bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing health impacts of home food gardens with Wind River Indian Reservation families: protocol for a randomised controlled trial
Authors: Porter Christine M , Wechsler Alyssa M , Naschold Felix , Hime Shawn J , Fox Lanae 
Published: April 2019

IntroductionThis community-based participatory research,Growing Resilience,will be the first full-scale randomised controlled trial we have identified that is designed to evaluate impacts of home gardening on family health. It is based on observational studies suggesting home food gardening has myriad health benefits, Wind River Indian Reservation (WRIR) families’ interest in home gardening and the need to end Native American health disparities with empowering, appropriate and effective health interventions.Methods and analysisA total of 100 Native American families in WRIR who have not gardened recently but want to garden will be randomly allocated (1:1) to intervention (receiving 2 years of support designing, installing and maintaining a home food garden of at least 80 square feet (approximately 7 square meters) or to delayed-intervention control (receiving same gardening support after 2 years of data collection). Willing family members aged 5 and up will participate in data collection each February and August for 2 years, with blood, biometric and survey measures at each. The primary outcome is adult body mass index (BMI). Secondary outcomes include child BMI, and adult hand strength, self-reported physical and mental health, diabetes control and food security. Primary analysis will be intention to treat (ITT), using univariate and bivariate descriptive statistics followed by a mixed model to estimate the ITT effect of the intervention using analysis of covariance (ANCOVA) estimation. We will also examine treatment affects using a gardening fidelity measure, combined adult and child BMI outcomes using a lambda mu and sigma (LMS) Z-score reference data set and possible mechanisms of health impacts.Ethics and disseminationThis protocol was approved by the University of Wyoming Institutional Review Board (IRB) and the project’s Community Advisory Board. De-identified data will be shared with each tribe, and results will be published in peer-reviewed journals, summarised for distribution in WRIR, and shared at a national event to be hosted in WRIR in 2020.Trial registration numberNCT02672748; Pre-results.
Comparative efficacy and safety of surgical and invasive treatments for adults with degenerative lumbar spinal stenosis: protocol for a network meta-analysis and systematic review
Authors: Chen Lingxiao , H Ferreira Paulo , R Beckenkamp Paula , L Ferreira Manuela 
Published: April 2019

IntroductionSurgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. To address this, we will perform a network meta-analysis (NMA) and systematic review to compare the efficacy and safety of surgical and invasive procedures for adults with degenerative lumbar spinal stenosis.Methods and analysisWe will include randomised controlled trials assessing surgical and invasive treatments for adults with degenerative lumbar spinal stenosis. We will search AMED, CINAHL, EMBASE, the Cochrane Library and MEDLINE. Only English studies will be included and no restriction will be set for publication status. For efficacy, our primary outcome will be physical function. Secondary outcomes will include pain intensity, health-related quality of life, global impression of recovery, work absenteeism and mobility. For safety, our primary outcome will be all-cause mortality. Secondary outcomes will include adverse events (number of events or number of people with an event) and treatment withdrawal due to adverse effect. Two reviewers will independently select studies, extract data and assess the risk of bias (Revised Cochrane risk-of-bias tool for randomized trials) of included studies. The quality of the evidence will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation framework. Random-effects NMA will be performed to combine all the evidence under the frequentist framework and the ranking results will be presented through the surface under the cumulative ranking curve and mean rank. All analyses will be performed in Stata and R.Ethics and disseminationNo ethical approval is required. The research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018094180.
Predicting fracture risk in patients with chronic obstructive pulmonary disease: a UK-based population-based cohort study
Authors: Akyea Ralph Kwame , McKeever Tricia M , Gibson Jack , Scullion Jane E , Bolton Charlotte E 
Published: April 2019

ObjectiveTo assess the incidence of hip fracture and all major osteoporotic fractures (MOF) in patients with chronic obstructive pulmonary disease (COPD) compared with non-COPD patients and to evaluate the use and performance of fracture risk prediction tools in patients with COPD. To assess the prevalence and incidence of osteoporosis.DesignPopulation-based cohort study.SettingUK General Practice health records from The Health Improvement Network database.ParticipantsPatients with an incident COPD diagnosis from 2004 to 2015 and non-COPD patients matched by age, sex and general practice were studied.OutcomesIncidence of fracture (hip alone and all MOF); accuracy of fracture risk prediction tools in COPD; and prevalence and incidence of coded osteoporosis.MethodsCox proportional hazards models were used to assess the incidence rates of osteoporosis, hip fracture and MOF (hip, proximal humerus, forearm and clinical vertebral fractures). The discriminatory accuracies (area under the receiver operating characteristic [ROC] curve) of fracture risk prediction tools (FRAX and QFracture) in COPD were assessed.ResultsPatients with COPD (n=80 874) were at an increased risk of fracture (both hip alone and all MOF) compared with non-COPD patients (n=308 999), but this was largely mediated through oral corticosteroid use, body mass index and smoking. Retrospectively calculated ROC values for MOF in COPD were as follows: FRAX: 71.4% (95% CI 70.6% to 72.2%), QFracture: 61.4% (95% CI 60.5% to 62.3%) and for hip fracture alone, both 76.1% (95% CI 74.9% to 77.2%). Prevalence of coded osteoporosis was greater for patients (5.7%) compared with non-COPD patients (3.9%), p<0.001. The incidence of osteoporosis was increased in patients with COPD (n=73 084) compared with non-COPD patients (n=264 544) (adjusted hazard ratio, 1.13, 95% CI 1.05 to 1.22).ConclusionPatients with COPD are at an increased risk of fractures and osteoporosis. Despite this, there is no systematic assessment of fracture risk in clinical practice. Fracture risk tools identify those at high risk of fracture in patients with COPD.
Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait Islander Australians: a systematic review
Authors: Gwynn Josephine , Sim Kyra , Searle Tania , Senior Alistair , Lee Amanda , Brimblecombe Julie 
Published: April 2019

ObjectiveTo review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Islander people.Study designSystematic review of peer-reviewed literature.Data sourcesMEDLINE, PubMed, Embase, Science Direct, CINAHL, Informit, PsychInfo and Cochrane Library, Australian Indigenous Health InfoNet.Study selectionPeer-reviewed article describing an original study; published in English prior to December 2017; inclusion of one or more of the following outcome measures: nutritional status, food/dietary/nutrient intake, diet-related biomedical markers, anthropometric or health measures; and conducted with Australian Aboriginal and Torres Strait Islander people.Data extraction and synthesisTwo independent reviewers extracted data and applied the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. A purpose designed tool assessed community engagement in research, and a framework was applied to interventions to report a score based on numbers of settings and strategies. Heterogeneity of studies precluded a meta-analysis. The effect size of health outcome results were estimated and presented as forest plots.ResultsThirty-five articles (26 studies) met inclusion criteria; two rated moderate in quality; 12 described cohort designs; 18 described interventions in remote/very remote communities; none focused solely on urban communities; and 11 reported moderate or strong community engagement. Six intervention types were identified. Statistically significant improvements were reported in 14 studies of which eight reported improvements in biochemical/haematological markers and either anthropometric and/or diet-related outcomes.ConclusionsStore-based intervention with community health promotion in very remote communities, fiscal strategies and nutrition education and promotion programmes show promise. Future dietary intervention studies must be rigorously evaluated, provide intervention implementation details explore scale up of programmes, include urban communities and consider a multisetting and strategy approach. Strong Aboriginal and Torres Strait Islander community engagement is essential for effective nutrition intervention research and evaluation.PROSPERO registration numberCRD42015029551.
Preoperative oral hygiene recommendation before open-heart surgery: patients’ adherence and reduction of infections: a quality improvement study
Authors: Pedersen Preben Ulrich , Tracey Anita , Sindby Jesper Eske , Bjerrum Merete 
Published: April 2019

AimTo implement recommendations for oral hygiene before elective open-heart surgery in a thoracic surgery ward and to evaluate whether the number of patients who needed to be treated with antibiotics postoperatively was reduced.BackgroundHealthcare systems are challenged to implement initiatives that reduce the development of nosocomial infections, to offer patients a safe and cost-efficient treatment and to reduce the use of antibiotics. Previous interventions have focused on staff behaviour in reducing postoperative infections. In this study, patients were recommended to carry out oral hygiene as recommended in a clinical guideline.MethodsA quasiexperimental design with a control and an intervention group was used. Information on adherence to the recommendation was collected at admission. All medical information and prescriptions of antibiotics were obtained from patients’ medical records. Data were reported as intention to treat.ResultsAltogether 972 patients (506 controls and 466 interventions) were included in the study. Of the intervention patients, 405 (86.9%, 95% CI 83.3 to 89.8) reported that they had adhered to the oral hygiene recommendation. 64 (12.6%) control patients and 36 (7.7%) in the intervention group (p=0.015) were treated with antibiotics postoperatively.ConclusionsIt was feasible to involve patients in a programme for oral hygiene and thereby reduce the number of patients needing antibiotics after open-heart surgery and this might contribute to reducing costs.
PROgnostic Model for Advanced Cancer (PRO-MAC)
Authors: Hum Allyn , Wong Yoko Kin Yoke , Yee Choon Meng , Lee Chung Seng , Wu Huei Yaw , Koh Mervyn Yong Hwang 
Published: April 2019

ObjectiveTo develop and validate a simple prognostic tool for early prediction of survival of patients with advanced cancer in a tertiary care setting.DesignProspective cohort study with 2 years’ follow-up.SettingSingle tertiary teaching hospital in Singapore.ParticipantsThe study includes consecutive patients diagnosed with advanced cancer who were referred to a palliative care unit between 2013 and 2015 (N=840). Data were randomly split into training (n=560) and validation (n=280) sets.Results743 (88.5%) patients died with a mean follow-up of 97.0 days (SD 174.0). Cox regression modelling was used to build a prognostic model, cross-validating with six randomly split dataset pairs. Predictor variables for the model included functional status (Palliative Performance Scale, PPS V.2), symptoms (Edmonton Symptom Assessment System, ESASr), clinical assessment (eg, the number of organ systems with metastasis, serum albumin and total white cell count level) and patient demographics. The area under the receiver operating characteristic curve using the final averaged prognostic model was between 0.69 and 0.75. Our model classified patients into three prognostic groups, with a median survival of 79.0 days (IQR 175.0) for the low-risk group (0–1.5 points), 42.0 days (IQR 75.0) for the medium-risk group (2.0–5.5 points), and 15.0 days (IQR 28.0) for the high-risk group (6.0–10.5 points).ConclusionsPROgnostic Model for Advanced Cancer (PRO-MAC) takes into account patient and disease-related factors and identify high-risk patients with 90-day mortality. PPS V.2 and ESASr are important predictors. PRO-MAC will help physicians identify patients earlier for supportive care, facilitating multidisciplinary, shared decision-making.
Cortical grey matter sodium accumulation is associated with disability and secondary progressive disease course in relapse-onset multiple sclerosis
Authors: Brownlee Wallace J , Solanky Bhavana , Prados Ferran , Yiannakas Marios , Da Mota Patricia , Riemer Frank , Cardoso Manuel Jorge , Ourselin Sebastian , Golay Xavier , Gandini Wheeler-Kingshott Claudia , Ciccarelli Olga 
Published: April 2019

ObjectiveSodium (23Na)-MRI is an emerging imaging technique to investigate in vivo changes in tissue viability, reflecting neuroaxonal integrity and metabolism. Using an optimised23Na-MRI protocol with smaller voxel sizes and improved tissue contrast, we wanted to investigate whether brain total sodium concentration (TSC) is a biomarker for long-term disease outcomes in a cohort of patients with relapse-onset multiple sclerosis (MS), followed from disease onset.MethodsWe performed a cross-sectional study in 96 patients followed up ~ 15 years after a clinically isolated syndrome (CIS) and 34 healthy controls. Disease course was classified as CIS, relapsing-remitting MS or secondary progressive MS (SPMS). We acquired1H-MRI and23Na-MRI and calculated the TSC in cortical grey matter (CGM), deep grey matter, normal-appearing white matter (WM) and WM lesions. Multivariable linear regression was used to identify independent associations of tissue-specific TSC with physical disability and cognition, with adjustment for tissue volumes.ResultsTSC in all tissues was higher in patients with MS compared with healthy controls and patients who remained CIS, with differences driven by patients with SPMS. Higher CGM TSC was independently associated with Expanded Disability Status Scale (R2=0.26), timed 25-foot walk test (R2=0.23), 9-hole peg test (R2=0.23), Paced Auditory Serial Addition Test (R2=0.29), Symbol Digit Modalities Test (R2=0.31) and executive function (R2=0.36) test scores, independent of grey matter atrophy.ConclusionsSodium accumulation in CGM reflects underlying neuroaxonal metabolic abnormalities relevant to disease course heterogeneity and disability in relapse-onset MS. TSC and should be considered as an outcome measure in future neuroprotection trials.
Tight Lower Bounds for the Complexity of Multicoloring
Authors: Bonamy Marthe , Kowalik łUkasz , Pilipczuk Michał , Socała Arkadiusz , Wrochna Marcin 
Published: April 2019

In the
multicoloring
problem, also known as (
a
:
b
)-
coloring
or
b-fold coloring
, we are given a graph
G
and a set of
a
colors, and the task is to assign a subset of
b
colors to each vertex of
G
so that adjacent vertices receive disjoint color subsets. This natural generalization of the classic coloring problem (the
b
=1 case) is equivalent to finding a homomorphism to the Kneser graph
KG

a,b

and gives relaxations approaching the fractional chromatic number.

We study the complexity of determining whether a graph has an (
a
:
b
)-coloring. Our main result is that this problem does not admit an algorithm with runtime
f
(
b
)ċ 2

o
(log
b
)ċ
n

for any computable
f(b)
unless the Exponential Time Hypothesis (ETH) fails. A (
b
+1)

n

ċ poly(
n
)-time algorithm due to Nederlof [33] shows that this is tight. A direct corollary of our result is that the graph homomorphism problem does not admit a 2

O
(
n
+
h
)

algorithm unless the ETH fails even if the target graph is required to be a Kneser graph. This refines the understanding given by the recent lower bound of Cygan et al. [9].

The crucial ingredient in our hardness reduction is the usage of
detecting matrices
of Lindström [28], which is a combinatorial tool that, to the best of our knowledge, has not yet been used for proving complexity lower bounds. As a side result, we prove that the runtime of the algorithms of Abasi et al. [1] and of Gabizon et al. [14] for the
r
-monomial detection problem are optimal under the ETH.
РЕТРОСПЕКТИВНИЙ АНАЛІЗ ЗАХВОРЮВАНОСТІ НА НЕГОСПІТАЛЬНУ ПНЕВМОНІЮ СЕРЕД ВІЛ-ПОЗИТИВНИХ ОСІБ У ХАРКОВІ ЗА ПЕРІОД 2013-2017 рр.
Authors: Tsyko O. V. , Kozko V. M. , Yurchenko I. S. 
Published: April 2019

Мета роботи – провести ретроспективний та структурний аналіз інфекційної захворюваності на легеневу патологію серед ВІЛ-інфікованих осіб, які перебували на лікуванні в ОКІЛ м. Харкова за період 2013-2017 рр. Окремо виділити кількість випадків бактерійної пневмонії на тлі ВІЛ упродовж зазначеного періоду, визначити фактори ризику її виникнення, клінічні особливості перебігу, діагностику залежно від імунного статусу, особливості лікування та можливості профілактики.
Матеріали і методи. Проведений ретроспективний аналіз захворюваності ВІЛ-інфікованих осіб на патологію легень з використанням 191 медичної картки стаціонарного хворого, з яких відібрано 102 історії хвороби ВІЛ-інфікованих з бактерійною пневмонією, які перебували на лікуванні у стаціонарі ОКІЛ за період 2013-2017 рр. Статистичну обробку отриманих даних здійснювали методами варіаційної та кореляційної статистики із застосуванням програмного забезпечення.
Результати досліджень та їх обговорення. Негоспітальна бактерійна пневмонія у ВІЛ-позитивних осіб виникає при будь-якому рівні CD4+ T-лімфоцитів в 1 мкл, частота її прогресивно збільшується у міру поглиблення імунодепресії. Клінічний перебіг не відрізняється від осіб з ВІЛ-негативним статусом, але при зниженні CD4+ T-лімфоцитів <50 в 1 мкл має тяжчий перебіг та ознаки інвазивності традиційного збудника, особливо в асоціації з Candida albicans та/або Pneumocystis jiroveci.
Висновки. За досліджуваний період з 2013 по 2017 рр. кількість випадків негоспітальної бактерійної пневмонії на тлі ВІЛ збільшилась. Факторами, що підвищують ризик її виникнення є вживання наркотичних речовин, зловживання алкоголем і куріння, а також низьке охоплення АРТ. Збудник з мокроти був виділений в 26,5 % випадків. Більш тяжкий перебіг бактерійної пневмонії був у групі хворих з кількістю CD4+ T-лімфоцитів <50 в 1 мкл, бактеріологічно в мокротинні таких хворих крім банального збудника була Candida albicans та/або Pneumocystis jiroveci, що ускладнювало клінічну картину. Рентгенологічно при цьому була тенденція до генералізації процесу в легенях. Мультипрофілактики виникнення негоспітальної бактерійної пневмонії у ВІЛ-інфікованих через величезну кількість її збудників немає, тому ризик її виникнення у цієї категорії буде завжди вищим, ніж в цілому в популяції. Єдиними рекомендаціями щодо профілактики є використання 23-валентної полісахаридної пневмококової вакцини та щорічна вакцинація від грипу.
ЕТІОЛОГІЧНА СТРУКТУРА ГОСТРОГО ЛАЙМ-БОРЕЛІОЗУ ЗА ВИДАМИ ЗБУДНИКА
Authors: Shkilna M. I. 
Published: April 2019

Мета дослідження – встановити частоту інфікування різними видами борелій пацієнтів із гострою формою Лайм-бореліозу (мігруючою еритемою та Лайм-артритом) в Тернопільській області.
Пацієнти і методи. Під спостереженням було 48 пацієнтів з гострою формою хвороби Лайма у віці від 19 до 65 років, які в 2018 р. перебували на амбулаторному та стаціонарному лікуванні в Тернопільському обласному клінічному шкірно-венерологічному диспансері та Університетській лікарні; серед них 19 (39,6 %) чоловіків і 29 (60,4 %) жінок. Пацієнтів поділили на дві групи: 34 (I група) – хворі на мігруючу еритему (МЕ) та 14 (II група) – на Лайм-артрит (ЛА). Діагноз Лайм-бореліозу підтверджували анамнестично, клінічно та серологічно. Специфічний діагноз встановлювали за наявності в сироватці крові пацієнтів специфічних IgМ і (або) IgG до комплексу B. burgdorferi sencu lato (s. l.) методом ELISA та лише IgМ, за допомогою реакції імунного блотингу (EUROLINE Borrelia RN-AT adv.).
Результати. Позитивні або проміжні результати серологічного дослідження сироваток крові на наявність специфічних IgM і IgG до комплексу B. burgdorferi s. l. (B. burgdorferi sensu stricto (s. s.), B. garinii, B. afzelii) за допомогою тесту ELISA (хоча б одного класу антитіл) знайдено в 24 (70,6 %) із 34 пацієнтів з мігруючою еритемою та 11 (78,6 %) з Лайм-артритом. Порівняння частоти діагностики специфічних антитіл IgM (позитивних і проміжних) до B. burgdorferi s. l. (B. burgdorferi s. s., B. garinii, B. afzelii та B. spielmanii) у 34 пацієнтів з мігруючою еритемою, методом ІФА – та імуноблоту, показало, що вона була вища при використанні імуноблоту: 76,5 % порівняно із методом ІФА 55,9 % (р<0,05). Вивчення етіологічної структури гострого Лайм-бореліозу в 26 пацієнтів з мігруючою еритемою (I група) та 12 – із Лайм-артритом (II група) встановило, що OspC B. spielmanii знайдено у 24 (92,3 %) пацієнтів I групи та 12 (100 %) пацієнтів з II.
Висновки. Специфічні IgG у тесті ELISA було виявлено лише в сироватці крові 35,3 % пацієнтів з мігруючою еритемою, що може свідчити про імунну пам’ять або хронічний процес. Гуморальну відповідь на поверхневий антиген (OspC) B. spielmanii встановлено в 92,3 % пацієнтів з мігруючими еритемами та всіх хворих із гострим Лайм-артритом.