bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addition of Spirulina as Feed Supplement in The Ration on Production and Eggs Quality of The Sentul Chickens
Authors: Widjasuti Tuti , Sujana Endang , Balia Roostita Lobo 
Published: March 2019

Sentul chicken is a specific chicken from Ciamis region, West Java, Indonesia, and it is a dual purpose type. To improve performance can be added with spirulina meal as a feed supplement. Spirulina is classified as blue-green algae or blue-green bacteria and can be as the source of protein. Spirulina is a source of carotenoids with the high content of beta-carotene and xanthopyl, so it can be used in rations to increase egg production. The purpose of this study was to obtain an effective level of use n of spirulina in the Sentul chicken ration of the layer phase. The study used 50 female chickens aged 7 months, which was kept in cages until 2 months and each cage contains 2 chickens. The method used was a completely randomized design with 5 treatments namely R0 (ration without spirulina ), R1 (ration with 1% spirulina addition), R 2 (addition of 1.5% ), R3 (addition of 2%) and R4 (addition of 2, 5%) with five replications. Furthermore, treatment differences were tested using Duncan Multiple Range test. The measured variables were feed consumption, egg weight, hen day production, feed conversion, thick of shell and egg yolk color. The results showed the addition of spirulina of 1.5 - 2% in the ration increased hen day production and egg quality but with the addition of 2.5%, feed consumption, hen day production, and feed conversion decreased. It can be concluded that spirulina can be used as feed supplement until 2% to gave the best on production and eggs quality of Sentul chicken.
Application of Road Engineering NSPM Action Programs on Sub-National Roads in Indonesia
Authors: Sutandi Anastasia Caroline , Mulyono Agus Taufik 
Published: March 2019

In Indonesia, the norm, the standard, the guidelines, and the manual regarding road engineering for sub-national roads are known as road engineering NSPM. Application of a road engineering NSPM action program is crucial to increase roadworthiness and infrastructure resilience. Sub-national roads in Indonesia are roads at a province, regency, and city level. This research aims to find out the identification and evaluation of existing road conditions of sub-national roads in Indonesia. This research also aims to identify difficulties to increase road engineering NSPM application on sub-national roads. This research recommends action programs to attain roadworthiness of 75 percent of sub-national road length in Indonesia between the years 2015-2019. Sub-national roads in six provinces in Indonesia are the location of case studies. The provinces are Riau, particular region province of Yogyakarta, province of South Kalimantan, province of South Sulawesi, province of Bali, and the province of Maluku. Survey data show that province roads have fulfilled 66 percent of roadworthiness, regency roads have fulfilled 63 percent, and city road has fulfilled 81 percent. The difficulties in NSPM application are the limited support of the financial facility, and substandard application of human resource ability, dissemination of NSPM, evaluation of performance, road technical guidance, and observation on-site. The research methodology used is based on a physical existing road condition. Finally, there is a recommendation of action programs that can be instituted, i.e. dissemination of regulations regarding guidelines of road function and status in Indonesia, regulation of Public Work Ministry of Republic of Indonesia no 03/PRT/M/2012, regular application of technical training and coaching about accurate location where road engineering NSPM will be applied to local government by central government, regular application of technical training and coaching about road infrastructure resilience, and application of road engineering NSPM on sub-national roads, including monitoring and evaluation both internally and externally.
Cross-Table Lateral Radiographs Accurately Predict Displacement in Valgus-Impacted Femoral Neck Fractures
Authors: Temmesfeld Max J. , Dolatowski Filip C. , Borthne Arne , Utvåg Stein Erik , Hoelsbrekken Sigurd Erik 
Published: March 2019

Background:
Femoral neck fractures are classified as nondisplaced (Garden types I and II) or displaced (Garden types III and IV) on the basis of anteroposterior radiographs. Cross-table lateral radiographs are important in the assessment of Garden type-I and II fractures as posterior tilt of the femoral head may influence treatment results. A posterior tilt of >20° has been associated with an increased risk of treatment failure after internal fixation, although the precision of these measurements has not been validated. Therefore, the purpose of the present study was to compare cross-table lateral radiographs with 3-dimensional computed tomographic (3D-CT) reconstructions of Garden type-I and II femoral neck fractures.

Methods:
Twenty-three patients presenting with Garden type-I and II femoral neck fractures that were verified on anteroposterior radiographs underwent CT scanning immediately after radiographic examination. 3D models of the fractured and uninjured femora were reconstructed from the CT images, and displacement of the 3D models was determined by superimposing the fractured and uninjured femora. We defined a coordinate system with its origin at the center of the uninjured femoral head with the x axis oriented medially; the y axis, posteriorly; and the z axis, cranially. Correlations between lateral radiographs and 3D models were assessed with the Spearman rank coefficient, mean difference, and limits of agreement.

Results:
Posterior tilt of the femoral head on lateral radiographs was strongly correlated with displacement of the femoral head along the y axis of the 3D models, with a correlation coefficient of 0.86 (p < 0.001). Correlations between the findings on lateral radiographs and displacements along the x or z axis were weak, with coefficients of −0.30 (p = 0.18) and 0.21 (p = 0.34), respectively. The mean difference between displacement on lateral radiographs and displacement along the y axis of the 3D models was smaller, and demonstrated a smaller limits-of-agreement interval, compared with the x or z axis.

Conclusions:
Our results demonstrated a strong correlation between posterior displacement of the femoral head on lateral radiographs and displacement along the y axis in 3D models of Garden type-I and II femoral neck fractures. This finding indicates that lateral radiographs provide an accurate assessment of posterior tilt.
Incidence and Economic Burden of Intertrochanteric Fracture
Authors: Adeyemi Ayoade , Delhougne Gary 
Published: March 2019

Background:
There is limited information on current cost estimates associated with intertrochanteric hip fractures in the United States. The purpose of the present study was to estimate the incidence and economic burden of both intertrochanteric and all hip fracture types in the Medicare patient population to the U.S. health-care system.

Methods:
This retrospective database analysis of the 2014 Medicare database involved Standard Analytic File (SAF) 5% sample claims and total enrollment files. Patients ≥65 years of age with a new principal diagnosis of hip fracture (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 820.xy) who were continuously enrolled for 18 months were included; those with intertrochanteric hip fracture were further identified with use of ICD-9-CM code 820.21. The total direct medical costs associated with hip fracture in the 90-day and 12-month post-fracture periods were estimated. The relevant costs were estimated on the basis of a propensity-score-matched analysis. The health-care services responsible for major expenses within the 90-day episode-of-care period were also identified.

Results:
The total annual direct medical costs associated with all hip fractures was $50,508 per patient, resulting in a yearly estimate of $5.96 billion to the U.S. health-care system. Intertrochanteric hip fractures accounted for an annual estimate of $52,512 per patient, corresponding to an overall annual economic burden of $2.63 billion to the U.S. health-care system and representing 44% of all hip fracture costs. Inpatient hospitalization and skilled nursing facility services jointly accounted for 76.3% of the $44,135 estimated cost per patient and 75.6% of the $42,388 estimated cost per patient within the 90-day post-acute care period for intertrochanteric and all hip fractures, respectively.

Conclusions:
Hip fracture represents a substantial economic burden to the U.S. health-care system, accounting for $5.96 billion per year, with intertrochanteric hip fracture accounting for 44% of total costs.

Level of Evidence:
Economic and decision analysis, Level IV. See Instructions for Authors for a complete description of levels of evidence.

Clinical Relevance:
The present study provides a comprehensive and updated annual estimate of the economic burden of all hip fracture types and estimates the economic burden of intertrochanteric hip fractures in the Medicare population; to our knowledge, prior availability of this information in the literature is limited.
Comparison of Postoperative Visual Performance Between Bifocal and Trifocal Intraocular Lens Based on Randomized Controlled Trails: A Meta-Analysis
Authors: Jin Shanshan , Friedman David S. , Cao Kai , Yusufu Mayinuer , Zhang Jingshang , Wang Jinda , Hou Simeng , Zhu Guyu , Wang Bingsong , Xiong Ying , Li Jing , Li Xiaoxia , He Hailong , Wan Xiuhua 
Published: March 2019

Abstract
Background：To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted.

Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction.

Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD=0.02, 95%CI: (-0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (-0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD=0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA(DCIVA) [MD= 0.09, 95%CI: (-0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839M) [MD= 0.18, 95%CI: (0.12, 0.24) for UIVA and MD= 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA(UDVA) and corrected distance visual acuity (CDVA) [MD=0.01, 95%CI: (-0.01,0.04) for UDVA; MD=0.00, 95%CI: (-0.01,0.01) for CDVA].
The postoperative refraction of bifocal group was similar to that of trifocal group [MD=-0.08, 95% CI: (-0.19, 0.03) for spherical equivalent; MD=-0.09, 95%CI: (-0.21, 0.03) for cylinder; MD=-0.09, 95% CI: (-0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR=0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR=1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR=0.98, 5% CI: (0.86, 1.12) for patient satisfaction].

Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

Keywords: bifocal; trifocal; intraocular lenses; cataract surgery; randomized; IOLs; meta-analysis.
Beyond interviews and focus groups: a framework for integrating innovative qualitative methods into randomised controlled trials of complex public health interventions
Authors: Davis Katy , Minckas Nicole , Bond Virginia , Clark Cari Jo , Colbourn Tim , Drabble Sarah J. , Hesketh Therese , Hill Zelee , Morrison Joanna , Mweemba Oliver , Osrin David , Prost Audrey , Seeley Janet , Shahmanesh Maryam , Spindler Esther J. , Stern Erin , Turner Katrina , Mannell Jenevieve 
Published: March 2019

Abstract
Background: Randomised controlled trials (RCTs) are widely used for establishing evidence of the effectiveness of interventions, yet public health interventions are often complex, posing specific challenges for RCTs. While there is increasing recognition that qualitative methods can and should be integrated into RCTs, few frameworks and practical guidance highlight which qualitative methods should be integrated and for what purposes. As a result, qualitative methods are often poorly or haphazardly integrated into existing trials, and researchers rely heavily on interviews and focus group discussions. To improve current practice, we propose a framework for innovative qualitative research methods that can help address the challenges of RCTs for complex public health interventions.

Methods: We used a stepped approach to develop a practical framework for researchers. This included: (1) a systematic review of the innovative qualitative methods mentioned in the health literature; (2) in-depth interviews with 23 academics from different methodological backgrounds working on RCTs of public health interventions in 11 different countries; and (3) a framework development and group consensus-building process.

Results: The findings are presented according to the CONSORT Statement categories for ease of use. We identify the main challenges of RCTs for public health interventions alongside each of the CONSORT categories and potential innovative qualitative methods that overcome each challenge are listed as part of a Framework for the Integration of Innovative Qualitative Methods into RCTs of Complex Health Interventions. Innovative qualitative methods described in the interviews include: rapid ethnographic appraisals, document analysis, diary methods, interactive voice responses and SMS, community mapping, spiral walks, pair interviews and visual participatory analysis.

Conclusions: The findings of this study point to the usefulness of observational and participatory methods for trials of complex public health interventions, offering a novel contribution to the broader literature about the need for mixed methods approaches. Integrating a diverse toolkit of qualitative methods can enable appropriate adjustments to the intervention and/ or process of data collection during RCTs, which in turn can create more sustainable and effective interventions. However, such integration will require a cultural shift towards the adoption of method-neutral research approaches, transdisciplinary collaborations, and publishing regimes.
Critical inspiratory pressure - new methodology for evaluating and training the inspiratory musculature for recreational cyclists: study protocol for a randomized control trial
Authors: Rehder-Santos Patricia , Minatel Vinicius , Milan-Mattos Juliana Cristina , Signini Étore De Favari , de Abreu Raphael Martins , Dato Carla Cristina , Catai Aparecida Maria 
Published: March 2019

Abstract
Background: Inspiratory muscle training(IMT) has brought great benefits to improving physical performance in healthy individuals. However, there is no consensus regarding the best training load as in most cases the maximum inspiratory pressure(MIP) has been used, whereby 60% of MIP is the most used. Therefore, the prescription of an IMT protocol that takes into account respiratory muscle strength and endurance may bring additional benefits to the commonly used protocols as respiratory muscles differ from other muscles because of their greater muscular resistance. Thus, IMT using inspiratory critical pressure(PThC) appears as an alternative since the calculation of PThC considers these characteristics. Therefore, the aim of this study is to propose a new IMT protocol to determine the best training load for recreational cyclists.
Methods: Thirty recreational cyclists(between 20-40 years) will be randomized to the SHAM Group(SG), the PThC Group(PCG) and the 60% of MIP Group(60G), taking into account age and aerobic functional capacity. All participants will undergo the following evaluations: pulmonary function test(PFT), respiratory muscle strength test(RMS), cardiopulmonary test(CPET), incremental respiratory muscle endurance test(iRME) [maximum sustained respiratory pressure for 1 minute(PThMAX)] and constant load test(CLT) (95%, 100% and 105% of PThMÁX) using a linear load inspiratory resistor(PowerBreathe K5). The PThC will be calculated from the inspiratory muscle endurance time(TLIM) and inspiratory loads of each CLT. The IMT will last 11 weeks(3 times/week and 1 hour/session). The session will consist of 5-minute warm-ups(50% of the training load) and 3 sets of 15-minute breaths (100% of the training load), with a 1 minute interval between them. RMS, iRME, CLT and CPET will be performed before, at week 3 and 7(to adjust the training load) and after training. PFT will be performed before and after training. The data will be analyzed by specific statistical tests (parametric or non-parametric) according to the data distribution and their respective variances. The p <0.05 will be established.
Conclusions: It is expected that the results of this study will enable the training performed with PThC to be used by health professionals as a new tool to evaluate and prescribe IMT. Clinical Trial: ClinicalTrial.gov, ID Number NCT02984189. Registered in December 6, 2016, https://clinicaltrials.gov/ct2/show/NCT02984189.
Combined Ultrasound and Nerve Stimulator-Guided deep nerve block may decrease the rate of local anesthetics systemic toxicity especially in HBV carriers: A Randomized clinical trial
Authors: Zhang Xu-hao , Li Yu-jie , He Wenquan , Yang Chunyong , Gu Jianteng , Lu Kaizhi , Yi Bin 
Published: March 2019

Abstract
Background: Ultrasound-guidance might decrease the incidence of local anesthetics systemic toxicity(LAST) for many peripheral nerve blocks compared with nerve stimulator-guidance. However, it remained uncertain whether ultrasound-guidance would be superior to the nerve stimulator-guidance for deep nerve block in the lower extremity. This study was designed to investigate that whether ultrasound-guided deep nerve block would decrease the incidence of LAST comparing with those with nerve stimulator-guidance, and to find out associated risk factors for LAST.
Methods: Three hundred patients for elective lower limb surgery and desiring lumbar plexus blocks(LPBs) and sciatic nerve blocks(SNBs) were enrolled in this study. Patients were randomly assigned to receive LPBs and SNBs with ultrasound-guidance (Group U), nerve stimulator-guidance (Group N) or dual-guidance (Group M). The primary outcome was the incidence of the LAST. The secondary outcomes were the number of needle redirection, motor and sensory block onset and restoration time in the nerve distributions, and associated risk factors.
Results: There were 18 patients occurring with LAST, including 12 in group U, 4 in group N and 2 in group M. For multiple comparisons among the three groups, we found that the incidence of LAST in group U(12%) was significantly higher than that in group N(4%)(P=0.037) and group M(2%)(P=0.006). The OR of LAST with hepatitis B （HBV） infection and female gender were 3.352(95% CI,1.233-9.108, P=0.013 ) and 9.488(95% CI,2.142-42.093, P=0.0004), respectively.
Conclusions: Ultrasound-guidance, HBV infection and female gender were risk factors for LAST in LPBs and SNBs. For patients with HBV infection or female gender undergoing LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator-guidance should be used to improve the safety.
Trial registration: This study was approved by the Ethical Committee from the first affiliated hospital of Army Medical University. The protocol was registered prospectively with Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15th，2016.
Key words: ultrasound; nerve stimulation; nerve block; female; HBV; LAST
Longitudinal observation of OCT imaging is a valuable tool to monitor primary vitreoretinal lymphoma treated with intravitreal injections of methotrexate
Authors: Zhao Huiying , Wang Xiaona , Mao Yu , Peng Xiaoyan 
Published: March 2019

Abstract
Background: Developing objective and repeatable indicators to evaluate the efficacy of PVRL treatment is important. The quantification of vitreous cells is a traditional criterion; however slight changes are difficult to ascertain. Spectral domain optical coherence tomography (SD-OCT) is objective, repeatable, and easily explained. The purpose of this study is to provide a longitudinal observation of OCT in PVRL treated with intravitreal injections of methotrexate (MTX) and to evaluate the utility of OCT in monitoringresponsiveness of PVRL to treatment. Methods: The medical records of patients with biopsy-positive PVRL attending our hospital between January 2016 and September 2017 who received intravitreal injections of MTX were included in this study. Pre- and posttreatment OCT images were reviewed independently by two researchers. Results: Of the 24 cases reviewed, 10 patients (18 eyes) were included. SD-OCT abnormalities at the initial visit included hyperreflective foci in the posterior vitreous (18/18), hyperreflective dots in the RPE (12/18), PEDs (detachment of retinal pigment epithelium) (9/18), hyperreflective band above the RPE (3/18), hyperreflectivity in the full thickness of the retina (8/18), and subretinal fluid (4/18). At one month after treatment, the subretinal fluid in cases with RD was absorbed, and subretinal fibrosis appeared. Other lesions were significantly reduced. At two months after treatment, the hyperreflective dots in the RPE, PEDs and subretinal fluid disappeared in 2 eyes, hyperreflectivity in the full thickness of the retina disappeared in 1 eye, and other abnormalities further improved. Additionally, retinal fibrosis was observed in 3 eyes. At nine months after treatment, all abnormalities observed at the first visit vanished. At the last visit, OCT showed subretinal fibrosis and in 3 eyes (16.7%), the disruption of outer retina in 9 eyes (50%) and thinning of the whole layer in 4 eyes (22.2%).Conclusions: Our observations reveal that characteristic OCT features in PVRL patients can reduce gradually and finally vanish with therapy. We propose that SD-OCT may be employed to monitor the responsiveness of PVRL to treatment, which may influence decision making in the management of this disease.