bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fewer hospitalizations and prolonged technique survival with Home Hemodialysis– a matched cohort study from the Swedish Renal Registry
Authors: Rydell Helena , Ivarsson Kerstin , Almquist Martin , Clyne Naomi , Segelmark Mårten 
Published: June 2019

Abstract
Background

Patients on home hemodialysis (HHD) exhibit superior survival compared with patients on institutional hemodialysis (IHD) and peritoneal dialysis (PD). However, the effects of treatment modality on morbidity and health care utilization are divergent between studies. The aim of this study is to compare health care utilization between modalities.

Methods

The Swedish Renal Registry was used to retrieve patients starting on HHD, IHD or PD. Patients were matched according to sex, age, comorbidity and start date. The Swedish Inpatient Registry was used to determine comorbidity before starting renal replacement therapy (RRT) and hospital admissions during RRT. Dialysis technique survival was compared between HHD and PD.

Results

RRT was initiated with HHD for 152 patients; these were matched with 608 patients with IHD and 456 with PD. Patients with HHD had significantly lower median annual admission rate and number of days in hospital. (1.7 admissions; 12 days) compared with IHD (2.2; 14) and PD (2.8; 20).

The annual admission rate was significantly lower for patients with HHD compared with IHD for cardiovascular diagnoses and compared with PD for infectious disease diagnoses. Dialysis technique survival was significantly longer with HHD compared with PD.

Conclusions

Patients choosing HHD as initial RRT spend less time in hospital compared with patients on IHD and PD and they were more likely than PD patients, to remain on their initial modality. These advantages, in combination with better survival and higher likelihood of renal transplantation, are important incentives for promoting the use of HHD.
Charging of overseas visitors within England and achieving Universal Health Coverage: A cross sectional analysis of a freedom of information request of NHS trusts in England
Authors: Dobbin Joanna , Milner Adrienne , Dobbin Alexander , Potter Jessica 
Published: June 2019

Abstract
Background
Not everybody living in or visiting the UK is eligible for free NHS care. Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. In 2017, new regulations introduced upfront charging for non-urgent care. Following this, reports of individuals being denied treatment – in particular British people from the Windrush generation appeared. This research provides the first large scale dataset examining the demographics of those charged.

Methods
A freedom of information request was sent to 135 acute non-specialist NHS trusts in England to create a database of non-EEA overseas visitors charges from 2016/17 and 2017/18. This cross sectional survey was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of health care.

Results
Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13,484 patients. Women were found to be invoiced higher amounts than men (p=0.002). Patients were more likely to be women (63% vs. 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16 to 40 years old. Multiple linear regression by age group showed that age is significantly related to the cost of health care with patients over 65 paying more than those aged 16-40, and 41-64 (p=0.011), and children under 16 paying less (p<0.001). The urgency of treatment was significantly related to cost, with the most urgent (immediantly necessary) treatment costing the most (p<0.001).

Conclusions
The demographics of those charged as overseas visitors alligns with the pattern of estimated costs of care for NHS care overall, where women of reproductive age and older patients require a higher amount of medical care. This research reflects current concerns of migrants being left behind in the strive towards universal health coverage which should be based upon quality, equality, and financial protection for patients. A key limitation was the low response rate.. The limitation of missing data has meant that questions surrounding possible charging discrimination of ethnic grounds cannot be answered.
Needs and skills of informal caregivers to care for a dependent person: a cross-sectional study
Authors: Dixe Maria , Teixeira Liliana , Areosa Timoteo , Frontini Roberta , Peralta Teresa , Querido Ana 
Published: June 2019

Abstract
Background: The world is facing many socio-demographic changes, such as an increased average life expectancy and the presence of chronic and non-communicable diseases, which in turn, leads to an enhanced dependency on others. Consequently, the demand for informal caregivers has significantly increased during the past few years. Caring for a dependent person is linked to a series of burdens that often leads to physical, psychological and emotional difficulties. Taking into consideration the difficulties faced by informal caregivers, knowing in which areas of functioning they need more guidance may help to relieve their burden. Therefore, the main goal of this study is to better understand the needs and competencies of the informal caregiver when caring for a dependent person in the different self-care domains.
Methods: cross-sectional study using face-to-face interviews. Descriptive and inferential statistics alongside non-parametric statistical techniques such as the Mann-Whitney test and Spearman’s correlation were used.
Results: The average age of the informal caregivers is 58 years old, with the youngest in our sample being 21 years of age. Most of them are female, and 50% of them are children taking care of one of their parents. Most of the dependent people are completely dependent in the areas of comfort and hygiene (53.8%) and medication management (55.9%). The female informal caregivers see themselves as having more competencies in sanitary hygiene than the male ones, with no significant differences in their competencies’ perception in the other areas of self-care. Older caregivers see themselves as less competent in certain areas of self-care such as feeding, mobility, transfers, medication and symptoms management and communication. Most part of the information given to the informal caregiver is about the disease (82.3%) and about the medication management (80.4%). There are still a lot of areas of self-care, where no information, or almost none, is given to the informal caregivers.
Conclusions: Prior to home discharge of a dependent person, it is important to acknowledge the needs and competencies of the informal caregiver, to capacitate them in looking after their relatives, in order to help decrease their burden and consequently, decrease the number of hospital readmissions.
Characterization of human norovirus binding to gut-associated bacterial ligands
Authors: Almand Erin , Moore Matthew D. , Jaykus Lee-Ann 
Published: June 2019

Abstract
Objective

Research suggests human norovirus binding to histo-blood group antigen (HBGA)-like molecules on enteric bacteria may enhance viral pathogenesis; however, the properties of these bacterial ligands are not well known. Previous work identified, but did not characterize seven norovirus-binding bacteria. To further characterize this bacteria-virus binding interaction, enteric bacteria were analyzed via Western blot with anti-HBGA antibodies and lectins targeting HBGA-associated sugar components. Virus overlay assays using capsids from six different human norovirus strains further identified responsible ligands and strain dependent binding properties.

Results

Each bacterial species possessed varying degrees of HBGA-like activity, and lectin binding further elucidated potential sugar residues involved (N-acetyl-galactosamine, α-D-galactose or α-L-fucose). Both GI and GII norovirus capsids bound specific bacterial ligand sizes, and generally corresponded to anti-HBGA Western blot patterns. A 35-kDa band reacted with all HBGA antibodies, bound all six of the noroviruses tested, and had a high affinity for the lectins. Collectively, this work characterizes the varying carbohydrate residues potentially responsible for norovirus-bacteria interactions and provides a basis for future ligand identification.
Prevalence and Etiological Agents for Chronic Suppurative Otitis Media among Patients Attending Otorhinolaryngology Department at Muhimbili National Hospital, Tanzania
Authors: Abraham Zephania Saitabau , Ntunaguzi Daudi , Kahinga Aveline Aloyce , Mapondella Kassim Babu , Massawe Enica Richard , Nkuwi Emmanuel James , Nkya Aslam 
Published: June 2019

Abstract
Objective

Chronic suppurative otitis media is among the commonest otological condition reported in otorhinolaryngology practice commonly attributing to preventable hearing loss. The aim of this study was thus to determine the prevalence and etiological agents for chronic suppurative otitis media in our department.

Results

A total of 5591 patients were recruited in this study where 79 (1.4%) were found to have chronic suppurative otitis media. Male preponderance (54.4%) was found in this study and the left ear (58.2%) was more affected than right ear. Central perforation was the commonest pattern reported in 53% of cases and none had attic perforation. Of the 81 processed ear swabs, microbial growth was seen in 80 (98.8%) whilst one sample showed no microbial growth whereas 52.5% had polymicrobial growth.
The Efficacy of 0.1% Tacrolimus Eye Drop for Noninfectious, Non-Necrotizing Anterior Scleritis
Authors: Yazu Hiroyuki , Miyazaki Dai , Fujishima Hiroshi 
Published: June 2019

Abstract
BACKGROUND: To examine the efficacy of 0.1% tacrolimus eye drops in the treatment of noninfectious, non-necrotizing anterior scleritis.
METHODS: This prospective, single-arm study included nine patients (4 males and 5 females; mean age = 59.4 years, standard deviation = 10.5) with anterior scleritis. All patients were first treated with steroids for 1 month and then switched to tacrolimus eye drops alone. We defined baseline as the initiation of steroid or tacrolimus eye drops. Hyperemia and pain were scored before each treatment, at 1 and 2 weeks, and at 1 month after initiation of each treatment by using 5 grades (0 = none; 1+ = mild; 2+ = moderate; 3+ = severe; 4+ = extremely severe). Intraocular pressure (IOP) was also measured from baseline to 6 months after initiating tacrolimus eye drops. Safety was assessed based on the severity and the incidence of adverse events.
RESULTS: The scores of hyperemia and pain had significantly decreased from baseline by 1 week after initiating tacrolimus eye drops (both P < 0.05). No significant reduction was observed with steroid treatment throughout the 1-month period in terms of both scores. Tacrolimus eye drops elicited statistically significant differences in mean IOP over the course of treatment (P = 0.02). No additional medications were required to provide relief in any of the patients receiving tacrolimus treatment. No patient had infectious adverse events after initiation of tacrolimus treatment.
CONCLUSIONS: Topical tacrolimus may effectively and immediately reduce clinical signs and symptoms of noninfectious, non-necrotizing anterior scleritis.
TRIAL REGISTRATION: This trial was prospectively registered on 16/10/2015 under the number (UMIN000034460).
Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation
Authors: Ying Pu , Shen Yingchao , Wang Qiang 
Published: June 2019

Abstract
Background

Numerous surgical methods have been used for acromioclavicular joint reconstruction.In this study, we analyzed the clinical and radiographic outcomes of truly anatomic coracoclavicular ligaments reconstruction (TACCR) and truly anatomic acromioclavicular ligaments reconstruction (TAACR) using suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation.

Methods

48 patients (mean age 49 years) with severe acromioclavicular joint dislocation. The patients were classified as Rockwood type III (n=28), IV (n=3) and V (n=17). All patients were operatively treated using anchor moored positioning technique by suture anchor and Endobutton fixation. Clinical and radiographic evaluation include the visual analog scale (VAS), Constant scores (CS) and American Shoulder and Elbow Surgeons (ASES) scores and radiographic outcomes.

Results

The mean follow-up was 34 months. The VAS decreased from 5 preoperatively to 0 at 24 months (P < .001). The CS and ASES scores improved from 43, 44 preoperatively to 96, 97 at 24 months separately (P < .001). Meanwhile, 47 patients (97.9%) demonstrated stable anatomical fixation on final postoperative radiographs. Loss of reduction occurred in 1 patient (2.1%), but was not correlated with functional outcome.

Conclusions

Anchor moored positioning technique with Bi-directional fixations by suture anchor and Endobutton fixation represents a new and reliable treatment of AC joint dislocation.
Profile of renal artery embolization (RAE) for renal trauma: A comparison of data from two major trauma centers
Authors: chen jie , cai wei cong , Li Li Ping 
Published: June 2019

Abstract
Background: The aim of this article is to elucidate the current situation of renal interventional therapy and discuss the indications for this treatment.
Methods: A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015.
Results: There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. low-grade renal trauma(LGRT) was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with high-grade renal trauma (HGRT). No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate analyses, the American Association for the Surgery of Trauma (AAST) renal grade was significantly associated with undergoing RAE. Additionally, in the multivariate analysis, only the AAST renal grade (odds ratio [OR], 13.56; 95% confidence interval [CI], 2.91-63.06) was significantly associated with undergoing RAE.
Conclusions: LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.
'The mean mummy way' – Experiences of parents instilling eye drops to their young children as described in online forums and blogs
Authors: Law Gloria C , Bülbül Alpaslan , Jones Christina , Smith Helen Elizabeth 
Published: June 2019

Abstract
Background: Adults often have difficulty instilling eye drops in their own eyes, but little is known about the difficulties experienced by parents when administering eye drops to their young children. The challenges of administering eye drops to children are accentuated by their poor cooperation, but little has been documented about the difficulties experienced by parents when administering eye drops to their young children. This qualitative study explores parents’ experiences of administering eye drops to their children in online forum discussions and blog posts.
Methods: The written exchanges between parents participating in online forum discussions and blog posts relating to the administration of eye drops to young children were thematically analysed.
Results: We found 64 forum discussion threads and 4 blog posts, representing 464 unique contributors expressing their experiences of eye drop administration to young children. Three major themes were identified - administration difficulties, administration techniques and role of health care professionals. Besides describing their children’s distress, parents discussed their own discomfort as the administrator of eye drops; alluding to feeling ‘horrible’ and ‘cruel’. Parents used a variety of techniques to facilitate adherence with medication, including restraining the child, role-play, reassurance, distraction or reward. The recommended strategies for eye drop administration occasionally included reiteration of professional advice, but were dominated by parents’ own ideas/suggestions; interestingly health care professionals were considered diagnosticians and prescribers, but not sources of practical advice on administration.
Conclusion: Parental narratives shared on the internet have highlighted significant young child and parental distress associated with eye drop administration. The analysis of digital social networks has the potential to identify patient problems that health professionals may not have previously recognised nor appreciated the magnitude. The current study reveals that parents’ experiences dominated the online discourse with their own advice and suggestions regarding administrating eye drops to young children but little did they recall on the advice from healthcare professionals, highlighting the need for clinicians in improving their explanations to parents about eye drop administration.
Retinal relaxation following membrane peeling: Effect on vision, central macular thickness, and vector analysis of motion
Authors: Smet Marc D. de , Julian Karina , Maurin Jerick , Jolissaint Laurent P. , Mura Marco 
Published: June 2019

Abstract
Purpose: Removal of an epiretinal membrane (ERM) leads to the outward displacement of retinal vessels and visual improvement. The direction and extent of displacement in the form of a vector analysis over the posterior pole can provide a better understanding of the dynamics and duration of this process, while the magnitude might have implications in terms of visual outcome. Methods: Scanning laser ophthalmoscope images of the retina of eyes undergoing ERM peeling were compared before and 6 months after surgery. Stratification was made between prominent and limited displacement, with assessment of visual acuity (VA), and central macular thickness (CMT). In three cases, using the optic nerve as reference, 50 landmarks were chosen within the posterior pole along large and small vascular structures allowing the construction of a vector map of displacement over 1 year. Results: Nine eyes with prominent displacement (up to 400µm) and 6 eyes with limited displacement were assessed. Three lines of improvements in VA were observed in both groups over a 6 month period. Starting vision was lower in the eyes with prominent displacement. The CMT decrease was variable in onset in both groups but when observed was present within the first 3 months. CMT decrease was most significant in eyes with the greatest vascular displacement (initial: mean 445+/- 173µm; 6 months mean 352+/- 95µm) compared to eyes with less displacement (initial 366+/- 82µm; at 6 months 317 +/- 94µm). Vector analysis showed that most vascular movements occurred over the first 6 months, and involved the whole surface of the posterior retina, extending in some cases beyond the arcades. The displacement originated around distinct nodes of contraction.Conclusions: Retinal relaxation can occur over a large surface area. The superficial displacement of structures which served as a basis for the current analysis did not correlate with the change in vision. Vision recovery is likely correlated more closely with wrinkling of outer retinal layers.
Usefulness of a stool to stabilize dental chairs for cardiopulmonary resuscitation (CPR)
Authors: Awata Norimasa , Hitosugi Takashi , Miki Yoichiro , Kawakubo Yoshifumi , Yokoyama Takeshi 
Published: June 2019

Abstract
Background: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion 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 ECC. We previously developed a procedure to stabilize a dental chair by using a stool. 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. ECC 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 ECC were compared between with and without a stool, and recorded by a camcorder.
Results: In all 8 dental chairs, the method by using a stool significantly (p < 0.001) reduced the vertical displacements of the backrest by ECC. The reduction ratio varies varied between nearly 39 and 85%, and the overall mean was 62 ± 11%although it was different by chairs.
Conclusions: Our procedure to stabilize dental chairs by using a stool reduced the displacement of a backrest against ECC in all chairs.
Clinical relevance: Effective ECC could be performed in dental chairs by using a stool when sudden cardiac arrest occurs during dental surgery.