bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current ophthalmology practice patterns for syphilitic uveitis
Authors: Oliver Genevieve F , Stathis Roy M , Furtado João M , Arantes Tiago E , McCluskey Peter J , Matthews Janet M ,   International Ocular Syphilis Study Group, Smith Justine R 
Published: January 2019

BackgroundSyphilitic uveitis is re-emerging alongside the systemic infection. In July 2017, an international group of uveitis-specialised ophthalmologists formed the International Ocular Syphilis Study Group to define current practice patterns.Methods103 Study Group members based in 35 countries completed a 25-item questionnaire focused on case load, clinical presentations, use and interpretation of investigations, treatment and clinical indicators of poor prognosis.ResultsMembers managed a mean of 6.1 patients with syphilitic uveitis in clinics that averaged 707 annual cases of uveitis (0.9%); 53.2% reported increasing numbers over the past decade. Patients presented to more members (40.2%) during secondary syphilis. Uveitis was usually posterior (60.8%) or pan (22.5%); complications included optic neuropathy, macular oedema and posterior synechiae. All members diagnosed syphilitic uveitis using serological tests (simultaneous or sequential testing algorithms), and 97.0% routinely checked for HIV co-infection. Cerebrospinal fluid (CSF) analysis was ordered by 90.2% of members, and 92.7% took uveitis plus Venereal Disease Research Laboratory test (VDRL) or fluorescent treponemal antibody absorption test (FTA-ABS) to indicate neurosyphilis. Patients were commonly co-managed with infectious disease physicians, and treated with penicillin for at least 10–14 days, plus corticosteroid. Features predicting poor outcome included optic neuropathy (86.3%) and initial misdiagnosis (63.7%). Reasons for delayed diagnosis were often practitioner-related. 82.5% of members tested every patient they managed with uveitis for syphilis.ConclusionThis comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.
Impact of scribes on emergency medicine doctors’ productivity and patient throughput: multicentre randomised trial
Authors: Walker Katherine , Ben-Meir Michael , Dunlop William , Rosler Rachel , West Adam , O’Connor Gabrielle , Chan Thomas , Badcock Diana , Putland Mark , Hansen Kim , Crock Carmel , Liew Danny , Taylor David , Staples Margaret 
Published: January 2019

Abstract

Objectives
To evaluate the changes in productivity when scribes were used by emergency physicians in emergency departments in Australia and assess the effect of scribes on throughput.

Design
Randomised, multicentre clinical trial.

Setting
Five emergency departments in Victoria used Australian trained scribes during their respective trial periods. Sites were broadly representative of Australian emergency departments: public (urban, tertiary, regional referral, paediatric) and private, not for profit.

Participants
88 physicians who were permanent, salaried employees working more than one shift a week and were either emergency consultants or senior registrars in their final year of training; 12 scribes trained at one site and rotated to each study site.

Interventions
Physicians worked their routine shifts and were randomly allocated a scribe for the duration of their shift. Each site required a minimum of 100 scribed and non-scribed shifts, from November 2015 to January 2018.

Main outcome measures
Physicians’ productivity (total patients, primary patients); patient throughput (door-to-doctor time, length of stay); physicians’ productivity in emergency department regions. Self reported harms of scribes were analysed, and a cost-benefit analysis was done.

Results
Data were collected from 589 scribed shifts (5098 patients) and 3296 non-scribed shifts (23 838 patients). Scribes increased physicians’ productivity from 1.13 (95% confidence interval 1.11 to 1.17) to 1.31 (1.25 to 1.38) patients per hour per doctor, representing a 15.9% gain. Primary consultations increased from 0.83 (0.81 to 0.85) to 1.04 (0.98 to 1.11) patients per hour per doctor, representing a 25.6% gain. No change was seen in door-to-doctor time. Median length of stay reduced from 192 (interquartile range 108-311) minutes to 173 (96-208) minutes, representing a 19 minute reduction (P<0.001). The greatest gains were achieved by placing scribes with senior doctors at triage, the least by using them in sub-acute/fast track regions. No significant harm involving scribes was reported. The cost-benefit analysis based on productivity and throughput gains showed a favourable financial position with use of scribes.

Conclusions
Scribes improved emergency physicians’ productivity, particularly during primary consultations, and decreased patients’ length of stay. Further work should evaluate the role of the scribe in countries with health systems similar to Australia’s.

Trial registration
ACTRN12615000607572 (pilot site); ACTRN12616000618459.
Social return on investment of emergency obstetric care training in Kenya
Authors: Banke-Thomas Aduragbemi , Madaj Barbara , van den Broek Nynke 
Published: January 2019

IntroductionEmergency obstetric care (EmOC) training is considered a key strategy for reducing maternal and perinatal morbidity and mortality. Although generally considered effective, there is minimal evidence on the broader social impact and/or value-for-money (VfM). This study assessed the social impact and VfM of EmOC training in Kenya using social return on investment (SROI) methodology.MethodsMixed-methods approach was used, including interviews (n=21), focus group discussions (n=18) incorporating a value game, secondary data analysis and literature review, to obtain all relevant data for the SROI analysis. Findings were incorporated into the impact map and used to estimate the SROI ratio. Sensitivity analyses were done to test assumptions.ResultsTrained healthcare providers, women and their babies who received care from those providers were identified as primary beneficiaries. EmOC training led to improved knowledge and skills and improved attitudes towards patients. However, increased workload was reported as a negative outcome by some healthcare providers. Women who received care expected and experienced positive outcomes including reduced maternal and newborn morbidity and mortality. After accounting for external influences, the total social impact for 93 5-day EmOC training workshops over a 1-year period was valued at I$9.5 million, with women benefitting the most from the intervention (73%). Total direct implementation cost was I$745 000 for 2965 healthcare providers trained. The cost per trained healthcare provider per day was I$50.23 and SROI ratio was 12.74:1. Based on multiple one-way sensitivity analyses, EmOC training guaranteed VfM in all scenarios except when trainers were paid consultancy fees and the least amount of training outcomes occurred.ConclusionEmOC training workshops are a worthwhile investment. The implementation approach influences how much VfM is achieved. The use of volunteer facilitators, particularly those based locally, to deliver EmOC training is a critical driver in increasing social impact and achieving VfM for investments made.
Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey
Authors: Zhu Zhengping , Yan Hongjing , Wu Sushu , Xu Yuanyuan , Xu Wenjiong , Liu Li , Li Xin , Xu Fei , Detels Roger 
Published: January 2019

ObjectiveTo examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing.DesignFive consecutive cross-sectional surveys.SettingNanjing, China.Primary and secondary outcome measuresHIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic characteristics and behaviours.Results649, 669, 577, 633, 503 MSM were recruited from 2013 to 2017. HIV prevalence was 9.9%, 12.3%, 12.5%, 9.8% and 10.1%, respectively. Syphilis prevalence decreased with a range from 10.6% to 5.6%. Risk behaviours like unprotected anal intercourse (UAI) and unprotected virginal sex in the past 6 months decreased, but multiple sex partners and ever used rush popper rose significantly. MSM tested for HIV in the previous year remained stable from 57.0% to 64.1% (P=0.633). Multivariate analysis showed that tested for HIV in the past year was protective factor against HIV infection. MSM who had UAI in the past 6 months, sex role as receptive and dual, diagnosed with sexually transmitted diseases (STDs) in the past year and currently syphilis infected were risk factors for HIV infection.ConclusionsWe observed stable high HIV prevalence, a steady HIV testing rate, decreasing syphilis prevalence and UAI among MSM in Nanjing. However, rush popper use rose dramatically. The HIV preventive strategies for MSM including condom promotion, HIV testing expansion and reduction of rush popper use, STDs screening and standardised treatment should be strengthened.
All-cause mortality among young men 24–26 years after a lifestyle health dialogue in a Swedish primary care setting: a longitudinal follow-up register study
Authors: Lingfors Hans , Persson Lars-Göran 
Published: January 2019

ObjectivesTo compare mortality and socioeconomic status among men invited to a health dialogue with men from all of Sweden approximately 24 years after the start of the study, and to analyse the associations between lifestyle and all-cause mortality, incidence of cardiovascular disease (CVD) and cancer.DesignLongitudinal follow-up register study of men 33–42 years old at baseline.SettingPrimary care in a community in Sweden.SubjectsAll 757 men aged 33–42 years old in a community in southern Sweden, and 652 of these men who participated in a health examination between 1985 and 1987.InterventionsHealth examination, lifestyle-directed health dialogue and group activities in primary care in cooperation with local associations.Primary and secondary outcome measuresAll-cause mortality, income and educational level, and associations between lifestyle at baseline and all-cause mortality, incidence of CVD and cancer.ResultsAt follow-up, all-cause mortality was 29% lower (OR=0.71, 95% CI 0.53 to 0.95) among all men invited to the health dialogue compared with all men from the same age cohort in all of Sweden (intention-to-treat) and 43% lower (OR=0.57, 95% CI 0.40 to 0.81) among participating men (on-treatment). A healthy lifestyle was associated with lower mortality (OR=0.16, 95% CI 0.07 to 0.36), with the strongest association for no smoking (OR=0.38, 95% CI 0.21 to 0.68) and a healthy diet (OR=0.37, 95% CI 0.20 to 0.68). A healthy lifestyle was also associated with a decreased incidence of CVD and cancer. There was a significantly higher proportion with short education among invited men compared with men from the same age cohort in all of Sweden.ConclusionsThis study indicates that a combination of low-risk and high-risk strategies, combining a health examination with a lifestyle-directed health dialogue conducted in an ordinary primary care setting in cooperation with local associations, may have contributed to reduced premature mortality. However, we cannot exclude that there may be other factors explaining the lower mortality.
Endovenous ablation and surgery in great saphenous vein reflux: a systematic review and network meta-analysis of randomised controlled trials protocol
Authors: Siribumrungwong Boonying , Srikuea Kanoklada , Orrapin Saritphat , Benyakorn Thoetphum , Rerkasem Kittipan , Thakkinstian Ammarin 
Published: January 2019

IntroductionEndovenous ablations are the new standard procedures for treatment of great saphenous vein reflux including endovenous laser ablation (EVLA), radio frequency ablation (RFA), endovenous steam ablation (EVSA), mechanochemical ablation (MOCA), cyanoacrylate injection and ultrasound-guided foam sclerotherapy (UGFS). EVLA and RFA have demonstrated similar anatomical success for short-term outcome, but results are controversial for longer term (≥5 years). Additional evidences from randomised controlled trials have been published. This study is, therefore, conducted to, directly and indirectly, compare outcomes among all procedures stratifying by short-term and long-term follow-up.Methods and analysisMedline and Scopus will be searched from 2000 to September 2018 with predefined search strategy. Interventions of interest are open surgery (ie, saphenofemoral or high ligation (HL) with stripping) and endovenous ablations (ie, EVLA, RFA, EVSA, MOCA, cyanoacrylate injection and UGFS). The primary outcome is anatomical success. Two independent reviewers will select studies, extract data and assess risk of bias. Disagreement will be adjudicated by the third party. Outcomes will be directly pooled if there are at least three studies in that comparison. A fixed-effect model will be used unless heterogeneity is present, in which case a random-effect model will be applied. Sources of heterogeneity will be explored using meta-regression analysis, and sub-group analysis will be done accordingly. Publication bias will be assessed using Egger’s test and funnel plot. A network meta-analysis will be applied to indirect compare all interventions including RFA, EVLA, EVLA with HL, UGFS, UGFS with HL and HL with stripping. Probability of being best intervention will be estimated and ranked. Inconsistency assumption will be checked using a design-by-treatment interaction model.Ethics and disseminationEthical approval is not required for systematic review and network meta-analysis. The study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018096794.
Traumatic hyphaema in children: a retrospective and prospective study of outcomes at an Australian paediatric centre
Authors: Richards Michael D , Barnes Kate , Yardley Anne-Marie E , Hanman Kate , Lam Geoffrey C , Mackey David A 
Published: January 2019

ObjectiveThis study aims to evaluate the presenting characteristics, management, outcomes and complications for paediatric traumatic hyphaema in Western Australia.Methods and AnalysisA retrospective review of medical records was conducted for consecutive patients ≤16 years of age admitted for traumatic hyphaema to Princess Margaret Hospital for Children (Perth, Australia) between January 2002 and December 2013 (n=82). From this sample, a cohort whose injury occurred ≥5 years prior attended a prospective ocular examination (n=16). Hospital records were reviewed for patient demographics, injury details, management, visual outcomes and complications. The prospective cohort underwent examination for visual and structural outcomes.ResultsMost injuries (72%) resulted from projectile objects. Angle recession was present in 53% and was associated with projectiles (p=0.002). Most eyes (81%) achieved a final visual acuity of 0.3 logarithm of the minimum angle of resolution (logMAR) (20/40) or better. Age ≤5 years and posterior segment injury were significant predictors of final visual acuity poorer than 0.3 logMAR. At ≥5 years post-trauma, injured eyes had greater intraocular pressure (IOP) (p=0.024) and anterior chamber depth (ACD) (p=0.022) compared with sound eyes. IOP asymmetry was associated with angle recession (p=0.008) and ACD asymmetry (p=0.012).ConclusionPoorer visual outcomes are associated with younger age at injury and posterior segment injury. Angle recession and ACD asymmetry are associated with IOP asymmetry 5–12 years after injury.
Fast-tracking acute stroke care in China: Shenzhen Stroke Emergency Map
Authors: Ren Lijie , Li Chao , Li Weiping , Zeng Yixuan , Ye Shisheng , Li Zhichao , Feng Hongye , Lei Zhihao , Cai Jingjing , Hu Shiyu , Sui Yi , Liu Qiang , Cheung Bernard M Y 
Published: January 2019

AbstractChina has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Two years ago, a new emergency system in China, Stroke Emergency Map, was first launched as a regional emergency system in Shenzhen, the bustling metropolis just north of Hong Kong. As a result of the Stroke Emergency Map in Shenzhen, the number of thrombolytic cases increased in the last 2 years, from 568 to 809 annually. The Stroke Emergency Map, first pioneered in Shenzhen and now spreading to the rest of China, is a comprehensive and interdisciplinary system. The benefits are not just the immediate improvements in the acute stroke care because the continuous data collection and audit allows for improvements in logistics and future strategies.
Regulating language, not inference: an examination of the potential effectiveness of Natural American Spirit advertising restrictions
Authors: Gratale Stefanie K , Maloney Erin K , Cappella Joseph N 
Published: January 2019

ObjectiveIn 2017, the United States Food and Drug Administration (FDA) reached an agreement with Santa Fe Natural Tobacco Company (SFNTC) stipulating that SFNTC will remove ‘natural’ and ‘additive-free’ from Natural American Spirit (NAS) marketing to combat misperceptions that NAS is a healthier cigarette. The purpose of this study was to assess experimentally the potential effectiveness of the agreement in addressing NAS misperceptions.MethodsIn an online experiment, 820 current and former smokers were assigned randomly to advertising conditions with existing claims from NAS advertisements, modified claims or a no-exposure control. Advertising conditions included (1) ‘original’ NAS advertising text before the agreement; (2) ‘2017 agreement’ language permissible under the FDA–SFNTC agreement (removing ‘natural’, ‘additive-free’); (3) more restrictive (‘stricter’) language representing additional regulation (removing ‘natural’ from the brand name and the phrases ‘tobacco+water’, ‘no chemicals’). Participants completed outcome measures assessing misinformed beliefs and intentions towards NAS.ResultsOne-way ANOVA showed that relative to the ‘original’ language, the ‘2017 agreement’ language reduced misconceptions about NAS addictiveness, but not about health or constituent composition. Yet ‘stricter’ language significantly reduced all categories of misinformed beliefs, which in turn mediated effects on (lower) intentions to use NAS.ConclusionThe 2017 agreement helps dispel some misconceptions about NAS addictiveness, but does not sufficiently rectify misinformation about health or composition. Since ‘stricter’ language more effectively corrects misinformed beliefs, our results suggest the need for further regulations in addressing misinformation that drives intentions towards NAS.
A comparison of methods to measure daily cigarillo consumption among adolescents and young adults
Authors: Antognoli Elizabeth , Ishler Karen J , Trapl Erika , Flocke Susan A 
Published: January 2019

ObjectiveCigarillo use is widespread among young people. Accurate assessment of cigarillo consumption is necessary to inform and evaluate tobacco research, but is complicated by product sharing and irregular use. This study compares a conventional approach with a detailed approach for measuring cigarillo consumption.MethodsData are drawn from a cross-sectional, web-based survey of 1089 young (aged 15–28 years) cigarillo smokers. The conventional measure of cigarillo consumption employs two common tobacco use items—the number of days a product was smoked in the past month and the average number of products smoked per day. The detailed measure uses a time line follow-back procedure to assess product use on each of the past 7 days, both in a group and alone. Paired t-tests compare daily cigarillo use estimates from the two methods overall, and are stratified by sample characteristics and behaviours; associations with multiple factors are examined simultaneously using linear regression.ResultsCompared with the conventional measure, the detailed measure yields significantly higher daily consumption estimates for moderate and high-level users and for non-daily tobacco users, and significantly lower estimates for those who always share products and daily tobacco users. Differences remain after controlling for demographics and product use behaviours. There are no differences by gender, age, race or multiple product use.ConclusionsThe two measurement methods yield significantly different consumption estimates based on sharing behaviour, regularity of use and use level. Improving accuracy in the measurement of tobacco product consumption is important and timely for tobacco control research and policy.
The New Silk Road of BLACKYAK
Authors: Kang Tae-Sun , Ko Young-Hee , Cho Dong-Sung 
Published: January 2019

BLACKYAK, a native brand founded over 40 years ago, is considered to have driven the growth of Korean outdoors market, the secondlargest single-country outdoors market in the world. It has seen remarkable achievements in Korea, and is now aggressively expanding to overseas markets in an attempt to develop the BLACKYAK version of ‘Silk Road’. BLACKYAK is taking aggressive measures to establish development processes and core capabilities that meet the global standard by entering Europe, the home of the outdoors market. It is implementing collaborative strategies to promptly make up for its weak points compared to local demands, such as adopting a product development strategy of applying high functionality to BLACKYAK’s differentiated designs and recruiting local marketers. This case study will analyze the core capabilities that enabled BLACKYAK’s global expansion as well as the limitations it must overcome, and research effective global expansion strategies in-depth based on the above.
HOGHS and Zernike Moments Features-Based Motion-Blurred Object Tracking
Authors: Wang Guang-Long , Tian Jie , Zhu Wen-Jie , Fang Dan 
Published: January 2019

Motion-blurred object tracking method integrating Histogram of Oriented Gradients and Hue Saturation (HOGHS) with Zernike moments features and based on ECO_HC tracker was proposed in this study to deal with object blur caused by the motion of the camera or the object itself. HOGHS was constructed by integrating fHOG with color features, and the properties of Zernike moments were introduced. The object was represented by combining HOGHS and Zernike moments. Furthermore, a novel quality evaluation method of response map considering both positioning accuracy and robustness was proposed and based on the method an adaptive fusion strategy utilizing the complementary properties of HOGHS and Zernike moments was implemented. Experiments were performed on the motion blur sequences from OTB-100 datasheet. Our method was compared with four other state-of-the-art methods. The precision as well as success rate were 0.849 and 0.827, respectively. Speed was 38.4 FPS. It is superior to VOT-2016’s excellent tracker ECO_HC, with relative gains of 2.3% for Pre-20 and 2.4% for AUC. The results show that the proposed method can effectively achieve the objective of motion-blurred object tracking.