bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Bone SPECT/CT: High Specificity for Identification of Prostate Cancer Bone Metastases
Authors: Tabotta Flavian , Jre Mario , Schaefer Niklaus , Becce Fabio , Geldhof Christine , Prior John O. , Nicod-Lalonde Marie 
Published: September 2019

Abstract
Purpose: Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions.
Methods: We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in lumbar and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions.
Results: In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6±24.6 and 20.8±14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2±3.8 and 8.9±2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p≤0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87%, 92%, 99% and 49%, respectively.
Conclusion: This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.
Point-of-care tests for hepatitis B are associated with a higher linkage to care and lower cost compared to venepuncture sampling during outreach screenings in an Asian migrant population
Authors: Ho Erwin , Michielsen Peter , Damme Pierre Van , Ieven Margareta , Veldhuijzen Irene , Vanwolleghem Thomas 
Published: September 2019

Abstract
Background

This study compares venepuncture versus point-of-care (POC) HBsAg tests on screening cost and linkage to care in prospective outreach screenings in an Asian population in 3 major cities in Belgium between 10/2014 and 5/2018.

Methods

Two community outreach screening programs were organised between 10/2014 and 5/2018. The first screening program used venepuncture and serologic testing for HBsAg. In the second program, HBsAg was tested in finger stick blood POC tests. Positive results were confirmed during outpatient visits with serologic testing. Linkage to care was defined as having received specialist care follow-up with at least 1 abdominal ultrasound within 3 months of screening.

Results

For 575 participating individuals, 571 valid results were obtained, 456 with venepuncture and 115 using POC testing. Overall HBsAg seroprevalence was 6.8%. Linkage to care was higher when using POC testing compared to venepuncture (86% or n=6/7 versus 34% or n=11/32; p= 0.020). The POC screening program was economically more attractive with a total cost of € 1,461.8 or € 12.7 per person screened compared to € 24,819 or € 54.0 per person screened when using venepuncture testing. Results and an appointment for specialist care follow-up were given onsite with POC testing, while with venepuncture testing; results were sent within 20-45 days.

Conclusion

In an Asian migrant population in Belgium with a HBsAg seroprevalence of 6.8%, HBV screening based on POC tests resulted in lower costs per person screened (76.5% lower), and higher linkage to care (2.5 times).
Capacity and patient flow planning in post-term pregnancy outpatient clinics: a computer simulation modelling study
Authors: Viana Joe , Simonsen Tone B , Faraas Hildegunn E , Schmidt Nina , Dahl Fredrik A , Flo Kari 
Published: September 2019

Abstract
Background The demand for a large Norwegian hospital’s post-term pregnancy outpatient clinic has increased substantially over the last 10 years due to changes in the hospital’s catchment area and to clinical guidelines. Planning the clinic is further complicated due to the high did not attend rates as a result of women giving birth. The aim of this study was to develop a tool that supports clinic management to better understand and improve capacity and patient flow planning.Methods A hybrid agent based discrete event simulation model of the clinic was used to evaluate alternative configurations to gain insight into clinic planning and to support decision making. Clinic configurations consisted of six factors: X0: Arrivals. X1: Arrival pattern. X2: Order of midwife and doctor consultations. X3: Number of midwives. X4: Number of doctors. X5: Number of cardiotocography (CTGs) machines. A full factorial experimental design of the six factors generated 608 configurations.Results Each configuration was evaluated using the following measures: Y1: Arrivals. Y2: Time last woman checks out. Y3: Women’s length of stay (LoS). Y4: Clinic overrun time. Y5: Midwife waiting time (WT). Y6: Doctor WT. Y7: CTG connection WT. Optimisation was used to maximise X0 with respect to the 32 combinations of X1-X5. Configuration 0a, the base case Y1 = 7 women and Y3 = 102.97 [0.21] mins. Changing the arrival pattern (X1) and the order of the midwife and doctor consultations (X2) configuration 0d, where X3, X4, X5 = 0a, Y1 = 8 woman and Y3 86.06 [0.10] mins.Conclusions From the clinic’s perspective, the changes in catchment area and clinical guidelines led to increased demand. The simulation model demonstrated flexible pathways in the order of midwife/doctor and appointment scheduling increases flow substantially, reducing LoS. Equipment appeared more of a bottleneck than personnel, as one additional CTG machine has the same effect as an extra midwife and an extra doctor, and the WT for CTG connection is a key contributor to LoS. A more general finding is that a simulation model can be used to identify bottlenecks, and efficient ways of restructuring an outpatient clinic.
Recipient and Instructor perspectives of an adapted exercise-based fall prevention program for older adults with vision impairment: a qualitative study nested within a randomised controlled trial
Authors: Dillon Lisa , Clemson Lindy , Nguyen Helen , Jakobsen Kirsten B , Martin Jodi , Tinsley Frances , Keay Lisa 
Published: September 2019

Abstract
Background

People with vision impairment are at an increased risk of falls compared with their sighted peers, but have very little access to existing community fall prevention programs. The Lifestyle-integrated Functional Exercise (LiFE) program can prevent falls in older people and may be suitable for adults aged ≥50 with vision impairment.

Methods

The LiFE program was adapted for older adults with vision impairment (v-LiFE) and delivered by Orientation and Mobility Specialists (Instructors), who are experienced with individualised programs for people with vision impairment. Perspectives of older adults with vision impairment (recipients) receiving the v-LiFE program and their Instructors were explored through semi-structured interviews.

Results

Of 73 trained Instructors, 51(70%) delivered at least one session to a total of 240 older adults with vision impairment between March 2017 and May 2019. Of these, 11/51(22%) Instructors and 154/172(90%) of invited recipients (until thematic saturation was reached) were interviewed. Six key themes were identified relating to recipient (delivery aptitude; social norms; habit formation) and Instructor (individualised adaptation; complimentary to scope of practice; challenges to delivery) perspectives. Instructors considered delivering v-LiFE as an extension of their scope of work.

Conclusions

Older adults with vision impairment demonstrated positive attitudes towards the program, but younger or more physically fit recipients considered the program too easy for them. The perspectives of recipients and instructors indicate that the v-LiFE program delivered within existing services may fill the gap for a fall prevention program for people with vision impairment.
Impact of liver damage and blood-borne variables on pulmonary hemodynamic responses to hypoxia and hyperoxia in anesthetized rats
Authors: Sepehrinezhad Ali , Dehghanian Amirreza , Rafati Ali , Ketabchi Farzaneh 
Published: September 2019

Abstract
Background : Liver disorders may lead to a wide spectrum of pulmonary complications from hepatopulmonary syndrome to portopulmonary hypertension. In this study, we aimed to investigate the effect of severity of liver dysfunctions on blood-borne variables, and pulmonary hemodynamic during repeated ventilation of animals with hypoxic and hyperoxic gases.
Methods: Female Sprague Dawley rats were divided into four groups of Sham, common bile duct ligation (CBDL), portal vein ligation (PPVL), and combination of them (CBDL+ PPVL). Twenty-eight days later, right ventricular systolic pressure (RVSP) and systemic blood pressure were recorded in anesthetized animals. Besides, we assessed blood parameters in parallel with liver histology.
Results: Data of liver histology and enzymes indicated a larger liver damage in the CBDL+PPVL group as compared with the other groups. Moreover, low platelet level was only observed in the CBDL+PPVL group. Besides, the enhancement of serum estradiol in the CBDL+PPVL group was less pronounced than that in the CBDL group. The baseline RVSP in the CBDL groups were significantly higher than those in the Sham and PPVL groups, and in the CBDL+PPVL group was higher than the ones in the other groups. Hypoxic pulmonary vasoconstriction (HPV) were eliminated in both CBDL groups, whereas, it was recovered in the PPVL group.
Conclusion: In this study, we presented, for the first time, ligations of both CBDL and PPVL as a possible animal model for POPH. High RVSP in this model may be linked to ROS production, serum estradiol level, low platelet level or a combination of them.
A INTERCULTURALIDADE NA FORMAÇÃO DOS PROFISSIONAIS DE ENFERMAGEM
Authors: Fontana Rosane Teresinha 
Published: September 2019

Trata-se de uma proposta de reflexão sobre a interculturalidade e a formação em enfermagem. Utilizou-se a revisão narrativa como método. Considerando que a intercultura vem se configurando como uma nova perspectiva epistemológica, e, como um objeto de estudo interdisciplinar e transversal, no sentido de tematizar e teorizar a complexidade, entende-se que refletir sobre o tema na formação em enfermagem pode agregar valor ao cuidado. Em todas as áreas do conhecimento, a diversidade cultural só pode ser promovida ao reconhecer, como princípio fundador, o diálogo e o respeito entre as civilizações e as culturas. Além disso, constitui força motriz do desenvolvimento, indispensável para atenuar a pobreza e promover tanto a igualdade como a equidade na assistência à saúde.
EDUCAÇÃO EM VALORES MORAIS NUMA PERSPECTIVA TRANSDISCIPLINAR
Authors: Skrsypcsak Daniel , Franzen Douglas Orestes 
Published: September 2019

Este artigo tem como objetivo refletir sobre a educação em valores morais numa perspectiva transdisciplinar. Estender essa discussão a partir das instituições que oferecem a educação pública básica nos faz pensar na necessidade de implementação de um projeto institucional tendo como pano de fundo a transdisciplinaridade. A partir de uma revisão bibliográfica trouxemos para o debate autores que se debruçam sobre a temática e que podem contribuir para aprofundar a discussão. Para atender o propósito do trabalho estruturamos o mesmo em três momentos: no primeiro apresentamos algumas considerações em relação à ética sob a perspectiva da complexidade de Edgar Morin. No segundo momento abordamos algumas questões conceituais sobre a transdiciplinaridade tendo em Basarab Nicolescu o principal autor utilizado. No terceiro momento problematizamos como os valores morais podem ser trabalhados na escola pública buscando na transdisciplinaridade uma possibilidade de discussão. Defendemos a possibilidade de elaboração de um projeto institucional em torno da temática onde todas as ações e relações da escola tenham os valores morais explicitados de forma consciente e intencional. Acreditamos que a escola não pode se silenciar para essa questão buscando um consenso sobre determinados valores morais indispensáveis para a formação integral.
Recent Advances in System Based Study for Anti-Malarial Drug Development Process
Authors: Yadav Brijesh S. , Chaturvedi Navaneet , Marina Ninoslav 
Published: September 2019

Background:
Presently, malaria is one of the most prevalent and deadly infectious disease across Africa,
Asia, and America that has now started to spread in Europe. Despite large research being carried out in the
field, still, there is a lack of efficient anti-malarial therapeutics. In this paper, we highlight the increasing efforts
that are urgently needed towards the development and discovery of potential antimalarial drugs, which must be
safe and affordable. The new drugs thus mentioned are also able to counter the spread of malaria parasites that
have been resistant to the existing agents.

Objective:
The main objective of the review is to highlight the recent development in the use of system biologybased
approaches towards the design and discovery of novel anti-malarial inhibitors.

Method:
A huge literature survey was performed to gain advance knowledge about the global persistence of
malaria, its available treatment and shortcomings of the available inhibitors. Literature search and depth analysis
were also done to gain insight into the use of system biology in drug discovery and how this approach could be
utilized towards the development of the novel anti-malarial drug.

Results:
The system-based analysis has made easy to understand large scale sequencing data, find candidate
genes expression during malaria disease progression further design of drug molecules those are complementary of
the target proteins in term of shape and configuration.

Conclusion:
The review article focused on the recent computational advances in new generation sequencing,
molecular modeling, and docking related to malaria disease and utilization of the modern system and network
biology approach to antimalarial potential drug discovery and development.
Assessment of Orthodontic Treatment Need in Kosovar Children
Authors: Reshitaj Albena , Reshitaj Krenar , Bytyqi Betina 
Published: September 2019

Background:
To date, no survey was done in Kosovo for the identification of orthodontic treatment needs. The aim of this study is to assess the prevalence of orthodontic treatment need among Kosovar children of ages 11-13, using the DAI and the DHC-IOTN in the identification of orthodontic treatment need.

Methods:
A sample of 185 children (50.3% female, 49.7% male), aged between 11-13, was randomly selected from one elementary school in Prishtina. Orthodontic treatment need was measured using the Dental Aesthetic Index (DAI) and the dental health component of the Index of Orthodontic Treatment Need (DHC-IOTN).

Results:
Based on DAI, treatment was found as elective in 11.9 percent of the children. Treatment was found as highly desirable and mandatory in 5.9 percent and 4.3 percent of children, respectively. No gender-based significant differences were noted. According to IOTN DHC: 16.2 percent of children had borderline treatment need, while 66.5 percent had severe and extreme treatment need (grades 4 and 5). Again, no significant gender-based differences in the treatment need were found.

Conclusion:
High prevalence of orthodontic treatment need was identified in Kosovar children of ages 11-13, while no gender-based statistically significant differences were noted in the need for orthodontic treatment.
An Electronic Medication Module to Improve Health Literacy in Patients With Type 2 Diabetes Mellitus: Pilot Randomized Controlled Trial
Authors: Seidling Hanna Marita , Mahler Cornelia , Strauß Beate , Weis Aline , Stützle Marion , Krisam Johannes ,   INFOPAT P4/P5 Study Team, Szecsenyi Joachim , Haefeli Walter Emil 
Published: September 2019

BackgroundIn primary care, patients play a crucial role in managing care processes and handling drug treatment. A decisive factor for success is their health literacy, and several interventions have been introduced to support patients in fulfilling their responsibility.ObjectiveThe aim of this study is to assess the influence of such an intervention (ie, a medication module) within a patient-led electronic health record on patients’ health literacy.MethodsWe conducted a randomized controlled study among community-dwelling patients with type 2 diabetes mellitus. Patients were recruited from primary care practices. After randomization, patients either had access to an internet-based medication module allowing them to store their medication information, look up drug information, and print a medication schedule (intervention group), or they received an information brochure on the importance of medication schedules (control group). After 4-8 weeks, all patients were invited to attend a structured medication review (ie, follow-up visit). Data were collected via questionnaires before the start of the intervention and during the follow-up visit. The main outcome measure was the mean difference in health literacy between baseline and follow-up assessments of patients in the control and intervention groups.ResultsOf 116 recruited patients, 107 (92.2%) completed the follow-up assessment and were eligible for intention-to-treat analyses. Only 73 patients, of which 29 were in the intervention group, followed the study protocol and were eligible for per-protocol analysis. No differences in overall health literacy were observed in either the intention-to-treat or in the per-protocol cohorts. Reasons for a null effect might be that the cohort was not particularly enriched with participants with low health literacy, thus precluding measurable improvement (ie, ceiling effect). Moreover, the success of implementation was considered poor because both the correct application of the study procedure (ie, randomization according to the protocol and dropout of 29 patients) and the actual interaction with the medication module was modest (ie, dropout of 9 patients).ConclusionsThe conduct of this randomized controlled study was challenging, leaving it open whether inadequate implementation, too short of a duration, or insufficient efficacy of the intervention, as such, contributed to the null effect of this study. This clearly outlines the value of piloting complex interventions and the accompanying process evaluations.
Performance of Fetal Medicine Foundation Software for Pre-Eclampsia Prediction Upon Marker Customization: Cross-Sectional Study
Authors: Rezende Karina Bilda De Castro , Cunha Antonio José Ledo Alves , Amim Jr Joffre , Oliveira Wescule De Moraes , Leão Maria Eduarda Belloti , Menezes Mariana Oliveira Alves , Jardim Ana Alice Marques Ferraz De Andrade , Bornia Rita Guérios 
Published: September 2019

Background
FMF2012 is an algorithm developed by the Fetal Medicine Foundation (FMF) to predict pre-eclampsia on the basis of maternal characteristics combined with biophysical and biochemical markers. Afro-Caribbean ethnicity is the second risk factor, in magnitude, found in populations tested by FMF, which was not confirmed in a Brazilian setting.

Objective
This study aimed to analyze the performance of pre-eclampsia prediction software by customization of maternal ethnicity.

Methods
This was a cross-sectional observational study, with secondary evaluation of data from FMF first trimester screening tests of singleton pregnancies. Risk scores were calculated from maternal characteristics and biophysical markers, and they were presented as the risk for early pre-eclampsia (PE34) and preterm pre-eclampsia (PE37). The following steps were followed: (1) identification of women characterized as black ethnicity; (2) calculation of early and preterm pre-eclampsia risk, reclassifying them as white, which generated a new score; (3) comparison of the proportions of women categorized as high risk between the original and new scores; (4) construction of the receiver operator characteristic curve; (5) calculation of the area under the curve, sensitivity, and false positive rate; and (6) comparison of the area under the curve, sensitivity, and false positive rate of the original with the new risk by chi-square test.

Results
A total of 1531 cases were included in the final sample, with 219 out of 1531 cases (14.30; 95% CI 12.5-16.0) and 182 out of 1531 cases (11.88%; 95% CI 10.3-13.5) classified as high risk for pre-eclampsia development, originally and after recalculating the new risk, respectively. The comparison of FMF2012 predictive model performance between the originally estimated risks and the estimated new risks showed that the difference was not significant for sensitivity and area under the curve, but it was significant for false positive rate.

Conclusions
We conclude that black ethnicity classification of Brazilian pregnant women by the FMF2012 algorithm increases the false positive rate. Suppressing ethnicity effect did not improve the test sensitivity. By modifying demographic characteristics, it is possible to improve some performance aspects of clinical prediction tests.
Penyesuaian Dosis Obat Berdasarkan Nilai Kreatinin Klirens pada Pasien Geriatri Rawat Inap di Rsup Dr. Kariadi Semarang, Indonesia
Authors: Haryati Noor , Rahmawati Fita , Wahyono Djoko 
Published: September 2019

Pasien geriatri biasanya mengalami multipathology dan polypharmacy yang dapat mengakibatkan munculnya respon yang berlebihan seperti efek samping bahkan efek toksik. Untuk menghindari hal ini diperlukan penyesuaian dosis berbasis farmakokinetika individual. Penelitian ini bertujuan untuk melihat persentase obat yang membutuhkan adjustment dose pada pasien geriatri berdasarkan kreatinin klirens ginjal yang diukur dengan formula Cockroft-Gault dan menganalisa hubungan ketepatan pendosisan dengan outcome clinic. Penelitian dilakukan dengan rancangan cross-sectional dengan pengambilan data secara retrospektif melalui penelusuran data rekam medis pasien geriatri rawat inap yang dirawat di RSUP dr. Kariadi Semarang tahun 2017. Data yang diamati adalah regimen pengobatan, serum kreatinin, outcome clinic dan adverse drug reaction yang terjadi. Selanjutnya dilakukan estimasi kreatinin kliren yang dilanjutkan dengan menilai kesesuaian dosis dengan referensi dan formula Giusti Hayton. Analisis data dilakukan secara deskriptif dan uji Chi-square dengan SPSS untuk menganalisa pengaruh penyesuaian dosis dengan clinical outcome. Hasil penelitian menunjukkan dari 100 rekam medis pasien yang memenuhi inklusi terdapat 99 pasien yang mendapatkan obat dan memerlukan penyesuaian dosis. Pasien yang mendapatkan regimen pengobatan tepat sebesar 73%. Dari 785 obat yang diresepkan, 353 (44,97%) obat memerlukan penyesuaian dosis. Dari obat-obat yang memerlukan penyesuaian dosis tersebut 322 (91,22 %) sudah tepat dan 31 (8,78 %) belum tepat. Obat-obat yang belum tepat dosis adalah ketorolak injeksi, ranitidin injeksi dan beberapa jenis antibiotik (meropenem injeksi, levofloksasin tablet, dan sefiksim tablet). Tidak ada hubungan yang bermakna antara ketepatan dosis dengan outcome clinic (p=0,289)