bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-care for head and neck cancer survivors with lymphedema and fibrosis: study protocol for a randomized controlled trial
Authors: Deng Jie , Dietrich Mary S. , Murphy Barbara 
Published: December 2019

AbstractBackgroundHead and neck cancer (HNC) patients are at high risk for developing lymphedema and fibrosis (LEF) following cancer treatment. Once HNC patients develop LEF, they need to conduct life-long self-care to slow LEF progression and reduce associated symptom burden and functional deficits. Data demonstrate that inadequate LEF self-care may be a potentially remediable issue. The objective of this study is to explore the feasibility and preliminary efficacy of an Information-Motivation-Behavioral (IMB) Skills model-driven self-care program (SCP) to improve LEF management and reduce LEF-related symptom burden and functional impairments.Methods/designThis is a three-arm, prospective, randomized controlled clinical trial to compare: Group 1 – Usual Care, Group 2 – Usual Care Plus LEF-SCP, and Group 3 – Usual Care Plus LEF-SCP Plus Follow-Up. Participants will be HNC survivors aged > 18 years of age, who meet predefined inclusion and exclusion criteria. A sample size of 75 participants is targeted. Interventions will be provided by trained staff. The study assessments for all groups will take place at five points: study entry then 3, 6, 9, and 12 months post enrollment. Outcome measures include: (1) feasibility (barriers to implementation, safety, and satisfaction) of the proposed intervention; (2) self-efficacy and adherence to self-care; and (3) preliminary efficacy (LEF progression, symptom burden, and functional status) of the proposed intervention.DiscussionThis will be the first study to evaluate the feasibility of a LEF-SCP in the HNC population and its impact on self-efficacy and adherence. Furthermore, it will evaluate the potential benefit of routine follow-up on adherence and fidelity to the self-care protocol. We expect that the trial will provide evidence supporting the feasibility of a LEF self-care program. In addition, we anticipate that preliminary data will support improved outcomes including increased adherence and fidelity, and decreased LEF-associated symptoms.Trial registrationClinicalTrials.gov, a service of the US National Institute of Health (NCT 03030859). Registered on 22 January 2017.
Pharmacist-led therapeutic carbohydrate restriction as a treatment strategy for type 2 diabetes: the Pharm-TCR randomized controlled trial protocol
Authors: Durrer Cody , McKelvey Sean , Singer Joel , Batterham Alan M. , Johnson James D. , Wortman Jay , Little Jonathan P. 
Published: December 2019

Abstract
Background
The current treatment paradigm for type 2 diabetes mellitus (T2D) typically involves use of multiple medications to lower glucose levels in hope of reducing long-term complications. However, such treatment does not necessarily address the underlying pathophysiology of the disease and very few patients achieve partial, complete, or prolonged remission of T2D after diagnosis. The therapeutic potential of nutrition has been highlighted recently based on results of clinical trials reporting remission of T2D with targeted dietary approaches. During the initial phase of such interventions that restrict carbohydrates and/or induce rapid weight loss, hypoglycemia presents a notable risk to patients. We therefore hypothesized that delivering very low-carbohydrate, low-calorie therapeutic nutrition through community pharmacies would be an innovative strategy to facilitate lowering of glycated hemoglobin (A1C) while safely reducing the use of glucose-lowering medications in T2D.

Methods
A community-based randomized controlled trial that is pragmatic in nature, following a parallel-group design will be conducted (N = 200). Participants will have an equal chance of being randomized to either a pharmacist-led, therapeutic carbohydrate restricted (Pharm-TCR) diet or guideline-based treatment as usual (TAU). Pharm-TCR involves a 12-week very low carbohydrate, calorie-restricted commercial diet plan led by pharmacists and lifestyle coaches with pharmacists responsible for managing medications in collaboration with the participants’ family physicians. Main inclusion criteria are diagnosis of T2D, currently treated with glucose-lowering medications, age 30–75 years, and body mass index ≥ 30. The primary outcome is a binary measure of use of glucose-lowering medication. Secondary outcomes include A1C, anthropometrics and clinical blood markers.

Discussion
There are inherent risks involved if patients with T2D who take glucose-lowering medications follow very low carbohydrate diets. This randomized controlled trial aims to determine whether engaging community pharmacists is a safe and effective way to deliver therapeutic carbohydrate restriction and reduce/eliminate the need for glucose-lowering medications in people with T2D.

Trial registration
ClinicalTrials.gov, NCT03181165. Registered on 8 June 2017.
Evaluation of bladder stimulation as a non-invasive technique for urine collection to diagnose urinary tract infection in infants under 6 months: a randomized multicenter study (“EE-Sti.Ve.N”)
Authors: Demonchy D. , Ciais C. , Fontas E. , Berard E. , Bréaud J. , Rohrlich P. S. , Dubos F. , Fortier C. , Desmontils J. , Hérisse A. L. , Donzeau D. , Haas H. , Tran A. 
Published: December 2019

Abstract
Background
Febrile urinary tract infection (UTI) is common in infants and needs to be diagnosed quickly. However, the symptoms are non-specific, and diagnosis can only be confirmed after high quality urinalysis. The American Academy of Pediatrics recommends suprapubic aspiration (1–9% contamination) and urinary catheterization (8–14% contamination) for urine collection but both these procedures are invasive. Recent studies have shown a new non-invasive method of collecting urine, bladder stimulation, to be quick and safe. However, few data about bacterial contamination rates have been published for this technique. We hypothesize that the contamination rate of urine collection by bladder stimulation to diagnose febrile UTI in infants under 6 months is equivalent to that of urinary catheterization.

Methods/design
This trial aims to assess equivalence in terms of bacterial contamination of urinary samples collected by urinary catheterization and bladder stimulation to diagnose UTI. Seven hundred seventy infants under 6 months presenting with unexplained fever in one of four Pediatric Emergency Departments in France will be enrolled. Each child will be randomized into a bladder stimulation or urinary catheterization group. The primary endpoints will be the validity of the urine sample assessed by the presence of contamination on bacterial culture.

Conclusion
A high recruitment rate is achievable due to the high prevalence of suspected UTIs in infants. The medical risk is the same as that for routine clinical care as we analyze patients with isolated fever.
If our hypothesis holds true and the rate of urine contamination collected by bladder stimulation is acceptable, the infants included in the study will have benefited from a non-invasive and reliable means of collecting urine.

Trial registration
ClinicalTrials.gov, NCT03801213. Registered on 11 January 2019.
Manual therapy as a prophylactic treatment for migraine: design of a randomized controlled trial
Authors: Amons Andreas Leonard , Castien Rene Franciscus , van der Wouden Johannes C. , De Hertogh Willem , Dekker Joost , van der Horst Henriëtte Eveline 
Published: December 2019

AbstractBackgroundPeople with migraine often experience disability with serious consequences for their social life and work productivity. The pharmacological prophylactic management of migraine is effective in reducing migraine attacks. However, many people are reluctant to use daily prophylactic medication, leading to a demand for non-pharmacological treatment options. We present the design for and discuss the feasibility of a pragmatic, randomized controlled trial on the effectiveness of a multimodal manual therapy (MT) treatment compared to usual care by the general practitioner (GP) for the prophylactic treatment of migraine.MethodsEligible participants will be recruited in primary care using the International Classification of Headache Disorders III criteria for migraine of the International Headache Society. Participants will be randomized to either multimodal MT treatment or usual care provided by the GP. GPs will be asked to treat the usual care group according to the Dutch GP guideline for headache. The multimodal MT intervention will include manual pressure techniques, neck muscle-strength exercises and mobilization of the cervical and thoracic spine.The trial will consist of a 12-week treatment period and follow-up measurements at 12, 26 and 52 weeks. The primary outcome measure is the number of migraine days per 4 weeks, assessed with a headache diary. Secondary outcome measures are the number of migraine attacks, medication use, disability due to headache, headache intensity, number of participants reporting a 50% migraine reduction, measurement of cervical pressure pain thresholds, presence of allodynia, endurance of cervical flexor muscles, days of absence of work and global perceived effect.DiscussionThe results of the trial will show whether a multimodal MT intervention is an effective non-pharmacological treatment option for people with migraine.Trial registrationDutch Trial Register,NL7504. Registered on 7 February 2019.
Enzymatic sugar production from elephant grass and reed straw through pretreatments and hydrolysis with addition of thioredoxin-His-S
Authors: Lu Xianqin , Li Can , Zhang Shengkui , Wang Xiaohan , Zhang Wenqing , Wang Shouguo , Xia Tao 
Published: December 2019

AbstractBackgroundThe bioconversion of lignocellulose to fermentable C5/C6-saccharides is composed of pretreatment and enzymatic hydrolysis. Lignin, as one of the main components, resists lignocellulose to be bio-digested. Alkali and organosolv treatments were reported to be able to delignify feedstocks and loose lignocellulose structure. In addition, the use of additives was an alternative way to block lignin and reduce the binding of cellulases to lignin during hydrolysis. However, the relatively high cost of these additives limits their commercial application.ResultsThis study explored the feasibility of using elephant grass (Pennisetum purpureum) and reed straw (Phragmites australis), both of which are important fibrous plants with high biomass, no-occupation of cultivated land, and soil phytoremediation, as feedstocks for bio-saccharification. Compared with typical agricultural residues, elephant grass and reed straw contained high contents of cellulose and hemicellulose. However, lignin droplets on the surface of elephant grass and the high lignin content in reed straw limited their hydrolysis performances. High hydrolysis yield was obtained for reed straw after organosolv and alkali pretreatments via increasing cellulose content and removing lignin. However, the hydrolysis of elephant grass was only enhanced by organosolv pretreatment. Further study showed that the addition of bovine serum albumin (BSA) or thioredoxin with His- and S-Tags (Trx-His-S) improved the hydrolysis of alkali-pretreated elephant grass. In particular, Trx-His-S was first used as an additive in lignocellulose saccharification. Its structural and catalytic properties were supposed to be beneficial for enzymatic hydrolysis.ConclusionsElephant grass and reed straw could be used as feedstocks for bioconversion. Organosolv and alkali pretreatments improved their enzymatic sugar production; however, the increase in hydrolysis yield of pretreated elephant grass was not as effective as that of reed straw. During the hydrolysis of alkali-pretreated elephant grass, Trx-His-S performed well as additive, and its structural and catalytic capability was beneficial for enzymatic hydrolysis.
Polyneuropathy, organomegaly, endocrinopathy, monoclonal band, and skin (POEMS) changes syndrome presenting with a pseudosensory level: a case report
Authors: Paranavitane Shiran , Gooneratne Lallindra , Chang Thashi 
Published: December 2019

Abstract
Introduction
Polyneuropathy is a key feature of polyneuropathy, organomegaly, endocrinopathy, monoclonal band, and skin changes syndrome, which is a paraneoplastic manifestation of an underlying lymphoproliferative neoplasm. We report the first case of polyneuropathy, organomegaly, endocrinopathy, monoclonal band, and skin changes syndrome presenting with a pseudosensory level.

Case presentation
A 59-year-old Tamil woman with long-standing diabetes mellitus and hypertension developed painless, progressive inguinal lymphadenopathy. A contrast-enhanced computed tomography scan showed mild hepatomegaly and intra-abdominal lymphadenopathy. A histological examination of an enlarged inguinal lymph node showed features of a plasma cell-type Castleman disease. She was treated with rituximab. Six months later, she developed gradually ascending numbness and weakness of both lower limbs. On examination, she had flaccid paraparesis (power 3/5) with a sensory level to pinprick at thoracic level 9. Joint position sense was preserved. Her cranial nerves and upper limbs were neurologically normal. Nerve conduction studies confirmed peripheral neuropathy with conduction slowing and a magnetic resonance imaging of her spine did not show cord or root compression. Serum protein electrophoresis showed a monoclonal band. A bone marrow biopsy showed a hypercellular marrow with 30% plasma cells. A repeat contrast-enhanced computed tomography scan showed sclerotic bony lesions involving multiple vertebrae in addition to mild hepatomegaly and intra-abdominal lymphadenopathy. Polyneuropathy, organomegaly, endocrinopathy, monoclonal band, and skin changes syndrome was diagnosed and she was treated with intravenously administered pulse therapy of dexamethasone and cyclophosphamide. After three cycles of treatment, she regained normal muscle power and sensation.

Conclusions
Polyneuropathy in polyneuropathy, organomegaly, endocrinopathy, monoclonal band, and skin changes syndrome can present as a pseudosensory level.
Association between fibrinogen receptor (Glycoprotein IIb) polymorphism and the risk of venous thromboembolism: a systematic review
Authors: Rezaei Dezaki Zahra , Bagheri Raihaneh , Pourgheysari Batoul 
Published: December 2019

Abstract
Background
The fibrinogen receptor is an integrin on the platelet surface and is shaped from two types of glycoprotein (GP) subunits, GPIIb and GPIIIa. Membrane glycoprotein IIb/IIIa plays an important role in platelet function. The gene encoding the glycoprotein IIIa shows a common polymorphism, PLA2 that increases the binding of the receptor to fibrinogen and enhances the platelet aggregation. The clinical impact of PLA2 polymorphism has been studied in some diseases, but the definition of its exact role on venous thromboembolism complications has been challenging. The present systematic review aimed to clarify the association of PLA2 polymorphism and venous thromboembolism.

Main text
In this study, Electronic databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched. All the assessed studies focused on the relationship between PLA2 polymorphism and venous thromboembolism. Five studies were eligible for systematic review. One study revealed a significant correlation between PLA2 polymorphism and venous thromboembolism. PLA2 polymorphism was associated with deep vein thrombosis in one study and pulmonary thromboembolism in another one.

Conclusion
The published data supported the hypothesis that having the PLA2 polymorphism of GPIIIa may be a risk factor for venous thromboembolism, but the association cannot be concluded; it needs more clinical investigation.
Correlation between prediabetes and coronary artery disease severity in patients undergoing elective coronary angiography
Authors: Muhammed Ahmed , Zaki Mohamed Tarek , Elserafy Ahmed Shawky , Amin Sameh Attia 
Published: December 2019

Abstract
Background
Diabetes is a chronic disease that is responsible for a high rate of morbidity and mortality which can be attributed to atherosclerosis and cardiovascular disease. Diabetes is heralded by prediabetes which not only indicates a higher risk of developing diabetes but also increases the burden of cardiovascular disease. The objective was to observe the effect of prediabetes on the severity of coronary artery disease in patients undergoing elective coronary angiography. Seven hundred and thirty-one patients were admitted for elective coronary angiography and/or PCI starting from September 2017 to August 2018. Patients were divided into group A (normoglycemic group, N = 228), group B (prediabetes group, N = 177), and group C (diabetic group, N = 326). Coronary artery disease (CAD) severity including number of vessels affected and atherosclerotic burden by Gensini score were compared among different groups.

Results
The number of vessels affected as well as left main (LM) disease was higher in the prediabetes group when compared to the normoglycemic group (P,=0.001, P = 0.009, respectively) and was comparable to the diabetes group (P = 0.4, P = 0.6, respectively). Prediabetes showed a Gensini score higher than the normoglycemic group (P = 0.0001) with no significant difference when compared to the diabetic group (P = 0.9).

Conclusion
Prediabetes is associated with high atherosclerotic burden and coronary artery disease complexity that is similar to diabetic than normoglycemic individuals.
Examining the effects of stress on the driving abilities of paramedic students
Authors: Duncliffe Trevor Hines , D'Angelo Brittany , Brock Michael , Fraser Cal , Lamarra Jake , Austin Nick , Pusateri Matt , Batt Alan 
Published: December 2019

Background: Research has suggested that stress may have a negative effect on paramedics' clinical performance. Stress has also been demonstrated to negatively affect the driving abilities of the general population, increasing the number of driving errors. However, no studies have explored stress and its potential impact on the non-clinical performance of paramedics, particularly their driving abilities. Methods: Paramedic students underwent emergency driving assessment in a driving simulator before and after exposure to a stressful medical scenario. The number and type of errors were documented before and after through the use of both driving simulator software and observation by two members of the research team. The NASA Task Load Index (TLX) was used to record self-reported stress levels. Results: Thirty-six students participated in the study. Following exposure to a stressful medical scenario, paramedic students had no rise in overall error rate, but demonstrated increases in three critical driving errors: namely, failure to wear a seat belt (three baseline versus 10 after stress); failing to stop for red lights or stop signs (seven versus 35); and losing control of the vehicle (two versus 11). Self-reported stress levels also increased after the clinical scenario, particularly in the area of mental (cognitive) demand. Conclusion: Paramedics are routinely exposed to acute stress in their everyday work, and this stress could affect their non-clinical performance. The critical errors committed by participants in the present study closely matched those considered to be contributory factors in many ambulance collisions. These results illustrate the need for further research into the effects of stress on non-clinical performance in general, and highlight the potential need to consider additional driver training and stress management education to mitigate the frequency and severity of driving errors among paramedics.
Multiprofessional assessment of patients with chronic pain in primary healthcare
Authors: Lövsund Anneli , Stålnacke Britt-Marie , Stenberg Gunilla 
Published: December 2019

Abstract

Background and aims
Chronic pain is a common reason to seek health care. Multimodal rehabilitation is frequently used to rehabilitate patients with complex pain conditions. The multiprofessional assessment that patients go through before entering multimodal rehabilitation may, in itself, have a positive impact on patient outcome but little is known regarding patients own view. Therefore, the purpose of this study was to discover how patients experienced this multiprofessional assessment project.

Methods
Ten patients participating in a multiprofessional assessment at a primary healthcare centre in Western Finland were interviewed using a semi-structured interview. Qualitative content analysis was used to analyse the interviews.

Results
The analysis resulted in six categories of participant description of their multiprofessional assessment experiences and the rehabilitation plan they received. Feeling chosen or not quite fitting in was a category describing participant feelings upon starting the assessment. They expressed their thoughts on the examinations in the category more than just an examination. Being affirmed described participant desire to be taken seriously and treated well. Receiving support described the perceived roles of the team members. Participant negative experiences of the assessment were described in confusion and disappointment. Finally, in taking and receiving responsibilities, participants described their own role in the team.

Conclusions
Experiences of patients in a multiprofessional assessment were mostly positive. This highlights the value of a team assessment that takes several aspects of chronic pain into account when assessing complex patients.
On the Design of Patch Antenna Array
Authors: Abdulhamid Mohanad F. , Ndung’u Waihenya 
Published: December 2019

Abstract
In this paper, a coaxial fed patch antenna array for application in the 2.4GHz ISM band was implemented using the Ansoft HFSS software. Standard formulas were used to calculate different parameters of the antenna. These were just used as a basis of design as some parameters varied considerably during simulation. A good extent of the antenna design was hence done through trial and error. The proposed antenna was designed to work at 2.44GHz frequency band. A fractional bandwidth of 2.62%, which was not close to the desired 10% and a reflection coefficient of -18.2131dB were attained. This may have been brought about by poor impedance matching and a high level of spurious feed radiation and surface waves. A way of improving the bandwidth would have been to use proximity coupling feeding method which offers the highest bandwidth (as high as 13%) and is somewhat easy to model and has low spurious radiation. However, its fabrication would have been more difficult. A directivity of 8.53dB was achieved. This was a fairly high though directivity increase could have been studied through use of different substrate material and thickness.
Computer-Aided Standardisation for Manufacturing and Maintenance Activities
Authors: Pfeifer Marcel Rolf 
Published: December 2019

AbstractThe paper deals with the development and application of computer-aided standardisation (CAS) for the distribution of standardisation data of production and maintenance processes within the company network.Rising integration pressure of company software tools also include CAx technologies. These CAx technologies provide software solutions for different applications, being able to work closely together with ERP-systems, Business Intelligence (BI) tools and further systems. The possibility of integration makes it also feasible to look on the CAS tool and its potential.While CAS is a topic not yet fully discussed, future development may lead to the requirement of integrating the CAS with the ERP and planning system. Approaches, such as CIM, digital factories (DF) and Industry 4.0 benefit from a broader database available with the CAS system employed