bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supportive supervision to improve the quality and outcome of outpatient care among malnourished children: a cluster randomised trial in Arua district, Uganda
Authors: Lazzerini Marzia , Wanzira Humphrey , Lochoro Peter , Muyinda Richard , Segafredo Giulia , Wamani Henry , Putoto Giovanni 
Published: July 2019

IntroductionSuboptimal quality of paediatric care has been reported in resource-limited settings, but little evidence exists on interventions to improve it in such settings. This study aimed at testing supportive supervision (SS) for improving health status of malnourished children, quality of case management, overall quality of care, and the absolute number of children enrolled in the nutritional services.MethodsThis was a cluster randomised trial conducted in Arua district. Six health centres (HCs) with the highest volume of work were randomised to either SS or no intervention. SS was delivered by to HCs staff (phase 1), and later extended to community health workers (CHWs) (phase 2). The primary outcome was the cure rate, measured at children level. Quality of case management was assessed by six pre-defined indicators. Quality of care was assessed using the national Nutrition Service Delivery Assessment (NSDA) tool. Access to care was estimated with the number of children accessing HC nutritional services.ResultsOverall, 737 children were enrolled. In the intervention arm, the cure rate (83.8% vs 44.9%, risk ratio (RR)=1.91, 95% CI: 1.56–2.34, p=0.001), quality of care as scored by NSDA (RR=1.57, 95% CI: 1.01–2.44, p=0.035) and correctness in complementary treatment (RR=1.52, 95% CI: 1.40–1.67, p=0.001) were significantly higher compared with control. With the extension of SS to CHWs (phase 2), there was a significant 38.6% more children accessing care in the intervention HCs (RR=1.26, 95% CI: 1.11–1.44, p=0.001) compared with control.ConclusionSS significantly improved the cure rate of malnourished children, and the overall quality of care, SS to CHWs significantly increased the crude number of children enrolled in the nutritional services. More studies should confirm these results, and evaluate the cost-effectiveness of SS.
Sudden infant death syndrome (SIDS) and the routine otoacoustic emission infant hearing screening test: an epidemiological retrospective case–control study
Authors: Blair Peter S , Rubens Daniel , Pease Anna , Mellers Diane , Ingram Jenny , Ewer Andrew K , Cohen Marta C , Sidebotham Peter , Ward Platt Martin , Coombs Robert , Davis Adrian , Hall Amanda , Fleming Peter 
Published: July 2019

ObjectivesTo investigate whether decreased otoacoustic emission (OAE) signal recordings in the right ear are associated with an increased risk of sudden infant death syndrome (SIDS) and to monitor any temporal changes in risk factors.DesignRetrospective case–control study.SettingTelephone interviews with families recruited in England between July 2016 and October 2017 who experienced the unexpected death of a child <4 years old since 2008 and control families recruited from maternity wards in Bristol and Birmingham.ParticipantsWe recruited 91 (89%) of the 102 bereaved families who made initial contact, 64 deaths were under 1 year (sudden unexpected death in infancy) of which 60 remained unexplained (SIDS). Of the 220 control families, 194 (88%) follow-up interviews were conducted. We had analysable hearing data for 24 SIDS infants (40%) and 98 controls (51%).ResultsOAE signals were marginally increased rather than decreased among SIDS infants for the right ear, especially at lower frequencies, but not significantly so. The strongest predictors of SIDS were bed-sharing in hazardous (infant sleeping next to a carer who smoked, drank alcohol or slept on a sofa) circumstances (35% vs 3% controls, p<0.0001), infants found prone (33% vs 3% controls, p<0.0001) and infants whose health in the final week was ‘not good’ (53% vs 9% controls, p<0.0001). The prevalence of maternal smoking during pregnancy among both SIDS mothers (20%) and controls (10%) was much lower than previous studies.ConclusionsHearing data were difficult to obtain; larger numbers would be needed to determine if asymmetrical differences between the right and left ear were a marker for SIDS. A national prospective registry for monitoring and a renewed campaign to a new generation of parents needs to be considered underlining the initial message to place infants on their backs for sleep and the more recent message to avoid bed-sharing in hazardous circumstances.
Quantifying the impact of the Public Health Responsibility Deal on salt intake, cardiovascular disease and gastric cancer burdens: interrupted time series and microsimulation study
Authors: Laverty Anthony A , Kypridemos Chris , Seferidi Paraskevi , Vamos Eszter P , Pearson-Stuttard Jonathan , Collins Brendan , Capewell Simon , Mwatsama Modi , Cairney Paul , Fleming Kate , O'Flaherty Martin , Millett Christopher 
Published: July 2019

BackgroundIn 2011, England introduced the Public Health Responsibility Deal (RD), a public-private partnership (PPP) which gave greater freedom to the food industry to set and monitor targets for salt intakes. We estimated the impact of the RD on trends in salt intake and associated changes in cardiovascular disease (CVD) and gastric cancer (GCa) incidence, mortality and economic costs in England from 2011–2025.MethodsWe used interrupted time series models with 24 hours' urine sample data and the IMPACTNCDmicrosimulation model to estimate impacts of changes in salt consumption on CVD and GCa incidence, mortality and economic impacts, as well as equity impacts.ResultsBetween 2003 and 2010 mean salt intake was falling annually by 0.20 grams/day among men and 0.12 g/d among women (P-value for trend both < 0.001). After RD implementation in 2011, annual declines in salt intake slowed statistically significantly to 0.11 g/d among men and 0.07 g/d among women (P-values for differences in trend both P < 0.001). We estimated that the RD has been responsible for approximately 9900 (interquartile quartile range (IQR): 6700 to 13,000) additional cases of CVD and 1500 (IQR: 510 to 2300) additional cases of GCa between 2011 and 2018. If the RD continues unchanged between 2019 and 2025, approximately 26 000 (IQR: 20 000 to 31,000) additional cases of CVD and 3800 (IQR: 2200 to 5300) cases of GCa may occur.InterpretationPublic-private partnerships such as the RD which lack robust and independent target setting, monitoring and enforcement are unlikely to produce optimal health gains.
The efficacy of 3D printing-assisted surgery for traumatic fracture: a meta-analysis
Authors: Xiong Liang , Li Xiaoyang , Li Hui , Chen Zhuoyuang , Xiao Tao 
Published: July 2019

AbstractBackgroundRecent years have witnessed a rapid development of three-dimensional (3D) printing technology applied in orthopaedic surgery. To be assisted by 3D printing is a potent method to realise accurate and individualised operation. The objective of this meta-analysis was to assess the efficacy of 3D printing technology in the management of trauma fractures.MethodsPubMed, Embase and the Cochrane Library were systematically searched up until January 2019 to identify relevant studies. All clinical studies comparing conventional surgery and 3D printing-assisted surgery in the management of orthopaedic trauma were obtained. The meta-analysis was performed with RevMan V.5.3 software.ResultsFour randomised controlled trials, four retrospective comparative studies and two prospective comparative studies involving 521 patients were included. Compared with conventional surgery, 3D printing-assisted surgery leads to shorter operation duration (mean difference (MD) −16.59 (95% CI −18.60 to –14.58), p&lt;0.001), less intraoperative blood loss (standardised mean difference (SMD) −1.02 (95% CI –1.25 to –0.79), p&lt;0.001) and fewer intraoperative fluroscopies (SMD −2.20 (95% CI –2.50 to –1.90), p&lt;0.001). However, 3D printing-assisted surgery leads to longer hospital stay (MD 2.51 (95% CI 0.31 to –4.72), p=0.03). No significant results were found regarding fracture healing time, the rate of excellent and good outcomes, anatomical reduction and complications.ConclusionsThese results suggest that 3D printing-assisted surgery outperforms conventional surgery in the management of orthopaedic trauma fractures with shorter operation duration, less intraoperative blood loss and fewer intraoperative fluoroscopies.
Electronic and optical properties of CsPb2Br5: A first-principles study
Authors: Jin Mingge , Li Zhibing , Huang Feng , Wang Weiliang 
Published: July 2019

There are conflicting understandings of the electronic and optical properties of CsPb2Br5. We investigated the electronic and optical properties of CsPb2Br5 with first-principles calculations. It is confirmed that CsPb2Br5 is a semiconductor with an indirect band gap of 3.08 eV at GGA/PBE level and 3.72 eV at the HSE06 hybrid functional level. The PBE results demonstrate that the inclusion of SOC slightly reduces the band gap. We calculate the optical absorbance/emission spectrum of CsPb2Br5. It is found the optical absorption edges locate at 360–380 nm, shorter than the wavelength of visible light. Our results support the experimental results of Li et al. [Chem. Commun. 52 (2016) 11296] and Zhang et al. [J. Mater. Chem. C 6 (2018) 446].
Structural Transformation of India: A Quantitative Analysis
Authors: Adhikari Santosh 
Published: July 2019

This article accounts for the structural transformation of the Indian economy over the recent decades. Empirical estimates imply a relatively higher elasticity of substitution in services than in manufacturing, while the growth rates of labour-augmenting productivity in both of these sectors are of similar magnitude, in contrary to what previous growth accounting exercises suggest. Simulation of a multi-sectoral growth model with these estimates succeeds in replicating the trends of sectoral value-added shares as well as the declining labour shares of value added in manufacturing and services sectors during the sample period. The model improves on previous studies in matching the trends of sectoral shares of employment. Thus, the services sector’s flexibility in factor substitution compared to that of manufacturing can explain, at least in part, the rapid growth of services in the recent period. JEL Classification: O11, O41, O53
Yellow Fever, as Seen by the Medical Officers of the Royal Navy in the Nineteenth Century
Authors: Dudley Sheldon F. 
Published: July 2019

A critical review of old Naval Reports, showing how some difficulties in the epidemiology vanished when the mosquito means of transmission was discovered. Data are abstracted to show that the fatality, while generally exaggerated by missed cases, was often as high as recorded—also that latent immunization accounts for some types of immunity, and that the disease was always more virulent in Africa—where it probably originated—rather than in the New World.
The Control of the Blood-Pressure
Authors: Burn J. H. 
Published: July 2019

Present conceptions of the control of the general blood-pressure are based on the view that the sympathetic nerves are only constrictor in action and the circulating hormones, adrenaline and vasopressin, only pressor in effect. Surgical treatment of high blood-pressure and allied conditions has been directed accordingly to the removal of portions of the sympathetic system and to the removal of the suprarenal glands or tumours connected with them. Removal of portions of the sympathetic has been successful in relieving attacks of angina pectoris and removal of suprarenal tumours has relieved paroxysmal hypertension. Neither removal of portions of the sympathetic systems nor removal of the suprarenal glands has been successful in reducing continuous hypertension. It is suggested that our conceptions of the control of the blood-pressure need revision.The normal variation in blood-pressure is not sufficiently realized. It may be as low as 85 mm. or as high as 190 mm. About one in every 40 men has a blood-pressure higher than 160 mm. It is suggested that the diagnosis of essential hypertension should never be made unless it is known that the blood-pressure has been rising. A single observation of a high pressure is not enough for the diagnosis.Evidence is described that adrenaline and vasopressin may lower the blood-pressure as well as cause it to rise; similarly there is evidence that the sympathetic nerve supply to the skeletal muscles is dilator rather than constrictor in effect. Hence, all three mechanisms commonly thought of as pressor may also be depressor, and it seems more accurate to think of them as controlling the blood-pressure by raising or lowering it than simply as factors which raise it.
The Use of Gonadotropic Hormones in the Treatment of Undescended Testes: Preliminary Report
Authors: Spence A. W. , Scowen E. F. 
Published: July 2019

Smith and Engle have shown that the injection of extracts of the anterior lobe of the pituitary into immature animals produces an increased growth of all the tissues of the testes, and, as a result of stimulation of the interstitial tissue, enlargement of the penis and accessory genital glands. Spermatogenesis is not produced in immature mammals by means of these extracts. Similar results are obtained with extracts of pregnancy urine, the gonadotropic principle (A.P.L. or anterior-pituitary-like hormone) of which is probably derived from the placenta. Engle has also shown that the injection of extracts of anterior lobe or of pregnancy urine causes descent of the testes in immature monkeys, in which animals they are situated in the inguinal canal. Eleven patients with undescended testes, aged 4½ to 15 years, have been treated with the gonadotropic hormones extracted from pregnancy urine. The dose used in most cases was 500 rat units injected intramuscularly twice weekly. Five of the patients had bilaterally undescended testes: during treatment both testes descended into the scrotum in two cases, one descended in each of two cases, and in the remaining case the position of the testes is unchanged. The remaining six had unilaterally undescended testes; of these, three have descended into the scrotum. Thus, nine of sixteen undescended testes have entered the scrotum during treatment. The time taken to effect this change varied from two to eleven weeks. The testes which have not yet responded have received treatment for from three to nine weeks. The mechanism whereby the descent is brought about is unknown. In view of the rather unsatisfactory surgical results, it is felt that in the treatment of undescended testes a trial should be made of this form of therapy before surgical measures are considered.
The Treatment of Addison's Disease by Whole Adrenal Gland
Authors: Hicks C. Stanton , Mitchell M. L. 
Published: July 2019

By cooling fresh suprarenal gland tissue immediately on removal from the animal, and by defatting, and mincing the same at low temperatures, and drying at 37°C. with the least loss of time, a preparation is obtained which in daily doses of 3 grm. per os, is effective in restoring a large measure of health to sufferers from Addison's disease.It is essential that a potent extract of suprarenal cortex be available for ( a) restoring the patient sufficiently to enable whole gland treatment to be instituted and ( b) to treat any return of abdominal symptoms or circulatory collapse induced by intercurrent illness or failure to retain the whole gland through vomiting.It is desirable to increase the intake of sodium chloride to 10 to 15 grm. daily.Neither saline alone, nor cortical extract alone produces the same effective result as whole suprarenal gland prepared as above administered per os.Commercial preparations of whole suprarenal can be entirely without effect.Subcutaneous injection of adrenalin in a phase of weakness may have disastrous results.Trials, using the whole gland preparation on normal subjects, further establish the observations of Rowntree, that the gastric musculature is stimulated by injection of whole suprarenal gland. In certain cases, considerable elevation of blood-pressure may also result.
Some Orthopædic Procedures Employed in the Treatment of Arthritis
Authors: Bastow John 
Published: July 2019

(1) A series of six cases of ankylosing spondylitis was shown to illustrate the benefit gained, even in very long-standing cases, by the following regime: ( a) Complete rest in a plaster shell. ( b) Gradual correction of kyphosis by adding thin layers of padding under the dorsolumbar junction, and subtracting similar layers of padding from under the head, to increase extension in the spine. ( c) Deep-breathing exercises practised constantly while the patient is lying in a plaster shell. ( d) Daily physiotherapy. ( e) The fitting of a Goldthwaite spinal brace to maintain the position of maximum correction that has been obtained. The improvement was manifested in all cases by alleviation of symptoms, improvement in posture, and increased chest expansion. (2) A series of six cases of arthritis of the knee was shown, including rheumatoid arthritis, infective arthritis and osteo-arthritis, illustrating treatment by rest plasters, followed by: ( a) Arthrotomy and lavage—where swelling and effusion persist, and ( b) Bone drilling—where bone changes are marked and there is constant pain at rest. Improvement was manifested by relief of symptoms, subsidence of signs of inflammation, and restoration of a considerable degree of movement. (3) A case of arthritis of the tarsal and metatarsal joints, illustrating relief of symptoms afforded by the application of a plaster boot.
Malignant Cachexia
Authors: Donovan Hugh 
Published: July 2019

Well-known authorities such as Ewing and Willis have thrown doubt on the existence of a constitutional effect of malignant disease other than that due to hæmorrhage, infection, mechanical pressure, &c. On the other hand, Greenstein has taken the opposite view and maintains that a local malignant growth has a general constitutional effect. The clinical picture of malignant cachexia is as clear cut as that, for example, of old age. Malignant cachexia is a recoverable state in certain circumstances when the primary growth is removed; clinical evidence warrants the conclusion that it is a genuine entity and that it is a generalized disease. The laboratory findings have not established that the degree of depression of any one system is the predominant cause of death. Clinically however, the most deadly effects seem to be those produced on the cardiac and alimentary musculature. Experimental evidence would seem to have shown that there is a specific effect, chiefly on one of the cellular enzymes, catalase, predominantly in the liver but also to a lesser extent in the kidney. There is also a marked effect on the blood-forming organs. Greenstein's view that there is depression of the metabolism of the iron porphyrins naturally attracts our attention. Whether this effect is the result of some substance added to the circulation or taken from the circulation is uncertain, but an additional effect seems most probable. Tissue culture may enable us to confirm the existence of the metabolite responsible, and perhaps to identify it. The hitherto untreatable anmmia of malignant cachexia gives us another line of investigation.
The role of MRI-derived depth of invasion in staging oral tongue squamous cell carcinoma: inter-reader and radiological–pathological agreement
Authors: Vidiri Antonello , Panfili Marco , Boellis Alessandro , Cristalli Giovanni , Gangemi Emma , Pellini Raul , Marzi Simona , Covello Renato 
Published: July 2019

Background The 8th edition of tumor, node, metastasis (TNM) classification incorporates depth of invasion evaluation in the staging of oral cavity squamous cell carcinoma, since it is a predictor of nodal metastasis and an independent prognostic factor. Although the histopathological definition of depth of invasion is clear, an accurate method for its radiological assessment has not yet been validated. Purpose To investigate the role of MRI-derived depth of invasion evaluation in staging oral tongue squamous cell carcinoma and to assess the inter-reader agreement and the radiological–pathological correlation. Material and Methods We retrospectively reviewed 43 patients with oral tongue squamous cell carcinoma who underwent preoperative MRI. The MRI-derived depth of invasion was measured by two radiologists, each with a different degree of experience in head and neck imaging. The pathological depth of invasion was recorded from histopathological reports. The inter-reader and the radiological–histopathological correlations for the depth of invasion were evaluated with Bland–Altman plots, the intraclass correlation coefficients (ICC), and the paired samples test; agreements for T staging were assessed using the Kappa coefficient. Results Inter-reader reliability was excellent for the MRI-derived depth of invasion (ICC = 0.91), very good between MRI-derived depth of invasion and pathological depth of invasion (ICC = 0.89 for the experienced reader, 0.86 for the inexperienced reader). Both readers reached a good agreement regarding T staging (kappa value = 0.70). Furthermore, the agreement between radiological and pathological T staging was good (kappa value = 0.74 for the experienced reader, 0.60 for the inexperienced reader). Conclusion MRI-derived depth of invasion should be measured in the pretreatment assessment of oral tongue squamous cell carcinoma as it has an excellent inter-reader reliability and nearly excellent radiological–pathological correlation.
What Are the Indications for Aspiration of a Possibly Infected Total Ankle Arthroplasty (TAA)?
Authors: Plöeger Milena M. , Aiyer Amiethab 
Published: July 2019

Recommendation: Whenever a periprosthetic joint infection (PJI) of a total ankle arthroplasty (TAA) is clinically possible or suspected, especially when elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels exist, and in correspondence to the literature on PJI in total hip and knee arthroplasties, joint aspiration is indicated. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Best Method to Differentiate Acute Charcot Foot From Acute Infection?
Authors: Heidari Nima , Oh Irvin , Li Yueyang , Vris Alexandros , Kwok Iris , Charalambous Alexander , Rogero Ryan 
Published: July 2019

Recommendation: Differentiation between acute Charcot neuroarthropathy (CN) and acute infection/osteomyelitis is complex and requires multiple (>1) diagnostic criteria. These criteria include an emphasis on the presence of neuropathy, history, and physical examination. The absence of skin wounds and resolution of swelling/erythema with elevation makes the likelihood of infection very low. In unclear cases, laboratory testing, histologic examination and culturing of bone specimens, scintigraphy, and imaging, especially magnetic resonance imaging (MRI), may be of benefit. Level of Evidence: Moderate. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Optimal (Type, Dose and Route of Administration) Antibiotic Treatment for Patients With Infected Total Ankle Arthroplasty (TAA)?
Authors: Embil John M. , O’Neil Joseph T. 
Published: July 2019

Recommendation: Though literature specific to total ankle arthroplasty (TAA) is lacking, based on recommendations for the management of hip and knee arthroplasties, the choice of antibiotic should be made based on the identification and sensitivities of the infecting organism(s). Dosing, frequency, and route of administration of antibiotics may be determined in consultation with an infectious disease specialist and by taking into account the patient’s weight and comorbidities, such as renal impairment and the antibiogram. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)