bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of drug prescription pattern using World Health Organization prescribing indicators in public health facilities found in Ethiopia: systematic reviews and meta-analysis
Authors: Tefera Bereket Bahiru , Getachew Melese , Kebede Bekalu 
Published: March 2021

AbstractBackgroundDrug use evaluation is a structured, methodological, and criteria-based drug assessment system that helps to evaluate the actual trend of drug use in a particular setting. If drug prescription practices are inappropriate, need to examine the patterns of drug use is necessary to change prescribing patterns accordingly. Therefore, this review aimed to determine the drug prescription pattern in public health facilities found in Ethiopia using prescribing indicators developed by the World Health Organization.MethodsThis review was conducted as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. Extensive searching to identify articles was conducted in PubMed, Medline, Web of Science, Research Gate, Africa Journal of Online, and Google scholar. Finally, 10 eligible articles were selected for analysis based on inclusion and exclusion criteria. The median value, as well as the 25th and 75th percentiles for each WHO prescribing indicator, were computed.ResultThe pooled median value of WHO prescribing indicators was reported as follows: the average number of drugs prescribed per encounter = 2.14 (IQR 1.79–2.52), the percentage of encounters with antibiotics prescribed = 43.46% (IQR 30.01–58.67), the percentage of encounters with an injection prescribed = 13.20% (6.47–40.7), percentage of drugs prescribed by generic name = 93.49% (89.13–97.96), and the percentage of medicines prescribed from essential medicines list = 92.54% (85.10–97.7). The forest plots determined for each prescribing indicator indicated that there is a high degree of heterogeneity across articles.ConclusionAll of the prescribing indicators were not consistent with the standard values recommended by the World Health Organization. Therefore, public health facilities should take appropriate measures for improving the prescription patterns as per the recommendation set by the World Health Organization.
Submarine terraces reveal Late Quaternary tectonic deformation in the intermediate zone between the island shelf and rift zone of the middle part of the Nanseishoto Islands, southwest Japan
Authors: Goto Hideaki 
Published: March 2021

AbstractLate Quaternary tectonic deformation of coastal areas is usually examined based on the height distribution of paleo-shorelines observed on marine terraces. However, it is difficult to examine deformation along the subduction zone, in which small, isolated islands are distributed. In this paper, the author focuses on the widespread shallow submarine terraces surrounding the Iheya–Izena islands in the middle part of the Nanseishoto Islands, Southwest Japan, where crustal deformation is not known. The islands are located in the intermediate zone between island shelf uplifted during the Late Quaternary and the rift zone occurred to the northwest, along the Okinawa trough. Detailed topographic anaglyph images and maps of the islands were produced using a digital elevation model (DEM) of the seafloor, which is stored by the Japan Coast Guard (JCG) and the Advanced Institute of Science and Technology (AIST). Topographic anaglyph images enabled us to identify the widespread distribution and deformation of the shallow seafloor above − 200 m using red–cyan glasses. Four terrace-like features divided by small steps were found on the shallow seafloor, which are named T1, T2, T3, and T4, in descending order. Topographic expressions of paleo-shoreline depths are preserved on submarine terraces formed during the last glacial period. The paleo-shoreline depths of terraces T2 and T3 are − 60 m and − 70 m on the west side and − 70 m and − 80 m, respectively, on the east side of Iheyajima Island; this indicates southeastward tilting. The tilting ratio of T2 and T3 was calculated to approximately 1‰. The tilting rate is approximately 1 × 10–4/kyr, assuming that the T2 was formed in 10–11 kyr. This is much more rapid than that of the last inter-glacial marine terraces in the Muroto peninsula of Shikoku, Japan, with a tilting rate of 4 × 10–5/kyr, which formed by steep northward tilting against the Nankai subduction zone. The author suggests that this phenomenon is not related to mega-thrusting along the subduction zone, but rather to local deformation, probably caused by the reverse faulting of nearby active submarine faults along the west side of the islands.
Laparoscopic approach to recurrence following multiple surgeries for external rectal prolapse: a case report
Authors: Toda Kosuke , Aoyama Taro , Hirai Kenjiro , Uemura Taisuke , Fujita Haruku , Okabe Asami , Ohe Hidenori , Tachibana Tsuyoshi , Mitsuyoshi Akira 
Published: March 2021

AbstractIntroductionThe optimal procedure for recurrent external rectal prolapse remains unclear, particularly in laparoscopic approach. In addition, pelvic organ prolapse (POP) is sometimes concomitant with rectal prolapse. We present a case who underwent laparoscopic procedure for the recurrence of full-thickness external rectal prolapse coexisting POP.Case presentationAn 81-year-old parous female had a 10-cm full-thickness external rectal prolapse following the two operations: the first was perineal recto-sigmoidectomy and the second was laparoscopic posterior mesh rectopexy. Imaging study revealed that the recurrent rectal prolapse was concomitant with both cystocele and exposed vagina, what we call POP. We planned and successfully performed laparoscopic ventral mesh rectopexy (LVMR) with laparoscopic sacrocolpopexy (LSC) using self-cut meshes without any perioperative complication.ConclusionThis is the first report of LVMR and LSC for recurrent rectal prolapse with POP following the perineal recto-sigmoidectomy and laparoscopic posterior mesh rectopexy. Even for recurrent rectal prolapse with POP, our experience suggests that LVMR and LSC could be utilized.
Qigong mind-body program for caregivers of cancer patients: design of a pilot three-arm randomized clinical trial
Authors: Shani Pinky , Raeesi Kristin , Walter Eli , Lewis Kai , Wang Wanyi , Cohen Lorenzo , Yeh Gloria Y. , Lengacher Cecile A. , Wayne Peter M. 
Published: March 2021

Abstract
Background
Informal caregivers, often family and friends, experience significant psychological and physical distress leading to reductions in health and quality of life (QOL). Mind-body interventions focused on caregivers are often limited and do not address multiple barriers, including caregivers’ economic, geographic, and time constraints. Translation of in-person, community-based interventions to Internet-based delivery may offer greater accessibility for caregivers, leading to increased adherence.

Methods
Caring for Caregivers with Mind-Body implements a three-arm, pilot, randomized controlled trial to evaluate the feasibility of delivering a Qigong intervention (Eight Brocades) to cancer caregivers. A total of 54 cancer caregivers will be randomized into one of three 12-week programs: (1) community-based Qigong, (2) Internet-based Qigong, or (3) a self-care control group. Study-specific aims include (1) modify intervention content for online delivery, (2) evaluate the feasibility of recruiting and retaining cancer caregivers into a 12-week clinical trial, and (3) evaluate the feasibility of collecting and managing data, and the suitability of questionnaires for this population. Several outcomes will be assessed, including caregiver QOL, caregiver burden, caregiver distress, perceived social support, physical function, and cognitive function. A 6-month follow-up will also assess longer-term changes in QOL and psychosocial well-being.

Discussion
Findings will be used to inform the design and conduct of a large-scale comparative effectiveness trial evaluating caregivers who received Qigong training delivered through community-based vs Internet-based programs. A finding that either or both programs are effective would inform care and options for caregivers.

Trial registration
NCT04019301; registered on July 15, 2019; clinicaltrials.gov
The Odon Device™ for assisted vaginal birth: a feasibility study to investigate safety and efficacy—The ASSIST II study
Authors:   The ASSIST II Study Group, Hotton Emily J. , Alvarez Mary , Lenguerrand Erik , Wade Julia , Blencowe Natalie S. , Draycott Tim J. , Crofts Joanna F. 
Published: March 2021

Abstract
Background
The Odon Device™ is a new device for assisted vaginal birth that employs an air cuff around the fetal head for traction. Assisted vaginal birth (AVB) is a vital health intervention that can result in better outcomes for mothers and their babies when complications arise in the second stage of labour. Unfortunately, instruments for AVB (forceps and ventouse) are often not used in settings where there is most clinical need often due to lack of training and resources, resulting in maternal and neonatal morbidity and mortality which could have been prevented.
This is often due to a lack of trained operators as well as difficulties in the sterilisation and maintenance of AVB devices. This novel, single use device has the potential to mitigate these difficulties as it is single use and is potentially simpler to use than forceps and ventouse.
All the studies of the Odon Device to date (pre-clinical, preliminary developmental and clinical) suggest that the Odon Device does not present a higher risk to mothers or babies compared to current standard care, and recruitment to intrapartum research exploring the device is feasible and acceptable to women. The first study in which the Odon Device was used in clinically indicated conditions (the ASSIST Study) reported a lower efficacy than those reported with established devices. The reasons need to be explored, specifically focussing on learning curve, the technique of the doctors using this new device and potential modifications to device design. A follow-on clinical study to further investigate the efficacy and safety of the Odon Device in its indicated use, the ASSIST II Study, is therefore being undertaken.

Methods
The primary feasibility outcome is study feasibility (recruitment and retention rates) whilst the primary clinical outcome successful vaginal birth completed with the Odon Device. Key secondary feasibility outcomes include participant withdrawal, compliance in data collection and acceptability of the device to women and operators. Secondary clinical outcomes include maternal, neonatal and device outcomes. Safety data will be reviewed following every birth exploring maternal, neonatal and device risks. Using A’Hern approach for sample size calculation, we aim to recruit 104 women requiring an assisted vaginal birth for a recognised clinical indication. Assuming an AVB success rate of 65% or more, a one-sided alpha risk of 5% and power of 90%.

Discussion
The data from the ASSIST II Study will provide the information required regarding acceptability, recruitment, outcome data collection, device design, technique of device use and operator learning curve in order to design a future randomised controlled trial of the Odon Device versus current modes of assisted vaginal birth.

Trial registration
ISRCTN registration: 38829082 (prospectively registered July 26, 2019)
Factors contributing to fidelity in a pilot trial of individualized resistant starches for pediatric inflammatory bowel disease: a fidelity study protocol
Authors: Castillo Gisell , Mack David R. , Lalu Manoj M. , Singleton Ruth , Fergusson Dean A. , Stintzi Alain , Harrison Megan , Presseau Justin 
Published: March 2021

Abstract
Background
The consumption of resistant starches is a promising adjuvant therapy for patients with inflammatory bowel disease. Rigorous evaluation of resistant starches in this setting depends on the intervention being delivered, received, and enacted as intended, that is, with fidelity. As part of a planned pilot trial, participants will be randomized to ingest resistant starches or a placebo. They will also be asked to collect stool samples and keep symptom and dose diaries to inform trial outcomes.
We aim to identify potential factors impacting fidelity to the receipt and enactment of trial intervention and data collection activities from the perspective of patients and caregivers in the trial. Identifying fidelity barriers and enablers at the pilot trial phase of a clinical intervention may help to determine optimization processes when expanding to multiple sites in future trials.

Methods
We will conduct 15-30 semi-structured interviews with pilot trial participants (aged 8-17) and their caregivers. Trial participants will be approached for interviews approximately 6 months after the start of their trial participation. Personal projects analysis, a tool for understanding how individuals manage competing demands in their daily lives, will guide an in-depth exploration of how trial participants engage in activities related to intervention and data collection fidelity (ingesting resistant starches or placebo, collecting stool samples, keeping a symptom and dose diary) amidst the complexities of daily living.

Discussion
The present study will seek to explore and demonstrate how theory-informed fidelity assessments can be conducted alongside pilot trials to inform future multisite trials. Study results will clarify what factors may affect fidelity to trial intervention and data collection activities. Results may suggest what to modify to optimize the design and conduct, and ensure the integrity, of future multisite trials. Conducting process evaluations alongside clinical trials has the potential to improve our understanding of trial participant experiences. Results will provide a better understanding of how trial participants manage to engage in necessary trial activities along with other priorities.
An external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime): study protocol
Authors:   On behalf of the PolyPrime team, Rankin Audrey , Cadogan Cathal A. , Barry Heather E. , Gardner Evie , Agus Ashley , Molloy Gerard J. , Gorman Ashleigh , Ryan Cristín , Leathem Claire , Maxwell Marina , Gormley Gerard J. , Ferrett Alan , McCarthy Pat , Fahey Tom , Hughes Carmel M. 
Published: March 2021

Abstract
Background
The use of multiple medications (polypharmacy) is a concern in older people (≥65 years) and is associated with negative health outcomes. For older populations with multimorbidity, polypharmacy is the reality and the key challenge is ensuring appropriate polypharmacy (as opposed to inappropriate polypharmacy). This external pilot cluster randomised controlled trial (cRCT) aims to further test a theory-based intervention to improve appropriate polypharmacy in older people in primary care in two jurisdictions, Northern Ireland (NI) and the Republic of Ireland (ROI).

Methods
Twelve GP practices across NI (n=6) and the six counties in the ROI that border NI will be randomised to either the intervention or usual care group. Members of the research team have developed an intervention to improve appropriate polypharmacy in older people in primary care using the Theoretical Domains Framework of behaviour change. The intervention consists of two components: (1) an online video which demonstrates how a GP may prescribe appropriate polypharmacy during a consultation with an older patient and (2) a patient recall process, whereby patients are invited to scheduled medication review consultations with GPs. Ten older patients receiving polypharmacy (≥4 medications) will be recruited per GP practice (n=120). GP practices allocated to the intervention arm will be asked to watch the online video and schedule medication reviews with patients on two occasions; an initial and a 6-month follow-up appointment. GP practices allocated to the control arm will continue to provide usual care to patients. The study will assess the feasibility of recruitment, retention and study procedures including collecting data on medication appropriateness (from GP records), quality of life and health service use (i.e. hospitalisations). An embedded process evaluation will assess intervention fidelity (i.e. was the intervention delivered as intended), acceptability of the intervention and potential mechanisms of action.

Discussion
This pilot cRCT will provide evidence of the feasibility of a range of study parameters such as recruitment and retention, data collection procedures and the acceptability of the intervention. Pre-specified progression criteria will also be used to determine whether or not to proceed to a definitive cRCT.

Trial registration
ISRCTN, ISRCTN41009897. Registered 19 November 2019. ClinicalTrials.gov, NCT04181879. Registered 02 December 2019.
Vitreomacular interface after anti-VEGF injections in diabetic macular edema
Authors: Veloso Carlos E. , Brocchi Daniel N. , Singh Rishi P. , Nehemy Márcio B. 
Published: March 2021

Abstract
Background
The purpose of this study was to evaluate the incidence of vitreomacular adhesion (VMA) release after anti-VEGF therapy for the treatment of diabetic macular edema (DME) and to evaluate further changes in outcome.

Methods

This was a retrospective study that enrolled 66 eyes of 66 patients with DME who presented with VMA diagnosed by spectral-domain optical coherence tomography (OCT) at baseline. VMA was classified as focal (attachment: ≤ 1500 μm) or broad (attachment: > 1500 μm). All patients received at least three monthly intravitreal injections of an anti-VEGF agent. Follow-up visits were performed 1 month after each injection to evaluate the incidence of VMA release.

Results
The mean patient age was 61.4 years (range: 29 to 78 years), and 72.7 % were male. The mean best-corrected visual acuity was 0.62 logMAR, and the mean central retinal thickness (CRT) was 473 μm at baseline. The mean length of follow-up was 18.5 months, and the mean number of injections was 5.8. The intravitreal drugs used were aflibercept (40.9 %), ranibizumab (37.9 %) and bevacizumab (21.2 %). Forty-seven eyes had broad VMA, and 19 had focal VMA. Twenty-two eyes (33.3 %) developed VMA release following a mean of 5.7 injections (range: 3–13). Sixteen eyes (72.7 %) with focal VMA and 6 eyes (27.3 %) with broad VMA at baseline developed VMA release. Twenty-one eyes that developed VMA release showed an improvement in CRT following VMA release (mean: -106 μm; range: 22 to 289 μm).

Conclusions
VMA release occurs in approximately 1/3 of patients with DME following anti-VEGF therapy. Most of them show a short-term decrease in CRT.
Grasshopper optimization algorithm optimized multistage controller for automatic generation control of a power system with FACTS devices
Authors: Nayak Pratap Chandra , Prusty Ramesh Chandra , Panda Sidhartha 
Published: March 2021

AbstractThis paper uses a Grasshopper Optimization Algorithm (GOA) optimized PDF plus (1 + PI) controller for Automatic generation control (AGC) of a power system with Flexible AC Transmission system (FACTS) devices. Three differently rated reheat turbine operated thermal units with appropriate generation rate constraint (GRC) are considered along with different FACTS devices. A new multistage controller design structure of a PDF plus (1 + PI) is introduced in the FACTS empowered power system for AGC while the controller gains are tuned by the GOA. The superiority of the proposed algorithm over the Genetic Algorithm (GA) and Particle Swarm Optimization (PSO) algorithms is demonstrated. The dynamic responses of GOA optimized PDF plus (1 + PI) are compared with PIDF, PID and PI controllers on the same system. It is demonstrated that GOA optimized PDF plus (1 + PI) controller provides optimum responses in terms of settling time and peak deviations compared to other controllers. In addition, a GOA-tuned PDF plus (1 + PI) controller with Interline Power Flow Controller (IPFC) exhibits optimal results compared to other FACTS devices. The sturdiness of the projected controller is validated using sensitivity analysis with numerous load patterns and a wide variation of parameterization. To further validate the real-time feasibility of the proposed method, experiments using OPAL-RT OP5700 RCP/HIL and FPGA based real-time simulations are carried out.
Capillaroscopy as a diagnostic tool in the diagnosis of mixed connective tissue disease (MCTD): a case report
Authors: Radić Mislav , Overbury Rebecca S. 
Published: March 2021

Abstract
Background
The concept of mixed connective tissue disease (MCTD) as a unique connective tissue disease has endured for half a century. Disease onset can be in adulthood (MCTD) or of juvenile onset (jMCTD) and is characterized by overlapping features of systemic lupus erythematosus (SLE), polymyositis or dermatomyositis (PM/DM) and systemic sclerosis (SSc). No universally accepted classification criteria for MCTD exists, however agreed upon overlapping disease features include the presence of high titers of U1 small nuclear ribonucleoprotein particle antibodies (U1snRNP) in the peripheral blood, Raynaud’s phenomenon, synovitis, myositis and swollen hands or fingers. Characteristic capillaroscopy findings are commonly seen in MCTD and jMCTD, which may represent a crucial and key clue for classification as well as prognosis in these patients.

Case presentation
We present a young male patient, with symptom onset as early as age 13, who was diagnosed with MCTD at age 16 and found to have high titers of anti-U1snRNP antibodies, Raynaud’s phenomenon, synovitis, and swollen hands and fingers. Most interestingly, his video capillaroscopy at diagnosis was abnormal and revealed an active SSc-like pattern. His presentation and course are described.

Conclusions
We conclude that based on existing data, and as highlighted by this case presentation, nailfold video capillaroscopy should be included as an early screening tool for the detection of microangiopathy in patients with the diagnosis MCTD and jMCTD. Additionally, given its prevalence in this population at disease diagnosis, we recommend consideration be given to nailfold video capillaroscopy as a potentially important classification criteria and prognostic tool for jMCTD and MCTD.
Super selective percutaneous transhepatic coil embolization of intrahepatic pseudoaneurysm after pediatric liver transplantation: a case report
Authors: Huf V. I. , Grothues D. , Knoppke B. , Goessmann H. , Wohlgemuth W. A. , Melter M. , Brunner S. M. , Schlitt H. J. , Uller W. 
Published: March 2021

AbstractBackgroundIntrahepatic arterial pseudoaneurysms are a rare, life-threatening complication after pediatric liver transplantation. Treatment of choice represents interventional radiological management with endovascular embolization of the segmental artery proximal and distal to the aneurysm. However, this technique results in loss of arterial perfusion distal to the aneurysm with subsegment arterial ischemia.Case presentationWe report a case of a 1-year-old girl with a pseudoaneurysm in the split-liver graft. Direct percutaneous, transhepatic access to the pseudoaneurysm was performed followed by super selective coil application into the aneurysm.ConclusionSuper selective percutaneous, transhepatic coil application is feasible even in pediatric patients after liver transplantation and results in preservation of the entire course of the liver artery.