bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of changes in rectal area and volume during MR evacuation proctography in healthy and constipated adults
Authors: Puthanmadhom Narayanan Susrutha , Sharma Mayank , Fletcher Joel G. , Karwoski Ronald A. , Holmes David R. , Bharucha Adil E. 
Published: April 2019

AbstractBackgroundDuring proctography, rectal emptying is visually estimated by the reduction in rectal area. The correlation between changes in rectal area, which is a surrogate measure of volume, is unclear. Our aims were to compare the change in rectal area and volume during magnetic resonance (MR) proctography and to compare these parameters with rectal balloon expulsion time (BET).MethodsIn 49 healthy and 46 constipated participants, we measured BET and rectal area and volume with a software program before and after participants expelled rectal gel during proctography.Key ResultsAll participants completed both tests; six healthy and 17 constipated patients had a prolonged (>60 seconds) BET. During evacuation, the reduction in rectal area and volume was lower in participants with an abnormal than a normal BET (P < 0.01). The reduction in rectal area and volume were strongly correlated (r = 0.93, P < 0.001) and equivalent for identifying participants with abnormal BET. Among participants with less evacuation, the reduction in rectal area underestimated the reduction in rectal volume. A rectocele larger than 2 cm was observed in eight of 18 (44%) participants in whom the difference between change in volume and area was ˃10% but only 14 of 77 (18%) participants in whom the difference was ≤10% (P = 0.03).ConclusionsMeasured with MR proctography, the rectal area is reasonably accurate for quantifying rectal emptying and equivalent to rectal volume for distinguishing between normal and abnormal BET. When evacuation is reduced, the change in rectal area may underestimate the change in rectal volume.
Differences in Bone Mineral Density and Hip Geometry in Trochanteric and Cervical Hip Fractures in Elderly Chinese Patients
Authors: Li Ming , Lv Hou‐chen , Liu Jian‐heng , Cui Xiang , Sun Guo‐fei , Hu Jian‐wei , Zhang Li‐cheng , Tang Pei‐fu 
Published: April 2019

ObjectiveTo assess the differences in bone mineral density (BMD) and hip geometry in trochanteric and cervical hip fractures in elderly Chinese patients.MethodsA consecutive series of 196 hip fracture patients aged over 50 years was recruited from November 2013 to October 2015, including 109 cases of cervical fractures (36 males and 73 females) and 87 cases of trochanteric fractures (34 males and 53 females). All patients were evaluated through dual‐energy X‐ray absorptiometry, and baseline characteristics, BMD and structural parameters were collected and reviewed.ResultsThere were statistically significant differences in age, height, and body mass index between patients with each type of fracture, and patients with trochanteric fractures were older than those with cervical fractures, especially in women. The BMD in trochanteric fractures was markedly lower than in cervical fractures in all five sites of the hip by an approximate reduction of 10%, in both men and women. The cross‐sectional area, cross‐sectional moment of inertia, and the cortical thickness in the cervical fracture group were significantly higher than in the trochanteric fracture group. However, the buckling ratio of both the femoral neck and trochanteric region were significantly lower in the cervical fracture group. Age (/10 years), cross‐sectional moment of inertia in femoral neck and buckling ratio in trochanteric region were significant risk factors for trochanteric fractures compared with cervical fractures.ConclusionsCompared with cervical hip fractures, patients with trochanteric fractures were older, had a lower BMD, and had less bone mechanical strength, especially in female patients. Age, femoral neck cross‐sectional moment of inertia (FNCSMI), and trochanteric region buckling ratio (ITBR) were stronger risk factors for trochanteric hip fractures than for cervical fractures.
Variation of cultured skin microbiota in mothers and their infants during the first year postpartum
Authors: Gaitanis Georgios , Tsiouri Georgia , Spyridonos Panagiota , Stefos Τheodoros , Stamatas Georgios N. , Velegraki Aristea , Bassukas Ioannis D. 
Published: April 2019

AbstractBackground/ObjectivesThe establishment of newborn skin flora depends on the ongoing skin maturation and the existence of potential microbial colonizers within the environment of the infant during a period of intense mother‐infant physical interaction. This longitudinal study assessed culturable skin bacteria in the mother‐infant dyad during the first year of life.MethodsA total of 17 mother‐infant dyads were swabbed within 24 hours postpartum and at 3, 6, 9, and 12 months. Skin swabbing was performed on two anatomical areas per individual (mothers: chest‐abdomen; infants: forehead‐buttocks) and were incubated in five different solid culture media to optimize yield. Isolated bacterial species were identified to genus or species level using the API system (BioMeriéux, Marcy l'Etoile, France).ResultsA total of 444 microbial strains were isolated belonging to 22 genera: 6 “frequent” (isolated from > 5% samples: S aureus, Proteus, Klebsiella, Pseudomonas, Enterobacter, and Enterococcus) and 16 “infrequent.” Isolated genera per individual peaked at 6 months postpartum for mothers and infants (P < 0.05). Enterobacter, Enterococcus, Klebsiella, and Pseudomonas isolation rates varied significantly as a function of sampling time contrary to the rather constant isolation rates of Proteus and S aureus. The rates of concordant isolation of the same microbial species within the mother‐infant dyad tended to drop from birth to the end of the first year postpartum.ConclusionsDistinct variations in the isolation rates of skin commensals from specific anatomical sites of the mother‐infant dyad indicate bidirectional microbial transmission. Increasing skin flora individuality of the growing infant was recorded, manifested by declining rates of concordant isolation of the same microbial species from mother and her infant.
Association of RBP‐4 gene polymorphisms with follicular cysts in large white sows
Authors: Wang Fengge , Chen Lu , Chen Shuxiong , Deng Liang , Tian Meng , Zheng Biaobiao , Li Chunjin , Zhou Xu 
Published: April 2019

AbstractFollicular cysts, which is a common infertility disease, can cause financial losses in pig breeding programmes. The pathogenesis and mechanisms of the formation of follicular cysts are not understood clearly. In our previous study, the concentration of retinol‐binding protein 4 (RBP‐4) in the follicular fluid (FF) of the ovary with follicular cysts was found to be significantly higher than that of normal ovary, thereby suggesting that RBP‐4 may be a candidate biomarker for porcine follicular cysts. To study the association of RBP‐4 and follicular cysts further, we detected the polymorphisms of the RBP‐4 gene and the presence of follicular cysts by PCR‐Restriction fragment length polymorphism (RFLP) assay. In this study, we screened the mutations of RBP‐4 gene in 79 sows with follicular cysts and 100 normal sows without cysts. Results showed that +249‐63G>C polymorphisms were significantly associated with follicular cysts, and sows with CC genotype in RBP‐4 gene had a high risk of developing follicular cysts. Hence, our findings further proved that RBP‐4 may be a novel biomarker for follicular cysts, which may be valuable for the diagnosis of follicular cysts and molecular breeding of pigs.
A Rigid Multibody Model to Study the Translational Motion of Guidewires Based on Their Mechanical Properties
Authors: Sharei Hoda , Kieft Jeroen , Takashima Kazuto , Hayashida Norihiro , van den Dobbelsteen John J. , Dankelman Jenny 
Published: April 2019

Abstract
During percutaneous coronary interventions (PCI), a guidewire is used as an initial way of accessing a specific vasculature. There are varieties of guidewires on the market and choosing an appropriate one for each case is critical for a safe and successful intervention. The main objective of this study is to predict the behavior of the guidewire and its performance in a vasculature prior to the procedure. Therefore, we evaluate the effectiveness of different mechanical properties of the guidewire on its behavior. A two-dimensional (2D) model has been developed in which a guidewire is considered as a set of small rigid segments connected to each other by revolute joints. These joints have two degrees-of-freedom to allow rotation. Linear torsional springs and dampers are applied in each joint to account for the elastic properties of the guidewire; the elastic properties have been measured for two commercially available guidewires (Hi-Torque Balance Middleweight Universal II—Abbot and Amplatz Super Stiff—Boston Scientific) and these are used in the model. Only translational motion has been applied to the guidewires and the effect of bending stiffness of the guidewire and also friction between guidewire and vasculature on its behavior are investigated. The results are validated with actual movement of the guidewires in a simple phantom model. Behavior of a guidewire in a vasculature was predicted using the developed model. The results of both simulation and experiment show that the behavior of a guidewire is influenced by its mechanical properties and by the friction between the guidewire and vasculature. This study is the first step to develop a complete model, which can predict the behavior of a guidewire inside the vasculature. We compared the tip trajectory for two commercial guidewires in one vasculature geometry. In future, this kind of knowledge might support not only the interventionist in choosing the best suitable guidewire for a procedure but also the designer to optimize new instrument to have the desired behavior.
Did government spending cuts to social care for older people lead to an increase in emergency hospital admissions? An ecological study, England 2005–2016
Authors: Seamer Paul , Brake Simon , Moore Patrick , Mohammed Mohammed A , Wyatt Steven 
Published: April 2019

ObjectivesGovernment spending on social care in England reduced substantially in real terms following the economic crisis in 2008, meanwhile emergency admissions to hospitals have increased. We aimed to assess the extent to which reductions in social care spend on older people have led to increases in emergency hospital admissions.DesignWe used negative binomial regression for panel data to assess the relationship between emergency hospital admissions and government spend on social care for older people. We adjusted for population size and for levels of deprivation and health.SettingHospitals and adult social care services in England between April 2005 and March 2016.ParticipantsPeople aged 65 years and over resident in 132 local councils.Outcome measuresPrimary outcome variable—emergency hospital admissions of adults aged 65 years and over. Secondary outcome measure—emergency hospital admissions for ambulatory care sensitive conditions (ACSCs) of adults aged 65 years and over.ResultsWe found no significant relationship between the changes in the rate of government spend (£’000 s) on social care for older people within councils and our primary outcome variable, emergency hospital admissions (Incidence rate ratio (IRR) 1.009, 95% CI 0.965 to 1.056) or our secondary outcome measure, admissions for ACSCs (IRR 0.975, 95% CI 0.917 to 1.038).ConclusionsWe found no evidence to support the view that reductions in government spend on social care since 2008 have led to increases in emergency hospital admissions in older people. Policy makers may wish to review schemes, such as the Better Care Fund, which are predicated on a relationship between social care provision and emergency hospital admissions of older people.
Rotavirus vaccine impact assessment surveillance in India: protocol and methods
Authors: Nair Nayana P , Reddy N Samarasimha , Giri Sidhartha , Mohan Venkata Raghava , Parashar Umesh , Tate Jacqueline , Shah Minesh Pradyuman , Arora Rashmi , Gupte Mohan , Mehendale Sanjay M ,   Investigators of the Rotavirus vaccine Impact Surveillance Network, Kang Gagandeep 
Published: April 2019

IntroductionRotavirus infection accounts for 39% of under-five diarrhoeal deaths globally and 22% of these deaths occur in India. Introduction of rotavirus vaccine in a national immunisation programme is considered to be the most effective intervention in preventing severe rotavirus disease. In 2016, India introduced an indigenous rotavirus vaccine (Rotavac) into the Universal Immunisation Programme in a phased manner. This paper describes the protocol for surveillance to monitor the performance of rotavirus vaccine following its introduction into the routine childhood immunisation programme.MethodsAn active surveillance system was established to identify acute gastroenteritis cases among children less than 5 years of age. For all children enrolled at sentinel sites, case reporting forms are completed and a copy of vaccination record and a stool specimen obtained. The forms and specimens are sent to the referral laboratory for data entry, analysis, testing and storage. Data from sentinel sites in states that have introduced rotavirus vaccine into their routine immunisation schedule will be used to determine rotavirus vaccine impact and effectiveness.Ethics and disseminationThe Institutional Review Board of Christian Medical College, Vellore, and all the site institutional ethics committees approved the project. Results will be disseminated in peer-reviewed journals and with stakeholders of the universal immunisation programme in India.
Evaluation of an innovative mobile health programme for the self-management of chronic obstructive pulmonary disease (MH-COPD): protocol of a randomised controlled trial
Authors: Ding Hang , Karunanithi Mohan , Ireland Derek , McCarthy Lisa , Hakim Rekha , Phillips Kirsten , Pradhan Rahul , Seah E-Hong , Bowman Rayleen V , Fong Kwun , Masel Philip , Yang Ian A 
Published: April 2019

IntroductionChronic obstructive pulmonary disease (COPD) is the fourth leading cause of death globally. In outpatient care, the self-management of COPD is essential, but patient adherence to this remains suboptimal. The objective of this study is to examine whether an innovative mobile health (mHealth)-enabled care programme (MH-COPD) will improve the patient self-management and relevant health outcomes.Methods and analysisA prospective open randomised controlled trial has been designed. In the trial, patients with COPD will be recruited from The Prince Charles Hospital, Brisbane, Australia. They will then be randomised to participate in either the MH-COPD intervention group (n=50 patients), or usual care control group (UC-COPD) (n=50 patients) for 6 months. The MH-COPD programme has been designed to integrate an mHealth system within a clinical COPD care service. In the programme, participants will use a mHealth application at home to review educational videos, monitor COPD symptoms, use an electronic action plan, modify the risk factors of cigarette smoking and regular physical activity, and learn to use inhalers optimally. All participants will be assessed at baseline, 3 months and 6 months. The primary outcomes will be COPD symptoms and quality of life. The secondary outcomes will be patient adherence, physical activity, smoking cessation, use of COPD medicines, frequency of COPD exacerbations and hospital readmissions, and user experience of the mobile app.Ethics and disseminationThe clinical trial has been approved by The Prince Charles Hospital Human Research Ethics Committee (HREC/16/QPCH/252). The recruitment and follow-up of the trial will be from January 2019 to December 2020. The study outcomes will be disseminated according to the Consolidated Standards of Reporting Trials statement through a journal publication, approximately 6 months after finishing data collection.Trial registration numberACTRN12618001091291.
Preoxygenation in difficult airway management: high-flow oxygenation by nasal cannula versus face mask (the PREOPTIDAM study). Protocol for a single-centre randomised study
Authors: Vourc’h Mickael , Huard Donatien , Feuillet Fanny , Baud Gabrielle , Guichoux Arthur , Surbled Marielle , Tissot Melanie , Chiffoleau Anne , Guitton Christophe , Jaber Samir , Asehnoune Karim 
Published: April 2019

IntroductionAlthough preoxygenation and airway management respond to precise algorithms, difficult intubation (DI) remains a daily challenge in intensive care units and in the operating rooms because of its frequent complications, including hypoxaemia. To prevent desaturation during DI, high-flow oxygenation by nasal cannula (HFNC) could prove beneficial. Indeed, contrary to standard preoxygenation device, it can be held in place throughout the intubation trying to perform apnoeic oxygenation during DI. Hence, recent guidelines recommend HFNC during DI, but its relevance has never been evaluated in this setting in a large randomised study until now.Methods and analysisThe PREOPTIDAM trial is a prospective, single-centre, randomised, controlled study in Nantes University Hospital. In anticipated DI, we hypothesised that HFNC can decrease the incidence of desaturation ≤94% or face mask ventilation from 16% to 4% compared with standard device. Using a two-sided t-test with a first species risk of 5% and 80% power, a total of 186 patients will be included. Using a computer-generated randomisation, with a 1:1 allocation ratio, patients will be randomised to HFNC or face mask preoxygenation. Randomisation will be stratified on intubation sequence: Rapid sequence intubation or awake fibreoptic intubation. The primary objective is to determine whether HFNC is more efficient than standard oxygenation techniques to prevent desaturation ≤94% or face mask ventilation during DI. Intent-to-treat and per-protocol analysis are planned for the primary outcome.Ethics and disseminationThe study project has been approved by an independent ethics committee. Written informed consent will be obtained before study inclusion. Participant recruitment begins in September 2018. Results will be submitted to international peer-reviewed medical journals.Trial registration numberNCT03604120.
Patient priorities in herpes simplex keratitis
Authors: Liu Xiaoxuan , Kolli Sai , McDonnell Peter , Patel Amit , Quinlan Michael , Skym Kevin , Denniston Alastair K , Shah Peter , Williams Geraint P 
Published: April 2019

ObjectiveHerpes simplex keratitis (HSK) is a sight-threatening disease and a leading cause of infectious corneal blindness. Involving patients in setting the research agenda maximises patient benefit and minimises research waste. With no published patient involvement exercises, patients’ priorities in HSK are unclear. The objective of this study is to explore patients' priorities for research in HSK.MethodsA literature review of publications in the year preceding recruitment of patients identified nine domains of research interest. A questionnaire was sent to participants asking them to rank these in order of priority. The ranking results were given a weighted-average score, and a thematic analysis was undertaken for the narrative data.ResultsThirty-seven patients participated in the survey. Top priorities for patients were risk factors for recurrence of infection, diagnostic tests and treatment failure. The narrative data revealed three key clinical needs: difficulties in long-term symptom control, the need for rapid access care in acute infection and the desire for more accessible information.ConclusionThis study highlighted three major issues in our current approach to HSK. First, there may be a misalignment between research efforts and patient priorities. Second, high-quality patient information is not widely available. This may hamper patients’ abilities to make informed decisions and contribute towards research. Third, clinical service priorities are of equal importance to patients as research. Researchers and clinicians are encouraged to address both needs in parallel.
Can universal patient-held health booklets promote continuity of care and patient-centred care in low-resource countries? The case of Mongolia
Authors: Ibrahim Hussein , Munkhbayar Uyanga , Toivgoo Aira , Humphries Claire , Ochir Chimedsuren , Narula Indermohan S , Lilford Richard , Manaseki-Holland Semira 
Published: April 2019

BackgroundA system of clinical records accessible by both patients and their attending healthcare professionals facilitates continuity of care and patient-centred care, thereby improving clinical outcomes. The need for such a system has become greater as the proportion of patients with chronic non-communicable diseases (NCDs) requiring ongoing care increases. This is particularly true in low-income and middle-income countries where the burden of these diseases is greatest.ObjectiveTo describe a nationwide patient-held health booklet (PHHB) system and investigate its use and completeness for clinical information transfer during chronic NCD outpatient visits in Ulaanbaatar, Mongolia.MethodsQualitative and quantitative methodologies were employed in this mixed-methods study. Structured interviews were used to study a sample of adult patients with chronic NCDs attending the outpatient departments (OPDs) of two large, public secondary care hospitals ; artefact reviews were used to analyse the content of the written documents relating to their clinical care; and snowball methodology was used to identify policy and training documents.Results96% (379/395) brought handover documentation from previous provider/s: 94% had PHHBs, 27% other additional documents and 4% had nothing. 67% were referred from primary care and 44% referred back for follow-up. On leaving the OPD, irrespective of requirements for computer data entry, doctors provided written clinical information in the PHHB for 93% of patients. 84% of patients recalled being given verbal information. However, only 41% of the consultation with written information included all three key handover information items (diagnosis, management/treatment and follow-up). The PHHBs were the best completed type of document, with evidence that they were consulted by patients (80%), public (95%) and private (77%) providers. Living >1 hour away (OR=0.28; 95% CI 0.13 to 0.61) decreased the likelihood of receiving written management/treatment information; living >1 hour away (OR=0.48; 95% CI 0.27 to 0.87), comorbidity (OR=0.55; 95% CI 0.35 to 0.87) and returning to secondary care (OR=0.52; 95% CI 0.33 to 0.80) all independently decreased the likelihood of receiving written follow-up information. A Ministry order mandates the use of the booklet, but there were no other related policies, guidelines or clinician training.ConclusionThe universal PHHBs were well accepted, well used and the best completed handover documentation. The PHHBs provided a successful handover option for patients with chronic NCDs in Mongolia, but their completeness needs improving. There is potential for global application.