bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motor Intervention With And Without Nintendo® Wii For Children With Developmental Coordination Disorder: Protocol For A Randomized Clinical Trial
Authors: NETO JORGE Lopes CAVALCANTE , Steenbergen Bert , Tudella Eloisa 
Published: October 2019

Abstract
Abstract
Background:
Despite the benefits highlighted by motor interventions based on virtual reality for children with Developmental Coordination Disorder (DCD), there are still doubts whether these are greater than those obtained with conventional interventions due to the absence of systematized protocols and lack of evidence. Here we present a protocol to systematically compare the effects of two motor training programs (one Nintendo® Wii based and the other no-Wii motor activities) on the motor learning in children with DCD.
Methods/Design:
Two intervention protocols (one based on Nintendo® Wii and the other no-Wii motor activities) will be carried out, with interventions occurring twice a week in 60-minute sessions, with a minimum of 12 and a maximum of 16 sessions per child.
The protocols were developed based on the domains of the Movement Assessment Battery for Children – Second Edition (MABC-2) (Manual dexterity, aiming & catching, balance), with two activities for each of the MABC -2 domains. The study will include children aged 7 to 10 with total MABC-2 score ≤16, and Developmental Coordination Disorder Questionnaire (DCDQ) score <46 (age of 7 years), score <55 (age group of 8 to 9 years and 11 months), or score <57 (age of 10 years) as scored by the parents. Children will be randomly allocated by draw in one of the two intervention protocols. MABC-2 and DCDQ will be applied before and after intervention to evaluate the effects of the interventions on motor performance and parents’ perception respectively. Motor learning will be assessed by means of the scores obtained in the games. Evaluators and therapists will be trained and evaluators will be blind about the data of the children in the study.
Discussion: Owing to its motivating aspects, training with Nintendo® Wii may be particularly beneficial for children with DCD. The results of this study protocol will help researchers and therapists to better understand the benefits of Nintendo® Wii based motor intervention over those obtained with no-Wii interventions in children with DCD. It will also create references about more systematized protocols for replication in clinical practice, seeking the improvement of the motor components of these children.
Trial registration: http://www.ensaiosclinicos.gov.br/rg/RBR-89ydgj/
Atmiyata, a community led intervention to address common mental disorders: Study protocol for a stepped wedge cluster randomized controlled trial in rural Gujarat, India
Authors: Joag Kaustubh , Kalha Jasmine , Pandit Deepa , Chatterjee Susmita , Krishnamoorthy Sadhvi , Shields-Zeeman Laura , Pathare Soumitra 
Published: October 2019

Abstract
Background: While lay-health worker models for mental health care have proven to be effective in controlled trials, there is limited evidence on the effectiveness and scalability of these models in rural communities in low- and middle-income countries (LMICs). Atmiyata is a rural community-led intervention using local community volunteers, called Champions, to identify and provide evidence-based counselling for persons with common mental disorders (CMD) as part of a package of community-based interventions for mental health. Methods: The impact of the Atmiyata intervention is evaluated through a stepped wedge cluster randomized controlled trial (SW-CRCT) with a nested economic evaluation. The trial spans across 10 sub-blocks (645 villages) in Mehsana district with 1.52 million rural adult population. There are 56Primary Health Centers (PHCs) in Mehsana district and villages covered under these PHCs are equally divided into four groups of clusters of 14 PHCs each, and the intervention is rolled out in a staggered manner in these groups of villages at an interval of 5 months. The primary outcome is symptomatic improvement measured through the GHQ-12 at 3-month follow-up. Secondary outcomes include: quality of life using the EURO-QoL (EQ- 5D), symptom improvement measured by the Self-Reporting Questionnaire-20 (SRQ-20), functioning using the WHO Disability Assessment Scale (WHO-DAS-12), depression symptoms using the Patient Health Questionnaire, (PHQ-9), anxiety symptoms using Generalized Anxiety Disorder Questionnaire, (GAD-7) and social participation using the Social Participation Scale (SPS). Generalized linear mixed effects model are employed for binary outcomes and linear mixed effects models for continuous outcomes. A Return on investment (ROI) analysis of the intervention will be conducted to understand whether the intervention generates any return on financial investments made into the project. Discussion: Stepped wedge designs are progressively being used to evaluate real-life effectiveness of interventions. To the best of our knowledge, this is the first SW-CRCT in a LMIC evaluating the impact of implementation of a psychosocial mental health intervention. The results of this study will contribute to the evidence on scaling-up lay health worker models for mental health interventions and contribute to the SW-CRCT literature in LMICs.
Do USMLE Steps and ITE Results Predict Performance in the American Board of Internal Medicine Certifying Exam?
Authors: Rayamajhi Supratik , Dhakal Prajwal , Wang Ling , Rai Manoj P , Shrotriya Shiva 
Published: October 2019

Abstract
Objective: To evaluate if United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2, USMLE Step 3, and residency third-year in-service training exam (ITE) results predict performance of Internal Medicine (IM) residents in American Board of Internal Medicine Certifying Exam (ABIM-CE).

Methods: A retrospective review of USMLE Step 1, USMLE Step 2, USMLE Step 3 scores, residency third year ITE and ABIM-CE of IM residents at our residency program from 2004 through 2017 was conducted. Pearson correlation coefficient and two-sample t-tests were used to assess the relationship between various scores. Multivariate logistic regression was used to predict pass or fail results in ABIM-CE using USMLE and third-year ITE test scores controlling for other covariates.

Results: Among 114 MD residents included in the study; 92% (n=105) passed the ABIM-CE. USMLE score was a significant predictor of passing ABIM-CE. The OR of passing ABIM-CE was 2.70 (95 % CI=1.38-5.29), 2.31 (95% CI=1.33-4.01), and 1.63 (95% CI=0.81-3.29) with a ten-point increase in USMLE Step 1, USMLE Step 2 and USMLE step 3 scores respectively. OR of ABIM-CE passing chance was 2.96 (95% CI=0.95-9.20) with a ten-point increase in the average score of the above three exams. A five percent increase in ITE percentage raised the likelihood of passing ABIM-CE (OR 2.92, 95% CI 1.15-7.38). All residents who failed ABIM-CE had Step 1 scores <220. Among 31 residents with Step 2 score <220, 20% (n=6) failed ABIM. Similarly, 9% of residents with USMLE Step 3 score < 220 failed ABIM-CE; all residents who failed had scored < 220. The probability curve predicted that the chance of passing ABIM- CE was around 80% with USMLE scores greater than 200 and increased to almost 100% with USMLE scores of 250 or more.

Conclusion: USMLE Step 1, USMLE Step 2, and third-year ITE scores strongly predict the chances of passing ABIM-CE. Thus, programs can identify internal medicine residents at risk of failing ABIM-CE and need intervention at an early stage. Various measures such as enrolling them in question banks or board review courses can then be implemented by programs to improve their chances to pass.
The side effects of service changes: exploring the longitudinal impact of participation in a randomised controlled trial (DOORWAYS) on staff perceptions of barriers to change.
Authors: Laker Caroline , Cella Matteo , Callard Felicity , Wykes Til 
Published: October 2019

Abstract
Background Staff and service users have expressed concerns that service improvements in U.K. mental health wards have been slow or transient. It is possible that certain changes are positive for some (e.g. service users), but negative for others (e.g. staff), which may affect implementation success. In this study, we explore whether a programme of change to improve the therapeutic milieu on mental health wards influenced staff perceptions of barriers to change, 12 months after implementation. Method A cluster randomised controlled trial called DOORWAYS was conducted on eight inner-city U.K. acute mental health wards. Randomisation was achieved using a list randomly generated by a computer. A psychologist trained ward staff (mainly nurses) to deliver evidence-based groups and supported their initial implementation. The impact of these changes was measured over 12 months (when 4 wards were randomised), according to nurses’ perceptions of barriers to change (VOCALISE), using unstructured multivariate linear regression models. This innovative analysis method allows maximum use of data in randomised controlled trials with reduced sample sizes due to substantial drop out rates. The contextual influences of occupational status (staff) and of workplace setting (ward) were also considered. Results Staff who participated in the intervention had significantly worse perceptions of barriers to change at follow up. The perceptions of staff in the control group did not change over time. In both groups (N=120), direct care staff had more negative perceptions of barriers to change, and perceptions varied according to ward. Across time, direct care staff in the intervention group became more negative than those in the control group. Conclusion Participation in this program of change, worsened staff perceptions of barriers to change. In addition, occupational status (being from the direct care group) had a negative effect on perceptions of barriers to change, an effect that continued across time and was worse in the intervention group. Those providing direct care should be offered extra support when changes are introduced and through the implementation process. More effort should be placed around reducing the perceived burden of innovation for staff in mental health wards.
Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China
Authors: Gao Ming , Hu Jiajin , Yang Liu , Ding Ning , Wei Xiaotong , Li Lin , Liu Lei , Ma Yanan , Wen Deliang 
Published: October 2019

Abstract
Background: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression.
Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to age.
Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64). The association of sleep quality in the second trimester with postnatal depression status was found in women older than 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) and not in women younger than 30 years old.
Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.
The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two South African hospitals with a high HIV burden
Authors: Raubenheimer Peter , Day Cascia , Abdullah Faried , Manning Katherine , Cupido Clint , Peter Jonny 
Published: October 2019

Abstract
Background: Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process.Aim: To evaluate the performance of a screening tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South AfricaDesign: Prospective cohort observational study using linkage analysis of hospitalised patients to death certification records.Setting/participants: Patients admitted to the acute medical services in two public hospitals in Cape Town, South AfricaResults: 822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68-81%), specificity of 85% (83-88%), a positive predictive value of 56% (49-63%) and a negative predictive value of 93% (91-95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87 – 16.9; p < 0.001). Conclusions:The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.
Long Term Surgical Outcomes For Infective Endocarditis In People Who Inject Drugs: A Systematic Review And Meta-Analysis
Authors: Goodman-Meza David , Weiss Robert E , Gamboa Sebastian , Gallegos Abel , Bui Alex AT , Goetz Matthew B , Shoptaw Steve , Landovitz Raphael J 
Published: October 2019

Abstract
Background: In recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID.
Methods: We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID . Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival.
Results: We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3%, 81.0%, 62.1%, and 56.6% in PWID, respectively; and 96.4%, 85.0%, 70.3%, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05-2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25-4.50) than non-PWID.
Conclusion: PWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.
Quality Of Life Questionnaire for women with Gestational Diabetes Mellitus (GDMQ-36): Development and Psychometric Properties
Authors: mokhlesi samira , simbar masoumeh , tehrani fahimeh ramezani , kariman Nourossadat , majd hamid alavi 
Published: October 2019

Abstract
Background Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers’ quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. Methods A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. Results Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of “Diabetes Clients Quality Of Life” and the researcher-made questionnaire (r=0.63). Cronbach’s alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. Conclusion Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.
Thermoregulation adaptation of Rheum tanguticum stereostructure leaf
Authors: Hu Yanping , Qian Qian , Zhang Huixuan , Lin Gonghua , Wang Jun , Wang Li , Li Yi , Jang Jyan-Chyun , Li Wenjing 
Published: October 2019

Abstract
Background: Leaf is an important plant organ with great variation in shape and size. Leaf size tends to be smaller in plants thrived in the areas of higher elevation and lower annual mean temperature. The Qinghai-Tibetan Plateau is situated at a high altitude of ＞4,000 m with low annual average temperature. Leaves for most plants species in Qinghai-Tibetan Plateau are small, however, Rheum tanguticum with large leaves is an exception. Here we show that large leaf of R. tanguticum with three-dimensional structure is an ideal solution of thermoregulation with little energy consumption.Results: With increase in age, leaves of R. tanguticum transit from a small oval plane to a large palmatipartite stereostructure. Furthermore, temperature variation of different parts is a distinct character in stereostructure leaves of R. tanguticum. The temperature of regular leaves under strong solar radiation could be much higher than the ambient temperature. However, the stereostructure leaf could lower leaf temperature by avoiding the direct solar radiation and promoting local airflow to prevent serious scorch.Conclusions: Our results demonstrate that the robust three-dimensional leaf structure is a formation for R. tanguticum to adapt to the strong solar radiation and low temperature in Qinghai-Tibetan Plateau through modulation of local temperature in different parts of the large leaves.
Immediate implant placement in anterior teeth with grafting material of autogenous tooth bone vs xenogenic bone
Authors: Wu Dong , Zhou Lin , Lin Jichao , Chen Jiang , Huang Wenxiu , Chen Yonghui 
Published: October 2019

Abstract
Objectives: The aim of the study was to compare the efficacy of the autogenous tooth bone and xenogenic bone grafted in immediate implant placement with bone defect. Material and methods: Thirty patients whose compromised anterior teeth need immediate implant placement were enrolled. Autogenous tooth bone made from the extracted teeth by chair-side or the xenogenic bone were used to repaired bone defect. Clinical examination, radiographic assessment about the horizontal bone change in the level of 0mm, 3mm and 6mm below the implant neck and the marginal bone loss were made immediately, 6 and 12 months after implant placement. Questionnaire of feeling was made at the time of removing the sutures.Results: All implants achieved the success criteria without any complications at the follow-up period. The percent of the horizontal bone change and the marginal bone loss at 6 and 12 months were almost the same between two groups (P>.05). The horizontal bone loss at the first or the latter 6 months is almost the same (P>.05). But the horizontal bone loss at the 6 mm level is less than the 0 mm and 3 mm levels at 6 and 12 months (P<.05). Meanwhile patients seem more satisfied with the autogenous tooth bone derived from the questionnaire.Conclusion: The bone volume change in the facial part of the implant after immediate placement is almost the same between two groups.Clinical Relevance: Providing clinical evidence that the autogenous tooth bone made from compromised tooth can be an acceptable bone graft material.
The impact of mental fatigue on brain activity: A comparative study between resting state and task state using EEG
Authors: Li Gang , Luo Youdong , Jiao Weidong , Jiang Yonghua , Gao Zhao , Huang Shan , Zhang Jianhua 
Published: October 2019

Abstract
Background: Mental fatigue is usually caused by long-term cognitive activities, mainly manifested as drowsiness, difficulty in concentrating, decreased alertness, disordered thinking, slow reaction, lethargy, reduced work efficiency, error-prone and so on. Mental fatigue has become a widespread sub-health condition, and has a serious impact on the cognitive function of the brain. However, seldom researches explore the differences of mental fatigue on electrophysiological activity between resting state and task state. In the present study, 20 healthy male individuals were recruited to do a consecutive mental arithmetic task to induce mental fatigue, and scalp electroencephalogram (EEG) data were collected before and after the task. The power and relative power of five EEG rhythms both in resting state and task state were analyzed statistically. Results: The results of brain topographies and statistical analysis indicated that mental arithmetic task can successfully induce mental fatigue in the enrolled subjects. The relative power index was more sensitive than the power index in response to mental fatigue, and the relative power for assessing mental fatigue was better in resting state than in task state. Furthermore, we found that it is of great physiological significance to divide alpha frequency band into alpha1 band and alpha2 band in fatigue related studies, and at the same time improve the statistical differences of sub-bands. Conclusions: Our current results suggested that the brain activity in mental fatigue state has great differences between resting state and task state, and it is imperative to select the appropriate state in EEG data acquisition and divide alpha band into alpha1 and alpha2 bands in mental fatigue related researches.