bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of electroglottographic and glottal area waveforms for phonation type differentiation in male professional singers
Authors: Selamtzis Andreas , Ternström Sten , Richter Bernard , Burk Fabian , Köberlein Marie , Echternach Matthias
Published: December 2018

This study compares the use of electroglottograms (EGGs) and glottal area waveforms (GAWs) to study phonation in different vibratory states as produced by professionally trained singers. Six western classical tenors were asked to phonate pitch glides from modal to falsetto phonation, or from modal to their stage voice above the passaggio (SVaP). For each pitch glide the sample entropy (SampEn) of the EGG signal was calculated to detect the occurrence of phonatory instabilities and establish a “ground truth” for the performed phonation type. The cycles before the maximum SampEn were labeled as modal, and the cycles after the peak were labeled as either falsetto, or SVaP. Three automatic categorizations of vibratory state were performed using clustering: one based only on the EGG, one based on the GAW, and one based on their combination. The error rate (clustering vs ground truth) was, on average, lower than 10% for all of the three settings, revealing no special advantage of the GAW over EGG, and vice versa. Modal voice cycles exhibited a larger contact quotient, larger normalized derivative peak ratio, and lower rise time, compared to SVaP and falsetto. The GAW-based normalized maximum area declination rate was larger in SVaP compared to modal voice.
Efficacy of Kinesio Taping and McConnell Taping Techniques in the Management of Anterior Knee Pain
Authors: Kakar Rumit S. , Greenberger Hilary B. , McKeon Patrick O.
Published: December 2018

Context: Anterior knee pain also known as patellofemoral pain syndrome is a frequently encountered musculoskeletal disorder that worsens with activity. The multifactorial etiology of patellofemoral pain syndrome alters lower-extremity mechanics, increasing patellofemoral joint stresses during weight-bearing tasks. Kinesio and McConnell tapings are often incorporated into the treatment, but their efficacy is still unclear. Objective: To test the efficacy of Kinesio taping, McConnell taping, and sham taping in improving knee mechanics and reducing pain during activity. Design: Cross-sectional design. Setting: Clinical biomechanics laboratory. Participants: Ten participants (age: 20.3 [1.5] y, height: 169.9 [10.4] cm, and mass: 70.17 [13.1] kg) with anterior knee pain and no history of trauma. Intervention: Three trials each of squat, drop jump, and step-down tasks with 3 taping conditions in a counterbalanced order. Main Outcome Measures: Two-dimensional motion capture data of lower-extremities in frontal and sagittal planes were recorded and analyzed using 3 iPads and Spark Motion® application. Pooled effect sizes (Hedges’ g), 95% confidence intervals, and repeated-measures analysis of variance (P < .05) compared baseline and taping conditions during exercises for pain Visual Analog Scale and knee flexion in all exercises, hip abduction during step-down and drop jump, frontal plane projection during step-downs, and knee translation in sagittal plane during squats. Results: Significant reductions in Visual Analog Scale were recorded during squats between tapes (F2.505,12.867 = 3.407, P = .04, Hedges’ g = −0.70). Pairwise comparison showed a decrease in Visual Analog Scale for sham taping (mean difference = 1.14 cm, P = .01) and Kinesio taping (mean difference = 1.54 cm, P = .02) compared with baseline during squats. Conclusions: A variety of taping methods can potentially reduce perceived pain in individuals with patellofemoral pain syndrome, allowing clinicians to perform rehabilitation exercises. Sensory effects associated with short-term taping may be sufficient enough to modify knee pain acutely by afferent input blocking nocioceptive pain before the participants could adapt. Most interestingly, the sham taping technique demonstrated promise for enhancing functional outcomes, depending on the length of the tape and area covered.
Effective Treatment for Chronic Ankle Instability During Lateral Step-Down—Kinesiology Tape, Resistance Exercise, or Both Accompanied With Heel Raise-Lower Exercise?
Authors: Lee Ji-Hyun , Yoon Tae-Lim
Published: December 2018

Context: Kinesiology tape (KT), multidirectional resistance exercise, and interventions for decreased ankle dorsiflexion range of motion are gaining popularity in the treatment of patients with chronic ankle instability (CAI). However, there is limited evidence of the effectiveness of combined interventions in patients with CAI. Objectives: To compare the effects of KT alone, KT with resistance exercise (KT + resistance), and KT with resistance and heel raise-lower exercise (KT + resistance + heel) on the results of the dynamic balance test (star excursion balance test [SEBT]), functional performance (lateral step-down test), and ankle muscle activation in patients with CAI. Design and Setting: This study used a repeated-measures design in a laboratory setting. Main Outcome Measures: The participants completed 3 different interventions with a 24-hour rest period between interventions. The SEBT, lateral step-down test, and ankle muscle activation results were used as the outcome measures. All outcomes were assessed before and immediately after the 3 interventions. Results: The results of the SEBT-anteromedial direction significantly increased with KT + resistance (78.61 [16.11] cm, P = .01, ES = 0.50) and KT + resistance + heel (76.94 [16.00] cm, P = .03, ES = 0.33) in comparison with the baseline values (73.68 [12.84] cm). Additionally, the result of the SEBT-anteromedial direction was significantly greater with KT + resistance (78.61 [16.11] cm) than with KT alone (76.00 [14.90] cm, P = .05, ES = 0.18). The number of errors during the lateral step-down test was significantly lower for the KT alone (2.16 [0.90] errors, P = .02, ES = 0.46), KT + resistance (2.10 [0.79] errors, P = .01, ES = 0.54), and KT + resistance + heel (2.03 [0.75] errors, P = .003, ES = 0.61) interventions than the baseline values (2.55 [0.85] errors). Conclusions: Patients with CAI should be encouraged to perform KT + resistance to improve balance.
Comparison of Myofascial Release Techniques on Pectoralis Minor Length, Glenohumeral Total Arc of Motion, and Skin Temperature: A Pilot Study
Authors: Rivera Matthew , Eberman Lindsey , Games Kenneth , Powden Cameron J.
Published: December 2018

Context: The pectoralis minor (PM) is an important postural muscle that may benefit from myofascial techniques, such as Graston Technique® (GT) and self-myofascial release (SMR). Objective: To examine the effects of GT and SMR on PM length, glenohumeral total arc of motion (TAM), and skin temperature. Design: Cohort. Setting: Laboratory. Participants: Twenty-six healthy participants (19 females and 7 males; age = 20.9 [2.24] y, height = 170.52 [8.66] cm, and weight = 72.45 [12.32] kg) with PM length restriction participated. Interventions: Participants were randomized to the intervention groups (GT = 12 and SMR = 14). GT and SMR interventions were both applied for a total of 5 minutes during each of the 3 treatment sessions. Main Outcome Measures: PM length, TAM, and skin temperature were collected before and after each intervention session (Pre1, Post1, Pre2, Post2, Pre3, and Post3) and at 1-week follow-up (follow-up). Separate intervention by time analyses of variance examined differences for each outcomes measure. Bonferroni post hoc analyses were completed when indicated. Significance was set a priori at P ≤ .05. Results: No significant intervention by time interactions were identified for PM length, TAM, or temperature (P > .05). No significant intervention main effects were identified for PM length (P > .05), TAM (P > .05), or temperature (P > .05) between the GT or SMR technique groups. Overall, time main effects were found for PM length (P = .02) and temperature (P < .001). Post hoc analysis showed a significant increase in PM length for both intervention groups at follow-up (P = .03) compared with Post2. Furthermore, there were significant increases in temperature at Post1 (P < .001), Post2 (P = .01), and Post3 (P < .001) compared with Pre1; Post2 was increased compared with Pre2 (P = .003), Pre3 (P < .001), and follow-up (P = .01); Post3 increased compared with Pre3 (P = .01) and follow-up (P = .01). Conclusion: Serial application of GT and SMR to the PM did not result in increases in PM length or TAM. Regardless of intervention, skin temperature increased following each intervention.
The Impact of a Previous Ankle Injury on Current Health-Related Quality of Life in College Athletes
Authors: Marshall Ashley N. , Snyder Valier Alison R. , Yanda Aubrey , Lam Kenneth C.
Published: December 2018

Context:There has been an increased interest in understanding how ankle injuries impact patient outcomes; however, it is unknown how the severity of a previous ankle injury influences health-related quality of life (HRQOL).Objective:To determine the impact of a previous ankle injury on current HRQOL in college athletes.Design:Cross-sectional study.Setting:Athletic training clinics.Participants:A total of 270 participants were grouped by the severity of a previous ankle injury (severe = 62, mild = 65, and no injury = 143).Main Outcome Measures:Participants completed the Foot and Ankle Ability Measure (FAAM) and the Short Form 12 (SF-12).Methods:A 2-way analysis of variance with 2 factors (injury group and sex) was used to identify interaction and main effects for the FAAM and SF-12.Results:No interactions were identified between injury group and sex. Significant main effects were observed for injury group, where the severe injury group scored lower than athletes with mild and no injuries on the FAAM activities of daily living, FAAM Global, and SF-12 mental health subscale scores. In addition, a main effect was present for sex in the SF-12 general health, social functioning, and mental health subscales in which females reported significantly lower scores than males.Conclusions:Our findings suggest that a severe ankle injury impacts HRQOL, even after returning back to full participation. In addition, females tended to report lower scores than males for aspects of the SF-12, suggesting that sex should be considered when evaluating HRQOL postinjury. As a result, clinicians should consider asking athletes about their previous injury history, including how much time was lost due to the injury, and should mindful of returning athletes to play before they are physiologically and psychologically ready, as there could be long-term negative effects on the patients’ region-specific function as well as aspects of their HRQOL.
The Fungal Cyp51-Specific Inhibitor VT-1598 Demonstrates
In Vitro
and
In Vivo
Activity against Candida auris
Authors: Wiederhold Nathan P. , Lockhart Shawn R. , Najvar Laura K. , Berkow Elizabeth L. , Jaramillo Rosie , Olivo Marcos , Garvey Edward P. , Yates Christopher M. , Schotzinger Robert J. , Catano Gabriel , Patterson Thomas F.
Published: December 2018

Candida auris
is an emerging pathogen associated with significant mortality and often multidrug resistance. VT-1598, a tetrazole-based fungal CYP51-specific inhibitor, was evaluated
in vitro
and
in vivo
against
C. auris
.
Lectin Activity of the TcdA and TcdB Toxins of Clostridium difficile
Authors: Hartley-Tassell Lauren E. , Awad Milena M. , Seib Kate L. , Scarselli Maria , Savino Silvana , Tiralongo Joe , Lyras Dena , Day Christopher J. , Jennings Michael P.
Published: December 2018

Clostridium difficile
is a major cause of hospital-acquired antibiotic-associated diarrhea.
C. difficile
produces two cytotoxins, TcdA and TcdB; both toxins are multidomain proteins that lead to cytotoxicity through the modification and inactivation of small GTPases of the Rho/Rac family.
Genomic and Phenotypic Diversity among Ten Laboratory Isolates of
Pseudomonas aeruginosa
PAO1
Authors: Chandler Courtney E. , Horspool Alexander M. , Hill Preston J. , Wozniak Daniel J. , Schertzer Jeffrey W. , Rasko David A. , Ernst Robert K.
Published: December 2018

Laboratory-adapted strains of bacteria are used throughout the world for microbiology research. These prototype strains help keep research data consistent and comparable between laboratories. However, we have observed phenotypic variability when using different strains of
Pseudomonas aeruginosa
PAO1, one of the major laboratory-adopted research strains. Here, we describe the genomic and phenotypic differences among 10 PAO1 strains acquired from independent sources over 15 years to understand how individual maintenance affects strain characteristics. We observed limited genomic changes but variable phenotypic changes, which may have consequences for cross-comparison of data generated using different PAO1 strains. Our research highlights the importance of limiting practices that may promote the microevolution of model strains and calls for researchers to specify the strain origin to ensure reproducibility.
Reassessment of Routine Midstream Culture in Diagnosis of Urinary Tract Infection
Authors: Sathiananthamoorthy Sanchutha , Malone-Lee James , Gill Kiren , Tymon Anna , Nguyen Trang K. , Gurung Shradha , Collins Linda , Kupelian Anthony S. , Swamy Sheela , Khasriya Rajvinder , Spratt David A. , Rohn Jennifer L.
Published: December 2018

Midstream urine (MSU) culture remains the gold standard diagnostic test for confirming urinary tract infection (UTI). We previously showed that patients with chronic lower urinary tract symptoms (LUTS) below the diagnostic cutoff on MSU culture may still harbor bacterial infection and that their antibiotic treatment was associated with symptom resolution.
Comprehensive Evaluation of Compendial USP<71>, BacT/Alert Dual-T, and Bactec FX for Detection of Product Sterility Testing Contaminants
Authors: England Matthew R. , Stock Frida , Gebo James E. T. , Frank Karen M. , Lau Anna F.
Published: December 2018

The emergence of cell therapy programs in large academic centers has led to an increasing demand for clinical laboratories to assist with product sterility testing. Automated blood culture systems have shown promise as alternatives to the manual USP<71> compendial method, but current published data are limited by small organism test sets, particularly for molds.
Noninvasive Detection of Tuberculosis by Oral Swab Analysis
Authors: Luabeya Angelique K. , Wood Rachel C. , Shenje Justin , Filander Elizabeth , Ontong Cynthia , Mabwe Simbarashe , Africa Hadn , Nguyen Felicia K. , Olson Alaina , Weigel Kris M. , Jones-Engel Lisa , Hatherill Mark , Cangelosi Gerard A.
Published: December 2018

Diagnostic tests for tuberculosis (TB) usually require collection of sputum, a viscous material derived from human airways. Sputum can be difficult and hazardous to collect and challenging to process in the laboratory.
Contact Challenge of Cattle with Foot-and-Mouth Disease Virus Validates the Role of the Nasopharyngeal Epithelium as the Site of Primary and Persistent Infection
Authors: Stenfeldt Carolina , Hartwig Ethan J. , Smoliga George R. , Palinski Rachel , Silva Ediane B. , Bertram Miranda R. , Fish Ian H. , Pauszek Steven J. , Arzt Jonathan
Published: December 2018

Foot-and-mouth disease virus (FMDV) is an important livestock pathogen that is often described as the greatest constraint to global trade in animal products. The present study utilized a standardized pig-to-cow contact exposure model to demonstrate that FMDV infection of cattle initiates in the nasopharyngeal mucosa following natural virus exposure. Furthermore, this work confirmed the role of the bovine nasopharyngeal mucosa as the site of persistent FMDV infection in vaccinated and nonvaccinated cattle. The critical output of this study validates previous studies that have used simulated natural inoculation models to characterize FMDV pathogenesis in cattle and emphasizes the importance of continued research of the unique virus-host interactions that occur within the bovine nasopharynx. Specifically, vaccines and biotherapeutic countermeasures designed to prevent nasopharyngeal infection of vaccinated animals could contribute to substantially improved control of FMDV.
Unusual sensory variant of Guillain-Barré syndrome
Authors: Semproni Milena , Gibson Gillian , Kuyper Laura , Tam Penny
Published: December 2018

We describe a 52-year-old woman presenting with acute onset of severe burning paraesthesia in the hands and feet associated with allodynia and antalgic gait. At the time of admission to hospital no motor weakness was present. A diagnosis of Guillain-Barré syndrome (GBS) was considered when neurophysiological studies were completed showing convincing evidence of demyelination on motor conduction studies and sural sparing on sensory nerve studies.1We describe this case as a sensory variant of GBS. Clinical improvement followed treatment with a single course of intravenous immunoglobulin (IVIG). The patient made a complete clinical recovery within 6 months of onset and repeat neurophysiological studies showed marked improvement. We encourage clinicians to consider an atypical variant of GBS in patients presenting with acute sensory complaints.
Small cell lung cancer presenting as unilateral rhinorrhoea
Authors: Haymes Adam , Mahalingam Sridhayan , Choudhury Natasha
Published: December 2018

The metastatic spread of infraclavicular malignancies to the nasal cavity is rare. We describe the case of a 58-year-old man who presented with a 4-month history of right-sided rhinorrhoea, maxillary hypoesthesia, hyposmia and hypogeusia. Clinical examination revealed an irregular mass within the right nasal cavity. Immunohistochemical analyses of biopsies were consistent with small cell carcinoma of indeterminate origin. A positron emission tomography scan demonstrated extensive mediastinal lymphadenopathy with collapse-consolidation of the right lung's middle lobe and no other sites of metastasis. Following discussion at the lung multidisciplinary team meeting, a diagnosis of metastatic small cell lung cancer (SCLC) was made; the patient was staged with N3, M1b disease and palliative chemo-radiotherapy was started. To the best of our knowledge, this report represents the first documented case of a solitary nasal cavity metastasis arising from a SCLC.
Cor triatriatum and stroke
Authors: Diestro Jose Danilo Bengzon , Regaldo Joseph Justin Hipolito , Gonzales Eddieson Masangcay , Dorotan Maria Kristina Casanova , Espiritu Adrian Isidoro , Pascual Jose Leonard Rivera
Published: December 2018

Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS. Despite anticoagulation with apixaban, she was admitted for a third stroke where she succumbed to hospital-acquired pneumonia. Among cases of CTS associated with stroke, anticoagulation and surgery were the main modes of treatment. This case has the longest follow-up and the first to demonstrate failure of antiplatelet therapy and anticoagulation.
Evaluation of vascular changes in intermediate uveitis and retinal vasculitis using swept-source wide-field optical coherence tomography angiography
Authors: Tian Meng , Tappeiner Christoph , Zinkernagel Martin S , Huf Wolfgang , Wolf Sebastian , Munk Marion R
Published: December 2018

Purpose

To evaluate vascular changes in patients with intermediate uveitis with or without retinal vasculitis using swept-source wide-field optical coherence tomography angiography (OCTA).

Methods

This is a prospective cross-sectional study. Consecutive patients with intermediate uveitis were evaluated using wide-field OCTA. Wide-field OCTA and en-face OCT images were analysed for the presence of capillary non-perfusion and reduced perfusion, disruption of ellipsoid zone, and abnormalities on en-face wide-field retinal thickness maps, respectively, and compared with fluorescein angiography (FA) findings in a subcohort.

Results

164 eyes of 88 patients with intermediate uveitis were included. Areas of capillary non-perfusion and reduced perfusion were more frequently observed in the choroidal OCTA slab (33.3% and 49.4%), choriocapillaris (CC; 31.4% and 48%) and deep capillary plexus (DCP; 9.6% and 34.6%) than in the superficial capillary plexus (SCP; 5% and 26.3%), respectively. Intermediate uveitis with vasculitis presented more frequently with non-perfusion and hypoperfusion in the DCP (p=0.003 and p=0.05, respectively) and SCP (p=0.007 and p=0.005, respectively) than intermediate uveitis without vasculitis. Peripheral capillary leakage on FA correlated with the presence of perivascular, macular and generalised thickening on en-face wide-field thickness maps (p=0.007). Ischaemia on FA was significantly associated with non-perfusion on wide-field OCTA in SCP and DCP (p=0.019 and p=0.027, respectively).

Conclusion

Changes in the choroid, CC and DCP are more frequently found than in the SCP on wide-field OCTA in intermediate uveitis. While wide-field OCTA is a reliable tool to detect capillary non-perfusion in intermediate uveitis, it was not helpful in determining disease activity.

Trial registration number

NCT02811536.
A cross-sectional study to assess Evidence-Based Medicine teaching method: online or face-to-face?
Authors: El Sayed Iman , Abdelmonem Sherif
Published: December 2018

We aimed to study differences in postgraduate students’ achievement if they are taught evidence-based medicine (EBM) by face-to-face or by online learning. We assessed the performance of 28 postgraduate students who completed a face-to-face learning module and 34 students who completed an online learning module in a cross-sectional study. The teaching materials were the same in both courses so that any performance difference would be due to the teaching method. Grading involved semester work (15%), midterm (25%), oral (15%) and final (30%) examinations. Students were evaluated by a project submitted by the end of the semester (15%). Percentage of student satisfaction was calculated. Mean midterm and final examination scores did not differ significantly between the two groups (p=0.759 and 0.721, respectively). Students from both groups achieved almost the same median score on the oral discussion examination (p=0.31). Students who attended the online learning module were associated with a significantly higher median project score compared with those who attended the face-to-face teaching (p<0.001). In general, students from both modules were similarly satisfied about course contents, lecturers and students’ assessment process although one-third of students felt non-equality and unfair instructors’ practice towards them in face-to-face teaching method. Further research should be paid towards assessment of EBM e-learning to support the developing era of evidence-based practice in low-income to middle-income countries.
Optimal dose of succinylcholine for laryngeal mask airway insertion: systematic review, meta-analysis and metaregression of randomised control trials
Authors: Liao Alan Hsi-Wen , Lin Yu-Cih , Bai Chyi-Huey , Chen Chien-Yu
Published: December 2018

Objectives

To evaluate the optimal dose of succinylcholine for laryngeal mask airway (LMA) insertion and all related morbidities.

Design

Systematic review, meta-analysis and metaregression of randomised controlled trials (RCTs).

Data source and study eligibility criteria

A comprehensive search of RCTs in the PubMed, Embase, the Cochrane Library and the ClinicalTrials.gov registry up to July 2016 and articles that evaluated the use of succinylcholine chloride for LMA insertion were included in the analyses. The relative risk (RR) and the corresponding 95% CIs were determined.

Intervention

Succinylcholine as the coinduction agent and the doses were divided into mini (≤0.3 mg/kg) and low (0.3–1.0 mg/kg) doses for dose-dependent effect analyses.

Primary and secondary outcomes

The primary outcome was the first-attempt LMA insertion failure rate. Secondary outcomes included all related adverse events.

Results

Data from 10 RCTs comprising 625 participants showed that succinylcholine reduced the first-attempt LMA insertion failure rate (RR, 0.22; 95% CI 0.12 to 0.43), coughing and gagging (RR, 0.26; 95% CI 0.15 to 0.45) and laryngospasm (RR, 0.14; 95% CI 0.05 to 0.39). The use of succinylcholine did not result in a significant increase of postoperative myalgia (RR, 2.58; 95% CI 0.79 to 8.44) and did not reduce the risk of postoperative sore throat (RR, 0.76; 95% CI 0.55 to 1.03). Subgroup analysis further showed that low-dose succinylcholine reduced the LMA insertion failure rate and its related coughing and gagging when compared with mini dose.

Conclusion

The use of succinylcholine compared with none can facilitate LMA insertion and reduce insertion-related reflexes without significant postoperative myalgia. However, additional prospective studies with a larger sample size are required to fully evaluate the dose-dependent effect and complications of succinylcholine for LMA insertion.
Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: protocol for a scoping study on SCI needs
Authors: Moreno Alexander , Zidarov Diana , Raju Chandhana , Boruff Jill , Ahmed Sara
Published: December 2018

Introduction

There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care.

Methods and analysis

(A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow's hierarchical model of human needs and the Ferranset al's model of health-related quality of life) and (E) a stakeholder consultation phase.

Ethics and dissemination

The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings.
Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings
Authors: Murphy Mark E , Byrne Molly , Galvin Rose , Boland Fiona , Fahey Tom , Smith Susan M
Published: December 2018

Objectives

Poorly controlled type 2 diabetes mellitus (T2DM) is a major international health problem. Our aim was to assess the effectiveness of healthcare interventions, specifically targeting patients with poorly controlled T2DM, which seek to improve glycaemic control and cardiovascular risk in primary care settings.

Design

Systematic review.

Setting

Primary care and community settings.

Included studies

Randomised controlled trials (RCTs) targeting patients with poor glycaemic control were identified from Pubmed, Embase, Web of Science, Cochrane Library and SCOPUS. Poor glycaemic control was defined as HbA1c over 59 mmol/mol (7.5%).

Interventions

Interventions were classified as organisational, patient-oriented, professional, financial or regulatory.

Outcomes

Primary outcomes were HbA1c, blood pressure and lipid control. Two reviewers independently assessed studies for eligibility, extracted data and assessed study quality. Meta-analyses were undertaken where appropriate using random-effects models. Subgroup analysis explored the effects of intervention type, baseline HbA1c, study quality and study duration. Meta-regression analyses were undertaken to investigate identified heterogeneity.

Results

Forty-two RCTs were identified, including 11 250 patients, with most undertaken in USA. In general, studies had low risk of bias. The main intervention types were patient-directed (48%) and organisational (48%). Overall, interventions reduced HbA1c by −0.34% (95% CI −0.46% to −0.22%), but meta-analyses had high statistical heterogeneity. Subgroup analyses suggested that organisational interventions and interventions on those with baseline HbA1c over 9.5% had better improvements in HbA1c. Meta-regression analyses suggested that only interventions on those with population HbA1c over 9.5% were more effective. Interventions had a modest improvement of blood pressure and lipids, although baseline levels of control were generally good.

Conclusions

This review suggests that interventions for T2DM, in primary care, are better targeted at individuals with very poor glycaemic control and that organisational interventions may be more effective.
Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada
Authors: Hadkhale Kishor , MacLeod Jill , Demers Paul A , Martinsen Jan Ivar , Weiderpass Elisabete , Kjaerheim Kristina , Lynge Elsebeth , Sparen Pär , Tryggvadottir Laufey , Anne Harris M , Tjepkema Michael , Peters Paul A , Pukkala Eero
Published: December 2018

Objectives

The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada.

Methods

In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC.

Results

Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort.

Conclusion

We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.
Active Play in After-school Programmes: development of an intervention and description of a matched-pair cluster-randomised trial assessing physical activity play in after-school programmes
Authors: Riiser Kirsti , Helseth Sølvi , Ellingsen Hanna , Fallang Bjørg , Løndal Knut
Published: December 2018

Introduction

Interventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the ‘Active Play in ASP’ intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention.

Methods and analysis

Informed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed.

Ethics and dissemination

The study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals.

Trial registration number

Clinical Trials (NCT02954614), pre-results.
7-day compared with 10-day antibiotic treatment for febrile urinary tract infections in children: protocol of a randomised controlled trial
Authors: Daniel Maria , Szajewska Hania , Pańczyk-Tomaszewska Małgorzata
Published: December 2018

Introduction

The optimal duration of antibiotic therapy in children with febrile urinary tract infections (UTIs) is still a matter of debate. Current guidelines recommend treating children with febrile UTIs with antimicrobials for 7 to 14 days. We aim to compare the efficacy and safety of 7-day versus 10-day course of oral or sequence therapy (intravenous with a switch to oral) with cefuroxime/cefuroxime axetil for febrile UTIs in children.

Methods and analysis

A non-inferiority, double-blind, randomised, controlled trial will be conducted. Two hundred twenty-one patients aged 3 months to 7 years with febrile UTIs (defined as a combination of fever and leucocyturia in urine sediment) will be randomly assigned to a 7-day treatment arm (7 days of cefuroxime/cefuroxime axetil followed by 3 days of blinded placebo) or a 10-day treatment arm (7 days of cefuroxime/cefuroxime axetil followed by 3 days of blinded cefuroxime axetil). The primary outcome measure will be frequencies of recurrence and reinfection of UTI during the 6 months after the intervention.

Ethics and dissemination

The Bioethics Committee approved the study protocol. The findings of this trial will be submitted to a peer-reviewed paediatric journal. Abstracts will be submitted to relevant national and international conferences.

Date and protocol version identifier

04/09/2017

Trial registration number

NCT03221504.
Wool-derived keratin dressings versus usual care dressings for treatment of slow-healing venous leg ulceration: study protocol for a randomised controlled trial (Keratin4VLU)
Authors: Jull Andrew , Wadham Angela , Bullen Chris , Parag Varsha , Waters Jill
Published: December 2018

Introduction

Keratins, filament-forming proteins found in vertebrate epithelium, are downregulated in slow-healing venous leg ulcers (VLU) compared with normal-healing VLU. Laboratory and animal model research has suggested exogenous keratins increase expression of endogenous keratins. A non-randomised controlled trial of an exogenous keratin dressing reported increased healing in slow-healing VLU. To date, no randomised controlled trial has been done to verify these promising findings.

Methods and analysis

The Keratin4VLU trial is a single-blind, pragmatic, parallel group, randomised controlled trial of keratin dressings compared with usual care non-medicated dressings in patients with VLU where either (1) the ulcer area is greater than 5 cm2, (2) the ulcer has been present for more than 26 weeks or (3) both. All patients will receive compression therapy. The primary outcome is the proportion of patients with healed VLU at 24 weeks after randomisation as adjudicated by blinded review of an ulcer photograph. Secondary outcomes are time to healing, estimated change in ulcer area, change in health-related quality of life, agreement between blinded and unblinded assessors and adverse events. The analysis will be intention-to-treat on the primary and secondary outcomes (excepting health-related quality of life).

Ethics and dissemination

The Keratin4VLU trial received ethical approval from the Northern A Health and Disability Ethics Committee. We plan to publish the results within 1 year of trial completion and will include the results on the trial registration page.

Trial registration number

NCT02896725; Pre-results.
Protocol for the trismus trial—therabite versus wooden spatula in the amelioration of trismus in patients with head and neck cancer: randomised pilot study
Authors: Lee Rana , Molassiotis Alex , Rogers Simon N , Edwards Rhiannon Tudor , Ryder David , Slevin Nick
Published: December 2018

Introduction

Patients can develop trismus from their head and neck cancer or as a result of treatment. Trismus affects the jaw muscles and makes mouth opening difficult. To potentially combat trismus, patients could undertake proactive jaw stretching exercises prior to, during and after radiotherapy, although currently these are not the standard of care.

Methods and analysis

This is a randomised, open-label, controlled, two-centre feasibility study, to assess the objective and subjective effectiveness and cost-effectiveness of therabite use compared with wooden spatula in ameliorating trismus in patients treated for stage 3 and 4 oral and oropharyngeal cancer, managed either by primary surgery followed by (chemo)radiotherapy or primary (chemo)radiotherapy. The principal objective assessment is measurement of maximum jaw opening. Assessments in all cases will be performed preradiotherapy and again at 3 and 6 months postintervention.

Secondary aims of the study will be (1) to assess whether therabite or the wooden spatula intervention improves patients’ quality of life, (2) reduce the level of post-treatment clinical management/healthcare use and (3) a nested qualitative study will explore the experience of the patient taking part in the intervention; data will be transcribed verbatim and analysis will be based on content analysis methods using the interview questions as the framework for examination.

Ethics and dissemination

North West Greater Manchester granted ethical approval (REC Reference 11/NW/0744). Good Clinical Practice and the Declaration of Helsinki have been adhered to. The results will be presented internationally and submitted to a peer-reviewed journal. Head and neck cancer charities and information websites will also be approached.

Trial registration number

NCT01733797.
Sexuality and intimacy in ALS: systematic literature review and future perspectives
Authors: Poletti Barbara , Carelli Laura , Solca Federica , Pezzati Rita , Faini Andrea , Ticozzi Nicola , Mitsumoto Hiroshi , Silani Vincenzo
Published: December 2018

Several features of amyotrophic lateral sclerosis (ALS) impact on sexuality and intimate relationship; however, the issue has received poor attention so far. We performed a systematic literature review in order to provide an up-to-date account of sexuality in ALS. References were identified by searches of PubMed, Web of Science, Scopus and PsycINFO (1970–2017, English literature). The following were the key terms: ‘sexual’ OR ‘sexuality’ OR ‘intimacy’ OR ‘marital’ AND ‘ALS’ OR ‘Amyotrophic Lateral Sclerosis’ OR ‘Motor Neuron Disease’ OR ‘MND’. Titles and abstracts were screened for relevance and a full-text analysis was performed on the selected articles. Studies were included if they referred to sexual well-being/activities/functions or intimate relationship between patients and their partners and management of such topic by clinicians. Eligibility assessment was performed independently by two reviewers. A thematic and level of evidence classification of studies was performed. Studies’ design, objectives, measurements and outcomes were summarised. Thirty articles were included and four topics were identified: intimacy in the dyads; sexual activities in patients and with their partners; sexual function disturbances; and sexuality and cognitive-behavioural alterations. The quality of the studies varies, with globally poor level of evidence. Some sexuality issues have been only sparsely addressed, such as gender-related differences, same-sex relationships and sexual activities other than intercourse. Sexuality in ALS is still not adequately considered by clinicians and researchers. We present preliminary recommendations for improving sexuality and intimacy at any ALS multidisciplinary clinics.
The most mentioned neurointervention articles in online media: a bibliometric analysis of the top 101 articles with the highest altmetric attention scores
Authors: Kim Hye Jeong , Yoon Dae Young , Kim Eun Soo , Yun Eun Joo , Jeon Hong Jun , Lee Jong Young , Cho Byung-Moon
Published: December 2018

Background and purpose

Alternative metrics (altmetrics), based on mentions in online media, is a new tool that can help to identify the most influential articles to diverse public audiences. This article aimed to determine the 100 most mentioned articles in the field of neurointervention and to analyze their characteristics.

Materials and methods

We selected the 808 journals that were considered journals potentially publishing articles on neurointervention. We also selected articles using keywords. Using the Altmetric.com search tool, we identified the 101 most mentioned neurointervention articles based on the highest altmetric attention scores (AASs) within selected journals and articles. Each article was evaluated for several characteristics including AAS, number of citations, journal title, journal category, impact factor of the journal, year of publication, authorship, country, type of document, and topic.

Results

The AASs for the top 101 articles ranged from 1586 to 39.Strokepublished the largest number of articles (19.8%) followed by theNew England Journal of Medicine(17.8%). The majority of articles were published in multidisciplinary journals (38.6%), were published in 2017–2018 (43.6%), originated from the USA (54.5%), were original articles (66.3%), and dealt with intra-arterial thrombolysis or thrombectomy for acute ischemic stroke (58.4%). Tudor G Jovin was the most prolific author, authoring 18 of the most mentioned neurointervention articles

Conclusions

This study presents a detailed list of the 101 most mentioned neurointervention articles in online media, thus providing useful information on the dissemination of neurointervention research to the general public.
A simple method for settlement evaluation of loess–pile foundation
Authors: Jin Xin , Wang Tie-Hang , Cheng Wen-Chieh , Luo Yang , Zhou Annan
Published: December 2018

Collapsible soils have been regarded to be a significant engineering concern for foundation constructions in northwest China. Given that the collapsible soils, also known as loess, cover most of northwest China, all buildings, structures, and utility pipelines have to deal with the collapse of loess. Despite the many empirically based methods available for evaluation of the collapse of loess, methods to assess the collapse of loess surrounded by piles are, however, rarely seen. This study proposes a simple method for evaluation of the collapse of loess surrounded by piles by taking into account both the collapsible deformation characteristics and friction at the loess–pile interface. The results of an application of the proposed method to three more loess–pile foundation worksites are presented and indicate that the proposed method can predict the settlement of loess–pile foundation satisfactorily.
Presence of genes associated with adhesion, invasion, and toxin production inCampylobacter jejuniisolates and effect of temperature on their expression
Authors: de Oliveira Mauricéia Greici , Rizzi Caroline , Galli Vanessa , Lopes Graciela Volz , Haubert Louise , Dellagostin Odir Antônio , da Silva Wladimir Padilha
Published: December 2018

The aims of this study were to evaluate the presence of genes associated with adhesion (cadF), invasion (ciaB), and cytotoxin production (cdtA, cdtB, and cdtC) among Campylobacter jejuni isolates from a poultry slaughterhouse and to investigate the effect of different temperatures on the expression of these virulence-associated genes. A total of 88 C. jejuni isolates from cecum, liver, chicken carcasses, chilled water, and scalding water were submitted to PCR assay for detection of virulence genes. Representative isolates were selected for gene expression evaluation at 37 and 42 °C, according to their virulence gene profile and genotypic typing. All C. jejuni isolates carried the five virulence-associated genes, which play an important role in the infectious process. Differential gene expression by RT–qPCR was observed among C. jejuni isolates at 37 and 42 °C. The expression levels at 37 °C showed upregulation of the ciaB, cdtA, cdtB, and cdtC genes in five isolates, with the exception of ciaB for isolate 4. At 42 °C, upregulation was observed for ciaB and cdtC, cdtA and cdtB, and cadF in four, three, and two isolates, respectively. The C. jejuni isolates expressed the virulence genes evaluated, and the expression is gene- and isolate-dependent and varied according the temperature.
Standardization of proton induced X-ray emission for analysis of trace elements in thick samples
Authors: Zeb Johar , Ali Shad , Haneef Muhammad , Naeem Azhar Muhammad , Akbar Jehan
Published: December 2018

This paper presents the standardization of proton induced X-ray emission (PIXE) technique for the analysis of trace elements in thick, standard samples. Three standard reference materials, titanium, copper, and iron base alloys, were used for the study due to their availability. The proton beam was accelerated up to 2.57 MeV energy by 5UDH-II tandem Pelletron accelerator, and samples were irradiated at different geometries and durations. Spectra were acquired using a multi-channel spectrum analyzer, and spectra analyses were done using GUPIXWIN software for determination of elemental concentrations of trace elements. The obtained experimental data were compared with theoretical data and results were found to be in close agreement.