bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of pre-participation cardiac evaluation recommendations among athletes participating in World Athletics Championships
Authors: Dahlström Örjan , Adami Paolo Emilio , Fagher Kristina , Jacobsson Jenny , Bargoria Victor , Gauffin Håkan , Hansson Per-Olof , Andersson Christer , Bermon Stéphane , Timpka Toomas 
Published: October 2019

Background Athletes competing in athletics (track and field) at international level may be participating with underlying undiagnosed life-threatening cardiovascular conditions. Our objective was to analyse variations in pre-participation cardiac evaluation prevalence among athletes participating in two International Association of Athletics Federations (IAAF) World Athletics Championships, with regard to the human developmental level and global region of their home countries, as well as athletes' age category, gender, event group and medical insurance type. Design Cross-sectional web-based survey. Methods A total of 1785 athletes competing in the IAAF World Under 18 Championships Nairobi 2017 and World Championships London 2017 were invited to complete a pre-participation health questionnaire investigating the experience of a pre-participation cardiac examination. Results A total of 704 (39%) of the athletes participated. Among these, 59% (60% of women; 58% of men) reported that they had been provided at least one type of pre-participation cardiac evaluation. Athletes from very high income countries, Europe and Asia, showed a higher prevalence of at least one pre-participation cardiac evaluation. Conclusions The prevalence of pre-participation cardiac evaluation in low to middle income countries, and the African continent in particular, needs urgent attention. Furthermore, increases in evaluation prevalence should be accompanied by the development of cost-effective methods that can be adopted in all global regions.
Antihypertensive drugs and the risks of cancer: More fakes than facts
Authors: Battistoni Allegra , Tocci Giuliano , Presta Vivianne , Volpe Massimo 
Published: October 2019

Abstract
In the last century, the diffusion of medical news to the public has been profoundly changed by the progressive spread of more pervasive, but at the same time often unreliable, means of communication. The misinterpretation of scientific evidence or fallacious presentation through social media could play as a great drawback to the success in the management of many diseases. This may become particularly alarming when concerning chronic diseases widely affecting the population. Arterial hypertension is still today one of the major causes of mortality and morbidity in most countries, and its management generally requires chronic therapy lasting for decades. Therefore, a recent debate about the potential oncogenic effect of antihypertensive drugs has been made widely available to patients mostly through social media. Since this is a topic of great impact for millions of patients and of main relevance for the scientific community, it must not be contaminated by the spread of fake or twisted news. The objective of this article is to briefly discuss the almost complete lack of hard evidence about the potential oncogenic effect of the major classes of antihypertensive drugs as opposed to the exaggerated mediatic communication and impact of scattered and unconfirmed observations. We believe that it is of key importance to provide authoritative support for patients and clinicians from scientific societies and guidelines to balance an unopposed widespread penetration of twisted or even fake news.
Effect of Germanium-Embedded Knee Sleeve on Osteoarthritis of the Knee
Authors: Marino Katherine , Lee Rachel , Lee Paul 
Published: October 2019

Background: Knee osteoarthritis (OA) affects an estimated 1 in 5 individuals older than 45 years of age in the United Kingdom. Previous studies have suggested that germanium-infused garments may provide improved clinical outcomes in OA. Germanium-embedded (GE) knee sleeves embrace this fabric technology. Purpose: To assess the outcomes of GE knee sleeves for patients with knee OA. Study Design: Cohort study; Level of evidence, 2. Methods: This study was undertaken at a hospital in the United Kingdom. Patients who had radiographic features of OA, experienced knee pain for at least 6 months, and opted for nonsurgical intervention were included. Patients were recruited over 3 months. The University of California, Los Angeles activity score, Lysholm score, visual analog scale (VAS) score, and Oxford Knee Score (OKS) were collected at monthly intervals for 6 months. Patients were followed to determine their compliance with wearing the knee sleeves at all times, as advised, and whether any adverse effects had occurred. Results: A total of 50 participants were recruited for the study; 4 participants were excluded due to pain and were converted to surgical management. Therefore, 46 patients were analyzed and placed into 2 groups according to severity of OA, as classified by the Kellgren-Lawrence system: group A had grade 1 or 2 OA, and group B had grade 3 or 4 OA. There were 25 patients in group A and 21 in group B. Improvements were seen in OKS, VAS, and Lysholm scores in both groups. Clinically significant improvements were seen in group A only for OKS (mean increase, 14), VAS (mean decrease, 4.1), and Lysholm (mean increase, 17.2) scores. These results were also statistically significant (OKS, P = 5.8 × 10-7; VAS, P = 7.7 × 10-12; Lysholm, P = 4.2 × 10-11). The data from this study demonstrated that GE knee sleeves gave better outcomes for patients with grades 1 and 2 OA compared with patients with more advanced disease, which is consistent with previous studies. A total of 3 patients reported skin irritation, which resolved with simple skin ointment application. No patients reported infection, deep vein thrombosis, or circulation problems. Conclusion: GE knee sleeves could play an important role in optimizing nonsurgical management of patients with knee OA, especially patients with grades 1 and 2 OA, as demonstrated by the clinically significant improvements.
Design Around Bundle Patent Portfolio Based on Technological Evolution
Authors: Li Hui , Yuan Jiefeng , Tan Runhua , Peng Qingjin 
Published: October 2019

Abstract
Product innovation can be achieved by analyzing leading products patents in the market. Different methods have been proposed for design around patent, commonly using the elimination or replacement of a single patent element. However, the existing research fails to restore the position and function of the design around object in the original patent portfolio of enterprises, which often leads to the phenomenon of evading one patent and violating another. This paper proposes a method for design around patent through using the fusion of technologies of the evolution theory and bundle-type patent portfolio analysis in the initial stage of product development. The object system is analyzed to select technical opportunities through the evolutionary path of technologies and functional trimming methods to achieve circumvent barriers of bundle-type patents. The bundle patent portfolio is analyzed for the product evolution with a radar map. The technological evolution path is combined with the TRIZ innovation method to identify and solve the design problem. Patentability of the new design is evaluated using the patent system rules for innovative scheme difference from the original patent portfolio. The method is verified in a case study for the design of a glass-wiping robot. The design solution has been patented.
Finite Element Method on Shape Memory Alloy Structure and Its Applications
Authors: Zhou Bo , Kang Zetian , Wang Zhiyong , Xue Shifeng 
Published: October 2019

Abstract
It is significant to numerically investigate thermo-mechanical behaviors of shape memory alloy (SMA) structures undergoing large and uneven deformation for they are used in many engineering fields to meet special requirements. To solve the problems of convergence in the numerical simulation on thermo-mechanical behaviors of SMA structures by universal finite element software. This work suppose a finite element method to simulate the super-elasticity and shape memory effect in the SMA structure undergoing large and uneven deformation. Two scalars, named by phase-transition modulus and equivalent stiffness, are defined to make it easy to establish and implement the finite element method for a SMA structure. An incremental constitutive equation is developed to formulate the relationship of stress, strain and temperature in a SMA material based on phase-transition modulus and equivalent stiffness. A phase-transition modulus equation is derived to describe the relationship of phase-transition modulus, stress and temperature in a SMA material during the processes of martensitic phase transition and martensitic inverse phase transition. A finite element equation is established to express the incremental relationship of nodal displacement, external force and temperature change in a finite element discrete structure of SMA. The incremental constitutive equation, phase-transition modulus equation and finite element equation compose the supposed finite element method which simulate the thermo-mechanical behaviors of a SMA structure. Two SMA structures, which undergo large and uneven deformation, are numerically simulated by the supposed finite element method. Results of numerical simulation show that the supposed finite element method can effectively simulate the super-elasticity and shape memory effect of a SMA structure undergoing large and uneven deformation, and is suitable to act as an effective computational tool for the wide applications based on the SMA materials.
Accelerated evolution and diversifying selection drove the adaptation of cetacean bone microstructure
Authors: Sun Di , Zhou Xuming , Yu Zhenpeng , Xu Shixia , Seim Inge , Yang Guang 
Published: October 2019

AbstractBackgroundThe transition from land to sea by the ancestor of cetaceans approximately 50 million years ago was an incredible evolutionary event that led to a series of morphological, physiological, and behavioral adaptations. During this transition, bone microstructure evolved from the typical terrestrial form to the specialized structure found in modern cetaceans. While the bone microstructure of mammals has been documented before, investigations of its genetic basis lag behind. The increasing number of cetaceans with whole-genome sequences available may shed light on the mechanism underlying bone microstructure evolution as a result of land to water transitions.ResultsCetacean bone microstructure is consistent with their diverse ecological behaviors. Molecular evolution was assessed by correlating bone microstructure and gene substitution rates in terrestrial and aquatic species, and by detecting genes under positive selection along ancestral branches of cetaceans. We found that: 1) Genes involved in osteoclast function are under accelerated evolution in cetaceans, suggestive of important roles in bone remodeling during the adaptation to an aquatic environment; 2) Genes in the Wnt pathway critical for bone development and homeostasis show evidence of divergent evolution in cetaceans; 3) Several genes encoding bone collagens are under selective pressure in cetaceans.ConclusionsOur results suggest that evolutionary pressures have shaped the bone microstructure of cetaceans, to facilitate life in diverse aquatic environments.
Foxp3+Helios+ regulatory T cells are associated with monocyte subsets and their PD-1 expression during acute HIV-1 infection
Authors: Liu Lifeng , Zhang Qiuyue , Chen Peng , Guo Na , Song Aixin , Huang Xiaojie , Xia Wei , Li Li , Moog Christiane , Wu Hao , Su Bin , Zhang Tong 
Published: October 2019

Abstract

Background
Helios has been reported to stabilize regulatory T (Treg) suppressive function. Programmed cell death protein 1 (PD-1) expression in three human monocyte subsets modulates immune responses. Recently, our team reported that three monocyte subsets are associated with T helper cell differentiation in HIV-1-infected patients. Until now, the effects of monocyte subsets and their PD-1 expression on Foxp3+Helios+ Treg cells have not been fully characterized, especially during acute HIV-1 infection.

Results
The frequency of Foxp3+Helios+CD45RA+ Treg cells is significantly higher in patients with acute HIV-1 infection than those of healthy controls and chronic HIV-1-infected patients undergoing combined antiretroviral therapy. The frequency of Foxp3+Helios+CD45RA+ Treg cells is inversely correlated with CD4 T-cell counts and the CD4/CD8 ratio in chronic HIV-1-infected patients. During acute HIV-1 infection, the frequency of Foxp3+Helios+CD45RA+ Treg cells is inversely correlated with the frequency of the intermediate CD14++CD16+ monocyte subset, but positively correlated with PD-1 expression in both intermediate CD14++CD16+ and non-classical CD14+CD16++ monocyte subsets.

Conclusions
In this study, the perturbations of Foxp3+Helios+ Treg cells were characterized, and the association between monocyte subsets and their PD-1 expression and Foxp3+Helios+ Treg cells was evaluated during HIV-1 infection. Our observations provide new evidence of the roles for Foxp3+Helios+ Treg cells and PD-1 expression on monocyte subsets in HIV pathogenesis.
Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners
Authors: Kersting Christine , Zimmer Lena , Thielmann Anika , Weltermann Birgitta 
Published: October 2019

Abstract

Background
The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs.

Methods
This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress.

Results
Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress.

Conclusions
This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.
Prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural communities of Lemo district, southern Ethiopia: community based cross sectional study
Authors: WoldeKidan Endale , Daka Deresse , Legesse Deresse , Laelago Tariku , Betebo Bealu 
Published: October 2019

Abstract

Background
Trachoma, caused by Chlamydia trachomatis is the leading infectious cause of blindness. It is transmitted via personal contact with infected ocular and nasal secretions by hands, fomites and eye- seeking flies. Active trachoma is more common among children aged 1 to 9 years. The objective of this study was determining the prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural community of Lemo district.

Methods
Community-based cross-sectional study was conducted from March to April, 2018 in rural community of Lemo district. Multistage sampling technique was used to select 589 study participants. Data were collected by using structured pre-tested questionnaire, physical examination and observation. Binocular loupe was used to identify active trachoma cases. The data were entered by using EPi-data version 3.1 and analyzed by SPSS. Binary logistic regression was used to assess factors associated with active trachoma. Variables with p-value < 0.05 in the multivariable analysis were used to declare significance of association.

Result
Eighty seven (15.2%) children were positive for active trachoma. Absence of solid waste disposal pit (AOR = 2.20, 95% CI (1.12-4.37), do not use latrine as reported by respondent (AOR = 7.53, 95% CI (2.86-19.84), do not use soap for face washing as reported by respondent (AOR =2.3, 95% CI (1.32–4.12), washing face frequency as reported by respondent (AOR = 1.86, 95% CI (1.06–3.26), and family size greater than five (AOR = 1.96, 95% CI (1.06–3.67) were significantly associated with active trachoma.

Conclusion
Active trachoma among children aged 1 to 9 years is high. Do not use latrine, do not use soap for face washing, and face washing frequency in a day as reported by respondents and family size were associated with active trachoma. Access to adequate water and sanitation can be important components in working towards eliminating trachoma as a public health problem. Therefore, prompt measures must be taken by concerned bodies to increase access to adequate water and sanitation facilities.
Identifying high risk areas of Zika virus infection by meteorological factors in Colombia
Authors: Chien Lung-Chang , Sy Francisco , Pérez Adriana 
Published: October 2019

Abstract

Background
Several Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations.

Methods
This study applied the Bayesian structured additive regression modeling approach to include spatial interactive terms with meteorological factors and a geospatial function in a zero-inflated Poisson model. The study area contained 32 administrative departments in Colombia from October 2015 to December 2017. Weekly ZIKV infection cases and daily meteorological measurements were collected. Mapping techniques were adopted to visualize spatial findings. A series of model selections determined the best combinations of meteorological factors in the same model.

Results
When multiple meteorological factors are considered in the same model, both total rainfall and average temperature can best assess the geographic disparities of ZIKV infection. Meanwhile, a 1-in. increase in rainfall is associated with an increase in the logarithm of relative risk (logRR) of ZIKV infection of at most 1.66 (95% credible interval [CI] = 1.09, 2.15) as well as a 1 °F increase in average temperature is significantly associated with at most 0.79 (95% CI = 0.12, 1.22) increase in the logRR of ZIKV. Moreover, after controlling rainfall and average temperature, an independent geospatial function in the model results in two departments with an excessive ZIKV risk which may be explained by unobserved factors other than total rainfall and average temperature.

Conclusion
Our study found that meteorological factors are significantly associated with ZIKV infection across departments. The study determined both total rainfall and average temperature as the best meteorological factors to identify high risk departments of ZIKV infection. These findings can help governmental agencies monitor at risk areas according to meteorological measurements, and develop preventions in those at risk areas in priority.
Interventions to treat methicillin-susceptible Staphylococcus aureus bacteremia: many methodological concerns
Authors: García-Perdomo Herney Andrés , Toro Maldonado Jessica Fernanda 
Published: October 2019

Abstract
The aim of this letter was to point out some methodological concerns about an article written by Shi et al. and published in the journal. There is an increasing trend in the isolation of Methicillin-susceptible Staphylococcus aureus bacteremia and a variety of questions regarding the best therapy to treat this condition. These concerns might lead to selection, publication and information bias that prevent the generalization and application of these results in our clinical practice.
Increase of CSF inflammatory profile in a case of highly active multiple sclerosis
Authors: Magliozzi R. , Marastoni D. , Rossi S. , Castellaro M. , Mazziotti V. , Pitteri M. , Gajofatto A. , Monaco S. , Benedetti M. D. , Calabrese M. 
Published: October 2019

Abstract

Background
Clinical and imaging follow-up coupled with cerebrospinal fluid (CSF) and possibly serum profiling could provide information on disease activity and disability evolution in multiple sclerosis patients.

Case presentation
We describe the case of a relapsing-remitting MS patient whose history was characterized by failure of several therapeutic approaches and sustained disease activity. By using a highly sensitive immunoassay methodology, we examined protein expression of 70 inflammatory/cytotoxic molecules in two consecutive paired CSF and serum samples, obtained respectively in 2006 and 2013. At disease diagnosis, elevated CSF protein levels of an inflammatory pattern, including CXCL13, CXCL12, IFNγ, TNF, sTNFR1, IL8, sCD163, APRIL, BAFF, pentraxin III and MMP2 were found compared with a group of controls. At the second lumbar puncture, sustained disease activity was accompanied by considerable (more than 2 fold changes) increase expression of most of these inflammatory molecules while no significant changes in serum inflammatory markers were detected in the two consecutive serum samples.

Conclusions
Elevated CSF protein expression of pro-inflammatory mediators, possibly specifically associated to GM demyelination, could remain stable or increase over time in patients with active multiple sclerosis. We underline the role of fluid analysis in understanding the pathophysiology of the disease and providing information on possible markers of disease activity and evolution.