bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pilot, proof of concept REMOTE-COVID trial: remote monitoring use in suspected cases of COVID-19 (SARS-CoV 2)
Authors: Iqbal Fahad Mujtaba , Joshi Meera , Davies Gary , Khan Sadia , Ashrafian Hutan , Darzi Ara 
Published: April 2021

Abstract
Background
SARS-CoV-2 has ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, outside of hospital facilities, recognising early clinical deterioration. We aim to determine the feasibility & acceptability of remote monitoring systems for quarantined individuals in a hotel suspected of COVID-19.

Methods
A pilot, proof-of-concept, feasibility trial was conducted in engineered hotels near London airports (May–June 2020). Individuals arriving to London with mild suspected COVID-19 symptoms requiring quarantine, as recommended by Public Health England, or healthcare professionals with COVID-19 symptoms unable to isolate at home were eligible. The SensiumVitals™ patch, measuring temperature, heart & respiratory rates, was applied on arrival for the duration of their stay. Alerts were generated when pre-established thresholds were breeched; trained nursing staff could consequently intervene.

Results
Fourteen individuals (M = 7, F = 7) were recruited; the mean age was 34.9 (SD 11) years. Mean length of stay was 3 (SD 1.8) days. In total, 10 vital alerts were generated across 4 participants, resulting in telephone contact, reassurance, or adjustment of the sensor. No individuals required hospitalisation or virtual general practitioner review.

Discussion
This proof-of-concept trial demonstrated the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a pandemic at a hotel, acting as an extension to a healthcare trust. Benefits included reduced viral exposure to healthcare staff, with recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor.

Conclusion
Remote monitoring systems can be applied to hotels to deliver healthcare safely in individuals suspected of COVID-19. Further work is required to evaluate this model on a larger scale.

Trial registration
Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04337489 (07/04/2020).
Efficacy and safety of arthroscopic treatment for native acute septic arthritis of the hip joint in adult patients
Authors: Fukushima Kensuke , Uekusa Yui , Koyama Tomohisa , Ohashi Yoshihisa , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi 
Published: April 2021

Abstract
Background
As septic arthritis is time-dependent and has a propensity for irreversible joint damage, early diagnosis and treatment are needed. Frequently, adult patients with septic arthritis cannot undergo invasive surgery because of comorbidities and a weakened immune system. Hip arthroscopic irrigation and debridement for native acute septic arthritis of the hip joint have been performed as the first choice of treatment for patients of all ages. This study aimed to assess the efficacy and safety of arthroscopic management for native acute septic arthritis of the hip joint in adult patients.

Methods
Five adult patients (mean age, 46.2 years; all male) were retrospectively reviewed. Immediately after diagnosis, all patients underwent hip arthroscopic irrigation, debridement with synovectomy, and drainage. Partial weight-bearing was permitted once the C-reactive protein level normalised to < 1.0 mg/dl. Preoperative comorbidities, bacterial culture results, surgical complications, duration of hospital stay, time-to-confirmed normalisation of the C-reactive protein level, and recurrence incidence were evaluated.

Results
All patients had comorbidities, and the cultured microorganisms differed among cases. There were no complications related to arthroscopic surgery. All patients achieved confirmed C-reactive protein normalisation within an average of 69.8 days, and there was no recurrence during the follow-up period (mean, 40.2 months; range, 16–60 months).

Conclusion
Arthroscopic management for native acute septic arthritis of the hip joint is a safe and effective procedure in adult patients.
Clinical outcomes of single implant supported crowns versus 3-unit implant-supported fixed dental prostheses in Dubai Health Authority: a retrospective study
Authors: Alhammadi Sara Hussain , Burnside Girvan , Milosevic Alexander 
Published: April 2021

Abstract
Background
This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs).

Methods
This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations.

Results
A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient’s age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001).

Conclusions
Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.
Acupuncture for post-stroke depression: a systematic review and meta-analysis
Authors: Liu Ran , Zhang Kun , Tong Qiu-yu , Cui Guang-wei , Ma Wen , Shen Wei-dong 
Published: April 2021

Abstract
Background
Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs.

Methods
An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system.

Results
A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies.

Conclusions
The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.
Storage management and wastage of reproductive health medicines and associated challenges in west Wollega zone of Ethiopia: a mixed cross-sectional descriptive study
Authors: Kebede Oliyad , Tilahun Gizachew , Feyissa Desalegn 
Published: April 2021

Abstract
Background
Keeping proper storage conditions at health facilities is vital to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities could lead to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expiration in the west Wollega zone of Ethiopia.

Method
We conducted a facility-based cross-sectional study from 15th to 31st July 2019 using quantitative and qualitative data from West Wollega Zone of Ethiopia.

Results
Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. Hospitals’ stores had equipment and furniture, fulfilled desirable storage conditions, whereas, a significant number of the health centers’ stores did not comply with desirable storage conditions. Challenges of store management identified were poor store infrastructure and shortage of manpower. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75 mg tablet is the highest in the percentage of stock wasted due to expiry. Factors contributing to wastage due to expiration were supply and demand imbalance.

Conclusion
Reproductive health medicines wasted due to expiration is high compared to the government of Ethiopia’s plan for the year 2018/19. This might imply that the monitoring of this plan is poor. Even though hospitals store management is good, there is a weakness in store management in health centers. This could be due to poor attention given to health centers. Therefore, west Wollega zonal health department should appropriately monitor the wastage of Reproductive health medicines and enforce health centers to follow appropriate storage guidelines. Hospitals and health centers should not accept medicines beyond their need to reduce expiry.
Orthopedist involvement in the management of clinical activities: a case study
Authors: Côté André , Abasse Kassim Said , Laberge Maude , Gilbert Marie-Hélène , Breton Mylaine , Lemaire Célia 
Published: April 2021

Abstract
Background
The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists’ level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement.

Methods
We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview.

Results
Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed.

Conclusions
Beyond simply identifying the underlying dynamics of orthopedists’ involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.
Rapid point-of-care (POC) testing for Hepatitis C antibodies in a very high prevalence setting: persons injecting drugs in Tallinn, Estonia
Authors: Uusküla Anneli , Talu Ave , Rannap Jürgen , Barnes David M. , Jarlais Don Des 
Published: April 2021

Abstract
Background
Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia.

Methods
We compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting.
Findings
Of the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives.

Conclusions
Oral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.
Epidemiology of pediatric uveitis and associated systemic diseases
Authors: Shin Yoonkyeom , Kang Ji-Man , Lee Junwon , Lee Christopher Seungkyu , Lee Sung Chul , Ahn Jong Gyun 
Published: April 2021

AbstractBackgroundThe early detection of uveitis associated with systemic inflammatory disease in children is important for proper treatment and prognosis. However, the diagnosis may be delayed because of difficulties in childhood examinations and early minor systemic symptoms. The objective of our study was to identify the pattern of childhood uveitis and investigate the frequency and clinical features of rheumatic diseases in pediatric patients with uveitis.MethodsThis retrospective observational study reviewed the medical records of children (age ≤ 18 years) with uveitis at a Korean tertiary hospital between January 2005 and December 2018. Data collected included the age at onset of uveitis, sex, anatomic location of ocular inflammation, comorbid disease (including systemic inflammatory disease), ocular complications, relevant laboratory data, and treatment. Fisher’s exact test was used to compare categorical variables and the Mann–Whitney U test was used to compare continuous variables. Ap-value of < 0.05 was considered statistically significant.ResultsA total of 155 pediatric patients with uveitis were included in this study. The median age at diagnosis was 13.0 years (interquartile range, 9.5–16.0 years). The male-to-female ratio was 1.09. The process was unilateral in 51.6% of children. Anterior uveitis, panuveitis, intermediate uveitis, and posterior uveitis represented 51.6, 26.5, 6.5, and 1.9% of the cases, respectively. Idiopathic uveitis (65.2%) was the most frequent type of uveitis. Systemic rheumatic disease associations were responsible for 28.4% of the cases, among which juvenile idiopathic arthritis (JIA) was the most frequent cause (14.8%). Human leukocyte antigen (HLA)-B27 and antinuclear antibody (ANA) positive rates were significantly higher in patients with JIA than in those with idiopathic uveitis (p = 0.006 andp = 0.007, respectively).ConclusionsApproximately one-third of children with uveitis in Korea have a systemic rheumatic disease, of which JIA accounts for the majority of cases. HLA-B27 and ANA can serve as risk factors for JIA-associated uveitis.
'Does HPV affect my fertility?' Reproductive concerns of HPV-positive women: a qualitative study
Authors: Qaderi Kowsar , Mirmolaei Seyedeh Tahereh , Geranmayeh Mehrnaz , Farnam Farnaz , Sheikh Hasani Shahrzad 
Published: April 2021

Abstract
Background
Reproductive health changes can occur following infection with Human papillomavirus. HPV is the most prevalent sexually transmitted infection causing a variety of clinical manifestations ranging from warts to cancer. This study aimed to explore the reproductive concerns of women infected with HPV.

Methods
In this qualitative study, we used the conventional content analysis approach, with the aid of MAXQDA.10 software, to analyze data extracted from the face-to-face semi-structured interviews with 20 Iranian HPV-positive women (sampled by maximum variation purposive sampling). The accuracy of this research was ensured according to the four criteria proposed by Guba and Lincoln.

Results
Exploring participants' reproductive concerns, three main categories were identified from the interviews including concerns about fertility potential, pregnancy and non-pregnancy reproductive issues. HPV-positive women concerned about reduced female/ male fertility due to HPV, the impact of the HPV on the fetal health, adverse pregnancy outcomes such as miscarriage and preterm delivery, and mother-to-child transmission of HPV during breastfeeding. HPV-positive women with abnormal cytology results were anxious that becoming pregnant or taking hormonal contraception might worsen their abnormalities. Most married women were reluctant to use a condom. Participants requested further information about the potential reproductive risks of the HPV vaccine. They also wanted to know about the safety of HPV vaccine during pregnancy and breastfeeding.

Conclusions
HPV-positive women had some reproductive concerns that should be considered in the designing of educational-consulting interventions. Women need to be better understood and informed about the impact of HPV on their reproductive health. Health care providers may lack knowledge about these specific areas, and they could benefit from additional up-to-date information to address women's reproductive concerns.
Use of fertility awareness methods as a component of safer conception for women in HIV-serodifferent relationships in Kenya
Authors: Zia Yasaman , Velloza Jennifer , Oluoch Lynda , Momanyi Richard , Mbugua Sarah , Njoroge John , Gakuo Stephen , Mugo Edwin , Thuo Nicholas , Kiptinness Catherine , Njuguna Njambi , Ngure Kenneth , R. Mugo Nelly , Heffron Renee 
Published: April 2021

Abstract
Background
For couples affected by HIV, and serodifferent couples in particular, pregnancy desire is often juxtaposed against the risk of HIV transmission between the couple and the potential neonate leading to thinking about measures to minimize risk of HIV transmission. We assess the use of fertility awareness methods [FAM] and evaluate the drivers of alignment between indicators of fertility and sexual behavior among HIV-serodifferent couples desiring pregnancy.

Methods
HIV-serodifferent couples from Thika, Kenya were enrolled into an open-label pilot evaluation of safer conception strategies. Women responded to daily 7-item short message service [SMS] surveys on FAM and sexual activity. Menstrual cycles were categorized as having condomless sex aligned, not aligned, or partially aligned to the predicted peak fertility. We used binomial logit models with generalized estimating equations to assess alignment between condomless sex during peak fertility days and FAM results. We used Cox proportional hazards to compare pregnancy incidence among months with sex and peak fertility aligned and mis-aligned.

Results
A total of 6929 SMS surveys across 252 menstrual cycles of 65 women were included. Reporting “sticky” cervical mucus (adjusted odds ratio [aOR]: 2.25, 95% confidence interval [95% CI]: 1.30, 3.90) and positive ovulation prediction kit [OPK] result (aOR: 2.07, 95% CI: 1.11, 3.86) were associated with increased likelihood of alignment of condomless sex during peak fertility. Pregnancy incidence was statistically similar among periods with sex aligned and not aligned with peak fertility.

Conclusions
Among women engaged in a comprehensive safer conception program, a moderate percentage of women aligned condomless sex and predicted peak fertility days at least once. While FAM, particularly cervical mucus and OPK, are an inexpensive option for couples to consider using as a component of their safer conception strategies, antiretroviral-based strategies remain important to minimize risk.
Practical strategies for handling breakdown of multiple imputation procedures
Authors: Nguyen Cattram D. , Carlin John B. , Lee Katherine J. 
Published: April 2021

AbstractMultiple imputation is a recommended method for handling incomplete data problems. One of the barriers to its successful use is the breakdown of the multiple imputation procedure, often due to numerical problems with the algorithms used within the imputation process. These problems frequently occur when imputation models contain large numbers of variables, especially with the popular approach of multivariate imputation by chained equations. This paper describes common causes of failure of the imputation procedure including perfect prediction and collinearity, focusing on issues when using Stata software. We outline a number of strategies for addressing these issues, including imputation of composite variables instead of individual components, introducing prior information and changing the form of the imputation model. These strategies are illustrated using a case study based on data from the Longitudinal Study of Australian Children.