bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro assessment of bacterial colonisation rates of goat umbilical cord segments using three embodiments of a novel neonatal umbilical catheter protection device
Authors: Dambkowski Carl L , Chehab Eric F , Shih Joseph D , Venook Ross , Wall James K 
Published: March 2016

IntroductionCentral line-associated bloodstream infections (CLABSIs) in neonates with umbilical catheters occur at a rate that is 5 times higher than CLABSIs in adults with central catheters. No device currently exists tailored to the unique constraints umbilical catheters pose. The current study examined the natural progression of bacterial colonisation in goat umbilical cords and the relationship between embodiments of a novel neonatal umbilical catheter protection device and bacterial colonisation rates. The authors hypothesise that device venting is required to minimise bacterial colonisation in the unique umbilical stump environment.MethodsThe natural progression of bacterial colonisation in goat umbilical cord segments was studied by examining bacterial colonisation rates each day over 7 days. To understand the relationship between protection and bacterial colonisation, umbilical catheters were placed in goat umbilical cord segments and secured with 1 of 3 embodiments of a novel umbilical catheter protection device, which offered varying degrees of venting. After a 7-day period of incubation, colony counts were compared.ResultsBacterial load was largest when umbilical cord segments were fresh and subsequently decreased over time. Further, bacterial colonisation rates showed a statistically significant difference between device embodiments (F(2,9)=4.26, p<0.05), with the non-vented embodiment showing the highest bacterial colonisation rate.ConclusionsA device to better stabilise and protect umbilical catheters in order to reduce bloodstream infections in neonates is greatly needed. The current experiments confirm the hypothesis that completely enclosed, or non-vented, protection device will have increased bacterial growth.
Could a disruptive out patient healthcare delivery model reduce escalating in-hospital healthcare costs in knee osteoarthritis
Authors: Doss Arockia 
Published: March 2016

BackgroundHealthcare costs from in-hospital joint surgery for degenerative joint diseases are predicted to significantly increase to potentially unsustainable levels in the next several decades.AimAs an index model, this paper presents cost-effectiveness predictions for an innovative combination treatment of image-guided percutaneous autologous blood-derived growth factors and exercises (IPGFE) for painful knee osteoarthritis managed in an out of hospital interventional radiology (IR) clinic through a disruptive healthcare delivery model.Materials and methodsNon-randomised retrospective case registry data were analysed. Patients suitable for TKR who underwent IPGFE were included. Knee function outcome scores were converted to quality of life years (QALY) gained. Median percentage improvement after IPGFE in knee function was converted to cost per QALYs by input of direct costs.ResultsMedian cost per QALY for IPGFE was AU$ 208.33 for 7.2 QALY gained. In comparison, the median cost per QALY for TKR was AU$2739 for 4.5 QALY gained. Incremental cost-effectiveness ratio for IPGFE was AU$4827.77 not spent per QALY gained in comparison to TKR.ConclusionsAn out of hospital care model may be a less expensive option to gain better quality of life in comparison to knee joint replacement surgery for some patients. Out of hospital IR techniques should be studied further for their efficacy and potential to offer considerable healthcare cost savings in comparison to joint replacement surgery.
Unemployment in the teens and trajectories of alcohol consumption in adulthood
Authors: Virtanen Pekka , Lintonen Tomi , Westerlund Hugo , Nummi Tapio , Janlert Urban , Hammarström Anne 
Published: March 2016

ObjectivesThe unemployed are assumed to adopt unhealthy behaviours, including harmful use of alcohol. This study sought to elucidate the relations between unemployment before age 21 years and consumption of alcohol from 21 to 42 years. The design was based on the conception of youth as a sensitive period for obtaining ‘drinking scars’ that are visible up to middle age.SettingThe Northern Swedish Cohort Study has followed up a population sample from 1981 to 2007 with five surveys.ParticipantsAll pupils (n=1083) attending the last year of compulsory school in Luleå participated in the baseline survey in classrooms, and 1010 of them (522 men and 488 women) participated in the last follow-up survey that was conducted at classmate reunions or by post or by phone.Outcome measureThe trajectory of alcohol consumption from 21 to 43 years, obtained with latent class growth analyses, was scaled.ResultsMen were assigned to five and women to three consumption trajectories. The trajectory membership was regressed on accumulation of unemployment from 16 to 21 years, with multinomial logistic regression analyses. The trajectory of moderate consumption was preceded by lowest exposure to unemployment in men and in women. With reference to this, the relative risk ratios for high-level trajectory groups were 3.49 (1.25 to 9.79) in men and 1.41 (0.74 to 2.72) in women, but also the trajectories of low-level consumption were more probable (relative risk ratio 3.18 (1.12 to 9.02) in men and 2.41 (1.24 to 4.67) in women).ConclusionsHigh-level alcohol consumption throughout adulthood is, particularly among men, partly due to ‘scars’ from youth unemployment, particularly in men, but there are also groups of men and women where unemployment in the teens predicts a trajectory of low consumption.
Association between sexually transmitted disease and church membership. A retrospective cohort study of two Danish religious minorities
Authors: Kørup Alex Kappel , Thygesen Lau Caspar , Christensen René dePont , Johansen Christoffer , Søndergaard Jens , Hvidt Niels Christian 
Published: March 2016

ObjectivesStudies comprising Danish Seventh-day Adventists (SDAs) and Danish Baptists found that members have a lower risk of chronic diseases including cancer. Explanations have pointed to differences in lifestyle, but detailed aetiology has only been sparsely examined. Our objective was to investigate the incidence of sexually transmitted diseases (STDs) among Danish SDAs and Baptists as a proxy for cancers related to sexual behaviour.MethodsWe followed the Danish Cohort of Religious Societies from 1977 to 2009, and linked it with national registers of all inpatient and outpatient care contacts using the National Patient Register. We compared the incidence of syphilis, gonorrhoea and chlamydia among members of the cohort with the general population.ResultsThe cohort comprised 3119 SDA females, 1856 SDA males, 2056 Baptist females and 1467 Baptist males. For the entire cohort, we expected a total of 32.4 events of STD, and observed only 9. Female SDAs and Baptists aged 20–39 years had significant lower incidence of chlamydia (both p<0.001). Male SDAs and Baptists aged 20–39 years also had significant lower incidence of chlamydia (p<0.01 and p<0.05, respectively). No SDA members were diagnosed with gonorrhoea, when 3.4 events were expected, which, according to Hanley's ‘rule of three’, is a significant difference. No SDA or Baptist was diagnosed with syphilis.ConclusionsThe cohort shows significant lower incidence of STD, most likely including human papillomavirus, which may partly explain the lower incidence of cancers of the cervix, rectum, anus, head and neck.
Chinese herbal medicine for patients with vascular cognitive impairment no dementia: protocol for a systematic review
Authors: Feng Mei , Lu Jingmin , May Brian H , Liu Shaonan , Guo Xinfeng , Zhang Anthony Lin , Xue Charlie Changli , Lu Chuanjian 
Published: March 2016

IntroductionThe aim of this systematic review is to assess the efficacy and safety of Chinese herbal medicine for the treatment of patients with vascular cognitive impairment but no dementia.Methods and analysisWe will perform a comprehensive retrieval in the following electronic databases: PubMed, Cochrane Library, EMBASE, CINAHL, Chinese Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang database and other sources. After screening the studies, the methodological quality of all included trials will be assessed according to the risk of bias instrument provided by the Cochrane Collaboration. A meta-analysis of randomised controlled trials will be conducted using RevMan V.5.3 software. Funnel plot analysis and Egger's test will be used to assess publication bias, if possible. The quality of evidence will be assessed by the GRADE system.DisseminationThis systematic review will be disseminated in a peer-reviewed journal and a relevant conference presentation.Trial registration numberPROSPERO CRD 42015023682.
Clinical impact of neoadjuvant treatment in resectable pancreatic cancer: a systematic review and meta-analysis protocol
Authors: Lee Jong-chan , Ahn Soyeon , Paik Kyu-hyun , Kim Hyoung Woo , Kang Jingu , Kim Jaihwan , Hwang Jin-Hyeok 
Published: March 2016

IntroductionAlthough the only curative strategy for pancreatic cancer is surgical resection, up to 85% of patients relapse after surgery. The efficacy of neoadjuvant treatment in resectable pancreatic cancer (RPC) remains unclear and there is no systematic review focusing fully on this issue. Recently, two prospective trials of neoadjuvant treatment in RPC were terminated early because of slow recruiting and existing randomised controlled trials (RCTs) have too small sample sizes. Therefore, to overcome probable biases, it would be more reasonable to include both RCTs and non-randomised studies (NRSs) with selected criteria. This review aims to investigate the effect of neoadjuvant chemotherapy (CTx) and chemoradiation therapy (CRT) in RPC using RCTs and specific NRSs.Method and analysisThis systematic review will include conventional RCTs as group I, and quasi-randomised controlled trials, non-randomised controlled trials and prospective cohort studies as group II. Two groups will be assessed and analysed separately. Comprehensive literature search will use Medline, Embase, Cochrane library and Scopus databases. Additionally, we will search references from relevant studies and abstracts from major conferences. Two authors will independently identify, screen, include studies, extract data and assess the risk of bias. Discrepancies will be resolved by consensus with another author. An independent methodologist will categorise and assess NRSs to minimise heterogeneity. In each study group, meta-analysis will be conducted using a random-effect model and statistical heterogeneity will be evaluated using I2-statistics. Publication bias will be visualised with contour-enhanced funnel plots and analysed with Egger's test. In group I, cumulative meta-analysis will be considered because the CTx regimen and CRT protocol have changed. The quality of evidence will be summarised using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.Ethics and disseminationThis review does not use primary data, and formal ethical approval is not required. Findings will be disseminated through peer-reviewed journals and committee conferences.Trial registration numberCRD42015023820.
Relationship between percentage of mean arterial pressure at the ankle and mortality in participants with normal ankle-brachial index: an observational study
Authors: Li Yu-Hsuan , Lin Shih-Yi , Sheu Wayne Huey-Herng , Lee I-Te 
Published: March 2016

ObjectivesPeripheral arterial disease (PAD) is associated with all-cause mortality. Ankle-brachial index (ABI) is the most widely used tool for detecting PAD, but can yield false-negative results in patients with non-compressible vessels. Pulse volume recording may be an alternative tool for assessing PAD in such patients. However, the association between pulse volume recording and all-cause mortality has seldom been reported. We hypothesised that the percentage of mean arterial pressure (%MAP) and upstroke time (UT), which are indexes of the arterial wave obtained on pulse volume recording, can predict mortality.DesignWe conducted this as a retrospective cohort study.SettingData were collected from the Taichung Veterans General Hospital.ParticipantsWe included 314 participants with complete data on ABI and pulse volume recording performed between June 2007 and November 2011.Primary outcome measureMortality data served as the follow-up outcome. Mortality data were obtained from the Collaboration Center of Health Information Application, Ministry of Health and Welfare, Executive Yuan, Taiwan.ResultsParticipants with ABI ≤0.9 showed a highest mortality rate (p<0.001 in the log-rank test), but the mortality rate was not significantly different between participants with 0.9<ABI≤1.1 and those with 1.1<ABI≤1.3 (p=0.553). Among the participants with 0.9<ABI≤1.3, the high %MAP (>45%) group showed a higher risk of all-cause mortality than the low %MAP (≤45%) group (HR=5.389, p=0.004) after adjustment for ABI, pulse wave velocity, UT, age, sex, blood pressure, serum cholesterol, and history of cardiovascular disease and diabetes.ConclusionsWe thus demonstrated that a high %MAP based on pulse volume recording in participants with 0.9<ABI≤1.3 could predict all-cause mortality during 20.3 months of follow-up.
Validity of ICD-9-CM codes for breast, lung and colorectal cancers in three Italian administrative healthcare databases: a diagnostic accuracy study protocol
Authors: Abraha Iosief , Serraino Diego , Giovannini Gianni , Stracci Fabrizio , Casucci Paola , Alessandrini Giuliana , Bidoli Ettore , Chiari Rita , Cirocchi Roberto , De Giorgi Marcello , Franchini David , Vitale Maria Francesca , Fusco Mario , Montedori Alessandro 
Published: March 2016

IntroductionAdministrative healthcare databases are useful tools to study healthcare outcomes and to monitor the health status of a population. Patients with cancer can be identified through disease-specific codes, prescriptions and physician claims, but prior validation is required to achieve an accurate case definition. The objective of this protocol is to assess the accuracy of International Classification of Diseases Ninth Revision—Clinical Modification (ICD-9-CM) codes for breast, lung and colorectal cancers in identifying patients diagnosed with the relative disease in three Italian administrative databases.Methods and analysisData from the administrative databases of Umbria Region (910 000 residents), Local Health Unit 3 of Napoli (1 170 000 residents) and Friuli-Venezia Giulia Region (1 227 000 residents) will be considered. In each administrative database, patients with the first occurrence of diagnosis of breast, lung or colorectal cancer between 2012 and 2014 will be identified using the following groups of ICD-9-CM codes in primary position: (1) 233.0 and (2) 174.x for breast cancer; (3) 162.x for lung cancer; (4) 153.x for colon cancer and (5) 154.0–154.1 and 154.8 for rectal cancer. Only incident cases will be considered, that is, excluding cases that have the same diagnosis in the 5 years (2007–2011) before the period of interest. A random sample of cases and non-cases will be selected from each administrative database and the corresponding medical charts will be assessed for validation by pairs of trained, independent reviewers. Case ascertainment within the medical charts will be based on (1) the presence of a primary nodular lesion in the breast, lung or colon–rectum, documented with imaging or endoscopy and (2) a cytological or histological documentation of cancer from a primary or metastatic site. Sensitivity and specificity with 95% CIs will be calculated.DisseminationStudy results will be disseminated widely through peer-reviewed publications and presentations at national and international conferences.
An investigation of general predictors for cognitive–behavioural therapy outcome for anxiety disorders in a routine clinical setting
Authors: Nielsen Sara Kerstine Kaya , Vangkilde Signe , Wolitzky-Taylor Kate B , Daniel Sarah Ingrid Franksdatter , Hageman Ida 
Published: March 2016

IntroductionCognitive–behavioural therapy (CBT) is effective for treating anxiety disorders and is offered in most mental health services around the world. However, a relatively large number of patients with anxiety disorders do not benefit from CBT, experience relapses or drop out. Reliable predictors of treatment effects are lacking. The aim of this study is to investigate the predictive value of emotion regulation and attentional control for CBT outcome in a routine setting.Methods and analysisIn this prospective and practice-based study, 112 patients with anxiety disorders referred for manual-based group CBT at two psychiatric outpatient clinics will be recruited. Emotion regulation, severity of anxiety and attentional control will be assessed with self-report measures and with an experimental computer-based attentional control task at baseline, post-treatment and at a 6-month follow-up. Emotion regulation will be measured with Difficulties in Emotion Regulation Questionnaire, severity of anxiety will be assessed with Beck Anxiety Inventory and attentional control will be measured with the self-report questionnaire, Attention Control Scale, and with an experimental computer-based attentional control task based on theory of visual attention. Data will be analysed using multilevel mixed-effects modelling.Ethics and disseminationThe study is approved by the Danish National Ethical Board, the Department of Psychology Ethical Board, University of Copenhagen and by the Danish Data Protection Agency. Study findings will be disseminated through peer-reviewed journal publications and conference presentations. The Danish Committee System on Health Research Ethics has been notified about the project.Trial registration numberNCT02638363.
The evolution of multiagency partnerships for safety over the course of research engagement: experiences from the NoGAPS project
Authors: Finch Caroline F , Donaldson Alex , Gabbe Belinda J , Muhammad Akram , Shee Anna Wong , Lloyd David G , Cook Jill 
Published: March 2016

ObjectiveImplementation of effective population-level injury prevention interventions requires broad multiagency partnerships. Different stakeholders address this from varying perspectives, and potential conflicts in priorities need to be addressed for such partnerships to be effective. The researcher-led National Guidance for Australian football Partnerships and Safety (NoGAPS) project involved the engagement and participation of seven non-academic partners, including government health promotion and safety agencies; peak sports professional and advocacy bodies and health insurance organisations.DesignThe partnership's ongoing development was assessed by each partner completing the Victorian Health Promotion Foundation Partnership Analysis Tool (VPAT) annually over 2011–2015. Changes in VPAT scores were compared through repeated measures analysis of variance.ResultsOverall, mean total VPAT scores increased significantly over the 5-year period (125.1–141.2; F5,30=4.61, p=0.003), showing a significant improvement in how the partnership was functioning over time. This was largely driven by significant increases in several VPAT domains: ‘determining the need for a partnership’ (F5,30=4.15, p=0.006), ‘making sure the partnership works’ (F5,30=2.59, p=0.046), ‘planning collaborative action’ (F5,30=5.13, p=0.002) and ‘minimising the barriers to the partnership’ (F5,30=6.66, p<0.001).ConclusionThis is the first study to assess the functioning of a multiagency partnership to address sport injury prevention implementation. For NoGAPS, the engagement of stakeholders from the outset facilitated the development of new and/or stronger links between non-academic partners. Partners shared the common goal of ensuring the real-world uptake of interventions and research evidence-informed recommendations. Effective multiagency partnerships have the potential to influence the implementation of policies and practices beyond the life of a research project.
Quality of consumer-targeted internet guidance on home firearm and ammunition storage
Authors: Freundlich Katherine L , Skoczylas Maria Shakour , Schmidt John P , Keshavarzi Nahid R , Mohr Bethany Anne 
Published: March 2016

Background and objectivesFour storage practices protect against unintentional and/or self-inflicted firearm injury among children and adolescents: keeping guns locked (1) and unloaded (2) and keeping ammunition locked up (3) and in a separate location from the guns (4). Our aim was to mimic common Google search strategies on firearm/ammunition storage and assess whether the resulting web pages provided recommendations consistent with those supported by the literature.MethodsWe identified 87 web pages by Google search of the 10 most commonly used search terms in the USA related to firearm/ammunition storage. Two non-blinded independent reviewers analysed web page technical quality according to a 17-item checklist derived from previous studies. A single reviewer analysed readability by US grade level assigned by Flesch–Kincaid Grade Level Index. Two separate, blinded, independent reviewers analysed deidentified web page content for accuracy and completeness describing the four accepted storage practices. Reviewers resolved disagreements by consensus.ResultsThe web pages described, on average, less than one of four accepted storage practices (mean 0.2 (95% CL 0.1 to 0.4)). Only two web pages (2%) identified all four practices. Two web pages (2%) made assertions inconsistent with recommendations; both implied that loaded firearms could be stored safely. Flesch–Kincaid Grade Level Index averaged 8.0 (95% CL 7.3 to 8.7). The average technical quality score was 7.1 (95% CL 6.8 to 7.4) out of an available score of 17. There was a high degree of agreement between reviewers regarding completeness (weighted κ 0.78 (95% CL 0.61 to 0.97)).ConclusionsThe internet currently provides incomplete information about safe firearm storage. Understanding existing deficiencies may inform future strategies for improvement.