bluuebunny/crossref_metadata_2025_split huggingface dataset:
MIS-TLIF versus O-TLIF for single-level degenerative stenosis: study protocol for randomised controlled trial
Authors: Leonova Olga N , Cherepanov Evgeny A , Krutko Aleksandr V 
Published: March 2021

IntroductionPatients with symptomatic single-level combination of degenerative stenosis and low-grade spondylolisthesis are often treated by nerve root decompression and spinal fusion. The gold standard is traditional open decompression and fusion, but minimally invasive method is more and more prevailing. However, there is lack of high-quality studies comparing these two techniques in order to obtain the advantages and certain indications to use one of these methods. The current study includes clinical, safety and radiological endpoints to determine the effectiveness of minimally invasive decompression and fusion (MIS-TLIF) over the traditional open one (O-TLIF).Methods and analysisAll patients aged 40–75 years with neurogenic claudication or bilateral radiculopathy caused by single-level combination of degenerative stenosis and low-grade spondylolisthesis, confirmed by MRI with these symptoms persisting for at least 3 months prior to surgery, are eligible. Patients will be randomised into MIS-TLIF or traditional O-TLIF. The primary outcome measure is Oswestry Disability Index at 3-month follow-up term. The secondary outcomes are patient-reported outcome measures by the number of clinical scales, radiological parameters including sagittal balance parameters, safety endpoints and cost-effectiveness of each method. All patients will be analysed preoperatively, as well as on the 14th day of hospital stay (or on the day of hospital discharge), 3 months, 6 months, 12 months and 24 months postoperatively. The study has the design of a parallel group to demonstrate the non-inferior clinical results of MIS-TLIF compared with the traditional O-TLIF.Ethics and disseminationThe study will be performed according to Helsinki Declaration. The study protocol was approved by the Local Ethical Committee of Priorov National Medical Research Center of Traumatology and Orthopedics in August 2020. Preliminary and final results will be presented in peer-reviewed journals, especially orthopaedic and spine surgery journals, at national and international congresses.Trial registration numberNCT04594980.
Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey
Authors: Kong Linglin , Zhao Huimin , Fan Junyao , Wang Quan , Li Jie , Bai Jinbing , Mao Jing 
Published: March 2021

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.
Improving the quality of child-care centres through supportive assessment and ‘communities of practice’ in informal settlements in Nairobi: protocol of a feasibility study
Authors: Nampijja Margaret , Okelo Kenneth , Wekulo Patricia Kitsao , Kimani-Murage Elizabeth W , Elsey Helen 
Published: March 2021

IntroductionInvesting in children during the critical period between birth and age 5 years can have long-lasting benefits throughout their life. Children in Kenya’s urban informal settlements, face significant challenges to healthy development, particularly when their families need to earn a daily wage and cannot care for them during the day. In response, informal and poor quality child-care centres with untrained caregivers have proliferated. We aim to co-design and test the feasibility of a supportive assessment and skills-building for child-care centre providers.Methods and analysisA sequential mixed-methods approach will be used. We will map and profile child-care centres in two informal settlements in Nairobi, and complete a brief quality assessment of 50 child-care centres. We will test the feasibility of a supportive assessment skills-building system on 40 child-care centres, beginning with assessing centre-caregivers’ knowledge and skills in these centres. This will inform the subsequent co-design process and provide baseline data. Following a policy review, we will use experience-based co-design to develop the supportive assessment process. This will include qualitative interviews with policymakers (n=15), focus groups with parents (n=4 focus group discussions (FGDs)), child-care providers (n=4 FGDs) and joint workshops. To assess feasibility and acceptability, we will observe, record and cost implementation for 6 months. The knowledge/skills questionnaire will be repeated at the end of implementation and results will inform the purposive selection of 10 child-care providers and parents for qualitative interviews. Descriptive statistics and thematic framework approach will respectively be used to analyse quantitative and qualitative data and identify drivers of feasibility.Ethics and disseminationThe study has been approved by Amref Health Africa’s Ethics and Scientific Review Committee (Ref: P7802020 on 20thApril 2020) and the University of York (Ref: HSRGC 20thMarch 2020). Findings will be published and continual engagement with decision-makers will embed findings into child-care policy and practice.
Serological surveillance of noroviruses in a community-based prospective cohort: a study protocol
Authors: Wang Lu , Xie Dongjie , Yu Jingrong , Koroma Mark Momoh , Qiu Mengsi , Duan Wentao , Zhang Xu-Fu , Dai Ying-Chun 
Published: March 2021

IntroductionNoroviruses are the leading cause of viral acute gastroenteritis affecting all age groups. Since 2014, the previous rarely reported GII.P17-GII.17 and recombinant GII.P16-GII.2 norovirus emerged, replacing GII.4 predominant genotype, causing increased outbreaks in China and other countries. Meanwhile, GII.4/2012 Sydney strain has re-emerged as the dominant variant in many places in 2015–2018. The role of herd immunity as the driving force during these new emerging or re-emerging noroviruses is poorly defined. Serological surveillance studies on community-based prospective cohort on norovirus are highly needed.Methods and analysesThis study will include 1000 out of 9798 participants aged 18 years and above from Caofeidian district, Tangshan city, northern China. Baseline data on sociodemographic characteristics and blood samples were collected in 2013–2014. Blood collection will be replicated annually throughout the cohort until 2023. Saliva samples were also collected in 2016. The seroprevalence and seroincidence of blockade antibodies against norovirus genotypes of GII.P17-GII.17, GII.P16-GII.2, the re-emerged GII.4/2012 and potential novel pandemic variants will be evaluated by ELISA. Associations between genotype blockade antibodies and sociodemographic factors and human histo-blood group antigens will be evaluated using univariate and multivariate analysis. The dynamics of herd immunity duration will be estimated in this longitudinal surveillance.Ethics and disseminationThe study has been approved by the Ethical Committees of the Staff Hospital of Jidong oil-field of China National Petroleum Corporation. This study will provide insight into the seroprevalence and seroincidence of noroviruses, and their relationships with sociodemographic characteristics and genetic susceptibility. It will also explain herd immunity of the emerged and re-emerged genotypes or variants. The study will further enable an understanding of the mechanism driving the replacement of norovirus genotypes. Research findings will be disseminated in peer-reviewed journals and at scientific meetings.
Increasing use of CT requested by emergency department physicians in tertiary hospitals in Western Australia 2003–2015: an analysis of linked administrative data
Authors: Maxwell Susannah , Ha Ninh Thi , Bulsara Max K , Doust Jenny , Mcrobbie Donald , O’Leary Peter , Slavotinek John , Moorin Rachael 
Published: March 2021

ObjectiveThis study aimed to examine trends in number of CT scans requested by tertiary emergency department (ED) physicians in Western Australia (WA) from 2003 to 2015 across broad demographic and presentation characteristics, anatomical areas and presented symptoms.DesignAn observational cross-sectional study over study period from 2003 to 2015.SettingLinked administrative health service data at individual level from WA.ParticipantsA total of 1 666 884 tertiary hospital ED presentations of people aged 18 years or older were included in this studyMain outcome measureNumber of CT scans requested by tertiary ED physicians in an ED presentation.MethodsPoisson regression models were used to assess variation and trends in number of CT scans requested by ED physicians across demographic characteristics, clinical presentation characteristics and anatomical areas.ResultsOver the entire study duration, 71 per 1000 ED episodes had a CT requested by tertiary ED physicians. Between 2003 and 2015, the rate of CT scanning almost doubled from 58 to 105 per 1000 ED presentations. After adjusted for all observed characteristics, the rate of CT scans showed a downward trend from 2009 to 2011 and subsequent increase. Males, older individuals, those attending ED as a result of pain, those with neurological symptoms or injury or with higher priority triage code were the most likely to have CT requested by tertiary ED physicians.ConclusionsNoticeable changes in the number of CTs requested by tertiary ED physicians corresponded to the time frame of major health reforms happening within WA and nationally.
Strategies for developing and implementing a rheumatoid arthritis healthcare quality framework: a thematic analysis of perspectives from arthritis stakeholders
Authors: Barber Claire , Lacaille Diane , Hall Marc , Bohm Victoria , Li Linda C , Barnabe Cheryl , Rankin James , Hazlewood Glen , Marshall Deborah A , Macmullan Paul , Mosher Dianne , Homik Joanne , English Kelly , Tsui Karen , Then Karen L 
Published: March 2021

ObjectivesTo obtain stakeholder perspectives to inform the development and implementation of a rheumatoid arthritis (RA) healthcare quality measurement framework.DesignQualitative study using thematic analysis of focus groups and interviews.SettingArthritis stakeholders from across Canada including healthcare providers, persons living with RA, clinic managers and policy leaders were recruited for the focus groups and interviews.ParticipantsFifty-four stakeholders from nine provinces.InterventionsQualitative researchers led each focus group/interview using a semistructured guide; the digitally recorded data were transcribed verbatim. Two teams of two coders independently analysed the transcripts using thematic analysis.ResultsPerspectives on the use of different types of measurement frameworks in healthcare were obtained. In particular, stakeholders advocated for the use of existing healthcare frameworks over frameworks developed in the business world and adapted for healthcare. Persons living with RA were less familiar with specific measurement frameworks, however, they had used existing online public forums for rating their experience and quality of healthcare provided. They viewed a standardised framework as potentially useful for assisting with monitoring the care provided to them individually. Nine guiding principles for framework development and 13 measurement themes were identified. Perceived barriers identified included access to data and concerns about how measures in the framework were developed and used. Effective approaches to framework implementation included having sound knowledge translation strategies and involving stakeholders throughout the measurement development and reporting process. Clinical models of care and health policies conducive to outcome measurement were highlighted as drivers of successful measurement initiatives.ConclusionThese important perspectives will be used to inform a healthcare quality measurement framework for RA.
Infection control teams for reducing healthcare-associated infections in hospitals and other healthcare settings: a protocol for systematic review
Authors: Thandar Moe Moe , Matsuoka Sadatoshi , Rahman Obaidur , Ota Erika , Baba Toshiaki 
Published: March 2021

IntroductionHealthcare-associated infections (HCAIs) are a worldwide problem. Infection control in hospitals is usually implemented by an infection control team (ICT). Initially, ICTs consisted of doctors, nurses, epidemiologists and microbiologists; then, in the 1980s, the infection control link nurse (ICLN) system was introduced. ICTs (with or without the ICLN system) work to ensure the health and well-being of patients and healthcare professionals in hospitals and other healthcare settings, such as acute care clinics, community health centres and care homes. No previous study has reported the effects of ICTs on HCAIs. This systematic review aims to assess the effectiveness of ICTs with or without the ICLN system in reducing HCAIs in hospitals and other healthcare settings.Methods and analysisWe will perform a comprehensive literature search for randomised controlled trials in four databases: PubMed, Embase, CINAHL and the Cochrane Library. The primary outcomes are: patient-based/clinical outcomes (rate of HCAIs, death due to HCAIs and length of hospital stay) and staff-based/behavioural outcomes (compliance with infection control practices). The secondary outcomes include the costs to the healthcare system or patients due to extended lengths of stay. Following data extraction, we will assess the risk of bias by using the Cochrane Effective Practice and Organization of Care risk of bias tool. If data can be pooled across all the studies, we will perform a meta-analysis.Ethics and disseminationWe will use publicly available data, and therefore, ethical approval is not required for this systematic review. The findings will be submitted for publication in peer-reviewed journals.Trial registration numberCRD42020172173.
Cefoxitin versus piperacillin–tazobactam as surgical antibiotic prophylaxis in patients undergoing pancreatoduodenectomy: protocol for a randomised controlled trial
Authors: Nevarez Nicole M , Brajcich Brian C , Liu Jason , Ellis Ryan , Ko Clifford Y , Pitt Henry A , D"Angelica Michael I , Yopp Adam C 
Published: March 2021

IntroductionAlthough antibiotic prophylaxis is established in reducing postoperative surgical site infections (SSIs), the optimal antibiotic for prophylaxis in pancreatoduodenectomy (PD) remains unclear. The study objective is to evaluate if administration of piperacillin–tazobactam as antibiotic prophylaxis results in decreased 30-day SSI rate compared with cefoxitin in patients undergoing elective PD.Methods and analysisThis study will be a multi-institution, double-arm, non-blinded randomised controlled superiority trial. Adults ≥18 years consented to undergo PD for all indications who present to institutions participating in the National Surgical Quality Improvement Program Hepato-Pancreato-Biliary (NSQIP HPB) Collaborative will be included. Data collection will use the NSQIP HPB Collaborative Surgical Clinical Reviewers. Patients will be randomised to either 1–2 g intravenous cefoxitin or 3.375–4.5 g intravenous piperacillin–tazobactam within 60 min of surgical incision. The primary outcome will be 30-day postoperative SSI rate following PD. Secondary outcomes will include 30-day postoperative mortality; specific postoperative complication rate; and unplanned reoperation, length of stay, and hospital readmission. A subset of patients will have bacterial isolates and sensitivities of intraoperative bile cultures and SSIs. Postoperative SSIs and secondary outcomes will be analysed using logistic regression models with the primary predictor as the randomised treatment group. Additional adjustment will be made for preoperative biliary stent presence. Additionally, bacterial cultures and isolates will be summarised by presence of bacterial species and antibiotic sensitivities.Ethics and disseminationThis study is approved by the Institutional Review Board at Memorial Sloan Kettering Cancer Center. This trial will evaluate the effect of piperacillin–tazobactam compared with cefoxitin as antibiotic prophylaxis on the hazard of postoperative SSIs. The results will be disseminated regardless of the effect of the intervention on study outcomes. The manuscript describing the effect of the intervention will be submitted to a peer-reviewed journal when data collection and analyses are complete.Trial registration numberNCT03269994.
In Vivo Comparison of Ultimate Tensile Strength and Surface Topography of Three Different Nickel–Titanium Archwires
Authors: Keerthana Pasupureddi , SB Puneeth , Chitra Prasad 
Published: March 2021

Objective: To investigate the surface topography and ultimate tensile strength of 3 types of nickel–titanium (NiTi) wires before and after 3 months of intraoral use and to assess the efficiency of the wires in cases requiring extensive alignment. Methods: NiTi wires of 0.016″ (0.40 mm) were divided into 3 groups—martensitic stabilized NiTi™ (group 1), austenitic active Copper NiTi™ 27°C (group 2), and martensitic active copper NiTi™ 35°C (group 3)—each further divided into 2 subgroups: (a) as-received wires; and (b) used wires. Each wire was subjected to scanning electron microscopy (SEM) analysis and tensile testing. Ultimate tensile strength data were analyzed using one-way analysis of variance (ANOVA) and Tukey testing at the .05 level of significance. Results: Martensitic stabilized archwires had a significantly lower ultimate tensile strength (93.99 ± 0.23 MPa) than martensitic active (116.96 ± 0.43 MPa) and austenitic active (106.94 ± 0.36 MPa) archwires. Among the used archwires, the martensitic stabilized ones showed the most and the martensitic active ones the least surface degradation. Conclusion: Ultimate tensile strength was the highest for martensitic active archwires with superior surface properties and the lowest for martensitic stabilized archwires with an increased amount of surface degradation.
The effect of occupation-based postural stability training on postural stability and occupational performance in visually impaired individuals: A randomised controlled trial
Authors: Özkan Esma , Akı Esra 
Published: March 2021

Introduction The purpose of this research was to examine the effect of occupation-based postural stability training on occupational performance and postural stability in visually impaired individuals. Method The research was designed as pre-test/post-test, with two groups (study group and control group). A total of 34 individuals with visual impairment were randomly assigned to the two groups. Participants were evaluated using a sociodemographic information form, the Biodex Balance System for postural stability, the Canadian Occupational Performance Measurement for assessing performance and satisfaction of occupations and the semi-structured interview form. The control group received only postural stability training with the Biodex Balance System and the study group received individualised occupation-based postural stability training with the Biodex Balance System BBS during a 12-week intervention (24 sessions). Results A statistically significant difference was found between the postural stability values of the study group and the control group when looking at pre and post-training measurements ( p < 0.05). It was observed that there was an improvement in the postural stability of the participants in both groups. There was a statistically significant increase in the occupational performance and satisfaction of participants in the study group ( p < 0.01). Conclusion Adding person-centred, meaningful and purposeful occupations into rehabilitation programmes that use technological devices increases functionality in activities of daily living.
Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis
Authors: Machlańska Agnieszka , Helbig Grzegorz , Chromik Karolina , Zapała Magdalena , Zwiernik Bartosz , Selmaj Krzysztof 
Published: March 2021

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rarely recognized hyperinflammatory condition of high death risk. Objective: The objective was to describe a case of HLH in a patient with multiple sclerosis (MS) treated with ocrelizumab Methods: Clinical observation, laboratory testing, and use of HLH-2004 criteria for HLH diagnosis. Results: A 32-year-old Caucasian female developed HLH during ocrelizumab treatment. She met six of the eight HLH criteria including fever, splenomegaly, cytopenia, hypertriglyceridemia and hypofibrinogenemia, high serum ferritin level, and low natural killer (NK) cells. Conclusion: HLH should be considered in the differential diagnosis in MS patients displaying a fever and malaise syndrome following administration of ocrelizumab.
Structural Transformation in South Asia: Does the Pattern Ensure Growth Momentum?
Authors: Jha Raghbendra , Afrin Sadia 
Published: March 2021

We model the evolution and determinants of shares of agriculture, manufacturing and services to gross domestic product for four South Asian countries (Bangladesh, India, Sri Lanka and Pakistan) for 41 years (1974–2018) to understand their structural transformation pattern. Determinants of shares were classified into three broad categories: ‘country fundamentals’, ‘policy’ and ‘decadal dummies’. This is the first article to investigate the empirical regularities of the structural transformation pattern and their determinants for this region. The generalized least squares estimation technique for panel data was applied. We find mixed evidence in support of structural transformation. With the increase in per capita income, the share of agriculture decreases and that of services increases, partially supporting the Kuznets hypothesis; however, the share of manufacturing sector shows a more tepid rise and even decreases in some model specifications. Thus, the Kuznets model of structural transformation is supported to some extent, but not strongly for these countries. JEL: C22, C23, F63, O11