bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progressive ossificans fibrodysplasia endodontic management: Case report
Authors: Dutra Thaís Torres Barros , Bezerra Thâmara Manoela Marinho , Chaves Filipe Nobre , Feitosa Sthefane Gomes , Costa Fábio Wildson Gurgel , Pereira Karuza Maria Alves 
Published: August 2019

AbstractThe objective of this case is to discuss the endodontic management in patient diagnosed with Progressive Ossificans Fibrodysplasia (POF) who sought the dental service due to discomfort in the mandible. Minor mobility of the peripheral joints, spinal involvement, gait limitation, inability to sit, report of joint pain, and limitation of TMJ movements were observed on the extra‐oral examination. The intraoral examination revealed the presence of ectopic teeth (13 and 23), prolonged retention of primary teeth (53 and 63), dental gyrosurgery (34 and 33), caries lesion on teeth 36 and 47, and dental crowding. To the percussion test and the thermal pulp sensitivity of the tooth 36, there was no response, indicating pulp necrosis. Conventional endodontic therapy was performed under intrapulpal anesthesia and the dental chair placed at 45º. The patient evolved without painful symptomatology, is free of heterotopic ossification resulting from the treatment and her ability to open the mouth remained the same. Thus, endodontic treatment is a viable procedure and should be eligible in patients with POF because it minimizes local trauma and reduces iatrogenic risks, which may exacerbate the progression of the disease.
Effects of active video games on children and adolescents: A systematic review with meta‐analysis
Authors: Oliveira Crystian B. , Pinto Rafael Z. , Saraiva Bruna T. C. , Tebar William R. , Delfino Leandro D. , Franco Marcia R. , Silva Claudiele C. M. , Christofaro Diego G. D. 
Published: August 2019

ObjectiveTo investigate the effectiveness of active video games (AVGs) on obesity‐related outcomes and physical activity levels in children and adolescents.DesignSystematic review with meta‐analysis.MethodsLiterature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity‐related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models.ResultsTwelve studies were considered eligible for this review. Included studies mostly reported outcome data at short‐term (less or equal than three months) and intermediate‐term follow‐up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short‐term (SMD = −0.34; 95% CI: −0.62 to −0.05) and intermediate‐term follow‐up (SMD = −0.36; 95% CI: −0.01 to −0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate‐term follow‐up (SMD = −0.25; 95% CI: −0.46 to −0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short‐term and intermediate‐term follow‐up.ConclusionsOur review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.
Benzodiazepine abuse among athletes: Pain relief or just a weapon against insomnia? A clinical case study
Authors: Zamboni Lorenzo , Lugoboni Fabio , Zandonai Thomas 
Published: August 2019

It is widely recognized that benzodiazepine abuse can potentially induce addiction. Benzodiazepine addiction among athletes is a new and growing phenomenon that we are encountering among our patients. We describe a case of lormetazepam addiction in a female competitive marathon runner. A 30‐year‐old female elite athlete developed lormetazepam addiction after increasing her daily benzodiazepine dosage in an attempt to achieve better sleep and enhanced performances during training. She was hospitalized for 7 days to undergo benzodiazepine detoxification. Her lormetazepam daily dosage on admission was 18 vials (20 ml × 18 = 360 ml). This report highlights the risk of athletes becoming addicted to benzodiazepines used to combat insomnia and pain. There is a need for clinical and epidemiological research to investigate the effects of this addiction, with a view to better protecting the health of athletes.
Tillage and residue management practices affect soil biological indicators in a rice–wheat cropping system in north‐western India
Authors: Saikia Rituparna , Sharma Sandeep , Thind Harmit Singh , Singh Yadvinder 
Published: August 2019

AbstractAgricultural productivity relies on a wide range of ecosystem services provided by the soil biota. Sustainable management practices, such as tillage and residue management, can influence structure and function of the soil microbiota, with direct consequences for the associated ecosystem services. Although there is increasing evidence that different tillage regimes alter the soil biological indices, we only have a limited understanding of their temporal changes in a rice (Oryza sativaL.)–wheat (Triticum aestivumL.) cropping system. We evaluated the effects of combinations of tillage, crop residue management and green manuring on soil biological indicators after 5 years of the practising rice–wheat system (RWS). Four main plot treatments in rice included the following: (a)PTRW0, puddled transplanted rice with no wheat straw retained; (b)PTRW25, puddled transplanted rice with 25% anchored wheat stubbles retained; (c)PTRW0+Sesbania aculeateL. green manure (GM); and (d)PTRW25+GM, puddled transplanted rice with 25% anchored wheat stubbles retained+GM. There were three subplot treatments in the subsequent wheat crop: (a)CTWR0, conventional tillage wheat with rice residue removed; (b)ZTWR0, zero tillage wheat with rice residue removed; and (c)ZTWR100,ZTWwith 100% rice residue retained as mulch. ThePTRW25+GMtreatment, followed byZTWR100, significantly increased soil microbial biomass carbon, basal soil respiration, microbial quotient and mineralization quotient measured during wheat‐growing season. These biological indicators were higher at vigorous vegetative wheat growth stage than at flowering stage and decreased at maturity. The principal component analysis of the assayed variables showed that all the variables significantly contributed to the variability in parameters examined and were more related to maximum tillering stage of wheat growth than to maturity or at sowing of wheat. Three highly effective biological indicators were microbial biomass carbon, microbial quotient and mineralization quotient, which responded significantly to changes in tillage and residue management practices in theRWS. We conclude that crop residues and green manure have significant to improve soil biochemical processes by improving soil organic carbon and soil biological indicators in rice–wheat cropping system.
Infectious diseases pre‐transplant evaluation improves vaccination rates for liver transplant candidates
Authors: Pineda Erika May Z. , Spinner Michael L. , Pallotta Andrea , Koval Christine , Bollinger Jessica 
Published: August 2019

AbstractImmunization rates in pre‐liver transplant patients have been historically below rates for immunocompetent patients. At Cleveland Clinic, an infectious diseases (ID) consult is required for all patients during the liver transplant evaluation and may beneficially impact vaccination rates. The goal of this study was to evaluate pre‐transplant vaccination rates in pre‐liver transplant candidates. This single‐center, retrospective chart review included adults transplanted between January 1, 2013, and December 31, 2016. Prior to transplant, rates of vaccination and/or documented seropositivity were 35% for hepatitis B vaccine, 92% for hepatitis A vaccine, 57% for pneumococcal conjugate vaccine, 62% for pneumococcal polysaccharide vaccine, and 77% for influenza vaccine. Vaccination rates were higher than to previously reported. Rates were also higher for several vaccines compared to transplant candidates for other organs without ID consult. With ongoing ID consult requirements for liver transplant candidates, combined with standardization of vaccine recommendations via technology, and increased multi‐disciplinary collaboration, vaccination rates should improve further.
It takes a community: a landscape analysis of global health research consortia
Authors: VanderZanden Amelia , Langlois Etienne V , Ghaffar Abdul , Bitton Asaf , Fifield Jocelyn , Hirschhorn Lisa R 
Published: August 2019

BackgroundThe increased recognition of the core role of effective primary healthcare has identified large gaps in the knowledge of components of high-quality primary healthcare systems and the need for resources positioned to better understand them. Research consortia are an effective approach to generate evidence needed to address knowledge and evidence gaps and accelerate change. However, the optimal design of consortia and guidance on design decisions is not well studied. We report on a landscape analysis to understand global health research consortium models and major design decisions that inform model choice.MethodsWe conducted a landscape analysis to identify health-related research consortia typologies and explore decision processes leading to their design and implementation. We identified and reviewed 195 research consortia, extracted data on organisation, characteristics and operations for 115 and conducted 14 key informant interviews representing 13 consortia. We analysed interviews using thematic content analysis using results to develop categories of major design choices and research consortia models, structures and processes.ResultsAcross a wide range of research consortia, the structure and function were determined by nine key design decisions that were mapped to three domains: scope: including mission and area of focus; organisational structure: including role and location of the core entity, choice of leader, governance and membership eligibility and responsibility; and funding decisions: including the funding source for research consortia operations and the funding sources and process for consortium research.DiscussionResearch consortia showed important heterogeneity across the nine decision points studied and based on their goals, needs and resources. These decisions and the three emerging domains (scope, organisation and funding) offer a potential framework for new research consortia and inform the design of a proposed primary health care research consortium intended to accelerate research to improve primary health care in LMICs.
Primary healthcare policy and governance in low-income and middle-income countries: an evidence gap map
Authors: Saif-Ur-Rahman K M , Mamun Razib , Nowrin Iffat , Hossain Shahed , Islam Khaleda , Rumman Tajkia , Kabir Ehtesham , Rahman Aminur , Dahal Ngamindra , Anwar Iqbal 
Published: August 2019

IntroductionGovernance is one of the most important aspects for strong primary healthcare (PHC) service delivery. To achieve the targets for the Sustainable Development Goals, good governance may play a prime role in low-income and middle-income countries (LMICs). This evidence gap map (EGM) explored the available evidence in LMICs to identify the knowledge gap concerning PHC policy and governance in these settings.MethodsWe followed the standard 3ie EGM protocol, finalising the scope of the EGM through a stakeholder workshop. We searched a total of 32 bibliographic databases, systematic review databases, impact evaluation databases, and donor and bilateral agency databases using a comprehensive search strategy. Two reviewers screened retrieved studies, extracted data and performed quality assessment. We plotted the interventions and outcomes derived from the included studies in a dynamic platform to build the interactive EGM and conducted a stakeholder consultation with nominal group technique methods to prioritise the identified gaps.ResultsThe EGM included 24 systematic reviews and 7 impact evaluations focusing on PHC policy and governance in LMICs. Most of the sources emphasised workforce management and supervision. There were noticeable evidence gaps regarding accountability and social responsibility. The most highly prioritised themes were the role of accountability, the role of public–private partnerships and the role of user–provider communication in PHC governance.ConclusionsThis EGM identified some important aspects of PHC policy and governance such as accountability, social responsibility, public–private partnership, user–provider communication through the methodological approaches of evidence synthesis and stakeholder consultation. Identified gaps will provide directions for an implementation research plan to improve the governance of PHC in LMICs.
Organisation of primary health care systems in low- and middle-income countries: review of evidence on what works and why in the Asia-Pacific region
Authors: Dodd Rebecca , Palagyi Anna , Jan Stephen , Abdel-All Marwa , Nambiar Devaki , Madhira Pavitra , Balane Christine , Tian Maoyi , Joshi Rohina , Abimbola Seye , Peiris David 
Published: August 2019

IntroductionThis paper synthesises evidence on the organisation of primary health care (PHC) service delivery in low-income and middle-income countries (LMICs) in the Asia Pacific and identifies evidence of effective approaches and pathways of impact in this region.MethodsWe developed a conceptual framework describing key inputs and outcomes of PHC as the basis of a systematic review. We searched exclusively for intervention studies from LMICs of the Asia-Pacific region in an effort to identify ‘what works’ to improve the coverage, quality, efficiency, equity and responsiveness of PHC. We conducted a narrative synthesis to identify key characteristics of successful interventions.ResultsFrom an initial list of 3001 articles, we selected 153 for full-text review and included 111. We found evidence on the impact of non-physician health workers (NPHWs) on coverage and quality of care, though better integration with other PHC services is needed. Community-based services are most effective when well integrated through functional referral systems and supportive supervision arrangements, and have a reliable supply of medicines. Many studies point to the importance of community engagement in improving service demand. Few studies adopted a ‘systems’ lens or adequately considered long-term costs or implementation challenges.ConclusionBased on our findings, we suggest five areas where more practical knowledge and guidance is needed to support PHC systems strengthening: (1) NPHW workforce development; (2) integrating non-communicable disease prevention and control into the basic package of care; (3) building managerial capacity; (4) institutionalising community engagement; (5) modernising PHC information systems.
Community-orientated primary care: a scoping review of different models, and their effectiveness and feasibility in sub-Saharan Africa
Authors: Mash Bob , Ray Sunanda , Essuman Akye , Burgueño Edu 
Published: August 2019

IntroductionCommunity-orientated primary care (COPC) is an approach to primary healthcare (PHC) that originated in South Africa and contributed to the formulation of the Declaration of Alma-Ata 40 years ago. Despite this, PHC remains poorly developed in sub-Saharan African countries. There has been a resurgence of interest in strengthening PHC systems in the last few years and identifying key knowledge gaps. COPC has been an effective strategy elsewhere, most notably Brazil. This scoping review investigated COPC in the sub-Saharan African context and looked for evidence of different models, effectiveness and feasibility.MethodsDatabases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Studies were grouped into five categories: historical analysis, models, implementation, educational studies and effectiveness.ResultsA total of 1997 publications were identified and 39 included in the review. Most publications were from the last 5 years (n = 32), research (n = 27), from South Africa (n = 27), focused on implementation (n = 25) and involving case studies (n = 9), programme evaluation (n = 6) or qualitative methods (n = 10). Nine principles of COPC were identified from different models. Factors related to the implementation of COPC were identified in terms of governance, finances, community health workers, primary care facilities, community participation, health information and training. There was very little evidence of effectiveness of COPC.ConclusionsThere is a need for further research to describe models of COPC in Africa, investigate the appropriate skills mix to integrate public health and primary care in these models, evaluate the effectiveness of COPC and whether it is included in training of healthcare workers and government policy.
Primary healthcare system performance in low-income and middle-income countries: a scoping review of the evidence from 2010 to 2017
Authors: Bitton Asaf , Fifield Jocelyn , Ratcliffe Hannah , Karlage Ami , Wang Hong , Veillard Jeremy H , Schwarz Dan , Hirschhorn Lisa R 
Published: August 2019

IntroductionThe 2018 Astana Declaration reaffirmed global commitment to primary healthcare (PHC) as a core strategy to achieve universal health coverage. To meet this potential, PHC in low-income and middle-income countries (LMIC) needs to be strengthened, but research is lacking and fragmented. We conducted a scoping review of the recent literature to assess the state of research on PHC in LMIC and understand where future research is most needed.MethodsGuided by the Primary Healthcare Performance Initiative (PHCPI) conceptual framework, we conducted searches of the peer-reviewed literature on PHC in LMIC published between 2010 (the publication year of the last major review of PHC in LMIC) and 2017. We also conducted country-specific searches to understand performance trajectories in 14 high-performing countries identified in the previous review. Evidence highlights and gaps for each topic area of the PHCPI framework were extracted and summarised.ResultsWe retrieved 5219 articles, 207 of which met final inclusion criteria. Many PHC system inputs such as payment and workforce are well-studied. A number of emerging service delivery innovations have early evidence of success but lack evidence for how to scale more broadly. Community-based PHC systems with supportive governmental policies and financing structures (public and private) consistently promote better outcomes and equity. Among the 14 highlighted countries, most maintained or improved progress in the scope of services, quality, access and financial coverage of PHC during the review time period.ConclusionOur findings revealed a heterogeneous focus of recent literature, with ample evidence for effective PHC policies, payment and other system inputs. More variability was seen in key areas of service delivery, underscoring a need for greater emphasis on implementation science and intervention testing. Future evaluations are needed on PHC system capacities and orientation toward social accountability, innovation, management and population health in order to achieve the promise of PHC.
Quick fix for care, productivity, hygiene and inequality: reframing the entrenched problem of antibiotic overuse
Authors: Denyer Willis Laurie , Chandler Clare 
Published: August 2019

Antimicrobial resistance (AMR) is a major challenge of our time. A key global objective is to reduce antibiotic use (ABU), in order to reduce resistance caused by antimicrobial pressure. This is often set as a ‘behaviour change’ issue, locating intervention efforts in the knowledge and attitudes of individual prescribers and users of medicines. Such approaches have had limited impact and fall short of addressing wider drivers of antibiotic use. To address the magnitude of antibiotic overuse requires a wider lens to view our relationships with these medicines.This article draws on ethnographic research from East Africa to answer the question of what roles antibiotics play beyond their immediate curative effects. We carried out interviews, participant observation and documentary analysis over a decade in northeast Tanzania and eastern and central Uganda. Our findings suggest that antibiotics have become a ‘quick fix’ in our modern societies. They are aquick fix for carein fractured health systems; aquick fix for productivityat local and global scales, for humans, animals and crops; aquick fix for hygienein settings of minimised resources; and aquick fix for inequalityin landscapes scarred by political and economic violence. Conceptualising antibiotic use as a ‘quick fix’ infrastructure shifts attention to the structural dimensions of AMR and antimicrobial use (AMU) and raises our line of sight into the longer term, generating more systemic solutions that have greater chance of achieving equitable impact.
New ophthalmic dual-viscoelastic device in cataract surgery: a comparative study
Authors: Monaco Gaspare , Gari Mariangela , Pelizzari Silvia , Lanfranchi Arianna , Ruggi Giada , Tinto Ilaria , Scialdone Antonio 
Published: August 2019

ObjectiveTo compare the performance and safety in cataract surgery of two ophthalmic viscoelastic devices (OVDs), each having separate dispersive and cohesive characteristics and different concentrations.Methods and analysisIn this prospective, randomised, controlled clinical study, one eye of each patient was injected with OVD1 (Viscopack14) or OVD2 (DuoVisc) during phacoemulsification and intraocular lens implantation. Endothelial cell count, intraocular pressure (IOP), central corneal thickness (CCT), intraocular inflammation and corrected distance visual acuity (CDVA) were compared 3 months postoperatively.ResultsThe study enrolled 127 patients. Randomisation assigned 50 eyes of as many patients to each arm of the study. The postoperative mean endothelial cell loss was 14.4% and 7.1% from baseline in the OVD1 and OVD2 groups, respectively (p=0.08). The incidence of IOP spikes at 2 hours was 0% and 8%, respectively (p=0.02). There were intergroup differences in postoperative IOP values, the OVD2 group showed significantly higher values at all of the follow-up visits starting from the 24 hours examination (p<0.05). There was no statistically significant difference in the CCT, intraocular inflammation and CDVA at the end of follow-up.ConclusionBoth OVDs showed similar clinical performances and were equally effective during cataract surgery. Viscopack14 showed more corneal endothelial cell reduction, while DuoVisc had more occurrences of IOP values and spikes. Future studies are mandatory to support these preliminary results.