a randomized controlled clinical trial
Authors: Reiterer Christian , Hu Karin , Sljivic Samir , Falkner von Sonnenburg Markus , Fleischmann Edith , Kainz Alexander , Kabon Barbara 
Published: July 2020

Abstract
Background
Ischaemia/reperfusion (I/R) injury is associated with renal tissue damage during deceased donor renal transplantation. The effect of mannitol to reduce I/R injury during graft reperfusion in renal transplant recipients is based on weak evidence. We evaluated the effect of mannitol to reduce renal graft injury represented by 16 serum biomarkers, which are indicators for different important pathophysiological pathways. Our primary outcome were differences in biomarker concentrations between the mannitol and the placebo group 24 h after graft reperfusion. Additionally, we performed a linear mixed linear model to account biomarker concentrations before renal transplantation.

Methods
Thirty-four patients undergoing deceased donor renal transplantation were randomly assigned to receive either 20% mannitol or 0.9% NaCl placebo solution before, during, and after graft reperfusion. Sixteen serum biomarkers (MMP1, CHI3L1, CCL2, MMP8, HGF, GH, FGF23, Tie2, VCAM1, TNFR1, IGFBP7, IL18, NGAL, Endostatin, CystC, KIM1) were measured preoperatively and 24 h after graft reperfusion using Luminex assays and ELISA.

Results
Sixteen patients in each group were analysed. Tie2 differed 24 h after graft reperfusion between both groups (p = 0.011). Change of log2 transformed concentration levels over time differed significantly in four biomarkers (VCAM1,Endostatin, KIM1, GH; p = 0.007; p = 0.013; p = 0.004; p = 0.033; respectively) out of 16 between both groups.

Conclusion
This study showed no effect of mannitol on I/R injury in patients undergoing deceased renal transplantation. Thus, we do not support the routinely use of mannitol to attenuate I/R injury.

Trial registration
NCT02705573. Registered on 10th March 2016.
Study protocol training for life: a stepped wedge cluster randomized trial about emergency obstetric simulation-based training in a low-income country
Authors: van Tetering A. A. C. , van Meurs A. , Ntuyo P. , van der Hout-van der Jagt M. B. , Mulders L.G.M. , Nolens B. , Namagambe I. , Nakimuli A. , Byamugisha J. , Oei S. G. 
Published: July 2020

Abstract
Background
Globally perinatal and maternal mortality rates remain unacceptably high. There is increasing evidence that simulation-based training in obstetric emergencies is associated with improvement in clinical outcomes. However, the results are not entirely consistent. The need for continued research in a wide variety of clinical settings to establish what works, where and why was recommended. The aim of this study is to investigate the effectiveness of an emergency obstetric simulation-based training program with medical technical and teamwork skills on maternal and perinatal mortality in a low-income country.

Methods
A stepped wedge cluster randomized trial will be conducted at the medium to high-risk labour ward at Mulago Hospital, Kampala, Uganda, with an annual delivery rate of over 23,000. The training will be performed using a train-the-trainers model in which training is cascaded down from master trainers to local facilitators (gynaecologists) to learners (senior house officers). Local facilitators will be trained during a four-day train-the-trainers course with an annual repetition. The senior house officers will be naturally divided in seven clusters and randomized for the moment of training. The training consists of a one-day, monodisciplinary, simulation-based training followed by repetition training sessions. Scenarios are based on the main local causes of maternal and neonatal mortality and focus on both medical technical and crew resource management skills. Kirkpatrick’s classification will be used to evaluate the training program. Primary outcome will be the composite of maternal and neonatal mortality ratios. Secondary outcome will comprise course perception, evaluation of the instructional design of the training, knowledge, technical skills, team performance, percentage of ventouse deliveries, percentage of caesarean sections, and a Weighted Adverse Outcome Score.

Discussion
This stepped wedge cluster randomized trial will investigate the effect of a monodisciplinary simulation-based obstetric training in a low-income country, focusing on both medical technical skills and crew resource management skills, on patient outcome at one of the largest labour wards worldwide. We will use a robust study design which will allow us to better understand the training effects, and difficulties in evaluating training programs in low-income countries.

Trial registration
ISRCTN98617255, retrospectively registered July 23, 2018.
Association between pre-pregnancy calcium intake and hypertensive disorders during the first pregnancy: the Japan environment and children’s study
Authors: Kyozuka Hyo , Murata Tsuyoshi , Fukuda Toma , Yamaguchi Akiko , Kanno Aya , Yasuda Shun , Sato Akiko , Ogata Yuka , Kuse Masahito , Hosoya Mitsuaki , Yasumura Seiji , Hashimoto Koichi , Nishigori Hidekazu , Fujimori Keiya ,   Japan Environment and Children’s Study (JECS) Group, Kamijima Michihiro , Yamazaki Shi , Ohya Yukihiro , Kishi Reiko , Yaegashi Nobuo , Hashimoto Koichi , Mori Chisato , Ito Shuichi , Yamagata Zentaro , Inadera Hidekuni , Nakayama Takeo , Iso Hiroyasu , Shima Masayuki , Kurozawa Youichi , Suganuma Narufumi , Kusuhara Koichi , Katoh Takahiko 
Published: July 2020

Abstract
Background
Determining the appropriate preconception care to reduce the occurrence of hypertensive disorder of pregnancy (HDP) remains a challenge in modern obstetrics. This study aimed to examine the association between pre-pregnancy calcium (Ca) intake and HDP in normotensive primiparas.

Methods
We used data from the Japan Environment Children’s study (JECS), which is the largest birth cohort study. A total of 33,894 normotensive Japanese primiparas were recruited for JECS between January 2011 and March 2014. Participants were categorized into five groups according to pre-pregnancy Ca intake quintiles (Q1 and Q5 were the lowest and highest Ca intake groups, respectively) to compare their basic background and obstetrics outcome. Multiple logistic regressions were performed to identify the effect of pre-pregnancy Ca intake on HDP, early onset HDP, and late-onset HDP, using Ca intake thresholds of 500, 550, 650, 700, 1000, 1500, and 1500 mg.

Results
We found significant differences in maternal background among the Ca intake groups; in particular, there were more participants with low socioeconomic status, indicated by low education level and low household income, and smokers in the lowest Ca intake group. Multiple logistic regression did not show any significant difference with regard to HDP, early onset HDP, and late-onset HDP in each Ca intake threshold.

Conclusions
Despite considerable recommendations concerning Ca intake for women of reproductive age, the present study indicates that pre-pregnancy Ca intake was not associated with an increased risk of new-onset hypertension among primiparas during pregnancy. Further studies examining the effect of other pre-pregnancy dietary factors on obstetric outcomes should be considered in the formulation of earlier preventive strategies for primiparas.
Burden of hepatitis E virus infection in pregnancy and maternofoetal outcomes: a systematic review and meta-analysis
Authors: Bigna Jean Joel , Modiyinji Abdou Fatawou , Nansseu Jobert Richie , Amougou Marie A. , Nola Moise , Kenmoe Sébastien , Temfack Elvis , Njouom Richard 
Published: July 2020

Abstract
Background
There is still a dearth of knowledge on the burden of HEV infection in the global population of pregnant women. Therefore, we conducted a systematic review and meta-analysis to estimate the global burden of HEV infection in pregnancy.

Methods
We searched PubMed, Embase, Web of Knowledge, and Global Index Medicus to identify articles published until January 26, 2020. We considered cross-sectional, case-control, and cohort studies reporting the immunoglobulins M HEV seroprevalence in asymptomatic and symptomatic (jaundice or elevated transaminases) pregnant women or investigating the association between HEV infection and maternofoetal outcomes. We used a random-effects model to pool studies. This review was registered with PROSPERO, CRD42018093820.

Results
For HEV prevalence estimates, we included 52 studies (11,663 pregnant women). The seroprevalence was 3.5% (95% confidence interval: 1.4–6.4) in asymptomatic women (most of whom from high endemic areas). The prevalence in symptomatic women was 49.6% (42.6–56.7) with data only from HEV high endemic countries. In the multivariable meta-regression model, the prevalence was higher in symptomatic women compared to asymptomatic (adjusted prevalence odds ratio [aPOR]: 1.76; 95%CI: 1.61–1.91) and decreased with increasing year of publication (by 10-year) (aPOR: 0.90; 95%CI: 0.84–0.96). The proportion of HEV vertical transmission was 36.9% (13.3–64.2). Risk of bias was low, moderate and high respectively in 12 (23%), 37 (70%), and 4 studies (7%) addressing HEV prevalence estimation. HEV infection was associated with maternal deaths (pooled OR 7.17; 3.32–15.47), low birth weight (OR: 3.23; 1.71–6.10), small for gestational age (OR: 3.63; 1.25–10.49), preterm < 32 weeks (OR: 4.18; 1.23–14.20), and preterm < 37 weeks (OR: 3.45; 2.32–5.13), stillbirth (OR: 2.61; 1.64–4.14), intrauterine deaths (OR: 3.07; 2.13–4.43), and not with miscarriage (OR: 1.74; 0.77–3.90). All studies which assessed the association between HEV infection and maternofoetal outcomes had a moderate risk of bias.

Conclusions
Findings from this study are suggestive of a high burden of HEV infection in pregnancy in high endemic countries, its association with poor maternofoetal outcomes, and a high rate of vertical transmission. This study supports the need for specific strategies to prevent exposure of pregnant women to HEV infection, especially in high endemic areas.
Associations between nutritional factors and KRAS mutations in colorectal cancer: a systematic review
Authors: El Asri Achraf , Zarrouq Btissame , El Kinany Khaoula , Bouguenouch Laila , Ouldim Karim , El Rhazi Karima 
Published: July 2020

Abstract
Background
Between 30 and 50% of colon tumors have mutations in the Kirsten-ras (KRAS) gene, which have a large nutritional attributable risk. Despite its high frequency in colorectal cancer (CRC), data to support specific associations between KRAS mutations in CRC and diet are sparse. Here, we conducted a systematic review to summarize the current epidemiological evidence on the association between various dietary factors and KRAS mutations.

Methods
PubMed, Science Direct, and Cochrane databases were searched for relevant studies published until December 31, 2019, using inclusion and exclusion criteria in accordance with PRISMA guidelines. We analyzed the studies to find associations between nutritional factors and CRC tumors with KRAS mutations in humans.

Results
We identified 28 relevant studies to include in this systematic review. In-depth analyses showed unclear associations between nutritional factors and KRAS mutations in CRC. Most epidemiological studies in the same nutrient or food often reported conflicting and/or inconclusive findings, whereas for some dietary factors, the results were homogeneous.

Conclusions
Further research using a more robust prospective cohort study is needed to lend more credence to the epidemiological associations found between KRAS mutations and dietary factors.
Case of primary intraocular lymphoproliferative disorder caused by Epstein–Barr Virus
Authors: Ban Yumiko , Okamoto Masahiro , Ogata Nahoko 
Published: July 2020

Abstract
Background
Cases of panuveitis caused by Epstein–Barr virus (EBV) associated with primary intraocular lymphoproliferative disorder (LPD) are rare in immunocompetent individuals.

Case presentation
A 67-year-old man noted blurred vision in both eyes and was referred to our hospital. His best-corrected visual acuity (BCVA) was 20/20 in both eyes. He had mild inflammation in the anterior chamber but not in the vitreous of both eyes. The inflammation was resolved with topical corticosteroid but 10 months later both eyes presented recurrence. Treatment with a sub-Tenon’s injection of steroid was effective for OS but not for OD and 2 months after, the inflammation in the anterior chamber and vitreous opacities got worsen in OD and BCVA decreased to 6/20 OD. Thus, pars plana vitrectomy was performed on OD, and EBV was detected in the aqueous humor by multiplex polymerase chain reaction, and an infiltration of CD19κ positive B cells was revealed in the vitreous specimens by flow cytometry. Systemic workup revealed no other sites of lymphoproliferation, no active EBV infection, or underlying immunodeficiency.

Conclusion
Panuveitis caused by EBV associated with primary intraocular LPD can occur in patients with no history of congenital or acquired immunodeficiencies.
Study protocol for a randomized controlled trial of the effectiveness of adding motivational interviewing or stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders. The MI-NAV study
Authors: Øiestad Britt Elin , Aanesen Fiona , Løchting Ida , Storheim Kjersti , Tingulstad Alexander , Rysstad Tarjei L. , Småstuen Milada C. , Tveter Anne Therese , Sowden Gail , Wynne-Jones Gwenllian , Fors Egil A. , van Tulder Maurits , Berg Rigmor C. , Foster Nadine E. , Grotle Margreth 
Published: July 2020

Abstract
Background
Little research exists on the effectiveness of motivational interviewing (MI) on return to work (RTW) in workers on long term sick leave. The objectives of this study protocol is to describe a randomized controlled trial (RCT) with the objectives to compare the effectiveness and cost-effectiveness of usual case management alone with usual case management plus MI or usual case management plus stratified vocational advice intervention (SVAI), on RTW among people on sick leave due to musculoskeletal (MSK) disorders.

Methods
A multi-arm RCT with economic evaluation will be conducted in Norway with recruitment of 450 participants aged 18–67 years on 50–100% sick leave for > 7 weeks due to MSK disorders. Participants will be randomized to either usual case management by the Norwegian Labour and Welfare Administration (NAV) alone, usual case management by NAV plus MI, or usual case management by NAV plus SVAI. Trained caseworkers in NAV will give two MI sessions, and physiotherapists will give 1–4 SVAI sessions depending upon risk of long-term sick leave. The primary outcome is the number of sick leave days from randomization to 6 months follow-up. Secondary outcomes are number of sick leave days at 12 months follow-up, time until sustainable RTW (≥4 weeks of at least 50% of their usual working hours) at 12 months, proportions of participants receiving sick leave benefits during 12 months of follow-up, and MSK symptoms influencing health at 12 months. Cost-utility evaluated by the EuroQoL 5D-5L and cost-benefit analyses will be performed. Fidelity of the interventions will be assessed through audio-recordings of approximately 10% of the intervention sessions.

Discussion
The results from this RCT will inform stakeholders involved in supporting RTW due to MSK disorders such as staff within NAV and primary health care.

Trial registration
ClinicalTrials.gov ID: NCT03871712 registered March 12th 2020.
Impact of posterior femoral condylar cartilage and posterior intercondylar distance on rotation of femoral component in total knee arthroplasty
Authors: Miyasaka Teruyuki , Saito Mitsuru , Kurosaka Daisaburo , Ikeda Ryo , Yamanaka Shoki , Marumo Keishi 
Published: July 2020

Abstract
Background
Greater accuracy is needed when determining the final femoral component (FC) rotation during total knee arthroplasty (TKA), because this parameter affects soft tissue balance during flexion and patellar tracking. Anatomical markers, such as the epicondylar axis, are typically used to determine the final FC rotation, although intraoperative confirmation may be challenging. Therefore, rotational position is frequently determined with the posterior condylar axis (PCA) as a landmark. However, the thickness of the posterior condylar cartilage has not been considered and may not be represented on preoperative images. We used plain X-rays to measure the thickness of the medial and lateral posterior condylar cartilage fragments postoperatively, and investigated the effects of differences in cartilage thickness on final FC rotation.

Methods
Fifty knees (19 men, 31 women) underwent primary TKA to treat medial knee osteoarthritis at our hospital between August 2015 and May 2017. All knees were treated using an Attune PS (DePuy Synthes, Inc., Warsaw, IN). We first measured the distance between the posterior femoral condyles, resected the posterior condyle, and measured the thickness of the resected cartilage fragments. We then took X-ray images from a direction tangential to the osteotomy surface, secured the cartilage fragments with digital calipers, and measured the thickness of the cartilage. We investigated the effects of differences in cartilage thickness on final FC rotation of the residual medial and lateral cartilage with a trigonometric function.

Results
Medial condylar cartilage thickness averaged 0.6 ± 0.5 mm and the lateral condylar thickness averaged 1.8 ± 0.6 mm; posterior intercondylar distance averaged 46.1 ± 3.3 mm and average impact on rotation of the cartilage remnant was 1.5 ± 0.9° (− 0.1–3.9°). There may be measurement error of up to 4° in the maximum values compared with the preoperative plan in cases with short intercondylar distance.

Conclusions
In cases where the FC external rotation angle is determined using the posterior condyles as landmarks, this angle can be affected by the intercondylar distance, especially in Japanese women who have small physical stature. This angle can potentially be much larger, so caution is advised. Our results suggest that several anatomical landmarks should be referenced to achieve accurate FC rotation.
Self-reported breast and cervical cancer screening practices among women in Ghana: predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health
Authors: Ayanore Martin Amogre , Adjuik Martin , Ameko Asiwome , Kugbey Nuworza , Asampong Robert , Mensah Derrick , Alhassan Robert Kaba , Afaya Agani , Aviisah Mark , Manu Emmanuel , Zotor Francis 
Published: July 2020

Abstract
Background
Breast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana.

Methods
Data from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices.

Results
We found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father’s education, mother’s employment and chronic disease status were associated with the uptake of both screening practices.

Conclusion
Nationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening.
Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study
Authors: Halladay Jacqueline R. , Weiner Bryan J. , In Kim Jung , DeWalt Darren A. , Pierson Stephanie , Fine Jason , Lefebvre Ann , Mackey Monique , Bergmire Dawn , Cené Crystal , Henderson Kamal , Cykert Samuel 
Published: July 2020

Abstract
Background
Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation.

Methods
One hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative’s NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator’s experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement.

Results
Among our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24–57.19), [0.00], and practice location in a MUA 7.25 (1.8–29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement.

Conclusions
Our analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services.