bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of established status epilepticus in the elderly - a study protocol for a prospective multicenter double-blind comparative effectiveness trial (ToSEE)
Authors: Müller Annekatrin , Schmiedeknecht Anett , Mende Meinhard , Awissus Carolin , Rosenow Felix , Hamer Hajo , Classen Joseph 
Published: December 2020

AbstractBackgroundStatus epilepticus (SE) is a common neurological emergency condition that especially affects the elderly and old population. Older people with SE frequently have non-convulsive SE (NCSE) and are also at special risk of suffering a poor outcome. The application of benzodiazepines fails to control SE in about one third of the cases. For benzodiazepine refractory SE (BRSE) in elderly, there is little evidence that would justify the choice of one of the commonly used antiepileptic drugs. The present study aims to generate evidence for the treatment of BRSE in this age group.MethodsWe will conduct a prospective, randomized, double-blind comparative effectiveness study in more than twenty hospitals in Germany over a four-year period. Four hundred and seventy-seven elderly patients (≥ 65 years old) diagnosed with BRSE will be allocated by 1:1 randomization to receive either levetiracetam or valproate. All types of SE will be considered. For the diagnosis NCSE a verification by EEG is required. Levetiracetam or valproate will be administered in one single infusion. The primary endpoint is the stable cessation of ictal activity 15 min after the start of infusion persisting for the following 45 min of observation. EEG recording is maintained over the whole observation period, clinical examinations are conducted in predefined intervals. In case of treatment success patients and study staff remain blinded until 60 min after the start of the infusion. Adverse events will be recorded until the end of the study. EEG data will be reviewed by two external independent experts. To obtain data about the further treatment of SE, intrahospital complications and the functional outcome in the short term the study participants will be observed until the day of discharge or day 30 whichever is earliest.DiscussionToSEE is the first study which shall deliver evidence for the SE-therapy in the elderly and old population in a controlled prospective comparator study. By design it also shall collect information about therapy regimes and outcome aspects of this disease.Trial registrationThe trial has been registered at the German Clinical Trials Register on 3 July, 2020 (DRKS00022308, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022308).
Cost-effectiveness evidence for strategies to promote or support breastfeeding: a systematic search and narrative literature review
Authors: Camacho Elizabeth M. , Hussain Hannah 
Published: December 2020

Abstract
Background
Global health policy recommends exclusive breastfeeding until infants are 6 months. Little is known about the cost-effectiveness of breastfeeding promotion strategies. This paper presents a systematic search and narrative review of economic evaluations of strategies to support or promote breastfeeding. The aim of the review is to bring together current knowledge to guide researchers and commissioners towards potentially cost-effective strategies to promote or support breastfeeding.

Methods
Searches were conducted of electronic databases, including MEDLINE and Scopus, for economic evaluations relevant to breastfeeding, published up to August 2019. Records were screened against pre-specified inclusion/exclusion criteria and quality was assessed using a published checklist. Costs reported in included studies underwent currency conversion and inflation to a single year and currency so that they could be compared. The review protocol was registered on the PROSPERO register of literature reviews (ID, CRD42019141721).

Results
There were 212 non-duplicate citations. Four were included in the review, which generally indicated that interventions were cost-effective. Two studies reported that breastfeeding promotion for low-birth weight babies in critical care is associated with lower costs and greater health benefits than usual care and so is likely to be cost-effective. Peer-support for breastfeeding was associated with longer duration of exclusivity with costs ranging from £19–£107 per additional month (two studies).

Conclusions
There is limited published evidence on the cost-effectiveness of strategies to promote breastfeeding, although the quality of the current evidence is reasonably high. Future studies should integrate evaluations of the effectiveness of strategies with economic analyses.
Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
Authors: Bouchez Clémentine , Pluvy Johan , Soussi Ghassen , Nguenang Marina , Brosseau Solenn , Tourne Morgan , Collin Mégane , Théou-Anton Nathalie , Guyard Alice , Ammar Jamila , Khalil Antoine , Zalcman Gérard , Gounant Valérie 
Published: December 2020

Abstract
Background
Choroidal metastases are the most common eye metastatic site. The prevalence of choroidal metastases in NSCLC patients has been reported to vary from 0.2 to 7% in historical series. Although previously reported, little is known about choroidal metastasis in Epidermal Growth Factor Receptor (EGFR)-mutant Non-small cell lung cancer (NSCLC). This study sought to describe the prevalence of choroidal metastases among patients with EGFR-mutated NSCLC and their characteristics, and to estimate their impact on prognosis.

Methods
We conducted a single-center retrospective study including all consecutive metastatic EGFR-mutant NSCLC patients, from Sept. 2015 to Oct. 2018. The EGFR-mutant NSCLC patients were identified via the Department of Genetics’ files. Patients who exhibited choroidal metastases were compared to patients without choroidal metastases. Kaplan-Meier analysis and log-rank test were conducted to assess median overall survival (OS) from diagnosis for the two groups. The study was approved by the IRB as CEPRO number #2020–010.

Results
Prevalence of choroidal metastases in EGFR-mutated NSCLCs was 8.4% (7/83). Five were women, and four current or former smokers. Molecular analysis showed three tumors with exon 19 deletion, three with L858R mutation, and one with complex exon 21 mutation. The choroidal metastases were symptomatic in six/seven patients. Visual disturbances decreased in all but one symptomatic cases upon EGFR TKI, and the choroidal response was maintained over time.
Median follow-up was 42.2 mo (95%CI [37.2–47.1]). Median OS in the choroidal metastasis group was 23.4 mo (95%CI [0.1–51.4]) versus 27.9 mo (95%CI [16.9–38.9]) in the non-choroidal metastasis group (p = 0.32). In the choroidal metastasis group, 2-year and 5-year OS were 47.6 and 0%, respectively, versus 55.8 and 26.3% in the non-choroidal metastasis subset.

Conclusions
Choroidal metastases in NSCLC EGFR-mutant patients are rare but should be systematically suspected in case of visual disturbance. TKIs are efficient for treating visual symptoms. Whether choroidal metastases confer a worse prognosis remains unclear owing to the third-generation EGFR TKI osimertinib first-line registration.
MNAT1 promotes proliferation and the chemo-resistance of osteosarcoma cell to cisplatin through regulating PI3K/Akt/mTOR pathway
Authors: Qiu Chensheng , Su Weiliang , Shen Nana , Qi Xiaoying , Wu Xiaolin , Wang Kai , Li Lin , Guo Zhu , Tao Hao , Wang Guanrong , Chen Bohua , Xiang Hongfei 
Published: December 2020

Abstract
Background
MNAT1 (menage a trois 1, MAT1), a cyclin-dependent kinase-activating kinase (CAK) complex, highly expressed in diverse cancers and was involved in cancer molecular pathogenesis. However, its deliverance profile and biological function in osteosarcoma (OS) remain unclear.

Methods
The expression of MNAT1 in OS was detected by western blot (WB) and immunohistochemistry (IHC). The potential relationship between MNAT1 molecular level expression and OS clinical expectations were analyzed according to tissues microarray (TMA). Proliferation potential of OS cells was evaluated in vitro based on CCK8 and OS cells colony formation assays, while OS cells transwell and in situ tissue source wound healing assays were employed to analyze the OS cells invasion and migration ability in vitro. A nude mouse xenograft model was used to detect tumor growth in vivo. In addition, ordinary bioinformatics analysis and experimental correlation verification were performed to investigate the underlying regulation mechanism of OS by MNAT1.

Results
In this research, we found and confirmed that MNAT1 was markedly over-expressed in OS tissue derived in situ, also, highly MNAT1 expression was closely associated with bad clinical expectations. Functional studies had shown that MNAT1 silencing could weaken the invasion, migration and proliferation of OS cells in vitro, and inhibit OS tumor growth in vivo. Mechanism study indicated that MNAT1 contributed to the progression of OS via the PI3K/Akt/mTOR pathway. We further verified that the MNAT1 was required in the regulation of OS chemo-sensitivity to cisplatin (DDP).

Conclusions
Taken together, the data of the present study demonstrate a novel molecular mechanism of MNAT1 involved in the formation of DDP resistance of OS cells.
Addressing sickness absence among adolescents and young adults: an evaluation of the Medical Advice for Sick-reported Students intervention
Authors: van den Toren Suzanne J. , Franse Carmen B. , Vanneste Yvonne T. M. , Bannink Rienke , Lugtenberg Marjolein , Mulder Wico C. , de Kroon Marlou L. A. , van Grieken Amy , Raat Hein 
Published: December 2020

Abstract
Background
Sickness absence is associated with lower school achievements and early school leaving. The Medical Advice for Sick-reported Students (MASS) intervention is a proactive school-based intervention focused primarily on early identification and reduction of sickness absence. This study used a program evaluation framework to evaluate the MASS intervention among intermediate vocational education students and Youth Health Care professionals. Outcome indicators were primarily number of sick days, education fit, and school performance, and secondarily, seven health indicators. Process indicators were dose delivered and received, satisfaction, and experience.

Methods
The MASS intervention evaluation was conducted in ten intermediate vocational education schools. Students with extensive sickness absence from school in the past three months were included in either the intervention or control condition. Students completed a baseline and a six-month follow-up self-report questionnaire. Linear and logistic regression analyses were applied. Students and Youth Health Care professionals completed an evaluation form regarding their satisfaction and experience with the intervention.

Results
Participants (n = 200) had a mean age of 18.6 years (SD = 2.02) and 78.5% were female. The MASS intervention showed positive results on decreasing sickness absence in days (β = -1.13, 95% CI = -2.22;-0.05, p < 0.05) and on decreasing depressive symptoms (β = -4.11, 95% CI = -7.06;-1.17, p < 0.05). No effects were found for other health indicators (p > 0.05). A significant interaction revealed a decline in sickness absence in males (p < 0.05) but not in females (p > 0.05). Youth Health Care professionals found the application of the MASS intervention useful (n = 35 forms). The mean rating of students for the consultation within the MASS intervention was an 8.3 (SD = 1.3) out of 10 (n = 14 forms).

Conclusions
Our study provides some indication that the MASS intervention has positive effects on decreasing both sickness absence and depressive symptoms among intermediate vocational education students. The Youth Health Care professionals who provided the consultation as part of the MASS intervention considered the intervention to be useful and stated that the consultation was delivered as intended in almost all cases. Students were generally satisfied with the intervention. We recommend that future research evaluates the MASS intervention in a large randomized controlled trial with a longer follow-up.

Trial registration
This study was prospectively registered in the Netherlands Trial Register under number NTR5556, in October 2015.
Validation of the Persian version of family health climate scale (FHC-Scale) in Iranian families
Authors: Kharazmi Akram , Brant Jeannine M. , Sajjadi Moosa , Moshki Mahdi , Sadegh Moghadam Leila 
Published: December 2020

AbstractBackgroundFamily health is an important issue which has attracted researchers from different fields. The present study aimed to validate the Persian version of the Family Health Climate Scale (FHC-Scale).MethodsIn this methodological research, a total of 620 individuals presenting to Comprehensive Healthcare centers affiliated with Mashhad University of Medical Sciences and Gonabad University of Medical Sciences were selected through random multistage sampling. Validation of the FHC-Scale was performed. First, the original scale was translated and back-translated. Then its content validity and construct validity were assessed using exploratory and confirmatory factor analysis. Reliability was assessed using internal consistency and stability. Data were analyzed using SPSS version 20 (IBM Corp., Armonk, NY, USA) and LISREL version 8.5 (SSI Inc., Skokie, IL, USA).ResultsResults of exploratory factor analysis showed that “physical activity” of family health climate scale (FHC-PA) has three dimensions: value, cohesion and information explaining 61.99% of the variance. “Nutrition” of family health climate scale (FHC-NU) had four dimensions of value, communication, cohesion and consensus explaining 66.19% of the variance. Internal consistency of the dimensions of (FHC-PA) ranged 0.82–0.85 and that for FHC-NU ranged 0.82–0.84. Confirmatory factor analysis revealed goodness of fit and confirmed family health climate scale (Nutrition and physical activity).ConclusionResults of the study revealed that the FHC-Scale has appropriate reliability and validity for Iranian families. Therefore, the Persian version of the scale can be used for assessing health-related aspects of family.
Are dietary interventions with a behaviour change theoretical framework effective in changing dietary patterns? A systematic review
Authors: Timlin Deirdre , McCormack Jacqueline M. , Kerr Maeve , Keaver Laura , Simpson Ellen E. A. 
Published: December 2020

AbstractBackgroundThe term ‘whole dietary pattern’ can be defined as the quantity, frequency, variety and combination of different foods and drinks typically consumed and a growing body of research supports the role of whole dietary patterns in influencing the risk of non-communicable diseases. For example, the ‘Mediterranean diet’, which compared to the typical Western diet is rich in fruits and vegetables, whole grains, and oily fish, is associated with reduced risk of cardiovascular disease and cancer. Social Cognition Models provide a basis for understanding the determinants of behaviour and are made up of behavioural constructs that interventions target to change dietary behaviour. The aim of this systematic review was to provide a comprehensive assessment of the effectiveness and use of psychological theory in dietary interventions that promote a whole dietary pattern.MethodsWe undertook a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis to synthesize quantitative research studies found in Embase, Medline, PsycInfo, CINAHL and Web of Science. The studies included were randomised and non-randomised trials published in English, involving the implementation of a whole dietary pattern using a Social Cognition Model to facilitate this. Two independent reviewers searched the articles and extracted data from the articles. The quality of the articles was evaluated using Black and Down quality checklist and Theory Coding Scheme.ResultsNine intervention studies met the criteria for inclusion. Data from studies reporting on individual food group scores indicated that dietary scores improved for at least one food group. Overall, studies reported a moderate application of the theory coding scheme, with poor reporting on fidelity.ConclusionTo our knowledge, this is the first review to investigate psychological theory driven interventions to promote whole dietary patterns. This review found mixed results for the effectiveness of using psychological theory to promote whole dietary pattern consumption. However, the studies in this review scored mostly moderate on the theory coding scheme suggesting studies are not rigorously applying theory to intervention design. Few studies reported high on treatment fidelity, therefore, translation of research interventions into practice may further impact on effectiveness of intervention. Further research is needed to identify which behaviour change theory and techniques are most salient in dietary interventions.
Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
Authors: Plecko Michael , Klein Karina , Planzer Katrin , Wähnert Dirk , Behm Pascal , Ferguson Stephen J. , Brianza Stefano , Stadelmann Vincent A. , von Rechenberg Brigitte 
Published: December 2020

AbstractBackgroundA new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model.MethodsA 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS3) or 3) variable fixation in both segments (group VFLS6). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations.ResultsCompared to LS callus, VFLS3callus was 40% larger and about 3% denser, while VFLS6callus was 93% larger and its density about 7.2% lower. VFLS3showed 65% and VFLS6163% larger amount of callus at the cis-cortex. There wasn’t a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups.ConclusionsVariable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined.
Treatment strategy for atypical ulnar fracture due to severely suppressed bone turnover caused by long-term bisphosphonate therapy: a case report and literature review
Authors: Abe Kensaku , Kimura Hiroaki , Yamamoto Norio , Shimozaki Shingo , Higuchi Takashi , Taniguchi Yuta , Uto Takaaki , Tsuchiya Hiroyuki 
Published: December 2020

AbstractBackgroundAtypical fractures may occur due to the combined effect of severely suppressed bone turnover (SSBT) caused by long-term bisphosphonate treatment and chronic repetitive bone microdamage. Atypical fracture of the ulna due to SSBT is a rare entity; there is no standardized treatment strategy for this condition. We successfully treated a patient with atypical fracture of the ulna. Herein, we present this patient, review the relevant literature, and discuss the treatment strategy.Case presentationAn 84-year-old woman presented with atypical fracture of the left ulnar shaft due to SSBT. She had a history of bisphosphonate therapy (ibandronate and alendronate) since more than 10 years; her bone turnover was severely suppressed. We performed open reduction and internal fixation (ORIF) using dual plate with some additional treatments. These included drilling and decortication, use of autogenous bone graft, low-intensity pulsed ultrasound (LIPUS) treatment, and administration of teriparatide. Finally, bone union was observed at 11 months after surgery.ConclusionsBased on the literature review and our experience with this case, ORIF alone may not be adequate to achieve bone union; drilling, decortication, and use of cancellus bone graft is important to achieve favorable outcomes. Administration of teriparatide and LIPUS may facilitate early bone union, although further studies are required to provide more definitive evidence. Furthermore, ORIF using dual plate may help avoid implant failure owing to the long time required for bone union.
Introduction to the Peer Teacher Training in health professional education supplement series
Authors: Burgess Annette , van Diggele Christie , Roberts Chris , Mellis Craig 
Published: December 2020

AbstractSkills in supervision, teaching, facilitation, assessment and feedback, leadership and interprofessional teamwork are required graduate attributes for health professionals. Despite this, the opportunity for learning these skills is rarely embedded within undergraduate and postgraduate health professional training curricula. Additionally, there are limited examples of interprofessional delivery of teaching programs. Since teaching skills can be learned, healthcare faculties play an important role in improving the teaching abilities of their students. At the University of Sydney, we developed and implemented interprofessional, blended learning teacher training programs for health professional students, and junior health professionals: The Peer Teacher Training (PTT) program, and the Clinical Teacher Training (CTT) program. Based on our successful programs, this paper provides an introduction to our Peer Teacher Training supplement. Namely, 11 articles designed to assist those who work and teach in a clinical context; address key challenges; and provide practical tips and frameworks to assist in teaching, assessment, and feedback.
Facilitating small group learning in the health professions
Authors: Burgess Annette , van Diggele Christie , Roberts Chris , Mellis Craig 
Published: December 2020

AbstractThere is now good evidence that small group teaching provides a fruitful academic environment, which optimises learning, particularly in the healthcare setting, and especially when compared to lectures. An individual student’s understanding of knowledge is increased when they are able to actively compare and build on their own understanding in conjunction with their peers. Small group teaching provides opportunities for learners to work collaboratively, and promotes team-building skills – skills that are essential to work within healthcare settings. The aim of this paper is to provide health professional students and early career health professionals involved in peer and near peer teaching, with an overview of approaches and tips to improve learner engagement when facilitating small groups.