bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulating the Chan-Hudspeth experiment on an active excised cochlear segment
Authors: Nankali Amir , Grosh Karl
Published: July 2017

Hearing relies on a series of coupled electrical, acoustical, and mechanical interactions inside the cochlea that enable sound processing. The local structural and electrical properties of the organ of Corti (OoC) and basilar membrane give rise to the global, coupled behavior of the cochlea. However, it is difficult to determine the root causes of important behavior, such as the mediator of active processes, in the fully coupled in vivo setting. An alternative experimental approach is to use an excised segment of the cochlea under controlled electrical and mechanical conditions. Using the excised cochlear segment experiment conducted by Chan and Hudspeth [Nat. Neurosci. 8, 149–155 (2005); Biophys. J. 89, 4382–4395 (2005)] as the model problem, a quasilinear computational model for studying the active in vitro response of the OoC to acoustical stimulation was developed. The model of the electrical, mechanical, and acoustical conditions of the experimental configuration is able to replicate some of the experiment results, such as the shape of the frequency response of the sensory epithelium and the variation of the resonance frequency with the added fluid mass. As in the experiment, the model predicts a phase accumulation along the segment. However, it was found that the contribution of this phase accumulation to the dynamics is insignificant. Taking advantage of the relative simplicity of the fluid loading, the three-dimensional fluid dynamics was reduced into an added mass loading on the OoC thereby reducing the overall complexity of the model.
Numerical investigation of cavity self-oscillation and noise radiation induced by turbulent flow at non-zero inclination angle
Authors: Wang Yiping , Guo Chengqi , Peng Chengjian , Yu Chenguang
Published: July 2017

A hybrid numerical approach was used on a three-dimensional cavity at a non-zero inclination angle of the upstream section to reveal the mechanism of self-oscillation and the characteristics of far-field sound field. In this hybrid approach, the unsteady flow physics was captured by a compressible large eddy simulation, and the far-field sound field was calculated by the FW–H integral equation, with the noise source provided by near-field calculation. The mechanism of self-oscillation was revealed based on the instantaneous flow field structure and the pressure inside the cavity. The effects of the position of opening, inclination angle and neck thickness on the frequency and amplitude of the fluctuation pressure inside the cavity were examined. Results showed that the frequency and the amplitude were sensitive to the inclination angle but not to the position of the opening. Under varying neck thicknesses, the fundamental frequencies changed, but the amplitude remained almost constant. The influences of the boundary layer thickness on the amplitude of the fluctuation pressure was also investigated. Results revealed that the oscillation was suppressed once the boundary layer thickness reached a critical value. The findings could provide a reference for a quiet car with a low sunroof buffeting noise.
Small-Sided Games in Elite Soccer: Does One Size Fit All?
Authors: Lacome Mathieu , Simpson Ben M. , Cholley Yannick , Lambert Philippe , Buchheit Martin
Published: July 2017

Purpose: To compare the peak intensity of typical small-sided games (SSGs) with those of official matches in terms of running demands and mechanical work (MechW) over different rolling average durations and playing positions. Methods: Data were collected in 21 players (25 [5] y, 181 [7] cm, and 77 [7] kg) belonging to an elite French football team. SSG data were collected over 2 seasons during typical training sessions (249 files, 12 [4] per player) and official matches (n = 12). Players’ locomotor activity was recorded using 5-Hz Global Positioning System. Total distance (m), high-speed distance (HS, distance above 14.4 km·h−1, m), and MechW (a.u.) were analyzed during different rolling average periods (1–15 min). The SSGs examined were 4v4+goalkeepers (GKs), 6v6+GKs, 8v8+GKs, and 10v10+GKs. Results: Peak total distance and HS during 4v4, 6v6, and 8v8 were likely-to-most likely lower than during matches (effect size: −0.59 [±0.38] to −7.36 [±1.20]). MechW during 4v4 was likely-to-most likely higher than during matches (1–4 min; 0.61 [±0.77] to 2.30 [±0.64]). Relative to their match demands, central defenders performed more HS than other positions (0.63 [±0.81] to 1.61 [±0.52]) during 6v6. Similarly, central midfielders performed less MechW than the other positions during 6v6 (0.68 [±0.72] to 1.34 [±0.99]) and 8v8 (0.73 [±0.50] to 1.39 [±0.32]). Conclusion: Peak locomotor intensity can be modulated during SSGs of various formats and durations to either overload or underload match demands, with 4v4 placing the greatest and the least emphasis on MechW and HS, respectively. Additionally, in relation to match demands central defenders and central midfielders tend to be the most and least overloaded during SSGs, respectively.
Lower-Extremity Muscle Activity, Kinematics, and Dynamic Postural Control in Individuals With Patellofemoral Pain
Authors: Goto Shiho , Aminaka Naoko , Gribble Phillip A.
Published: July 2017

Context: Altered lower-extremity muscle activity has been associated with lower-extremity kinematics in individuals with patellofemoral pain (PFP). However, few studies have examined these relationships, and the results are inconsistent. Objective: To compare the lower-extremity muscle activity, kinematics, pain level, and reach distance during the anterior reach of the star excursion balance test (SEBT) between participants with PFP and healthy individuals (control [CON] group). Design: Case control. Setting: Research laboratory. Participants: Twenty-eight (PFP = 14 and CON = 14) participants volunteered. Intervention: Each participant performed 3 maximal voluntary isometric contractions of the gluteus maximus, gluteus medius (GMED), adductor longus (AL), and vastus medialis, and 5 anterior reaches of the SEBT. Main Outcome Measures: Three-dimensional joint kinematics of the hip and knee at the time of touchdown of the SEBT and integrated electromyography of each muscle were recorded during the descent phase of the SEBT. Coactivation ratios between the GMED and AL were calculated (GMED/AL). Pain level was assessed at the baseline and during performance of the SEBT, using a visual analog scale. Results: Participants with PFP demonstrated decreased GMED/AL coactivation ratio (P = .01) and shorter reach distance (P = .01) during anterior reach of the SEBT compared with the CON group. Participants with PFP demonstrated higher pain levels at baseline (P = .03) and during test performance (P < .001) compared with the CON group and increased pain level during the test performance compared with the baseline (P < .001). No other significant differences were observed. Conclusions: There were alterations in muscle activity during SEBT performance, suggesting that overactivity of AL relative to GMED is a unique neural recruitment pattern in those with PFP. However, hip and knee joint kinematics did not seem to contribute to deficits in the anterior reach distance, suggesting a need for continued assessment of these deficiencies.
Comparative Effects of 4 Single-Leg Squat Exercises in Subjects With Gluteus Medius Weakness
Authors: Han Hae-rim , Yi Chung-hwi , You Sung-hyun , Cynn Heon-seock , Lim One-bin , Son Jae-ik
Published: July 2017

Context:Of the weight-bearing exercises, single-leg squats (SLSs) represent one of the most commonly used hip-strengthening exercises that require more gluteus medius (GMED) activity. To date, no studies have investigated how the 4 SLS exercises affect muscle imbalance of GMED, tensor fasciae latae (TFL), and adductor longus (AL), and kinematics of hip.Objective:To investigate the hip muscle activities, onset time, and kinematics during 4 different SLS exercises (unilateral squat, unilateral wall-squat [UWS], lateral step-down, and front step-down) in subjects with GMED weakness.Design:Repeated-measures experimental design.Setting:Research laboratory.Participants:Twenty-two subjects (11 males and 11 females) participated in this study and were compared using 1-way repeated-measures analysis of variance.Main Outcome Measures:Surface electromyography was used to measure the muscle activities and onset time of the GMED, TFL, and AL, and 3-dimensional motion tracking system was used to measure the hip adduction and internal/external rotation angles during SLS exercises. One-way repeated-measures analysis of variance was used at a significance level ofP < .05.Results:The UWS produced higher GMED/TFL activity ratio and lower GMED/TFL onset time ratio than in the other 3 exercises (P < .05). No difference in GMED/AL activity ratio and GMED/AL onset time ratio was observed. The hip adduction angle was greater in UWS than in the other 3 exercises (P < .05). As for the hip internal/external rotation, lateral step-down exhibited higher hip internal rotation angle than front step-down (P < .05).Conclusion:The UWS may be recommended as an effective exercise for the subjects with GMED weakness, but they should take care to avoid excessive hip adduction during the exercise.
Effects of Rigid and Kinesio Taping on Shoulder Rotation Motions, Posterior Shoulder Tightness, and Posture in Overhead Athletes: A Randomized Controlled Trial
Authors: Gulpinar Damla , Tekeli Ozer Sibel , Yesilyaprak Sevgi Sevi
Published: July 2017

Context:Alterations in posture and motion patterns are thought to play a role in developing shoulder injuries in overhead athletes. Taping is widely used in the sporting population, but there are limited empirical data regarding its effectiveness.Objectives:To determine and compare the effects of rigid and kinesio taping on shoulder rotation motions, posterior shoulder tightness (PST), and posture in overhead athletes.Design:Randomized controlled trial.Setting:Athletic training rooms.Participants:Eighty-six asymptomatic elite overhead athletes.Interventions:Participants were randomly divided into 4 groups: rigid taping group (RTG) that underwent therapeutic rigid taping, kinesio taping group (KTG) that underwent therapeutic kinesio taping, placebo group that underwent placebo kinesio taping (shoulder and scapular region taping for taping groups), and control group (no taping).Main Outcome Measures:Shoulder rotation motions, PST, and head and shoulder posture were evaluated at baseline, immediately after application and 60 to 72 hours after application for all groups.Results:Glenohumeral internal rotation increased immediately (P < .001) and at 60 to 72 hours after application in the KTG (P = .01), whereas it decreased immediately after application in the RTG (P < .001). Immediately after application, total rotation range of motion increased in the KTG (P =.02) and decreased in the RTG (P < .001), and there was a difference between groups (P = .02). Immediately after application, PST increased in the RTG (P < .001); after 60 to 72 hours, it decreased in the KTG (P = .04) and increased in the RTG (P = .01). Posture outcomes did not change significantly (P > .05).Conclusions:Kinesio taping may improve and rigid taping may worsen glenohumeral internal rotation and PST in overhead athletes. For increasing total rotation range of motion, kinesio taping is superior to rigid taping. Taping did not affect posture. Short-term kinesio taping in overhead athletes may be useful to improve glenohumeral internal rotation, total rotation range of motion, and PST.
IgG4-related disease: long-term natural history and management of a relapsing multisystem disease entity
Authors: Kotha Sreelakshmi , Tritto Giovanni , Wong Terry , Berry Philip
Published: July 2017

Although awareness of IgG4-related disease has grown over the past decade, with earlier diagnosis and treatment, understanding of its natural history over the long term and the optimal management remains unclear. We report the case of a 48-year-old man who presented with a pancreatic pseudotumour causing bile duct obstruction with coexisting autoimmune hepatitis and multisystem involvement. His symptoms settled on steroids and maintenance with azathioprine was commenced, however periodic relapses occurred involving multiple organs. A timeline-relating IgG4 levels, clinical features and immunosuppressive therapy are presented. The protean and relapsing–remitting nature of this condition is emphasised, and a brief review of long-term therapeutic options is provided.
Acute rehabilitation after resuscitative endovascular balloon occlusion of the aorta (REBOA) in major trauma
Authors: Rich Jessica Anne , Coleman Julia , Devaux Camille , Hoffman Karen
Published: July 2017

We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient’s complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries.

The patient was admitted to the acute critical care unit and underwent repeated operations and was not ready to start active rehabilitation until 12 days into her admission. Prior to this she was on movement restrictions and received physiotherapy for limb care and dietetics in order to meet her nutritional requirements. The patient was stepped down to a ward setting and started on an extensive physiotherapy programme and was then transferred to the rehabilitation unit for amputees at Roehampton.
EFFECTS OF A PREVENTION PROGRAM FOCUSED ON HIP JOINT FUNCTION ON THE INCIDENCE OF ANTERIOR CRUCIATE LIGAMENT INJURIES IN FEMALE BASKETBALL PLAYERS
Authors: Ohmi Yorikatsu , Hirose Norikazu
Published: July 2017

Background

Previous meta-analyses have revealed that effective programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players have not been established.

Objective

To investigate the effects of an ACL injury prevention program focused on improving hip joint function in female basketball players.

Design

Cohort study.

Setting

Intervention study for well-trained varsity athletes.

Patients (or Participants)

Four hundred eighty-nine (180 intervention and 309 control) female varsity division II basketball players (18–22 years of age) participated in this study.

Interventions (or Assessment of Risk Factors)

The prevention program consisted of education (injury mechanism, neutral position, etc.) and neuromuscular training to improve hip joint function (jump-landing exercise with a band, hip external rotator and abductor strength training, and balance exercises). Players were guided through this program by several physical therapists. They were instructed to keep the knee and toe in a neutral position in the jump-landing exercise. The intervention group performed this program three times a week throughout the season. The control group maintained their routine warm-up session. All ACL injuries were verified by arthroscopy or magnetic resonance imaging findings.

Main Outcome Measurements

The 1000 athlete-exposure (1000 AE) and relative risk index (intervention vs. control) of ACL injuries were calculated and compared between the groups using the χ2test. Statistical significance was set at P<0.05.

Results

Three ACL injuries occurred in the intervention group, whereas 16 occurred in the control group. The incidence of injury in the intervention and control groups was 0.08/1000 AE and 0.25/1000 AE, respectively. The relative risk index was 0.32 (95% CI, 0.092–1.086; P=0.053, χ2test).

Conclusions

Prevention programs to reduce ACL injuries may be beneficial in well-trained female basketball players.
Homeless people’s access to primary care physiotherapy services: an exploratory, mixed-method investigation using a follow-up qualitative extension to core quantitative research
Authors: Dawes Jo , Deaton Stuart , Greenwood Nan
Published: July 2017

Objectives

The purpose of this study was to appraise referrals of homeless patients to physiotherapy services and explore perceptions of barriers to access.

Design

This exploratory mixed-method study used a follow-up qualitative extension to core quantitative research design. Over 9 months, quantitative data were gathered from the healthcare records of homeless patients referred to physiotherapy by a general practitioner (GP) practice, including the number of referrals and demographic data of all homeless patients referred. Corresponding physiotherapy records of those people referred to physiotherapy were searched for the outcome of their care. Qualitative semi-structured telephone interviews, based on the quantitative findings, were carried out with staff involved with patient care from the referring GP practice and were used to expand insight into the quantitative findings.

Setting

Two primary care sites provided data for this study: a GP practice dedicated exclusively to homeless people and the physiotherapy department receiving their referrals.

Participants

Quantitative data from the healthcare records of 34 homeless patient referrals to physiotherapy were collected and analysed. In addition, five staff involved in patient care were interviewed.

Results

34 referrals of homeless people were made to physiotherapy in a 9-month period. It was possible to match 25 of these to records from the physiotherapy department. Nine (36%) patients did not attend their first appointment; seven (28%) attended an initial appointment, but did not attend a subsequent appointment and were discharged from the service; five (20%) completed treatment and four patients (16%) had ongoing treatment. Semi-structured interviews revealed potential barriers preventing homeless people from accessing physiotherapy services, the complex factors being faced by those making referrals and possible ways to improve physiotherapy access.

Conclusions

Homeless people with musculoskeletal problems may fail to access physiotherapy treatment, but opportunities exist to make access to physiotherapy easier.
The job content questionnaire in various occupational contexts: applying a latent class model
Authors: Santos Kionna Oliveira Bernardes , Araújo Tânia Maria de , Carvalho Fernando Martins , Karasek Robert
Published: July 2017

Objective

To evaluate Job Content Questionnaire(JCQ) performance using the latent class model.

Methods

We analysed cross-sectional studies conducted in Brazil and examined three occupational categories: petroleum industry workers (n=489), teachers (n=4392) and primary healthcare workers (3078)and 1552 urban workers from a representative sample of the city of Feira de Santana in Bahia, Brazil. An appropriate number of latent classes was extracted and described each occupational category using latent class analysis, a multivariate method that evaluates constructs and takes into account

the latent characteristics underlying the structure of measurement scales. The conditional probabilities of workers belonging to each class were then analysed graphically.

Results

Initially, the latent class analysis extracted four classes corresponding to the four job types (active, passive, low strain and high strain) proposed by the Job-Strain model (JSM) and operationalised by the JCQ. However, after taking into consideration the adequacy criteria to evaluate the number of extracted classes, three classes (active, low strain and high strain) were extracted from the studies of urban workers and teachers and four classes (active, passive, low strain and high strain) from the study of primary healthcare and petroleum industry workers.

Conclusion

The four job types proposed by the JSM were identified among primary healthcare and petroleum industry workers—groups with relatively high levels of skill discretion and decision authority. Three job types were identified for teachers and urban workers; however, passive job situations were not found within these groups. The latent class analysis enabled us to describe the conditional standard responses of the job types proposed by the model, particularly in relation to active jobs and high and low strain situations.
Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
Authors: Gustafson Deborah R , Shi Qiuhu , Holman Susan , Minkoff Howard , Cohen Mardge H , Plankey Michael W , Havlik Richard , Sharma Anjali , Gange Stephen , Gandhi Monica , Milam Joel , Hoover Donald R
Published: July 2017

Objectives

Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates.

Design

Prospective, observational cohort.

Setting

Multicentre, across six sites in the USA.

Participants

1385 multirace/ethnic ART-experienced HIV+ women in 2005.

Primary and secondary outcomes

All deaths, AIDS deaths and non-AIDS deaths up to ~8 years from baseline.

Results

Included together in one model, VACS Index was the dominant, significant independent predictor of all deaths within 3 years (HR=2.20, 95% CI 1.83, 2.65, χ2=69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, χ2=23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, χ2=6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, χ2=16.18, p=0.0001). CES-D score was not independently associated with mortality.

Conclusions and relevance

This is the first simultaneous evaluation of three common health indices in HIV+ adults. Indices reflecting physical and biological ageing were associated with death.
Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper
Authors: Pomery Amanda , Schofield Penelope , Xhilaga Miranda , Gough Karla
Published: July 2017

Introduction

Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders.

Methods and analysis

We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities.

Ethics and dissemination

The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies.
Socially disparate trends in lifespan variation: a trend study on income and mortality based on nationwide Danish register data
Authors: Brønnum-Hansen Henrik
Published: July 2017

Background

Social inequality trends in life expectancy are not informative as to changes in social disparity in the age-at-death distribution. The purpose of the study was to investigate social differentials in trends and patterns of adult mortality in Denmark.

Methods

Register data on income and mortality from 1986 to 2014 were used to investigate trends in life expectancy, life disparity and the threshold age that separates ‘premature’ and ‘late’ deaths. Mortality compression was quantified and compared between income quartiles.

Results

Since 1986, male life expectancy increased by 4.2 years for the lowest income quartile and by 8.4 years for the highest income quartile. The clear compression of mortality apparent in the highest income quartile did not occur for the lowest income quartile. Premature and late deaths accounted both by 2.1 years of the increase in life expectancy in the lowest income quartile and by 6.0 and 2.4 years, respectively, in the highest income quartile. Life expectancy increased by 5.2 years among women in the lowest income quartile, 2.4 years due to premature deaths and 2.8 years due to late deaths. The gain in life expectancy among women in the highest income quartile of 5.6 years was distributed by 5.0 and 0.6 years due to premature and late deaths, respectively.

Conclusion

The study demonstrates that the increasing social gap in mortality appears differently in the change of the age-at-death distribution. Thus, no compression of mortality was seen in the lowest income quartile. The results do not provide support for a uniformly extension of pension age for all.
Prospective observational study in two Dutch hospitals to assess the performance of inflammatory plasma markers to determine disease severity of viral respiratory tract infections in children
Authors: Ahout Inge M L , Brand Kim H , Zomer Aldert , van den Hurk Wilhelma H , Schilders Geurt , Brouwer Marianne L , Neeleman Chris , Groot Ronald de , Ferwerda Gerben
Published: July 2017

Introduction

Respiratory viruses causing lower respiratory tract infections (LRTIs) are a major cause of hospital admissions in children. Since the course of these infections is unpredictable with potential fast deterioration into respiratory failure, infants are easily admitted to the hospital for observation. The aim of this study was to examine whether systemic inflammatory markers can be used to predict severity of disease in children with respiratory viral infections.

Methods

Blood and nasopharyngeal washings from children <3 years of age with viral LRTI attending a hospital were collected within 24 hours (acute) and after 4–6 weeks (recovery). Patients were assigned to a mild (observation only), moderate (supplemental oxygen and/or nasogastric feeding) or severe (mechanical ventilation) group. Linear regression analysis was used to design a prediction rule using plasma levels of C reactive protein (CRP), serum amyloid A (SAA), pentraxin 3 (PTX3), serum amyloid P component and properdin. This rule was tested in a validation cohort.

Results

One hundred and four children (52% male) were included. A combination of CRP, SAA, PTX3 and properdin was a better indicator of severe disease compared with any of the individual makers and age (69% sensitivity (95% CI 50 to 83), 90% specificity (95% CI 80 to 96)). Validation in 141 patients resulted in 71% sensitivity (95% CI 53 to 85), 87% specificity (95% CI 79 to 92), negative predictive value of 64% (95% CI 47 to 78) and positive predictive value of 90% (95% CI 82 to 95). The prediction rule was not able to identify patients with a mild course of disease.

Conclusion

A combination of CRP, SAA, PTX3 and properdin was able to identify children with a severe course of viral LRTI disease, even in children under 2 months of age. To assess the true impact on clinical management, these results should be validated in a prospective randomised control study.
A cluster-randomised, controlled proof-of-concept study to explore the feasibility and effect of a patient-directed intervention on quality of life in patients with advanced soft tissue sarcoma
Authors: Schuler Markus , Richter Stephan , Ehninger Gerhard , Bornhäuser Martin , Hentschel Leopold
Published: July 2017

Introduction

Even with evolving and expanding therapeutical options for the treatment of advanced sarcomas over recent years, the balance between efficacy and toxicity still remains a major concern. Moreover, the symptom burden in patients with sarcoma remains high compared with other malignant diseases. It is, therefore, crucial to assess treatment effectiveness not only in terms of disease-related outcomes (eg, overall survival) but also from an individual and patient-centred perspective using the assessment of patient-reported outcomes (PROs). By focusing on PROs as a primary study endpoint, we aim to address key issues for patients with advanced soft tissue sarcoma (STS) undergoing palliative treatment.

Methods and analysis

The protocol of the YonLife study describes a multicentre, cluster-randomised, controlled, open-label proof-of-concept study conducted in patients with advanced or metastatic STS treated with trabectedin in seven German hospitals. The primary objective of the study is to exploratively compare overall quality of life between the patients receiving a multidimensional intervention based on individual PROs and those receiving usual supportive treatment. This complex intervention consists of the (1) electronic assessment of PRO, (2) creation of a case vignette based on PRO and clinical data and (3) treatment suggestions based on the discussion of these vignettes in a regularly meeting expert panel. Additionally, the YonLife trial assesses the applicability of a tablet-based assessment of PROs. Patients’ and physicians’ acceptance and challenges concerning the implementation process will be evaluated.

Ethics and dissemination

The YonLife trial has been approved by the Ethics Committee of the University Hospital Dresden as well as by the relevant institutions of each participating centre before patient enrolment. The findings will be reported via relevant peer-reviewed journals as well as through presentation at international conferences.

Trial registration number

NCT02204111, pre-results.
Assessment of the effect of an Interactive Dynamic Referral Interface (IDRI) on the quality of referral letters from general practitioners to gastroenterologists: a randomised cross-over vignette trial
Authors: Eskeland Sigrun Losada , Brunborg Cathrine , Rueegg Corina Silvia , Aabakken Lars , Lange Thomas de
Published: July 2017

Objectives

We evaluated whether interactive, electronic, dynamic, diagnose-specific checklists improve the quality of referral letters in gastroenterology and assessed the general practitioners’ (GPs’) acceptance of the checklists.

Design

Randomised cross-over vignette trial.

Setting

Primary care in Norway.

Participants

25 GPs.

Intervention

The GPs participated in the trial and were asked to refer eight clinical vignettes in an internet-based electronic health record simulator. A referral support, consisting of dynamic diagnose-specific checklists, was created for the generation of referral letters to gastroenterologists. The GPs were randomised to refer the eight vignettes with or without the checklists. After a minimum of 3 months, they repeated the referral process with the alternative method.

Main outcome measures

Difference in quality of the referral letters between referrals with and without checklists, measured with an objective Thirty Point Score (TPS).

Difference in variance in the quality of the referral letters and GPs’ acceptance of the electronic dynamic user interface.

Results

The mean TPS was 15.2 (95% CI 13.2 to 16.3) and 22.0 (95% CI 20.6 to 22.8) comparing referrals without and with checklist assistance (p<0.001), respectively. The coefficient of variance was 23.3% for the checklist group and 39.6% for the non-checklist group. Two-thirds (16/24) of the GPs thought they had included more relevant information in the referrals with checklists, and considered implementing this type of checklists in their clinical practices, if available.

Conclusions

Dynamic, diagnose-specific checklists improved the quality of referral letters significantly and reduced the variance of the TPS, indicating a more uniform quality when checklists were used. The GPs were generally positive to the checklists.
Factors associated with online victimisation among Malaysian adolescents who use social networking sites: a cross-sectional study
Authors: Marret Mary J , Choo Wan Yuen
Published: July 2017

Objective

To determine the prevalence of online interpersonal victimisation and its association with patterns of social networking site (SNS) use, offline victimisation, offline perpetration and parental conflict among Malaysian adolescents using SNS.

Methods

A cross-sectional study of students from randomly selected public secondary schools in the state of Negeri Sembilan was conducted using an anonymous self-administered questionnaire. The questionnaire examined patterns of SNS use and included measures of online victimisation, online perpetration, offline victimisation and parental conflict. A response rate of 91% from a total of 1634 yielded a sample of 1487 students between 15 years and 16 years of age.

Results

Ninety-two per cent of respondents had used at least one SNS. More than half of SNS users (52.2%) reported experiences of online victimisation over the past 12 months. Boys were significantly more likely to experience online harassment compared with girls (52.2% vs 43.3%, p<0.001). There were no significant gender differences in experiences of unwanted sexual solicitation. Adolescents who engaged in perpetration behaviours online had almost six times higher odds of reporting frequent online victimisation compared with online behaviours involving personal disclosure. There was a significant dose-response relationship between engagement in multiple types of online behaviour and the risk of frequent online victimisation. Both online and offline perpetrations were associated with an increased risk of victimisation. Those who were victimised offline or experienced parental conflict were twice as likely to report online victimisation.

Conclusion

Interventions to prevent online electronic aggression should target perpetration behaviour both online and offline. Youth should be equipped with skills in communication and decision-making in relationships that can be applied across a spectrum of contexts both online and offline.
Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: a realist review
Authors: Handley Melanie , Bunn Frances , Goodman Claire
Published: July 2017

Objectives

To identify features of programmes and approaches to make healthcare delivery in secondary healthcare settings more dementia-friendly, providing a context-relevant understanding of how interventions achieve outcomes for people living with dementia.

Design

A realist review conducted in three phases: (1) stakeholder interviews and scoping of the literature to develop an initial programme theory for providing effective dementia care; (2) structured retrieval and extraction of evidence; and (3) analysis and synthesis to build and refine the programme theory.

Data sources

PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, NHS Evidence, Scopus and grey literature.

Eligibility criteria

Studies reporting interventions and approaches to make hospital environments more dementia-friendly. Studies not reporting patient outcomes or contributing to the programme theory were excluded.

Results

Phase 1 combined findings from 15 stakeholder interviews and 22 publications to develop candidate programme theories. Phases 2 and 3 identified and synthesised evidence from 28 publications. Prominent context–mechanism–outcome configurations were identified to explain what supported dementia-friendly healthcare in acute settings. Staff capacity to understand the behaviours of people living with dementia as communication of an unmet need, combined with a recognition and valuing of their role in their care, prompted changes to care practices. Endorsement from senior management gave staff confidence and permission to adapt working practices to provide good dementia care. Key contextual factors were the availability of staff and an alignment of ward priorities to value person-centred care approaches. A preoccupation with risk generated responses that werelikely to restrict patient choice and increase their distress.

Conclusions

This review suggests that strategies such as dementia awareness training alone will not improve dementia care or outcomes for patients with dementia. Instead, how staff are supported to implement learning and resources by senior team members with dementia expertise is a key component for improving care practices and patient outcomes.

Trial registration number

CRD42015017562.
Seroprevalence of hepatitis B virus infection in Cameroon: a systematic review and meta-analysis
Authors: Bigna Jean Joel , Amougou Marie A , Asangbeh Serra Lem , Kenne Angeladine Malaha , Noumegni Steve Raoul N , Ngo-Malabo Elodie T , Noubiap Jean Jacques
Published: July 2017

Objective

Better knowledge of hepatitis B virus (HBV) infection prevalence at the national level can help to implement pertinent strategies to address HBV related burden. The aim was to estimate the seroprevalence of HBV infection in Cameroon.

Design

Systematic review and meta-analysis.

Participants

People residing in Cameroon.

Data sources

Electronic databases including PubMed/MEDLINE, African Journals Online (AJOL), ScienceDirect, WHO-Afro Library, WHO-IRIS, African Index Medicus, National Institute of Statistics and National AIDS Control Committee, Cameroon; regardless of language and from 1 January 2000 to 30 September 2016. This was completed with a manual search of references of relevant papers. Risk of bias in methodology of studies was measured using the Newcastle-Ottawa Scale.

Results

Out of 511 retrieved papers, 44 studies with a total of 105 603 individuals were finally included. The overall pooled seroprevalence was 11.2% (95% CI 9.7% to 12.8%) with high heterogeneity between studies (I2=97.9%). Egger’s test showed no publication bias (p=0.167). A sensitivity analysis excluding individuals at high risk of HBV infection and after adjustment using trim and fill method showed a pooled seroprevalence of 10.6% (95% CI 8.6% to 12.6%) among 100 501 individuals (general population, blood donors and pregnant women). Sources of heterogeneity included geographical regions across country and setting (rural 13.3% vs urban 9.0%), and implementation of HBV universal immunisation (born after 9.2% vs born before 0.7%). Sex, site, timing of data collection, HBV screening tools and methodological quality of studies were not sources of heterogeneity.

Limitation

Only a third of the studies had low risk of bias in their methodology.

Conclusion

The seroprevalence of HBV infection in Cameroon is high. Effective strategies to interrupt the transmission of HBV are urgently required. Specific attention is needed for rural settings, certain regions and people born before the implementation of the HBV universal immunisation programme in Cameroon in 2005.

Registration

PROSPERO, CRD42016042654.
Extrapulmonary effects of continuous airway pressure on patients with obstructive sleep apnoea: protocol for an overview of systematic reviews
Authors: Labarca Gonzalo , Ortega Francisco , Arenas Alex , Reyes Tomas , Rada Gabriel , Jorquera Jorge
Published: July 2017

Introduction

Obstructive sleep apnoea (OSA) is associated with both pulmonary and extrapulmonary consequences. Continuous positive airway pressure (CPAP) is an effective treatment for pulmonary symptoms. However, it is not clear if CPAP modifies extrapulmonary symptoms, especially in the long term. To date, several studies addressing this issue have been performed, but the evidence is scattered across different reviews that address each outcome separately. Therefore, we will conduct an overview to assess and summarise all systematic reviews on the extrapulmonary effects of this intervention in patients with OSA.

Methods

This is a protocol for a systematic overview of reviews that will follow the guidelines from the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA-P. We will conduct comprehensive literature searches using MEDLINE, EMBASE, Cochrane, CINAHL, DARE and Epistemonikos. We will consider systematic reviews and meta-analyses of randomised controlled trials evaluating the extrapulmonary effects of CPAP on OSA. Two reviewers will independently screen articles for inclusion using criteria that are determined a priori, assessing the quality of included reviews and extracting relevant information. We will create matrices of evidence in the Epistemonikos database, including all systematic reviews addressing a similar question and all studies addressing the question in those reviews. We will try to explain why studies are not included in individual reviews using the inclusion criteria, and we will estimate the overlap between different reviews in the same matrix of evidence.

Ethics and dissemination

This review will be published in a peer-reviewed journal.

Trial registration number

CRD42014013036
Efficacy of non-invasive ventilation and oxygen therapy on immunocompromised patients with acute hypoxaemic respiratory failure: protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Li Zongru , Wang Tao , Yang Yi , Zhang Lixi , Wang Meng , Liu Gang , He Kun , Shi Juhong , He Jianqiang , Ma Yong , Li Yi , Zhu Huadong , Yu Xuezhong
Published: July 2017

Background

The number of immunocompromised patients has increased in recent years. Acute respiratory failure is a common complication leading to intensive care unit (ICU) admission and high mortality among such patients. The use of non-invasive ventilation (NIV) or oxygen therapy among these patients remains controversial, according to the inconsistent results of several randomised clinical trials (RCTs). This meta-analysis aims to evaluate whether NIV or oxygen therapy is the more appropriate initial oxygenation strategy for the immunocompromised patients with acute respiratory failure.

Method

We will search all the RCTs that compared the efficacy of NIV and oxygen therapy on immunocompromised adult patients with acute hypoxaemic respiratory failure on the major databases (Cochrane Library, MEDLINE, EMBASE, Web of Science and others), conference proceedings and grey literature. Eligible RCTs will be included in accordance with the pre-specified eligibility criteria. The risk of bias will be assessed using the Cochrane Collaboration criteria and the quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation system. Data will be extracted with a standardised form and analysed using RevMan V.5.3 analyses software. Heterogeneity will be assessed using I2statistic and the source of which will be investigated. Publication bias will be identified with the funnel plot.

Ethics and dissemination

Ethical approval is not required since it is not carried out in humans. The systematic review will be published in peer-reviewed journals and disseminated extensively through conferences.
What techniques might be used to harness placebo effects in non-malignant pain? A literature review and survey to develop a taxonomy
Authors: Bishop Felicity L , Coghlan Beverly , Geraghty Adam WA , Everitt Hazel , Little Paul , Holmes Michelle M , Seretis Dionysis , Lewith George
Published: July 2017

Objectives

Placebo effects can be clinically meaningful but are seldom fully exploited in clinical practice. This review aimed to facilitate translational research by producing a taxonomy of techniques that could augment placebo analgesia in clinical practice.

Design

Literature review and survey.

Methods

We systematically analysed methods which could plausibly be used to elicit placebo effects in 169 clinical and laboratory-based studies involving non-malignant pain, drawn from seven systematic reviews. In a validation exercise, we surveyed 33 leading placebo researchers (mean 12 yearsâ€™ research experience, SD 9.8), who were asked to comment on and add to the draft taxonomy derived from the literature.

Results

The final taxonomy defines 30 procedures that may contribute to placebo effects in clinical and experimental research, proposes 60 possible clinical applications and classifies procedures into five domains: the patientâ€™s characteristics and belief (5 procedures and 11 clinical applications), the practitionerâ€™s characteristics and beliefs (2 procedures and 4 clinical applications), the healthcare setting (8 procedures and 13 clinical applications), treatment characteristics (8 procedures and 14 clinical applications) and the patientâ€“practitioner interaction (7 procedures and 18 clinical applications).

Conclusion

The taxonomy provides a preliminary and novel tool with potential to guide translational research aiming to harness placebo effects for patient benefit in practice.
A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries
Authors: Franse Carmen B , Rietjens Judith AC , Burdorf Alex , van Grieken Amy , Korfage Ida J , van der Heide Agnes , Mattace Raso Francesco , van Beeck Ed , Raat Hein
Published: July 2017

Objectives

The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation.

Design

Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE).

Setting

Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland).

Participants

Community-dwelling persons aged ≥65 years (n=18 596).

Measurements

Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview.

Results

There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (p<0.05). Between-country differences in falling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors.

Conclusion

There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the association between these intrinsic risk factors and falling. These findings emphasise the importance of addressing intrinsic fall risk in (inter)national fall-prevention strategies, while highlighting country-specific priorities.