bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness and Attitudes toward Corneal Donations among Applicants and Staff of a Driver, Vehicle and Licensing Authority (DVLA) in Ghana
Authors: Lartey Seth , ANTWI-ADJEI ELLEN KONADU , Agyapong Solomon , Mohammed Abdul-Kabir , Mensah Derrick N.O. , Genego Edward S 
Published: October 2019

Abstract
Background: Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana.
Methods: A descriptive cross-sectional study was conducted. 100 participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant.
Results: The mean ± SD age of the participants was 32.05 ± 11.48years and age range, 18-67years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p<0.05, ᵪ 2 = 12.187).
Conclusion: There is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.
Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016
Authors: Guo Xiaorong , Yang Dong , Liu Ruchun , Li Yaman , Hu Qingqing , Ma Xinrui , Li Yelan , Zhang Heng , Zhang Xixing , Zhao Benhua , Chen Tianmu 
Published: October 2019

Abstract
BACKGROUND: Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease.
METHODS: The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases.
RESULTS: From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available.
CONCLUSIONS: The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.
Supervised exercise protocol for lower limbs in subjects with chronic venous disease: an evaluator-blinded randomized clinical trial
Authors: Volpe Esther Tinoco , Resqueti Vanessa Regiane , Silva Ana Aline Marcelino , Gualdi Lucien Peroni , Fregonezi Guilherme Augusto de Freitas 
Published: October 2019

Abstract
ABSTRACT
Background : Chronic venous insufficiency (CVI) causes pathophysiological changes in lower limb muscles, particularly calf muscles, and limits ankle range of motion (ROM). These changes reduce functional activities and decreases the quality of life (QOL). Although several studies have shown benefits of exercise (strengthening the calf muscles to improve calf muscle pumping and QOL in patients with CVI), only a few randomized clinical trials are based on exercise programs. This has led to a weak indication of exercise for the treatment of patients with CVI. The aim of this study is to analyze the effects of a supervised exercise program to improve calf muscle strength and endurance besides QOL in patients with CVI. Methods : This is an evaluator-blind, randomized clinical trial with an 8-week duration and 16-week follow-up period. This study is planned to include 26 participants with CVI diagnosis. The participants will be randomly allocated (1:1) into a treatment or control group (usual care/no intervention). The treatment intervention consists of a bi-weekly supervised exercise program of the lower limbs that will include aerobic training, strengthening, and cardiovascular exercises. The participants from both groups will participate in a health education lecture. Primary outcomes are change of calf muscle endurance, strength, and QOL score and secondary outcomes are change of exercise capacity and ankle ROM. Discussion : Patients with CVI may have an impaired calf muscle pump. Strengthening calf muscles and increasing resistance can significantly improve exercise capacity and health in patients with CVI. A supervised exercise program will provide much needed information on the management of CVI to promote health and independence.

Trial registration: This study was registered on the Brazilian Clinical Trials Database (REBEC) (RBR-57xtk7). The results will be disseminated at scientific events, presentations, and publications in peer reviewed journals.
The Effect of Comprehensive Rehabilitation Program plus Chemotherapy on Quality of Life in Patients with Postoperative Non-Small-Cell Lung Cancer: A study protocol of a multi-center randomized clinical trial
Authors: Yao JiaLin , Jiao Lijing , Lu Yan , Shi Jun , Li Jiaqi , Chen Peiqi , Yao Yiqing , Xu Ling , Gong Yabin 
Published: October 2019

Abstract
Background: Comprehensive rehabilitation therapy based on traditional Chinese medicine (TCM) has been widely applied in various cancer treatments in China. Thus far, Chinese herbal medicine (CHM) has been shown to be effective in reducing the adverse effects of chemotherapy and improving the quality of life (QoL) during chemotherapy. The purpose of the present study is to compare the effects of CHM plus Liu Zi Jue (LZJ) exercises with CHM plus rehabilitation education and placebo plus rehabilitation education in patients who have undergone complete resection for non-small-cell lung cancer (NSCLC) followed by postoperative adjuvant chemotherapy.
Methods and design: A multi-center, randomized clinical trial will be performed with 354 stage Ib-IIIa NSCLC patients in 5 centers in China. Patients satisfying the inclusion criteria will be randomly divided into 3 groups according to a 1:1:1 ratio, intervention group A (IGA), intervention group B (IGB) and control group (CG). Each group will receive adjuvant platinum-based doublet chemotherapy for a total of 4 cycles. IGA participants will receive chemotherapy combined with CHM and LZJ exercises, IGB participants will receive chemotherapy combined with CHM and rehabilitation education, and CG participants will receive chemotherapy combined with placebo and rehabilitation education. The herbal treatment patients will be given granules daily and LZJ exercises will be performed 4 times a week during chemotherapy. The primary outcome is QoL, which will be assessed with the EORTC (The European Organization for Research and Treatment of Cancer)-QLQ-C43 scale each cycle. The secondary outcomes include the 2-year disease-free survival rate, disease-free survival (DFS), TCM symptoms, tumor markers, safety and adverse events. After treatment, the patients will be followed up every 3 months within 2 years and every 6 months after 2 years until disease recurrence and/or metastasis.
Discussion: Our previous study reported that CHM in combination with chemotherapy could lower the overall incidence of adverse events but increased digestive and gastrointestinal (GI) side effects compared with chemotherapy alone in postoperative NSCLC patients. This study will lay a foundation for the effectiveness of chemotherapy with or without a comprehensive rehabilitation program for QoL in patients with postoperative NSCLC.
Contributions of Vitamin D in the management of depressive symptoms and cardiovascular risk factors: study protocol for a randomized, double-blind, placebo-controlled clinical trial
Authors: Porto Catarina Magalhaes , Silva Tatiana de Paula Santana da , Sougey Everton Botelho 
Published: October 2019

Abstract
Background: Depression is a major cause of chronic disability throughout the world and an important cardiovascular risk factor, increasing the relative risk of coronary artery disease as well as rates of cardiovascular morbidity and mortality. Concomitant to the greater prevalence of depression, there has been a reduction in exposure to sunlight with the increase in urbanization and the use of sun block, which has led to a reduction in serum levels of 25-hydroxyvitamin D. Therefore, this paper describes a protocol for a clinical trial aimed at evaluating the effects of vitamin D supplementation on depression and cardiovascular risk factors to contribute evidence regarding the potential influence of supplementation in situations related to mood regulation. Methods: This protocol study was guided by the SPIRIT recommendations. A randomized, placebo-controlled, double-blind trial will be conducted with 224 adults (age range: 18 to 59 years) with depression taking antidepressants with no history of vitamin D supplementation, psychiatric comorbidities, chronic kidney disease, hypercalcemia or neoplasm in care at psychiatric outpatient clinics of two universities in northeast Brazil. Eligible participants who provided written consent will be randomly designated to either the intervention group (n = 112; vitamin D supplementation – 50,000 IU per week for six months) or control group (n = 112; placebo taken weekly for six months). Measures for monitoring depressive symptoms, clinical trials and laboratory tests for evaluating cardiovascular risk factors and serum vitamin D levels will be performed before and after the intervention period. Discussion: To the best of our knowledge, this will be the first clinical trial with the aim of testing the effectiveness of vitamin D supplementation on the reduction in cardiovascular risk and as an adjuvant to depression therapy for a prolonged period (six months). The findings will contribute to the understanding of the therapeutic effects of vitamin D supplementation on the management of depression and can help guide public policies directed toward vitamin supplementation for the reduction of cardiovascular risk. Trial registration: Proof: http://www.ensaiosclinicos.gov.br/rg/. Number: RBR-6yj8sj / UTN Number: U1111-1217-9237 (July 23, 2018)
Recruitment Effort and Costs from a Multi-Center Randomized Controlled Trial for Treating Depression in Type 2 Diabetes
Authors: Myers Barbara A , Pillay Yegan , Hornsby Guy , Shubrook Jay , Saha Chandan , Mather Kieren J. , Fitzpatrick Karen , de Groot Mary 
Published: October 2019

Abstract
Background Participant recruitment for clinical trials is a significant challenge for the scientific research community. Federal funding agencies have made continuation of funding of clinical trials contingent on meeting recruitment targets. It is incumbent on investigators to carefully set study recruitment timelines and resource needs to meet those goals as required under current funding mechanisms. This paper highlights the cost, labor, and barriers to recruitment for Program ACTVE II, a successful multi-site randomized controlled trial of behavioral treatments for depression in adults with type 2 diabetes, conducted in rural and urban settings in three states. Methods Quantitative and qualitative data on recruitment were gathered from study staff throughout the study recruitment period and were used to calculate costs and effort. The study utilized two main approaches to recruitment: 1.) relying on potential participants to see ads in the community and call a toll-free number, and 2.) direct phone calls to potential participants by study staff. Results Contact was attempted with 18,925 people to obtain the enrolled sample of 140. The cost of recruitment activities during the 4.5-year recruitment period totaled $190,056, an average cost of $1,358 per enrolled participant. Qualitative evaluations identified multiple barriers to recruitment. Conclusions Recruitment for Program ACTIVE II exemplifies the magnitude of resources needed to reach recruitment targets in the current era. Continuous evaluation, flexibility, and adaptation are required on the part of investigators, community partners, and funding agencies to successfully reach high risk populations in rural and urban areas.
Efficacy and safety of Dexmedetomidine for prevention of withdrawal syndrome in Pediatric Intensive Care Unit: protocol for an adaptive, multicenter, randomized, double blind, placebo-controlled, non-profit clinical trial
Authors: Mondardini Maria Cristina , Sperotto Francesca , Daverio Marco , Caramelli Fabio , Gregori Dario , Caligiuri Maria Francesca , Vitale Francesca , Cecini Maria Teresa , Piastra Marco , Mancino Aldo , Pettenazzo Andrea , Conti Giorgio , Amigoni Angela 
Published: October 2019

Abstract
Background: Prolonged treatment with analgesic and sedative drugs in Pediatric Intensive Care Unit (PICU) may lead to undesirable effects as dependence and tolerance. Moreover, during the analgosedation weaning patients may develop clinical signs of withdrawal, known as withdrawal syndrome (WS). Some studies indicated that dexmedetomidine, a selective α2-adrenoceptors agonist, may be useful to prevent WS, but no clear evidences support this data. Aims of the present study are to evaluate the efficacy of dexmedetomidine in reducing the occurrence of WS during the analgosedation weaning, and to clearly assess its safety.
Methods: We will perform an adaptive, multicenter, randomized, double-blind, placebo-controlled trial. Patients <18 years receiving a continuous intravenous analgosedation treatment for at least 5 days and presenting with clinical conditions that allows the analgosedation weaning will be randomly assigned to treatment A (dexmedetomidine) or treatment B (placebo). The treatment will be started 24 hours before the analgosedation-weaning at 0.4 mcg/kg/h, increased of 0.2 mcg/kg/h per hour up to 0.8 mcg/Kg/h (neonate: 0.2 mcg/Kg/h, increased of 0.1 mcg/Kg/h per hour up to 0.4 mcg/Kg/h)and continued throughout the whole weaning-time. The primary endpoint is the efficacy of the treatment, defined by the reduction in WS rate among patients treated with dexmedetomidine comparing with patients treated with placebo. Safety will be assessed collecting any potentially-related adverse event. The sample size assuring a power of 90% is 77 patients for each group (N total=154 patients). The study was approved by the Ethics Committee of the University-Hospital S.Orsola-Malpighi of Bologna on 22 March 2017.
Discussion: The present trial will allow to clearly assess the efficacy of dexmedetomidine in reducing the occurrence of WS during the weaning of analgosedation drugs. In addition, the study will provide a unique insight into the safety profile of dexmedetomidine.
Trial registration: AIFA ID TIP-15-01.ClinicalTrials.govID NCT03645603, registered on 24 August 2018. Retrospectively registered on EudraCT with ID 2015-002114-80 on 2 Jan 2019.
Genetic polymorphisms of interleukin-6 influence the development of hepatitis B virus-related liver cirrhosis in the Han Chinese population
Authors: Xia Caixia , Zhu Wei , Huang Chunhong , Lou Guohua , Ye Bingjue , Chen Feng , Chen Zhi , Liu Yanning , zheng min 
Published: October 2019

Abstract
Background

Interleukin-6 (IL-6) plays an important role in chronic inflammation. Thus, we aimed to investigate the effects of IL-6 polymorphisms on predicting the progression of hepatitis B virus (HBV)-r elated liver cirrhosis.Methods

A cross-sectional study was conducted to analyse IL-6 polymorphisms and serum levels of IL-6 in HBV-infected patients at different clinical phases and in healthy controls. IL-6 polymorphisms were detected by the TaqMan PCR method, and plasma IL-6 levels were assessed by ELISA.Results

Our analysis included 182 chronic hepatitis B (CHB) patients, 190 HBV-infected liver cirrhosis cases, 125 inactive HBsAg carriers, and 246 healthy controls. Seven SNPs in IL-6 including rs10499563, rs17147230, rs1800796, rs2069837, rs1524107, rs2066992, and rs2069852 were analysed. In a haplotype analysis between HBV-infected liver cirrhosis cases and CHB patients, inactive HBV carriers or healthy controls, haplotype CT in block 1 and haplotype GGCGG in block 2 were associated with liver cirrhosis (P<0.05). Moreover, the genotype or allele frequencies were significantly different in IL-6 rs10499563 and rs2069837 when HBV-infected liver cirrhosis patients were compared with CHB patients, inactive HBV carriers or healthy controls. A further study found that compared with that in the healthy controls, inactive HBV carriers or CHB patients, plasma IL-6 was elevated in HBV-infected liver cirrhosis patients (P<0.05).Conclusion

In conclusion, the IL-6 rs10499563 and rs2069837 polymorphisms are associated with susceptibility to liver cirrhosis may through their effects on IL-6 expression and these two single nucleotide polymorphisms can be used as potential prognostic markers of HBV-related liver cirrhosis.
The effect of Spinal Manipulative Therapy on Heart Rate Variability and pain in patients with chronic neck pain: A Randomized Controlled trial
Authors: Bakken Anders Galaasen , Eklund Andreas , O'neill Sören , Axén Iben 
Published: October 2019

Abstract
Background Recent experimental research has suggested that Spinal Manipulative Therapy (SMT) may reduce pain through modulation of the ascending pain signals and/or the central pain regulating mechanisms. People with persistent neck pain (NP) have also been found to have disturbances in Autonomic Nervous System (ANS) regulation. A common way to study ANS is to measure heart rate variability (HRV). It is not known if deviations in HRV are related to changes in pain perception or to the treatment response to SMT. Commonly, an individual in pain will experience pain reduction when exposed to a second pain stimulus, a mechanism known as Conditioning Pain Modulation (CPM). Patients with persistent pain have been found to have a reduced CPM reaction. It is not known if this is predictive of treatment response to SMT. The aim of the study is to examine the effects of SMT on HRV and pain and to test if a CPM test can be used to predict treatment response, in a population of patients with recurrent and persistent NP. Method/Design A multicentre randomized controlled clinical trial will be carried out in multidisciplinary primary care clinics. This setting is chosen to minimize bias resulting from patient preference to treatment modality and provider. The subjects are either self-referred or referred from other health care practitioners locally. The treatment modalities are two well-known interventions for NP; SMT and stretching exercises compared to stretching exercises alone. The subjective pain experience will be investigated by assessing pain intensity and the affective quality of pain. HRV will be measured using a portable heart monitor and CPM will be measured with a standardized cold-pressor-test. Measurements will be performed at baseline, prior to the third treatment and after the fourth treatment. Discussion The study will utilize normal clinical procedures, which should aid transferability and external validity of the results. The study will provide knowledge regarding the underlying mechanisms of the effects of SMT. Furthermore, the study will examine if a CPM test is predictive of treatment outcome in a population of patients with recurrent and persistent NP.
Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography
Authors: Li Bing , Chen Youxin , Li Donghui 
Published: October 2019

Abstract
Background: To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment. Case presentation: A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris. Conclusion: This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.
Molecular characterization of human isolates of Strongyloides stercoralis and Rhabditis spp. based on mitochondrial cytochrome c oxidase subunit 1 (cox1)
Authors: Tehrani Mandana Fadaei , Sharifdini Meysam , Zahabiun Farzaneh , Latifi Robabeh , Kia Eshrat bigom 
Published: October 2019

Abstract
Abstract
Background: Due to the similarity of Strongyloides stercoralis with free-living nematodes of Rhabditis species they might be miss-diagnosed with each other in microscopical examination of stool samples. The aim of this study was molecular characterization and differentiation of human derived isolates of S. stercoralis and Rhabditis species based on the mitochondrial gene of cytochrome c oxidase subunit 1 ( cox1 ) amplification.
Methods: Using parasitological methods, ten isolates of S. stercoralis and three isolates of Rhabditis spp. were obtained from fresh stool samples of patients and the genomic DNA of the samples were extracted. PCR amplification of cox1 gene was carried out for all the isolates and the products were sequenced.
Results: The phylogenetic analysis illustrated that S. stercoralis and Rhabditis spp. isolates were placed in two distinguishable separate clades. Inter-species genetic variation between isolates of S. stercoralis and Rhabditis spp . were ranged from 13.5 to 14.5%.
Conclusions: Cox1 gene was a suitable marker for discrimination of S. stercoralis from Rhabditis spp. retrieved from human in the current study. The availability of gene sequence information will be helpful in the future development and validation of discriminatory PCR-based assays of these nematodes.