bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Pore Architecture on the Hydroconversion of Long Chain Alkanes over Micro and Mesoporous Catalysts
Authors: Vaugon Laura , Finiels Annie , Cacciaguerra Thomas , Hulea Vasile , Galarneau Anne , Aquino Cindy , Dath Jean-Pierre , Minoux Delphine , Gerardin Corine , Fajula François 
Published: May 2020

Abstractn-Hexadecane hydroconversion has been investigated in a series of bifunctionnal metal/acid catalysts featuring distinct well-defined pore architectures. The acidic components were prepared from dealuminated Y zeolites with Si/Al of 15 and 30 post treated in alkaline medium to generate ordered or non-ordered secondary networks of mesopores and from aluminated ordered mesoporous materials MCM-41, MCM-48, KIT-6 type materials and amorphous silica gel. Activity relates linearly to the strength and number of strong Brönsted acid sites, while selectivity, more precisely the yield in isomerization products, scales directly with the mesopore volume of the catalyst. The architecture of the mesoporous network, namely the ordering, interconnectivity, homogeneity of the mesopores, affects little catalytst behavior. Confrontation of catalytic data with diffusion measurements suggests the existence of an optimal mesopore size above which the number of strong Brönsted sites and the mesopore volume are the only parameters governing catalytic performance.
Evidence from the Kaduna State Health Accounts on the pattern of sub-national health spending in Nigeria, 2016
Authors: Azubuike Chukwuemeka Emmanuel , Ogundeji Yewande Kofoworola , Butawa Nuha , Orji Nneka , Dogo Paul , Ohiri Kelechi 
Published: May 2020

Health accounts provide accurate estimates of health expenditure, which are important for effective resource allocation and planning in the health sector. In Nigeria, four rounds of health accounts have been conducted at the national level. However, the national estimates do not necessarily reflect realities at the subnational level and may only provide limited information for decision making at that level. This study highlights the pattern of health spending in Kaduna State from the 2016 Health Accounts, with a view to providing more reliable evidence for decision making in the state.Health accounts expenditure surveys were administered to government, donors, non-governmental organizations (NGOs), private health insurance organisations and employers in the health sector for the reference year 2016. Household health expenditure was derived from a household survey administered across a representative sample of 1024 households selected from six local government areas across the three senatorial districts in the state. We estimated disease expenditure by deploying a health provider survey across a sample of 100 health facilities. Analysis was conducted using Microsoft Excel, Stata and the Health Accounts Production Tool.Findings show that current health expenditure (CHE) accounted for only 7% of the total health expenditure in 2016. Out-of-pocket spending among households was about 81% of CHE, compared with a national average of 71.5% of CHE between 2010 and 2014. The health expenditure findings highlight several policy imperatives for the Kaduna State Health System. Primary among these is the heavy dependence on out-of-pocket financing for health, which has negative implications on vulnerable households. A shift to pooled prepaid mechanisms would reduce the financial burden on the most vulnerable households in Kaduna State. In addition, considering the government’s current contribution to health expenditure, there is a strong need for increased government prioritisation of the Kaduna State health sector.
Community-based health insurance and healthcare service utilisation, North-West, Ethiopia: a comparative, cross-sectional study
Authors: Atnafu Desta Debalkie , Tilahun Hiwot , Alemu Yihun Mulugeta 
Published: May 2020

ObjectivesThe objective of this study was to compare differences in healthcare utilisation between community-based health insurance member households and non-member households and to identify factors for community-based health insurance enrolment in South Achefer District.DesignComparative, cross-sectional study.SettingsCommunity-based.ParticipantsA total of 652 selected households (326 insured and 326 uninsured households) participated in the study.MethodsA two-sample t-test (for proportions) and χ2(for categorical data) were computed.Main outcome measureUtilisation of healthcare.ResultsThere was a significant difference in the rate of healthcare utilisation between insured (50.5%) and uninsured (29.3%) households (χ2=27.864, p<0.001). Significant variations of enrolment status in community-based health insurance were observed in the following variables: educational status, family size, occupation, marital status, travel time to the nearest health institution, perceived quality of care, first choice of place for treatment during illness and expected healthcare cost of a recent treatment.ConclusionsUtilisation of health services among insured households with community-based health insurance was higher. Educational status, family size, occupation, marital status, travel time to the nearest health institution, perceived quality of care, first choice of place for treatment during illness and expected healthcare cost of a recent treatment should be emphasised to enhance community health insurance enrolment.
Study protocol for a randomised controlled trial: treatment of early intrauterine growth restriction with low molecular weight heparin (TRACIP)
Authors: Mazarico Edurne , Peguero Anna , Camprubí Marta , Rovira Carlota , Gomez Roig Maria Dolores , Oros Daniel , Ibáñez-Burillo Patricia , Schoorlemmer Jon , Masoller Narcís , Tàssies Maria Dolors , Figueras Francesc 
Published: May 2020

IntroductionThe incidence of intrauterine growth restriction (IUGR) is estimated at about 3% of pregnancies, and it is associated with 30% of all perinatal mortality and severe morbidity with adverse neurodevelopmental and cardiovascular health consequences in adult life. Early onset IUGR represents 20%–30% of all cases and is highly associated with severe placental insufficiency. The existing evidence suggests that low molecular weight heparin (LMWH) has effects beyond its antithrombotic action, improving placental microvessel structure and function of pregnant women with vascular obstetric complications by normalising proangiogenic and antiapoptotic protein levels, cytokines and inflammatory factors. The objective of our study is to demonstrate the effectiveness of LMWH in prolonging gestation in pregnancies with early-onset IUGR.Methods and analysisThis is a multicentre, triple-blind, parallel-arm randomised clinical trial. Singleton pregnancies qualifying for early (20–32 weeks at diagnosis) placental IUGR (according to Delphi criteria) will be randomised to subcutaneous treatment with bemiparin 3500 IU/0.2 mL/day or placebo from inclusion at diagnosis to the time of delivery. Analyses will be based on originally assigned groups (intention-to-treat). The primary objective will be analysed by comparing gestational age and prolongation of pregnancy (days) in each group with Student’s t-tests for independent samples and by comparing Kaplan-Maier survival curves (from inclusion to delivery, log-rank test). A linear regression model for gestational age at birth will consider the following covariates: gestational age at inclusion (continuous) and pre-eclampsia (binary).Ethics and disseminationThe study will be conducted in accordance with the principles of Good Clinical Practice. This study was approved by the Clinical Research Ethics Committee (CEIC) of Sant Joan de Déu Hospital, on 13 July 2017. The trial is registered in the public registrywww.clinicaltrial.gov. according to Science Law 14/2011, and the results will be published in an open access journal.Trial registration numberNCT03324139; Pre-results.
Effects of a 6-month self-rehabilitation programme in addition to botulinum toxin injections and conventional physiotherapy on limitations of patients with spastic hemiparesis following stroke (ADJU-TOX): protocol study for a randomised controlled, investigator blinded study
Authors: Bonnyaud Celine , Gallien Philippe , Decavel Pierre , Marque Philippe , Aymard Claire , Pellas Frédéric , Isner Marie-Eve , Boyer François Constant , Muller François , Daviet Jean-Christophe , Dehail Patrick , Perrouin-Verbe Brigitte , Bayle Nicolas , Coudeyre Emmanuel , Perennou Dominic , Laffont Isabelle , Ropers Jacques , Domingo-Saidji Nabila-Yasmine , Bensmail Djamel , Roche Nicolas 
Published: May 2020

IntroductionHome-based self-rehabilitation programmes combined with botulinum toxin injections (BTIs) appear to be a relevant approach to increase the recommended intensive rehabilitation of patients with spasticity following a stroke. The literature highlights a lack of evidence of beneficial effects of this adjuvant therapy to reduce limitations of patients with stroke. The aim of this study is to assess the effects of a 6-month self-rehabilitation programme in adjunction to BTI, in comparison with BTI alone, to reduce limitations of patients with spasticity following a stroke.Methods and analysis220 chronic patients will participate to this multicentre, prospective, randomised, controlled, assessor blinded study. All patients will benefit from two successive BTI (3 months apart), and patients randomised in the self-rehabilitation group will perform in adjunction 6 months of self-rehabilitation at home. All patients continue their conventional physiotherapy. The main outcome is the primary treatment goal (PTG), which will be determined jointly by the patient and the medical doctor using Goal Attainment Scaling. Impairments and functions, quality of life, mood and fatigue will be assessed. Botulinum toxin will be injected into the relevant muscles according to the PTG. Patients in the self-rehab group will be taught the self-rehabilitation programme involving respectively 10 min of stretching, 10 min of strengthening and 10 min of task-oriented exercises, corresponding to their PTG. Compliance to the self-rehabilitation programme will be monitored.Ethics and disseminationPatients will sign written informed consent. Ethical approval was obtained from ethics committee. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients.Trial registration numberNCT02944929.
Conservative care with or without manipulative therapy in the management of back and/or neck pain in Danish children aged 9–15: a randomised controlled trial nested in a school-based cohort
Authors: Dissing Kristina Boe , Hartvigsen Jan , Wedderkopp Niels , Hestbæk Lise 
Published: May 2020

BackgroundA substantial number of children experience spinal pain, that is, back and/or neck pain. Today, no ‘gold-standard’ treatment for spinal pain in children exists, but manipulative therapy is increasingly being used in spite of a lack of evidence of its effectiveness. This study investigates the effectiveness of adding manipulative therapy to other conservative care for spinal pain in a school-based cohort of Danish children aged 9–15 years.Methods and findingsThe design was a two-arm pragmatic randomised controlled trial, nested in a longitudinal open cohort study in Danish public schools. 238 children from 13 public schools were randomised individually from February 2012 to April 2014. A text message system and clinical examinations were used for data collection. Interventions included either (1) advice, exercises and soft-tissue treatment or (2) advice, exercises and soft-tissue treatment plus manipulative therapy. The primary outcome was number of recurrences of spinal pain. Secondary outcomes were duration of spinal pain, change in pain intensity and Global Perceived Effect.We found no significant difference between groups in the primary outcome (control group median 1 (IQR 1–3) and intervention group 2 (IQR 0–4), p=0.07). Children in the group receiving manipulative therapy reported a higher Global Perceived Effect: OR 2.22, (95% CI 1.19 to 4.15). No adverse events were reported. Main limitations are the potential discrepancy between parental and child reporting and that the study population may not be comparable to a normal care-seeking population.ConclusionsAdding manipulative therapy to other conservative care in school children with spinal pain did not result in fewer recurrent episodes. The choice of treatment—if any—for spinal pain in children therefore relies on personal preferences, and could include conservative care with and without manipulative therapy. Participants in this trial may differ from a normal care-seeking population.Trial registration numberNCT01504698; Results.
Efficacy and safety of electroacupuncture on treating depression-related insomnia: a study protocol for a multicentre randomised controlled trial
Authors: Yin Xuan , Dong Bo , Liang Tingting , Yin Ping , Li Xia , Lin Xiang , Zhou Shuang , Qian Xiaolu , Lao Lixing , Xu Shifen 
Published: May 2020

IntroductionSleep disorders including insomnia occur frequently in depressive patients. Acupuncture is a widely recognised therapy to treat depression and sleep disorders in clinical practice. This multicentre randomised controlled trial (RCT) is aimed to investigate the efficacy and safety of electroacupuncture (EA) in the treatment of depression patients with insomnia.Methods and analysisWe describe a protocol for a multicentre RCT. A total of 270 eligible patients in three different healthcare centres in Shanghai will be randomly assigned to one of these three groups: treatment group (EA + standard care), control A group (sham electroacupuncture + standard care) and control B group (standard care). Treatment will be given three times per week for 8 consecutive weeks. The primary outcome is the Pittsburgh Sleep Quality Index. The secondary outcomes are sleep parameters recorded in the actigraphy, Hamilton Rating Scale for Depression score and Self-rating Anxiety Scale score. Daily dose of patients’ antidepressant and sedative-hypnotic medication will be recorded in the dairy. All adverse effects will be assessed by the Treatment Emergent Symptom Scale. Outcomes will be evaluated at baseline, 4 weeks post-treatment and 8 weeks post-treatment, as well as at 1-month, 3-month and 6-month follow-up.Ethics and disseminationThe trial has been approved by the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2017SHL-KY-04). Written informed consent will be obtained from all participants. The results of this study will be published in peer-reviewed journals or presented at academic conferences.Trial registration numberNCT03122080; Pre-results.
Effectiveness of traditional lectures and case methods in Swedish general practitioners’ continuing medical education about COPD: a cluster randomised controlled trial
Authors: Sandelowsky Hanna , Krakau Ingvar , Modin Sonja , Ställberg Björn , Johansson Sven-Erik , Nager Anna 
Published: May 2020

ObjectivesTo study the effects of continuing medical education (CME) about chronic obstructive pulmonary disease (COPD) for general practitioners (GPs) by comparing two commonly used CME methods with each other and no CME (reference group).DesignA pragmatic cluster randomised controlled trial with primary healthcare centres (PHCCs) as units of randomisation.Setting, participants and interventions24 PHCCs in Stockholm County, Sweden, were randomised into two CME intervention arms: case method learning (CM) (n=12) and traditional lectures (TL) (n=12). A reference group without CME (n=11) was recruited separately. GPs (n=255) participated in the study arm to which their PHCC was allocated: CM, n=87; TL, n=93; and reference, n=75. Two 2-hour CME seminars were given in a period of 3 months.Primary outcome measuresChanges in scores between baseline and 12 months on a 13-item questionnaire about evidence-based COPD management (0–2 points/question, maximum total score 26 points).Results133 (52%) GPs completed the questionnaire both at baseline and 12 months. Both CM and TL resulted in small yet significantly higher total scores at 12 months than at baseline (CM, 10.34 vs 11.44; TL, 10.21 vs 10.91; p<0.05); there were few significant differences between these CME methods. At both baseline and 12 months, all three groups’ scores were generally high on questions about smoking cessation support and low on those that measured spirometry interpretation skills, interprofessional care and management of multimorbidity.ConclusionsNeither short CM nor short TL CME sessions substantially improve GPs’ skills in managing COPD. It is justified to challenge the use of these common CME methods as a strategy for improving GPs’ level of knowledge about management of COPD and other complex chronic diseases characterised by multimorbidity.Trial registration numberNCT02213809; Results.
Ecological study on the use of hormonal contraception, abortions and births among teenagers in the Nordic countries
Authors: Hognert Helena , Skjeldestad Finn Egil , Gemzell-Danielsson Kristina , Heikinheimo Oskari , Milsom Ian , Lidegaard Øjvind , Lindh Ingela 
Published: May 2020

ObjectivesCompare hormonal contraceptive use, birth and abortion rates among teenagers in the Nordic countries. A secondary aim was to explore plausible explanations for possible differences between countries.DesignEcological study using national registry data concerning births and abortions among all women aged 15–19 years residing in Denmark, Finland, Iceland, Norway and Sweden 2008–2015. Age-specific data on prescriptions for hormonal contraceptives for the period 2008–2015 were obtained from national databases in Denmark, Norway and Sweden.SettingDenmark, Finland, Iceland, Norway and Sweden.ParticipantsWomen 15–19 years old in all Nordic countries (749 709) and 13–19 years old in Denmark, Norway and Sweden (815 044).ResultsBoth annual birth rates and abortion rates fell in all the Nordic countries during the study period. The highest user rate of hormonal contraceptives among 15–19-year-olds was observed in Denmark (from 51% to 47%) followed by Sweden (from 39% to 42%) and Norway (from 37% to 41%). Combined oral contraceptives were the most commonly used methods in all countries. The use of long-acting reversible contraceptives (LARC), implants and the levonorgestrel-releasing intrauterine systems, were increasing, especially in Sweden and Norway. In the subgroup of 18–19-year-old teenagers, the user rates of hormonal contraceptives varied between 63% and 61% in Denmark, 56% and 61% in Norway and 54% and 56% in Sweden. In the same subgroup, the steepest increase of LARC was seen, from 2% to 6% in Denmark, 2% to 9% in Norway and 7% to 17% in Sweden.ConclusionsBirth and abortion rates continuously declined in the Nordic countries among teenagers. There was a high user rate of hormonal contraceptives, with an increase in the use of LARC especially among the oldest teenagers.
Evaluation of a digital platform for osteoarthritis treatment: study protocol for a randomised clinical study
Authors: Nero Håkan , Ranstam Jonas , Kiadaliri Aliasghar Ahmad , Dahlberg Leif E 
Published: May 2020

IntroductionDespite favourable results from structured face-to-face treatment of osteoarthritis (OA) in Sweden through the Better management of patients with OsteoArthritis (BOA) initiative, only around 20% of people with knee or hip OA receive the primary treatment recommended by international guidelines (ie, information, exercise, weight management). In 2014, a digital treatment programme named Joint Academy was introduced in Sweden, based on the same concept as the face-to-face BOA programme. In line with BOA, Joint Academy follows national and international guidelines and best practice for OA treatment. Results from observational studies suggest that this digital treatment is a valuable alternative to the traditional treatment approach and can positively impact patients’ function and pain. However, conclusions from such studies commonly suggest that more rigorous testing is necessary to ascertain the benefits of digital treatment delivery for people with OA.Methods and analysisA randomised clinical trial will be performed, comparing regular face-to-face care according to BOA with the digital version, Joint Academy. A total of 270 participants with clinically diagnosed knee OA will be recruited at primary care centres and randomised to either standard treatment (BOA) for 3 months, or the experimental group (digital intervention programme). Both groups will receive educational sessions and exercises yet with a difference in programme deliverance. The objective of the trial is to evaluate the effectiveness of the online treatment programme, in comparison with BOA. The two treatment groups will be compared with respect to the number of repetitions of the 30 s chair stand test at 3, 6 and 12 months, using a mixed model repeated measures analysis of variance.Ethics and disseminationEthical approval has been attained from the Regional Board of Ethics in Lund, Sweden (Dnr 2017/719). Results will be published in peer-reviewed journals.Trial registration numberNCT03328741.
Morita Therapy for depression (Morita Trial): an embedded qualitative study of acceptability
Authors: Sugg Holly Victoria Rose , Frost Julia , Richards David A 
Published: May 2020

ObjectiveTo explore the views of UK-based recipients of Morita Therapy (MT) on the acceptability of MT.DesignQualitative study nested within a pilot randomised controlled trial of MT (a Japanese psychological therapy largely unknown in the UK) versus treatment as usual, using post-treatment semistructured interviews analysed with a framework approach.Setting and participantsParticipants who received MT as part of the Morita Trial, recruited for the trial from General Practice record searches in Devon, UK. Data from 16 participants were purposively sampled for analysis.ResultsWe identified five themes which, together, form a model of how different participants viewed and experienced MT. Overall, MT was perceived as acceptable by many participants who emphasised the value of the approach, often in comparison to other treatments they had tried. These participants highlighted how accepting and allowing difficulties as natural phenomena and shifting attention from symptoms to external factors had facilitated symptom reduction and a sense of empowerment. We found that how participants understood and related to the principles of MT, in light of their expectations of treatment, was significantly tied to the extent to which MT was perceived as acceptable. Our findings also highlighted the distinction between MT in principle and practice, with participants noting challenges of engaging with the process of therapy such as fear and discomfort around rest, needing sufficient support from the therapist and others, and the commitment of treatment.ConclusionsPeople in the UK can accept the premise of MT, and consider the approach beneficial and novel. Therefore, proceeding to a large-scale trial of MT is appropriate with minor modifications to our clinical protocol. Participants’ expectations and understandings of treatment play a key role in acceptability, and future research may investigate these potential moderators of acceptability in MT.Trial registration numberCISRCTN17544090; Pre-results.