bluuebunny/crossref_metadata_2025_split huggingface dataset:
SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes
Authors: Porter Kathleen J. , Brock Donna Jean , Estabrooks Paul A. , Perzynski Katelynn M. , Hecht Erin R. , Ray Pamela , Kruzliakova Natalie , Cantrell Eleanor S. , Zoellner Jamie M. 
Published: September 2019

Abstract

Background
SIPsmartER is a 6-month evidenced-based, multi-component behavioral intervention that targets sugar-sweetened beverages among adults. It consists of three in-person group classes, one teach-back call, and 11 automated phone calls. Given SIPsmartER’s previously demonstrated effectiveness, understanding its adoption, implementation, and potential for integration within a system that reaches health disparate communities is important to enhance its public health impact. During this pilot dissemination and implementation trial, SIPsmartER was delivered by trained staff from local health districts (delivery agents) in rural, Appalachian Virginia. SIPsmartER’s execution was supported by consultee-centered implementation strategies.

Methods
In this mixed-methods process evaluation, adoption and implementation indicators of the program and its implementation strategy (e.g., fidelity, feasibility, appropriateness, acceptability) were measured using tracking logs, delivery agent surveys and interviews, and fidelity checklists. Quantitative data were analyzed with descriptive statistics. Qualitative data were inductively coded.

Results
Delivery agents implemented SIPsmartER to the expected number of cohorts (n = 12), recruited 89% of cohorts, and taught 86% of expected small group classes with > 90% fidelity. The planned implementation strategies were also executed with high fidelity. Delivery agents completing the two-day training, pre-lesson meetings, fidelity checklists, and post-lesson meetings at rates of 86, 75, 100, and 100%, respectively. Additionally, delivery agents completed 5% (n = 3 of 66) and 10% (n = 6 of 59) of teach-back and missed class calls, respectively. On survey items using 6-point scales, delivery agents reported, on average, higher feasibility, appropriateness, and acceptability related to delivering the group classes (range 4.3 to 5.6) than executing missed class and teach-back calls (range 2.6 to 4.6). They also, on average, found the implementation strategy activities to be helpful (range 4.9 to 6.0). Delivery agents identified strengths and weakness related to recruitment, lesson delivery, call completion, and the implementation strategy.

Conclusions
In-person classes and the consultee-centered implementation strategies were viewed as acceptable, appropriate, and feasible and were executed with high fidelity. However, implementation outcomes for teach-back and missed class calls and recruitment were not as strong. Findings will inform the future full-scale dissemination and implementation of SIPsmartER, as well as other evidence-based interventions, into rural health districts as a means to improve population health.
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study
Authors:   on behalf of China collaborative study on AKI (CCS-AKI), Xu Libin , Chen Yuanhan , Xie Zhen , He Qiang , Chen Shixin , Wang Wenji , Liu Guohui , Liao Yuanjiang , Lu Chen , Hao Li , Sun Jin , Shi Wei , Liang Xinling 
Published: September 2019

Abstract

Background
Chronic kidney disease (CKD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). Although high hemoglobin (Hb) is detrimental to CKD patients, its relationship with poor outcomes in the COPD population has not been reported. This study aimed to investigate the relationship between high Hb and in-hospital mortality and to explore reference Hb intervals in patients with COPD and CKD.

Methods
This retrospective study was multicenter population-based. A total of 47,209 patients who presented with COPD between January 2012 and December 2016 were included. The average Hb level during hospitalization was used as the Hb level. CKD and advanced CKD were defined as estimated glomerular filtration rates < 60 and < 30 ml/min/1.73 m2, respectively. The association between Hb level (measured in 1 g/dL intervals) and in-hospital mortality was analyzed in different multivariable logistic regression models by CKD stratification.

Results
The Hb level was decreased in the CKD subgroup. In the non-CKD group, a higher Hb level was not associated with an increased risk of in-hospital death. However, the Hb level and mortality showed a U-shaped relationship in the CKD group. After adjusting for age and Charlson Comorbidity Index, multivariable regression analysis showed that an Hb level > 17 g/dL was associated with an increased risk of death in the CKD group with an odds ratio (OR) of 2.085 (95% CI, 1.019–4.264). Hb > 14 g/dL was related to an increased risk of death in advanced CKD patients (OR, 4.579 (95% CI, 1.243–16.866)).

Conclusions
High Hb is associated with an increased risk of in-hospital death in COPD patients with CKD, especially among those with advanced CKD. In this group of patients, attention should be paid to those with high Hb levels.
Unconventional implant strategy for patients with a limited interocclusal space in the posterior region: a case report
Authors: Wang Yi , Cen Wen , Huang Jiang-Qin , Wei Hong-Wu 
Published: September 2019

Abstract

Background
Implant prostheses require sufficient interocclusal space. In cases of limited interocclusal space, reducing or extracting over-erupted opposing teeth, orthodontic intrusion, or surgical reconstruction of the edentulous space are commonly used to restore the interocclusal space. However, there are disadvantages to these approaches.

Case presentation
The present case report describes a patient with a limited interocclusal space managed using an unconventional implant strategy.

Conclusions
The patient presented satisfactory outcomes without any signs of implant failure, suggesting that the unconventional implant treatment strategy is a useful option for patients with a limited interocclusal space in the posterior region. This unconventional implant surgery provides a minimally invasive treatment alternative.
Does PBL deliver constructive collaboration for students in interprofessional tutorial groups?
Authors: Lestari Endang , Stalmeijer Renée E. , Widyandana Doni , Scherpbier Albert 
Published: September 2019

AbstractBackgroundTraining health professional students in teamwork is recognized as an important step to create interprofessional collaboration in the clinical workplace. Interprofessional problem-based learning (PBL) is one learning approach that has been proposed to provide students with the opportunity to develop the necessary skills to work collaboratively with various health professionals. This study aimed to explore the extent to which students in interprofessional tutorial groups demonstrate constructive collaboration during group discussions.MethodsStudents (N = 52) from the Medical, Midwifery and Nursing programmes took part in the study. Video-recordings were made of interprofessional PBL discussions (N = 40) in five groups, eight videos per group. Over a period of 4 weeks, participants discussed four scenarios concerned with the reproductive system. The resulting 67 h of video data were analysed qualitatively. To ensure inter-rater reliability, two tutors assessed the students’ constructive, collaborative activities using the Maastricht Peer-Activity Rating Scale (MPARS). Finally, to gain an understanding of students’ perceptions of their performance and participation in the interprofessional PBL tutorial, we organized three uni-professional focus groups (FGs) at the end of pilot project.ResultsThe translated MPARS was reliable (Kappa coefficient 0.01–0.20 andp < 0.05). Students were actively involved in the discussion and contributed to a better understanding regardless of their professional background. Group members from different professions complemented one another in solving learning issues. They were open, feeling free to question and argue from the viewpoint of their own profession, and also understood their strengths and limitations. The statistical test of the scores for constructive and collaborative activities indicated a significant difference between students and the various healthcare professionals,p = 0.000, with medical students scoring highest on both activities. Focus groups further clarified some of the observed dynamics.ConclusionImplementing interprofessional PBL could motivate students to engage collaboratively in co-constructing knowledge to solve the patients’ problem. Medical students scored highest on constructive and collaborative activities.
Efficacy of a self-management program in patients with chronic viral hepatitis in China
Authors: Cui Ying’ai , Moriyama Michiko , Chayama Kazuaki , Liu Yanhui , Ya Chunmei , Muzembo Basilua Andre , Rahman Md Moshiur 
Published: September 2019

Abstract

Background
Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients’ knowledge of the disease, mental health, and clinical management.
This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients.

Method
In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients’ QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions.

Results
Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program.

Conclusions
This program contributed to patients’ acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients.

Trial registration
UMIN000025378. Registered December 23, 2016.
Effectiveness and efficiency of teleimaging in the transplantation process: a mixed method protocol
Authors: Zarca Kevin , Dupont Jean-Claude K. , Jacoud Lorène , Bulsei Julie , Huot Olivier , Logerot Hélène , Durand-Zaleski Isabelle 
Published: September 2019

Abstract

Background
The transplantation process usually takes place without transplant teams being able to use imaging data to assess graft quality. The decision of whether to go get the graft or not is therefore limited and suboptimal. “Cristal images” is a teleimaging project allowing real-time visualization of images of the organs of the donor. The objective of our study is to assess whether the use of a secure teleimaging can improve the effectiveness and efficiency of the procurement and transplantation processes.

Methods
We will use the exhaustive national registry of organ allocation and transplantation, and compare outcomes before the deployment of “Cristal images” (years 2015–2016) and after it becomes operational (years 2018–2019) for heart, lung, liver and kidney transplant in a before-after study, combined with a preference elicitation study. The primary endpoint will be the number of successful organ transplantations. Secondary endpoints will be related to the efficiency of the transplant process (decision making, transportation, cost) and a preference elicitation study will determine the relative preferences of transplant teams towards few “Cristal images”’ components or potential developments, which are yet to be determined through a qualitative analysis based on interviews with professionals.

Discussion
This study will provide stakeholders data on the efficiency of real-time visualization for transplant teams and identify the levers likely to influence the technology use among these teams.

Trial registration
clinicaltrials.gov: NCT03201224, 13 June 2017, retrospectively registered.
A crossectional investigation of the relationship between complementary health insurance and frequency of dental visits in 15 to 64 years old of Tehran population, Iran, a secondary data analysis (urban HEART-2)
Authors: Rostam Beigi Morteza , Shamshiri Ahmad Reza , Asadi- Lari Mohsen , Hessari Hossein , Jafari Ahmad 
Published: September 2019

Abstract

Background
This study aimed to investigate the relationship between complementary health insurance and frequency of dental visits.

Methods
The present study was performed using the Urban Health Equity Assessment and Response Tool (Urban HEART). A cross-sectional study was conducted in Tehran (Iran) to assess inequalities in health status among different socioeconomic and ethnic groups, genders, geographical areas, and social determinants of health. Out of 20,320 records retrieved from the original study with dental information, 17,252 had both dental insurance and dental visit information. Complementary health insurance as the main independent variable had three categories (i.e., basic insurance, with complementary medical coverage, and with dental coverage). The frequency of dental visits during the last year as a dependent variable had also three categories (i.e., no visit, one, and two, or more dental visits in the last year). In this study, in addition to investigating the relationship between complementary health insurance and frequency of dental visits, potential covariates that may affect the mentioned relationship were evaluated in the regression model. Statistical analyses included simple and multiple multinomial logistic regression considering the sampling method and sampling weights.

Results
The meanage of 17,252 participants (Tehran citizens) was 39.36 years; 49.4%were women, 86.0%hadonly basicinsurance, 7.2% had complementary medical insurance, and 6.8% had complementary dental insurance. Of all subjects, 43.8% reported no dental visit, 26.1% reported one, and 30.1% reportedtwoor more dental visits during the lastyear. The frequency of dental visits was lower in people who had basic insurance than others such that that odds ratio (OR) was 0.73 (p-value < 0.001) for one visit and 0.68 (p-value< 0.001) for two or more visits in the last year. The frequency of dental visits was also positively associated with dental brushing, toothpaste use, high educational level, being married, having more than 20 teeth, and having dental pain.

Conclusion
Having dental insurance increases the frequency of dental visits but the association between dental insurance and dental visits was independently influenced by other predictors.
Distinct impact of antibiotics on the gut microbiome and resistome: a longitudinal multicenter cohort study
Authors: Willmann Matthias , Vehreschild Maria J. G. T. , Biehl Lena M. , Vogel Wichard , Dörfel Daniela , Hamprecht Axel , Seifert Harald , Autenrieth Ingo B. , Peter Silke 
Published: September 2019

Abstract

Background
The selection pressure exercised by antibiotic drugs is an important consideration for the wise stewardship of antimicrobial treatment programs. Treatment decisions are currently based on crude assumptions, and there is an urgent need to develop a more quantitative knowledge base that can enable predictions of the impact of individual antibiotics on the human gut microbiome and resistome.

Results
Using shotgun metagenomics, we quantified changes in the gut microbiome in two cohorts of hematological patients receiving prophylactic antibiotics; one cohort was treated with ciprofloxacin in a hospital in Tübingen and the other with cotrimoxazole in a hospital in Cologne. Analyzing this rich longitudinal dataset, we found that gut microbiome diversity was reduced in both treatment cohorts to a similar extent, while effects on the gut resistome differed. We observed a sharp increase in the relative abundance of sulfonamide antibiotic resistance genes (ARGs) by 148.1% per cumulative defined daily dose of cotrimoxazole in the Cologne cohort, but not in the Tübingen cohort treated with ciprofloxacin. Through multivariate modeling, we found that factors such as individual baseline microbiome, resistome, and plasmid diversity; liver/kidney function; and concurrent medication, especially virostatic agents, influence resistome alterations. Strikingly, we observed different effects on the plasmidome in the two treatment groups. There was a substantial increase in the abundance of ARG-carrying plasmids in the cohort treated with cotrimoxazole, but not in the cohort treated with ciprofloxacin, indicating that cotrimoxazole might contribute more efficiently to the spread of resistance.

Conclusions
Our study represents a step forward in developing the capability to predict the effect of individual antimicrobials on the human microbiome and resistome. Our results indicate that to achieve this, integration of the individual baseline microbiome, resistome, and mobilome status as well as additional individual patient factors will be required. Such personalized predictions may in the future increase patient safety and reduce the spread of resistance.

Trial registration
ClinicalTrials.gov, NCT02058888. Registered February 10 2014
The case for a universal hepatitis C vaccine to achieve hepatitis C elimination
Authors: Scott Nick , Wilson David P. , Thompson Alexander J. , Barnes Eleanor , El-Sayed Manal , Benzaken Adele Schwartz , Drummer Heidi E. , Hellard Margaret E. 
Published: September 2019

Abstract

Background
The introduction of highly effective direct-acting antiviral (DAA) therapy for hepatitis C has led to calls to eliminate it as a public health threat through treatment-as-prevention. Recent studies suggest it is possible to develop a vaccine to prevent hepatitis C. Using a mathematical model, we examined the potential impact of a hepatitis C vaccine on the feasibility and cost of achieving the global WHO elimination target of an 80% reduction in incidence by 2030 in the era of DAA treatment.

Methods
The model was calibrated to 167 countries and included two population groups (people who inject drugs (PWID) and the general community), features of the care cascade, and the coverage of health systems to deliver services. Projections were made for 2018–2030.

Results
The optimal incidence reduction strategy was to implement test and treat programmes among PWID, and in settings with high levels of community transmission undertake screening and treatment of the general population. With a vaccine available, the optimal strategy was to include vaccination within test and treat programmes, in addition to vaccinating adolescents in settings with high levels of community transmission. Of the 167 countries modelled, between 0 and 48 could achieve an 80% reduction in incidence without a vaccine. This increased to 15–113 countries if a 75% efficacious vaccine with a 10-year duration of protection were available. If a vaccination course cost US$200, vaccine use reduced the cost of elimination for 66 countries (40%) by an aggregate of US$7.4 (US$6.6–8.2) billion. For a US$50 per course vaccine, this increased to a US$9.8 (US$8.7–10.8) billion cost reduction across 78 countries (47%).

Conclusions
These findings strongly support the case for hepatitis C vaccine development as an urgent public health need, to ensure hepatitis C elimination is achievable and at substantially reduced costs for a majority of countries.
Prevalence and course of disease after lung resection in primary ciliary dyskinesia: a cohort & nested case-control study
Authors:   on behalf of the Israeli PCD Consortium, Kouis Panayiotis ,   on behalf of the Italian PCD Consortium,   on behalf of the Swiss PCD Group,   on behalf of the French Reference Centre for Rare Lung Diseases,   on behalf of the PCD Italian Consortium,   on behalf of the French Reference Centre for Rare Lung Diseases, Goutaki Myrofora , Halbeisen Florian S. , Gioti Ifigeneia , Middleton Nicos , Amirav Israel , Barbato Angelo , Behan Laura , Boon Mieke , Emiralioglu Nagehan , Haarman Eric G. , Karadag Bulent , Koerner-Rettberg Cordula , Lazor Romain , Loebinger Michael R. , Maitre Bernard , Mazurek Henryk , Morgan Lucy , Nielsen Kim Gjerum , Omran Heymut , Özçelik Ugur , Price Mareike , Pogorzelski Andrzej , Snijders Deborah , Thouvenin Guillaume , Werner Claudius , Zivkovic Zorica , Kuehni Claudia E. , Yiallouros Panayiotis K. 
Published: September 2019

Abstract

Background
Lung resection is a controversial and understudied therapeutic modality in Primary Ciliary Dyskinesia (PCD). We assessed the prevalence of lung resection in PCD across countries and compared disease course in lobectomised and non-lobectomised patients.

Methods
In the international iPCD cohort, we identified lobectomised and non-lobectomised age and sex-matched PCD patients and compared their characteristics, lung function and BMI cross-sectionally and longitudinally.

Results
Among 2896 patients in the iPCD cohort, 163 from 20 centers (15 countries) underwent lung resection (5.6%). Among adult patients, prevalence of lung resection was 8.9%, demonstrating wide variation among countries. Compared to the rest of the iPCD cohort, lobectomised patients were more often females, older at diagnosis, and more often had situs solitus. In about half of the cases (45.6%) lung resection was performed before presentation to specialized PCD centers for diagnostic work-up. Compared to controls (n = 197), lobectomised patients had lower FVC z-scores (− 2.41 vs − 1.35, p = 0.0001) and FEV1 z-scores (− 2.79 vs − 1.99, p = 0.003) at their first post-lung resection assessment. After surgery, lung function continued to decline at a faster rate in lobectomised patients compared to controls (FVC z-score slope: − 0.037/year Vs − 0.009/year, p = 0.047 and FEV1 z-score slope: − 0.052/year Vs − 0.033/year, p = 0.235), although difference did not reach statistical significance for FEV1. Within cases, females and patients with multiple lobe resections had lower lung function.

Conclusions
Prevalence of lung resection in PCD varies widely between countries, is often performed before PCD diagnosis and overall is more frequent in patients with delayed diagnosis. After lung resection, compared to controls most lobectomised patients have poorer and continuing decline of lung function despite lung resection. Further studies benefiting from prospective data collection are needed to confirm these findings.