bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility cluster randomised controlled trial evaluating a theory-driven group-based complex intervention versus usual physiotherapy to support self-management of osteoarthritis and low back pain (SOLAS)
Authors: Hurley Deirdre , Jeffares Isabelle , Hall Amanda M , Keogh Alison , Toomey Elaine , McArdle Danielle , Lonsdale Chris , McDonough Suzanne M , Guerin Suzanne , Segurado Ricardo , Matthews James 
Published: August 2019

Abstract
Background

The Self-management of Osteoarthritis (OA) and Low back pain (LBP) through Activity and Skills (SOLAS) theory-driven group-based complex intervention was developed primarily for the evaluation of its acceptability to patients and physiotherapists and the feasibility of trial procedures, to inform the potential for a definitive trial.

Methods

This assessor-blinded multicentre two-arm parallel cluster randomised controlled feasibility trial compared the SOLAS intervention to usual individual physiotherapy (UP; pragmatic control group). Patients with OA of the hip, knee, lumbar spine and/or chronic LBP were recruited in primary care physiotherapy clinics (i.e. clusters) in Dublin, Ireland between September 2014 and November 2015. The primary feasibility objectives were evaluated using quantitative methods and individual telephone interviews with purposive samples of participants and physiotherapists. A range of secondary outcomes were collected at baseline, 6 weeks (behaviour change only), 2 months and 6 months to explore the preliminary effects of the intervention. Analysis was by intention-to-treat according to participants’ cluster allocation and involved descriptive analysis of the quantitative data and inductive thematic analysis of the qualitative interviews. A linear mixed model was used to contrast change over time in participant secondary outcomes between treatment arms, while adjusting for study waves and clusters.

Results

14 clusters were recruited (7 per trial arm), each cluster participated in two waves of recruitment, with the average cluster size below the target of six participants (Intervention: mean (SD) =4.92 (1.31), range 2-7; UP: mean (SD) =5.08 (2.43), range 1-9). 120 participants (83.3% of n=144 expected) were recruited (Intervention n=59; UP n=61), with follow up data obtained from 80.8% (n=97) at 6 weeks, 84.2% (n=101) at 2 months and 71.7% (n=86) at 6 months. Most participants received treatment as allocated (Intervention n=49; UP n=54). The qualitative interviews (12 participants; 10 PTs) found the Intervention and trial procedures acceptable and appropriate, with minimal feasible adaptations required. Linear mixed methods showed improvements in most secondary outcomes at 2 and 6 months with small between group effects.

Conclusions

While the SOLAS intervention and trial procedures were acceptable to participants and PTs, the recruitment of enough participants is the biggest obstacle to a definitive trial.

Trial Registration: ISRCTN Registry, ISRCTN49875385, Registered 26 March 2014. https://doi.org/10.1186/ISRCTN49875385
Clinical analysis of Kimura’s disease in 24 cases from China
Authors: Zhang Guoliang , Qi Weidong , Li Xumao , Sun Guangbin , Cao Yitan , Gao Nan 
Published: August 2019

Abstract
Background

We reviewed details of Chinese Kimura’s disease (KD) cases. A full clinical analysis was subsequently performed to improve the accuracy of clinical diagnosis and treatment of KD.

Methods

A total of 24 patients with pathologically confirmed KD treated between March 2008 and March 2018 were reviewed retrospectively for clinical and histopathological analysis.

Results

In the 24 KD cases, 20 were male and 4 were female with the age of onset ranging from 5 to 65 years. Lesion diameter ranged from 0.6 cm to 7 cm with unilateral involvement being more popular (79%). Imaging examination had a high detection rate for KD involving the parotid gland and subcutaneous but had low specificity. Microscopic analysis indicated that KD mainly involved subcutaneous soft tissue and lymph nodes. The prominent feature of lymphoid tissue was germinal center hyperplasia surrounded by several lobules associated with hyperplastic vascular structures. Out of the 24 patients, 11 experienced recurrence of disease after treatment (surgical resection: 46.2%, surgical resection followed by oral corticosteroids: 71.4% and surgical resection combined with radiotherapy: 0%).

Conclusions

Our analysis revealed clinical, imaging, and histological characteristics of KD. A better understanding of the disease will help clinicians reduce misdiagnosis and improve the diagnostic rate upon patient first clinical visit.
Influence of complete uncinate process removal on 2-year assessment of radiologic outcomes: subsidence and sagittal balance in patients receiving one-level anterior cervical discectomy and fusion
Authors: Noh Sung Hyun , Park Jeong Yoon , Kuh Sung Uk , Chin Dong Kyu , Kim Keun Su , Cho Yong Eun , Kim Kyung Hyun 
Published: August 2019

Abstract
Background: Many patients who appealed cervical radiculopathy have stenosis of neural foramens because of cumulative osteophyte or uncovertebral joint hypertrophy. For cervical foraminal stenosis, complete UPR conducted concurrently with ACDF. The aim of this study was to evaluate the clinical and radiological consequences of complete uncinate process resection (UPR) during anterior discectomy and fusion (ACDF) versus those seen with ACDF without UPR.

Methods: In total, 105 patients who underwent one-level ACDF with a cage-and-plate construct between 2011 and 2015 were retrospectively reviewed. Among them, 37 underwent ACDF with complete UPR, and 68 underwent ACDF without UPR. Radiographic parameters of disc height, C2–C7 lordosis, T1 slope, C2–C7 sagittal vertical axis (SVA), center of the sellar turcica–C7 SVA (St-SVA), spinocranial angle (SCA), and fusion rate were measured on plain radiographs at pre-operation, immediately post-operation, and during the follow-up period (median follow-up duration: 37.7 ± 10.5 months).

Results: Improvement in Visual analogue scale (VAS) score for arm pain was significantly better in the ACDF with complete UPR group immediately post-operation. Fusion rates, C2–C7 lordosis, T1 slope, and C2–C7 SVA after single-level ACDF were not significantly different between the two groups (p>0.05). Subsidence occurred in 23 patients (ACDF with complete UPR: 14 cases [37%] versus ACDF without UPR: 9 cases [13%]; p < 0.05).

Conclusions: Cervical sagittal alignment after ACDF with complete UPR is not significantly different from that achieved with ACDF without UPR. However, subsidence occurred more frequently after ACDF with complete UPR than after ACDF without UPR, although there was no clinical impact. More precise and careful selection of patients is needed when deciding on additional complete UPR.
Factors associated with child health service delivery by female community health volunteers in Nepal: Findings from a national survey
Authors: Bhattarai Hari Krishna , Khanal Pratik , Khanal Vishnu , Regmi Kiran , Paudel Narendra Raj , Dhakal Liladhar , Singh Samikshya 
Published: August 2019

Abstract
Background
Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been a lot of documented studies and reports, rarely has been explored the status and factors associated with the child health service provided by these volunteers. This study aimed to measure the child health service delivery status by FCHVs and its associated factors.

Methods
A national survey was conducted in 2014 in Nepal that included 4,302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. The data was extracted and the association of child health services with characteristics was examined using Chi-square test (χ2) followed by logistic regression.

Results
Two out of three FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted mothers’ group meeting, involved in the local committees and those who supported in antenatal care related activities were more likely to provide child health services. Similarly, FCHVs having the stock of cotrimoxazole tablet, Zinc tablet, oral rehydration salt were also more likely to provide child health services. Province wise analysis showed that FCHVs from Province 5 and Province 7 were more likely to provide child health services compared to their counterparts from province 1.

Conclusions
FCHVs are an important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs, availability of the key commodities, the involvement of FCHVs in regular health mothers’ group meeting, use of mobile phone, involvement in other health programs and social networks, and utilization of fund need to be taken into consideration.
The Spectrum of heart disease among adults at the Bamenda Regional Hospital, North west Cameroon: a semi urban setting
Authors: Akono Manuel Ndo , Simo Larissa Pone , Agbor Valirie Ndip , Njoyo Sylvain Laah , Mbanya Dora 
Published: August 2019

Abstract
Background

Non-communicable diseases are the leading causes of global mortality, and the second commonest cause in sub-Saharan Africa. They have been projected to drive mortality in sub-Saharan Africa by 2030.

Methods

This is a chart review of echocardiographic records of adult patients of the Imagery Centre of the Bamenda Regional Hospital in the North West Region of Cameroon. Data was collected for the period between July 2015 and April 2018, and included age, sex, comorbidities, ejection fraction and echocardiographic findings.

Results

In total, 673 records were included in our study, of which 506 had a definite heart disease. Amongst those with a definite heart disease, 93 had mixed cardiopathies. Their ages ranged from 18 – 105 years with a median age of 64.0 (Interquartile range [IQR] = 47 – 75) years. Females accounted for a greater proportion (55.3%) of the study population. The most common echocardiographic diagnoses were hypertensive heart disease (41.1%), valvular heart disease (22.3%) and cardiomyopathies (11.4%). The prevalence of heart failure was 17.5%, with hypertensive heart disease being the leading cause.

Conclusion

Hypertensive heart disease is the most common heart disease in this semi-urban setting in Cameroon. A significant proportion of the population has more than one heart disease (mixed cardiopathies).
Stroke in Maputo Central Hospital, Mozambique 2019: A Glimpse of Epidemic or Endemicity?
Authors: Baduro Yanina , Ndala Omer , Vaz Deise , Buque Helena , Sebastião Frederico , Baco Jamal , Arroz Nachan , Casas Carlos , Lorenzo Elder , Arroz Jorge 
Published: August 2019

Abstract
Objective The aim of this study is to determine the endemic/epidemic pattern of stroke in Maputo Central Hospital in the first semester of 2019. Results During the period 2014-18, there were 2,979 registered cases of stroke in MCH, ranging from 512 in 2017 and 687 in 2015. The mean monthly registered cases per year ranged from 43 in 2017 to 57 in 2015. The C-SUM+1.96SD and mean+2SD methods have the highest monthly thresholds comparing to C-SUM and 3rd quartile methods. An epidemic pattern of stroke was observed during the first semester of 2019 when 3rd quartile and C-SUM threshold epidemic method was used. A relatively stable pattern of stroke occurrence with high registered cases was observed during the study period. It can be concluded that stroke is an endemic disease for the Maputo Central Hospital, with an epidemic pattern during the first semester of 2019. Adoption of 3rd quartile threshold methods for stroke surveillance might well add value for the control of the stroke epidemics.
Knowledge of reproductive age women on prevention of mother to child transmission of human immunodeficiency virus and associated factors at Mecha district, Northwest Ethiopia: A community based cross sectional study
Authors: liyeh Tewachew Muche , Cherkose Endeshaw Admasu , Limenih Miteku Andualem , Yimer Tigist Seid , Tebeje Hailemariam Demewozu 
Published: August 2019

Abstract
Objective: To asses knowledge of reproductive age women on prevention of mother to child transmission of HIV and associated factors at Mecha district, North West Ethiopia, 2016. Result: About 22.4% of the respondents were knowledgeable on prevention of mother to child transmission (PMTCT) of HIV. Having knowledge on PMTCT of HIV was significantly associated with urban residence (AOR =2.486, 95%CI= 1.160-5.328), education level of secondary and above (AOR =5.445, 95%CI=2.698-10.986), those having history of antenatal care followup (AOR =4.430, 95%CI=1.471-13.340), those with history of institutional delivery (AOR=4.766, 95%CI = 2.004-11.334), those having comprehensive knowledge on HIV/AIDS (AOR=1.697, 95%CI = 1.011-2.846), women who were knowledgeable about mother to child transmission of HIV (AOR =2.203, 95% CI =1.37-3.54), and women who held discussions with their husband regarding HIV/AIDS, (AOR= 2.700, 95%CI =1.658-4.396).
Efficacy of a complex intervention comprising the guideline evidence-based health information and a training programme on the quality of health information: study protocol of a randomised controlled trial
Authors: Lühnen Julia , Berger-Höger Birte , Haastert Burkhard , Hinneburg Jana , Kasper Jürgen , Steckelberg Anke 
Published: August 2019

Abstract
Background
Evidence-based health information (EBHI) is a prerequisite for informed and shared decision-making. The criteria for EBHI have been described comprehensively but the implementation in practice is still insufficient. The guideline evidence-based health information addresses providers of health information. Its goal is to improve the quality of health information. The evidence-based guideline emerged from the German Network for Evidence-based Medicine (DNEbM) and was published in February 2017. In addition, the competences of providers of health information were explored and a training programme was developed.
Aim of this study is to evaluate the efficacy of an intervention comprising the guideline evidence-based health information and a training programme addressing providers of health information in a randomised controlled trial. We expect the intervention to improve the quality of health information in comparison to provision of the guideline only.
Methods
The trial uses a superiority randomised control group design with ten months follow-up. 26 providers of health information (groups with up to ten members) will be enrolled to compare the intervention (guideline & training programme) with usual care (guideline publicly available). The 5-day training programme comprises an evidence-based medicine training module and a module to prepare the application of the guideline. The primary outcome measure is the quality of the health information. Quality is operationalised as the extent of adherence to the guideline’s recommendations. Each provider will prepare a single health information informing a health-related decision. The quality of this information will be rated using the MAPPIN Health Information Quality instrument. An accompanying process evaluation will then be conducted.
Discussion
The study results will show whether the efficacy of the intervention justifies implementation of the training programme to enhance health information developers’ competences in evidence-based medicine and to ensure high quality EBHI in the long-term.
Trial registration ISRCTN registry, registration number: ISRCTN96941060, Date: 7 March 2019, URL: http://www.isrctn.com/ISRCTN96941060 Keywords
health information; guideline implementation, training programme; evidence-based medicine; guideline evidence-based health information
Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study
Authors: Chen Yao , Hu Yanyan , Zhang Jin , Shen Yue , Huang Junling , Yin Jun , Wang Ping , Fan Ying , Wang Jianli , Lu Su , Yang Yilin , Yan Lei , Li Keyong , Song Zhenju , Tong Chaoyang , Du Shilin 
Published: August 2019

Abstract
Background: Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis.

Methods: A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively.

Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection development. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival curves and Log-rank test revealed secondary infection group had a worse survival between day 15 and day 90.

Conclusions: Urinary and deep venous catheter indwelling increased the risk of developing secondary infection. Secondary infection influenced outcomes of septic patients and prolonged in-hospital length of stay. Underlying immunosuppression led to a higher tendency to developing secondary infection.
Optical Quality after Posterior Chamber Phakic Implantation of an Intraocular Lens with a Central Hole (V4c Implantable Collamer Lens) under Different Lighting Conditions
Authors: He Tianrui , Zhu Yi , Zhou Jibo 
Published: August 2019

Abstract
Background

The current study compared optical quality before and after implantation of a posterior chamber phakic intraocular lens with a central hole [V4c implantable collamer lens (ICL)] under bright and dark lighting conditions by means of the Optical Quality Analysis System™ (OQAS; Visiometrics, Terrassa, Spain).

Methods

This prospective study involved 91 eyes of 46 consecutive patients undergoing implantation of a V4c ICL (15 males and 31 females). The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs; 100%, 20%, and 9%), under different lighting conditions, were measured before and 1 week, 1 month, and 3 months after surgery.

Results

All optical parameters showed significant improvements, at all time points, under dark condition after surgery. We observed no significant changes in PVA 9% at 1 week (P=0.12) or 1 month after surgery (P=0.08) under light condition; but all other postoperative parameters improved significantly. Comparing the two lighting conditions, the OSI decreased more under dark conditions at 1 week (P=0.02), 1 month (P=0.004), and 3 months (P=0.002), but there was no significant difference in any other parameter. In addition, patients were divided into a high myopia group (group H) and a super-high myopia group (group S), the group S improved significantly more than group H in all parameters, under both bright and dark conditions.

Conclusions

V4c ICL implantation improved optical quality under both bright and dark lighting conditions, and had a better ability to reduce the extent of scattering in the dark. Furthermore, group S achieved greater improvement in visual quality, which should be considered by physicians before surgery.
Usefulness of a stool to stabilize dental chairs for cardiopulmonary resuscitation (CPR)
Authors: Awata Norimasa , Hitosugi Takashi , Miki Yoichiro , Tsukamoto Masanori , Kawakubo Yoshifumi , Yokoyama Takeshi 
Published: August 2019

Abstract
Background: Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During dental surgery, CPR could be started in the dental chair considering difficulty to move the patient from the dental chair to the floor. However, all types of dental chairs are not stable for MCC. We previously developed a procedure to stabilize a dental chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of dental chairs.
Methods: Three health care providers participated in this study, and 8 kinds of dental chairs were examined. MCC were performed on a manikin that was laid on the backrest of a dental chair. A stool was placed under the backrest to stabilize the dental chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool.
Results: In all 8 dental chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p < 0.001).
Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography
Authors: Li Bing , Chen Youxin , Li Donghui 
Published: August 2019

Abstract
Background: To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment.

Case presentation: A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris.

Conclusion: This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.