bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol randomised controlled trial comparison of cost–utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain
Authors: Castro-Sanchez Adelaida M , Matarán-Peñarrocha Guillermo Adolfo , Gómez-García Silvia , García-López Héctor , Andronis Lazaro , Albornoz-Cabello Manuel , Lara Palomo Inmaculada C 
Published: December 2020

IntroductionChronic lower back pain is a highly prevalent medical condition in Western countries, which that incurs a considerable social and economic burden. Although prescription exercise at home for chronic pain has become a widely used alternative to reduce healthcare costs, the evidence regarding patient adherence and decreased in costs in European countries is scarce and inconclusive. The objective of this study is to examine the cost–utility and cost-effectiveness in patients with chronic lower back pain treated with the McKenzie Method and electroanalgesia via a telemedicine programme versus a face-to-face programme.Methods and analysisThis study reports the protocol for a randomised, two-arm, multicentre, parallel controlled trial. A total of 540 patients with chronic lower back pain (onset time ≥3 months, Roland Morris Disability Questionnaire ≥4) will be recruited in three hospitals in Andalusia. Participants will be assigned to one of two groups (n=270, respectively) to receive electroanalgesia and Mckenzie method exercises through a telemedicine or a face-to-face programme. A total of 24 sessions will be administered three times a week for 8 weeks. Since the study design does not allow participant blinding, the outcome assessor and the statistician will be blinded. Use of helth care resources and costs due to work absenteeism will be captured and analysed. In addition, pain, intensity, fear of movement, quality of life and strength of the core muscle and anteflexion lumbar will be recorded at 2 and 6 months after the start of treatment.Ethics and disseminationHuman Research and Local Ethics Committee of the ‘Hospital Complex Torrecárdenas of Almeria, University Hospital of Granada and Virgen Macarena de Sevilla Hospital—Andalusian Health Service’. Study ﬁndings will be released to the research, clinical and health service through publication in international journals and conferences.Trial registration numberNCT04266366.
Qualitative exploration of patient flow in a Caribbean emergency department
Authors: De Freitas Loren , Goodacre Steve , O’Hara Rachel , Thokala Praveen , Hariharan Seetharaman 
Published: December 2020

ObjectivesEmergency departments (EDs) are complex adaptive systems and improving patient flow requires understanding how ED processes work. This study aimed to explore the patient flow process in an ED in Trinidad and Tobago, identifying organisational factors influencing patient flow.MethodsMultiple qualitative methods, including non-participant observations, observational process mapping and informal conversational interviews were used to explore patient flow. The process maps were generated from the observational process mapping. Thematic analysis was used to analyse the data.SettingThe study was conducted at a major tertiary level ED in Trinidad and Tobago.ParticipantsPatient and staff journeys in the ED were directly observed.ResultsSix broad categories were identified: (1) ED organisational work processes, (2) ED design and layout, (3) material resources, (4) nursing staff levels, roles, skill mix and use, (5) non-clinical ED staff and (6) external clinical and non-clinical departments. Within each category there were individual factors that appeared to either facilitate or hinder patient flow. Organisational processes such as streaming, front loading of investigations and the transfer process were pre-existing strategies in the ED while staff actions to compensate for limitations with flow were more intuitive. A conceptual framework of factors influencing ED patient flow is also presented.ConclusionThe knowledge gained may be used to strengthen the emergency care system in the local context. However, the study findings should be validated in other settings.
Study protocol for the systematic review and meta-analyses of the association between schizophrenia and bone fragility
Authors: Azimi Manavi Behnaz , Stuart Amanda L , Pasco Julie A , Hodge Jason M , Corney Kayla , Berk Michael , Williams Lana J 
Published: December 2020

IntroductionIndividuals with schizophrenia are known to be at higher risk of comorbid conditions, both physical and psychological. Osteoporosis is possibly one of these, leading to public health concerns due to higher rates of associated mortality and morbidity. We aim to systematically search all available evidence across electronic databases regarding the relationship between schizophrenia and bone fragility.Methods and analysisA systematic search of the research databases CINAHL, MEDLINE Complete, Embase and PsycINFO will be conducted and identified papers reviewed for eligibility, with a second reviewer confirming inclusions. Searches will be run from database inception to 1 October 2020 and supplemented by the hand checking of references of identified articles. A previously published scoring system will be used for assessing the methodological quality and risk of bias. A meta-analysis is planned.Ethics and disseminationDue to including published literature only, ethical permission will not be necessary. Results of this study will be published in a relevant scientific journal and presented at a conference in the field of interest.PROSPERO registration numberCRD42020171959.
Colonization and Forestry in French Indochina: the Control, Use, and Exploitation of Forests
Authors: Namba Chizuru 
Published: December 2020

Abstract
This paper aims to illustrate how forests, which play an important role in the economy, the environment, the military, and culture, were managed and used in French Indochina through the colonial period. The Forest Service’s plan involved rational, systematic logging with the participation of companies that generally excluded local inhabitants from the reserved forests and restricted forest use for their livelihoods. Also, the “communal reserves” established in some areas to prioritize locals’ forest use led to regional strife. Despite the colonial authorities’ view that maintenance of the abundant forests was a manifestation of their civilizing mission, the actual implementation of such policies was frequently accompanied by strict policies and repressive control. Friction existed between the various parties using the forest and the Forest Service concerning forest management. The views and behavior of the colonial authorities were also inconsistent, due to the multifaceted nature of the forests, which were at once natural treasures that supported people’s lives as well as a stage for conflicts between varied actors and interests, including local inhabitants, villages, outsiders, the Forest Service, and administrative agencies.
Energy Use in the Sugar Industry in Colonial Taiwan (1895–1945)
Authors: Hirai Kensuke 
Published: December 2020

Abstract
This paper discusses energy use in the Taiwanese sugar industry under Japanese colonial rule (1895–1945) and reconsiders the “unilinear energy shift” from organic resources to fossil resources. Although the sugar industry could obtain much of its energy from bagasse, it had to procure supplementary energy sources, such as firewood and coal from energy markets. Furthermore, technological improvements made by the sugar industry resulted in increased demand for these supplementary energy sources. Companies improved supply by increasing the range of procurement options according to the fluctuation of relative prices between resources or by improving procurement methods through negotiating with seller and transporter, and they lowered demand through the introduction of energy-saving technologies. As a result of each company pursuing the “optimal energy mix” in response to its own business environment (corporate culture, location, and management strategy), energy consumption did not converge on coal as a single source but diversified.
Energy Use in the Japanese Copper Industry from the Meiji Period to World War I
Authors: Yamaguchi Asuka 
Published: December 2020

Abstract
In recent years, energy constraints have been discussed from a historical point of view. This study aims at examining the copper industry’s energy use in Japan from the Meiji period to the time of World War I and clarifying the process of, and reasons for, the selection of energy sources. This study considered not only energy use in the large-scale mines but also energy use in the small-scale mines and miners’ homes. As a result, it was clarified that the mines changed into a space that was based on a diverse combination of energy sources, depending on differences in location (access to energy), natural conditions, financial power, the required amount and price of energy, energy use technologies, ore quality, and end product (usage).
Development of the dementia community attitudes questionnaire
Authors: Read Sheridan T , Wynaden Dianne , Albrecht Matthew A , Toye Christine 
Published: December 2020

Background What it means to live with dementia is changing. Autonomy, independence and continued community involvement are now recognised goals. As a result, new initiatives are required to support people with dementia to sustain their quality of life, update community understanding and reflect resultant change in community attitudes. Measuring the impact of such initiatives can help determine the extent of their success, inform needs for further intervention and, ultimately, shape policy. Objective To discover – or, if this could not be achieved, develop – a questionnaire measuring community attitudes towards people with dementia reflecting these newly recognised goals in terms of both content and expression. Methods A four-stage approach was used in this research: a scoping review of the literature, questionnaire development and expert review, questionnaire piloting, including with people living with dementia and their families, and preliminary psychometric testing. Results The review failed to retrieve a suitable existing questionnaire. A ten-item questionnaire, the Dementia Community Attitudes Questionnaire was developed, content validity was established by expert review and piloting led to refinements. Exploratory factor analysis ( N = 92) generated an interpretable three-factor solution. Cronbach’s alpha coefficient for Factor 1, Engagement, was good (0.855); for Factor 2, Challenges, and Factor 3, Decision-Making, reliability was acceptable (0.785 and 0.709, respectively). Conclusion Supporting people with dementia to sustain their quality of life requires new initiatives and suitable measures to evaluate their impact. The Dementia Community Attitudes Questionnaire was developed with input from people with dementia, their families, and relevant experts. Items reflect current opportunities for people with dementia to retain their independence, autonomy and community engagement for as long as possible. Following further psychometric testing, this new questionnaire may be useful to evaluate such initiatives.
Factors associated with modern family planning use among women living with HIV who attended care and treatment clinics in Jigjiga town, Eastern Ethiopia
Authors: Aradom Habtom Semereab , Sendo Endalew Gemechu , Teshome Girum Sebsibe , Dinegde Negalign Getahun , Demie Takele Gezahegn 
Published: December 2020

Background: Family planning helps to reduce the number of high-risk births and prevent unplanned pregnancies and mother-to-child transmission of HIV. The main purpose of this study was to determine the usage of family planning and its associated factors among women living with HIV who attended care and treatment clinics. Methods: This was a health facility–based cross-sectional study conducted among 332 sexually active reproductive-age women living with HIV who visited care and treatment clinics from 15 April and 15 June 2017. We used a systematic sampling technique for sample selection. The data were collected using pretested and structured questionnaires through face-to-face interviews. Seriously ill women living with HIV who were unable to respond to the questionnaire and refused to participate were excluded from this study. Logistic regression was fitted, and an odds ratio with a 95% confidence interval with a p value less than 0.05 was used to identify factors associated with modern family planning use. Result: The study revealed that the overall use of the modern family planning method was 56.3%, and the most common method used was injectable (37.4%) followed by implants (28.9%). About 19% of the users reported dual contraceptive use. About 58% got family planning from antiretroviral therapy clinics. Almost all the women (97.6%) had heard of seven modern family planning methods. Desire to have another child was the most common (79.7%) reason for not using family planning. Women who attended primary/secondary education (adjusted odds ratio: 2.61; 95% confidence interval: 1.29–5.28], who had no future fertility desire (adjusted odds ratio: 2.94; 95% confidence interval: 1.51–5.73), who had discussed family planning with their husband (adjusted odds ratio: 2.06; 95% confidence interval: 1.04–4.10), and who were counseled by the antiretroviral therapy provider about family planning (adjusted odds ratio: 4.53; 95% confidence interval: 1.70–12.06) were more likely to use family planning methods than their counterparts. Conclusion: The results of this study revealed that the use of modern family planning was low. There is a high frequency of implant usage, fear of mother-to-child transmission as a motivator for family planning usage, and low dual method usage. Hence, improving women’s education, involving husbands, and consistent family planning counseling by antiretroviral therapy providers are promising strategies to improve the uptake of modern family planning by women living with HIV.
Risk of neurodevelopmental disorders in children born from different ART treatments: a systematic review and meta-analysis
Authors: Djuwantono Tono , Aviani Jenifer Kiem , Permadi Wiryawan , Achmad Tri Hanggono , Halim Danny 
Published: December 2020

Abstract
Background
Various techniques in assisted reproductive technology (ART) have been developed as solutions for specific infertility problems. It is important to gain consensual conclusions on the actual risks of neurodevelopmental disorders among children who are born from ART. This study aimed to quantify the relative risks of cerebral palsy, intellectual disability, autism spectrum disorder (ASD), and behavioral problems in children from different ART methods by using systematic review and meta-analysis. Healthcare providers could use the results of this study to suggest the suitable ART technique and plan optimum postnatal care.

Methods
Pubmed, Google Scholar, and Scopus databases were used to search for studies up to January 2020. Of the 181 screened full manuscripts, 17 studies (9.39%) fulfilled the selection criteria. Based on the Newcastle-Ottawa scale ratings, 7 studies were excluded, resulting in 10 studies that were eventually included in the meta-analyses. Mantel-Haenszel risk ratio model was used in the meta-analysis, and the results are described using forest plot with 95% confidence interval. Heterogeneity was assessed using the I2 value.

Results
Pooled evaluation of 10 studies showed that the risk of cerebral palsy in children from assisted reproductive technology (ART) is higher than children from natural conceptions (risk ratio [RR] 1.82, [1.41, 2.34]; P = 0.00001). Risk of intellectual disability (RR 1.46, [1.03, 2.08]; P = 0.03) and ASD (RR 1.49 [1.05, 2.11]; P = 0.03) are higher in intracytoplasmic sperm injection (ICSI) children compared to conventional in vitro fertilization (IVF) children. The differences in the risk of neurodevelopmental disorders in children born after frozen and fresh embryo transfers are not significant. Analysis on potential cofounder effects, including multiple birth, preterm birth, and low birth body weight highlight possibilities of significant correlation to the risks of neurodevelopmental disorders.

Conclusions
Pooled estimates suggest that children born after ART are at higher risk of acquiring cerebral palsy. ICSI treatment causes higher risk of intellectual disability and ASD. These findings suggest the importance of the availability of intensive care unit at the time of delivery and long-term developmental evaluation particularly in children from ICSI.
Mutational Analysis of Ocriplasmin to Reduce Proteolytic and Autolytic Activity in Pichia pastoris
Authors: Baghban Roghayyeh , Farajnia Safar , Ghasemi Younes , Hoseinpoor Reyhaneh , Safary Azam , Mortazavi Mojtaba , Zarghami Nosratollah 
Published: December 2020

Abstract
Background
Ocriplasmin (Jetrea) is using for the treatment of symptomatic vitreomacular adhesion. This enzyme undergoes rapid inactivation and limited activity duration as a result of its autolytic nature after injection within the eye. Moreover, the proteolytic activity can cause photoreceptor damage, which may result in visual impairment in more serious cases.

Results
The present research aimed to reduce the disadvantages of ocriplasmin using site-directed mutagenesis. To reduce the autolytic activity of ocriplasmin in the first variant, lysine 156 changed to glutamic acid and, in the second variant for the proteolytic activity reduction, alanine 59 mutated to threonine. The third variant contained both mutations. Expression of wild type and three mutant variants of ocriplasmin constructs were done in the Pichia pastoris expression system. The mutant variants were analyzed in silico and in vitro and compared to the wild type. The kinetic parameters of ocriplasmin variants showed both variants with K156E substitution were more resistant to autolytic degradation than wild-type. These variants also exhibited reduced Kcat and Vmax values. An increase in their Km values, leading to a decreased catalytic efficiency (the Kcat/Km ratio) of autolytic and mixed variants. Moreover, in the variant with A59T mutation, Kcat and Vmax values have reduced compared to wild type. The mix variants showed the most increase in Km value (almost 2-fold) as well as reduced enzymatic affinity to the substrate. Thus, the results indicated that combined mutations at the ocriplasmin sequence were more effective compared with single mutations.

Conclusions
The results indicated such variants represent valuable tools for the investigation of therapeutic strategies aiming at the non-surgical resolution of vitreomacular adhesion.
Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences
Authors: Imlach Fiona , McKinlay Eileen , Middleton Lesley , Kennedy Jonathan , Pledger Megan , Russell Lynne , Churchward Marianna , Cumming Jacqueline , McBride-Henry Karen 
Published: December 2020

Abstract
Background
During the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March–May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future.

Methods
Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective.

Results
In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person.

Conclusions
Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.
Aligning text mining and machine learning algorithms with best practices for study selection in systematic literature reviews
Authors: Popoff E. , Besada M. , Jansen J. P. , Cope S. , Kanters S. 
Published: December 2020

Abstract
Background
Despite existing research on text mining and machine learning for title and abstract screening, the role of machine learning within systematic literature reviews (SLRs) for health technology assessment (HTA) remains unclear given lack of extensive testing and of guidance from HTA agencies. We sought to address two knowledge gaps: to extend ML algorithms to provide a reason for exclusion—to align with current practices—and to determine optimal parameter settings for feature-set generation and ML algorithms.

Methods
We used abstract and full-text selection data from five large SLRs (n = 3089 to 12,769 abstracts) across a variety of disease areas. Each SLR was split into training and test sets. We developed a multi-step algorithm to categorize each citation into the following categories: included; excluded for each PICOS criterion; or unclassified. We used a bag-of-words approach for feature-set generation and compared machine learning algorithms using support vector machines (SVMs), naïve Bayes (NB), and bagged classification and regression trees (CART) for classification. We also compared alternative training set strategies: using full data versus downsampling (i.e., reducing excludes to balance includes/excludes because machine learning algorithms perform better with balanced data), and using inclusion/exclusion decisions from abstract versus full-text screening. Performance comparisons were in terms of specificity, sensitivity, accuracy, and matching the reason for exclusion.

Results
The best-fitting model (optimized sensitivity and specificity) was based on the SVM algorithm using training data based on full-text decisions, downsampling, and excluding words occurring fewer than five times. The sensitivity and specificity of this model ranged from 94 to 100%, and 54 to 89%, respectively, across the five SLRs. On average, 75% of excluded citations were excluded with a reason and 83% of these citations matched the reviewers’ original reason for exclusion. Sensitivity significantly improved when both downsampling and abstract decisions were used.

Conclusions
ML algorithms can improve the efficiency of the SLR process and the proposed algorithms could reduce the workload of a second reviewer by identifying exclusions with a relevant PICOS reason, thus aligning with HTA guidance. Downsampling can be used to improve study selection, and improvements using full-text exclusions have implications for a learn-as-you-go approach.