bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported fall and associated factors among adult people with visual impairment in Gondar, Ethiopia: a cross-sectional study
Authors: Gashaw Moges , Janakiraman Balamurugan , Minyihun Amare , Jember Gashaw , Sany Kedir 
Published: April 2020

AbstractBackgroundFall is a major public health problem and potentially disabling issue. A vast burden of visually impaired live in low-middle income countries particularly in Sub-Saharan Africa. Limited ability to detect environmental hazards puts visually impaired at a greater risk of falls and unintentional injuries. Falls among visually impaired is associated with considerable disability, health care cost, loss of independence, and socio-economic consequences. Ethiopia lacked estimates of fall among any vulnerable population, particularly among visually impaired people. Therefore, this study aimed to estimate the prevalence of falls and factors associated among adult people with medically diagnosed visual impairment in Ethiopia.MethodsAn institutional-based cross-sectional study was conducted among visually impaired adults who attended the ophthalmology clinic at the University of Gondar comprehensive specialized hospital during the study period. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Bivariate and multivariable binary logistic regression model analysis was used to identify factors associated with falls. Adjusted odds ratio with corresponding 95% confidence intervals were computed to show the strength of association.ResultsA total of 328 adults medically diagnosed with visual impairment participated in the study (97.3% response rate). The age of the participants ranged from 25 to 89 years with a mean age of (56.46 ± 14.2 years). The overall cumulative prevalence of self-reported falls among adults with visual impairment was 26.8% with 95%CI (22.7, 32.4%). The major associated factors of fall identified by multivariate analysis were; visual impairment in both eye (AOR 3.21, 95% CI 1.11, 9.29), fear of falling: some concerned: (AOR, 4.12; 95%CI, 1.44, 11.76), very concerned fear (AOR 10.03; 95% CI, 3.03, 33.21), medications: (AOR 4.63; 95% CI 2.14, 10.00) and self-reported depression: (AOR 3.46; 95% CI 1.11, 10.79).ConclusionThe result of this study indicates a moderate self-reported prevalence of fall among adult people with medically diagnosed visual impairment. Identifying sub-groups at risk of falls among visually impaired, modifiable risk factors, implementation of precaution measures to avoid fall and fall-related injuries, and most importantly measures that would reduce the fear of falls in visually impaired people deserves immediate attention.
Treatment success and mortality among adults with tuberculosis in rural eastern Uganda: a retrospective cohort study
Authors: Izudi Jonathan , Tamwesigire Imelda K. , Bajunirwe Francis 
Published: April 2020

Abstract
Background
Successful treatment of tuberculosis leads to clinical and public health benefits such as reduction in transmission, complications, and mortality among patients. However, data are limited on treatment outcomes and the associated factors among persons with bacteriologically confirmed pulmonary (BC-PTB) in rural areas of high dual tuberculosis and Human Immunodeficiency Virus (HIV) burden countries such as Uganda. We investigated factors associated with successful treatment of tuberculosis and mortality among adult persons with BC-PTB in rural eastern Uganda.

Methods
We constructed a retrospective cohort of persons with BC-PTB from a routine tuberculosis clinic database in eastern Uganda. We performed bivariate and multivariate analysis. Using a 5% level of significance, we ran a modified Poisson regression analysis to determine factors independently associated with treatment success and mortality rates.

Results
We retrieved 1123 records for persons with BC-PTB and the treatment outcomes were distributed as follows: 477(42.5%) cured, 323 (28.0%) treatment completed, 17(1.5%) treatment failed, 81(7.2%) died, 89(7.9%) lost to follow-up, and 136(12.1%) not evaluated. Overall, 800 (81.1%) of the 987 persons with BC-PTB that had treatment outcome, were successfully treated. Successful treatment of tuberculosis was less likely to occur among those with HIV infection (Adjusted risk ratio (aRR), 0.88; 95% Confidence Interval (CI), 0.82–0.95), older than 50 years (aRR, 0.89; 95% CI, 0.81–0.97), or male sex (aRR, 0.92; 95% CI, 0.87–0.98). Mortality was associated with HIV infection (aRR, 4.48; 95% CI, 2.95–6.79), older than 50 years (aRR, 2.93; 95% CI, 1.74–4.92), year of enrollment into treatment after 2015 (aRR, 0.80; 95% CI, 0.66–0.97), and Community-Based Directly Observed Therapy Short Course (aRR, 0.26; 95% CI, 0.13–0.50).

Conclusions
Treatment success rate among adult persons with BC-PTB in rural eastern Uganda is suboptimal and mortality rate is high. HIV infection and older age reduce chances of treatment success, and increase mortality rate. Older and HIV infected persons with BC-PTB will require special consideration to optimize treatment success rate and reduce mortality rate.
Impact of social participation on health among middle-aged and elderly adults: evidence from longitudinal survey data in China
Authors: Ma Xinxin , Piao Xiangdan , Oshio Takashi 
Published: April 2020

Abstract
Background
Social participation (SP) is known to have a favourable impact on health. However, studies on this issue have been conducted mainly in advanced countries, and results in China have been mixed. This study examined the impact of SP on health outcomes of middle-aged and elderly adults in China, adjusted for simultaneity and heterogeneity biases.

Methods
In total, 57,417 observations of 28,935 individuals obtained from the population-based, three-wave panel survey, Chinese Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015 were used. The associations between one- or two-wave-lagged SP and health outcomes (mental health, self-rated health [SRH], activities of daily living [ADL], and diagnosed diseases) were examined by linear regression models. Individual-level heterogeneity was addressed by the random-effects estimation method.

Results
SP was found to have a positive impact on mental health and ADL. Specifically, one-wave-lagged SP improved mental health measure (range: 10–70) by 0.820 (standard error [SE]: 0.199, p <  0.001), the basic ADL measure (range: 6–24) by 0.147 (SE: 0.043, p <  0.001), and the instrumental ADL measure (range: 5–20) by 0.159 (SE: 0.035, p <  0.001). In contrast, SP did not significantly affect SRH or diagnosed diseases. The impact of SP differed by SP type; playing Mah-jong (Chinese traditional game), chess, or cards, or going to the community club had the most favourable effect. The impact of SP on health was also greater for women than men and greater for individuals aged 60–69 years than those aged 45–59 years and aged 70 and older.

Conclusions
SP had a positive, albeit selective, impact on health outcomes among middle-aged and elderly adults in China. The results suggest that policy measures to encourage these individuals to engage in SP are needed to enhance their health.
Evaluation of a computer-assisted multi-professional intervention to address lifestyle-related risk factors for overweight and obesity in expecting mothers and their infants: protocol for an effectiveness-implementation hybrid study
Authors: Alayli Adrienne , Krebs Franziska , Lorenz Laura , Nawabi Farah , Bau Anne-Madeleine , Lück Isabel , Moreira Andrea , Kuchenbecker Judith , Tschiltschke Elena , John Michael , Klose Stefan , Häusler Benny , Giertz Christian , Korsten-Reck Ulrike , Stock Stephanie 
Published: April 2020

AbstractBackgroundThe first 1000 days after conception are a critical period to encourage lifestyle changes to reduce the risk of childhood obesity and early programming of chronic diseases. A healthy lifestyle during pregnancy is also crucial to avoid high post-partum weight retention. Currently, lifestyle changes are not consistently discussed during routine health services in Germany. The objective of this study is to evaluate a novel computer-assisted lifestyle intervention embedded in prenatal visits and infant check-ups. The intervention seeks to reduce lifestyle-related risk factors for overweight and obesity among expecting mothers and their infants.MethodsThe study is designed as a hybrid effectiveness-implementation trial to simultaneously collect data on the effectiveness and implementation of the lifestyle intervention. The trial will take place in eight regions of the German state Baden-Wuerttemberg. Region were matched using propensity score matching. Expecting mothers (n = 1860) will be recruited before 12 weeks of gestation through gynecological practices and followed for 18 months. During 11 routine prenatal visits and infant check-ups gynecologists, midwives and pediatricians provide lifestyle counseling using Motivational Interviewing techniques. The primary outcome measure is the proportion of expecting mothers with gestational weight gain within the recommended range. To understand the process of implementation (focus group) interviews will be conducted with providers and participants of the lifestyle intervention. Additionally, an analysis of administrative data and documents will be carried out. An economic analysis will provide insights into cost and consequences compared to routine health services.DiscussionFindings of this study will add to the evidence on lifestyle interventions to reduce risk for overweight and obesity commenced during pregnancy. Insights gained will contribute to the prevention of early programming of chronic disease. Study results regarding implementation fidelity, adoption, reach and cost-effectiveness of the lifestyle intervention will inform decisions about scale up and public funding.Trial registrationGerman Clinical Trials Register (DRKS00013173). Registered 3rd of January 2019, https://www.drks.de
Symptom control among asthmatics with a clinically significant smoking history: a cross-sectional study in Finland
Authors: Kiljander Toni , Poussa Tuija , Helin Timo , Jaakkola Antero , Venho Kari , Lehtimäki Lauri 
Published: April 2020

Abstract
Background
Surprisingly little is known about asthma control among asthmatics who smoke. The aim of this cross-sectional study was to investigate asthma symptom control according to the GINA guidelines among asthmatics with a clinically significant smoking history.

Methods
One hundred ninety asthmatics from primary care in Finland were investigated. The patients were current or previous cigarette smokers with a history of 10 or more pack-years. They completed a questionnaire including questions on asthma symptoms and reliever use so that their level of asthma symptom control (well controlled, partly controlled, or uncontrolled) according to GINA could be determined.

Results
Sixty-six (34.7%) patients had their asthma well controlled, 81 (42.6%) had their asthma partly controlled, and 43 (22.6%) had uncontrolled asthma. Current smokers had uncontrolled asthma more often than ex-smokers, OR 2.54 (95% CI 1.25–5.14, p = 0.01). Patients with moderate to severe asthma exacerbation during the previous year had uncontrolled asthma more often than patients without an exacerbation, OR 2.17 (95% CI 1.06–4.47, p = 0.04), and patients with FEV1 <  80% of predicted had uncontrolled asthma more often than patients with FEV1 > 80% of predicted, OR 2.04 (95% CI 1.02–4.08, p = 0.04).

Conclusions
Asthmatic patients with a clinically significant smoking history often do not have well controlled asthma. Poor asthma symptom control was associated with current smoking status, history of exacerbations and impaired lung function. Therefore, every attempt should be made to help asthmatics who smoke to quit smoking.
Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study
Authors: Lin Po-Hsun , Chien Jui-Teng , Hung Jung-Pin , Hong Chih-Kai , Tsai Tzung-Yi , Yang Chang-Chen 
Published: April 2020

AbstractBackgroundWith an increase in the elderly population, the occurrence of hip fractures, femoral neck fractures, and intertrochanteric fractures (ITFs) is also increasing. It is important to establish effective perioperative methods that would help reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop.MethodsSeventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measure and calculated as the difference between pre- and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and the use of anticoagulants.ResultsAmong the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.04). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05).ConclusionsPatients with unstable ITFs exhibited a greater hemoglobin drop and a hidden blood loss was suspected around the fracture site. We believe that this should be taken into consideration when presurgical blood transfusion is being planned for patients with unstable ITFs, to reduce associated postoperative complications, especially in patients with severe anemia or high risk of mortality.
Footwear for osteoarthritis of the lateral knee: protocol for the FOLK randomised controlled trial
Authors: Paterson Kade L. , Bennell Kim L. , Metcalf Ben R. , Campbell Penny K. , Kasza Jessica , Wrigley Tim V. , Hinman Rana S. 
Published: April 2020

Abstract
Background
Structural features of lateral tibiofemoral (TF) joint osteoarthritis (OA) occur in up to half of all people with knee OA, and co-existing lateral TF OA is associated with worse knee pain in people with mixed compartmental knee OA. Clinical guidelines for management of knee OA advocate advice about appropriate footwear, yet there is no research evaluating which types of footwear are best for managing pain associated with lateral TF OA. Biomechanical evidence suggests that “motion-control” footwear, which possess midsoles that are stiffer medially compared to laterally, may shift load away from the lateral compartment of the knee and thus may reduce knee pain associated with lateral TF OA. The primary aim of this study is to compare the effects of motion-control shoes to neutral shoes on knee pain in people with predominantly lateral TF OA.

Methods
This will be an assessor- and participant-blinded, two-arm, comparative effectiveness randomized controlled trial (RCT) conducted in Melbourne, Australia. We will recruit a minimum of 92 people with painful lateral TF OA from the community. Participants will be randomly allocated to receive either motion-control shoes or neutral shoes and will be instructed to wear their allocated shoes for a minimum of 6 h per day for 6 months. The primary outcome is change in self-reported knee pain on walking, measured using a numerical rating scale, assessed at baseline and 6 months. Secondary outcomes include other measures of knee pain, physical function, quality of life, participant-perceived change in pain and function, and physical activity levels.

Discussion
This study will compare the efficacy of motion-control shoes to neutral shoes for people with painful lateral TF OA. Findings will be the first to provide evidence of the effects of footwear on knee pain in this important subgroup of people with knee OA and allow clinicians to provide accurate advice about the most appropriate footwear for managing pain associated with lateral TF OA.

Trial registration
This trial has been prospectively registered by the Australian New Zealand Clinical Trials Registry on 15/11/2018 (reference: ACTRN12618001864213).
Intra-abdominal haemorrhage from uterine fibroids: a systematic review of the literature
Authors: LIM Wei How , COHEN Sally Charlotte , LAMARO Vincent P 
Published: April 2020

Abstract
Background
Uterine leiomyomas are common benign tumours found in women of reproductive age that are rarely associated with intra-abdominal haemorrhage. The aetiology behind this relationship is poorly understood and the aforementioned association poorly recognized from a patient’s clinical presentation. Available information in the literature is limited to case reports. The aim of this systematic review is to document and highlight the occurrence of intra-abdominal haemorrhage from uterine fibroids, and determine associated morbidity and mortality.

Methods
A systematic review of Medline, EMBASE, Web of Science, Scopus, and The Cochrane Library – CENTRAL was performed from the databases inception through to December 2018 for case report and series of patients who experienced intra-abdominal haemorrhage from uterine fibroids. Findings were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results
We identified 115 publications reporting on 125 original case reports. The documented intra-abdominal haemorrhage were commonly due to the rupture of superficial blood vessels over the surface of a fibroid, followed by rupture and avulsion of the fibroid involved. A clinical picture of sudden and profound hypovolemic shock with severe abdominal pain was often the presenting complaint, with a correct pre-operative diagnosis only made in 7 cases on computed tomography imaging. Hysterectomy and myomectomy were the most common surgery performed. Mortality was reported in 4 cases which were directly related to complications of uterine fibroids.

Conclusion
Intra-abdominal haemorrhage secondary to uterine fibroids remained a rare phenomenon which is poorly recognized among clinicians. While this association is not representative of the population of interest, it highlights the pathophysiological spectrum of uterine fibroids and its relevance to emergency physicians, surgeons and gynaecologists during clinical practice.
Obesity status is a risk factor for secondary surgery after neurolysis, direct nerve repair or nerve grafting in traumatic brachial plexus injury: a retrospective cohort study
Authors: Atthakomol Pichitchai , Oflazoglu Kamilcan , Eberlin Kyle R. , Winograd Jonathan , Chen Neal C. , Lee Sang-Gil 
Published: April 2020

AbstractBackgroundThe objective of the study was to investigate the association between obesity and the presence of secondary surgery following neurolysis, direct nerve repair, or nerve grafting in patients with traumatic brachial plexus injury.MethodsIn this retrospective chart review spanning two Level I medical centers in a single metropolitan area, 57 patients who underwent neurolysis, direct nerve repair, or nerve grafting for brachial plexus injuries between 2002 and 2015 were identified. Risk regression analysis was used to evaluate the association between obesity status and secondary surgery.ResultsAfter controlling for the confounding variables of age, high energy injury, associated shoulder dislocation and associated clavicle fracture using multivariate regression (risk regression), the risk ratio of secondary surgery in obese patients compared to non-obese patients was 6.99 (P = 0.028). The most common secondary surgery was tendon or local muscle transfer.ConclusionsThere is an increased risk of secondary surgery in obese patients compared to non-obese patients of the same age and with the same severity of injury. The increased risk may be due to challenges related to powering a heavier upper extremity. A weight reduction program might be considered as part of the preoperative strategy.
Compound-specific stable isotope analyses in Falkland Islands seabirds reveal seasonal changes in trophic positions
Authors: Quillfeldt Petra , Masello Juan F. 
Published: April 2020

Abstract
Background
While nitrogen and carbon stable isotope values can reflect ecological segregation, prey choice and spatial distribution in seabirds, the interpretation of bulk stable isotope values is frequently hampered by a lack of isotopic baseline data. In this study, we used compound-specific isotope analyses of amino acids (CSIA-AA) to overcome this constraint and to study interspecific differences, seasonal and historical changes in trophic positions of five seabird species, three penguins and two petrels, from a sub-Antarctic seabird community.

Results
CSIA-AA allowed comparing trophic positions of seabirds with temperate and polar distributions. Gentoo and Magellanic penguins had the highest trophic positions during the breeding season (3.7 and 3.9), but decreased these (2.9 and 3.3) during the feed-up for moult. Intra-specific differences were also detected in Thin-billed prions, where carbon isotope values clearly separated individuals with polar and temperate distributions, both in the breeding and interbreeding periods. Thin-billed prions that foraged in polar waters had lower trophic positions (3.2) than conspecifics foraging in temperate waters (3.8). We further investigated historical changes by comparing museum samples with samples collected recently. Our pilot study suggests that Rockhopper penguins, Magellanic penguins and Thin-billed prions with temperate non-breeding distributions had retained their trophic levels over a 90–100 year period, while Gentoo penguins and Thin-billed prions with polar non-breeding distributions had decreased trophic levels compared to historical samples. In contrast, Wilson’s storm-petrels had slightly increased trophic levels compared to samples taken in 1924–1930.

Conclusions
We applied compound-specific stable isotope analyses across a range of contexts, from intra-specific comparisons between stages of the breeding cycle to inter-specific seabird community analysis that would not have been possible using bulk stable isotope analyses alone due to differences in isotopic baselines.
Methanandamide diminish the Porphyromonas gingivalis lipopolysaccharide induced response in human periodontal ligament cells
Authors: Zhang Fengqiu , Özdemir Burcu , Nguyen Phuong Quynh , Andrukhov Oleh , Rausch-Fan Xiaohui 
Published: April 2020

Abstract
Background
The endocannabinoid system is involved in the regulation of periodontal tissue homeostasis. Synthetic cannabinoid methanandamide (Meth-AEA) has improved stability and affinity to cannabinoid receptors compared to its endogenous analog anandamide. In the present study, we investigated the effect of methanandamide on the production of pro-inflammatory mediators in primary human periodontal ligament cells (hPdLCs).

Methods
hPdLCs were treated with Meth-AEA for 24 h, and the resulting production of interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1 was measured in the absence or the presence of Porphyromonas gingivalis lipopolysaccharide (LPS). Additionally, the effect of Meth-AEA on the proliferation/viability of hPdLCs was measured by the MTT method.

Results
Methanandamide at a concentration of 10 μM significantly inhibited P. gingivalis LPS induced production of IL-6, IL-8, and MCP-1. Basal production of IL-6 and IL-8 was slightly enhanced by 10 μM Meth-AEA. No effect of Meth-AEA on the basal production of MCP-1 was observed. Meth-AEA in concentrations up to 10 μM did not affect the proliferation/viability of hPdLCs, but significantly inhibited it at a concentration of 30 μM.

Conclusion
Our study suggests that the inflammatory response in periodontal ligament cells could be influenced by the activation of the cannabinoid system, which might be potentially involved in the progression of periodontal disease.