bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a School Physical Activity Policy Improves Student Physical Activity Levels: Outcomes of a Cluster-Randomized Controlled Trial
Authors: Nathan Nicole K. , Sutherland Rachel L. , Hope Kirsty , McCarthy Nicole J. , Pettett Matthew , Elton Ben , Jackson Rebecca , Trost Stewart G. , Lecathelinais Christophe , Reilly Kathryn , Wiggers John H. , Hall Alix , Gillham Karen , Herrmann Vanessa , Wolfenden Luke 
Published: September 2020

Aim: To assess the impact of a multistrategy intervention designed to improve teachers’ implementation of a school physical activity (PA) policy on student PA levels. Methods: A cluster-randomized controlled trial was conducted in 12 elementary schools. Policy implementation required schools to deliver 150 minutes of organized PA for students each week via physical education, sport, or class-based activities such as energizers. Schools received implementation support designed using the theoretical domains framework to help them implement the current policy. Results: A total of 1,502 children in kindergarten to grade 6 participated. At follow-up compared with control, students attending intervention schools had, measured via accelerometer, significantly greater increases in school day counts per minute (97.5; 95% confidence interval [CI], 64.5 to 130.4; P < .001) and moderate to vigorous physical activity (MVPA) (3.0; 95% CI, 2.2–3.8, P < .001) and a greater decrease in sedentary time (−2.1; 95% CI, −3.9 to −0.4, P = .02) per school day. Teachers in intervention schools delivered significantly more minutes (36.6 min) of PA to their students at follow-up (95% CI, 2.7–70.5, P = .04). Conclusions: Supporting teachers to implement a PA policy improves student PA. Additional strategies may be needed to support teachers to implement activities that result in larger gains in student MVPA.
A bigger splat: The catastrophic geology of a 1.2-b.y.-old terrestrial megaclast, northwest Scotland
Authors: Killingback Z. , Holdsworth R.E. , Walker R.J. , Nielsen S. , Dempsey E. , Hardman K. 
Published: September 2020

Abstract
Rockfalls are relatively little described from the ancient geological record, likely due to their poor preservation potential. At Clachtoll, northwest Scotland, a megaclast (100 m × 60 m × 15 m) of Neoarchean Lewisian gneiss with an estimated mass of 243 kt is associated with basal breccias of the Mesoproterozoic Stoer Group. Foliation in the megablock is misoriented by ∼90° about a subvertical axis relative to that in the underlying basement gneisses, and it is cut by fracture networks filled with Stoer Group red sandstone. Bedded clastic fissure fills on top of the megablock preserve way-up criteria consistent with passive deposition during burial. Sediment-filled fractures on the lateral flanks and base show characteristics consistent with forceful injection. Using numerical calculations, we propose that rift-related seismic shaking caused the megablock to fall no more than 15 m onto unconsolidated wet sediment. On impact, overpressure and liquefaction of the water-laden sands below the basement block were sufficient to cause hydrofracturing and upward sediment slurry injection. In addition, asymmetrically distributed structures record internal deformation of the megablock as it slowed and came to rest. The megablock is unrelated to the younger Stac Fada impact event, and represents one of the oldest known terrestrial rockfall features on Earth.
Applications of physical performance measures to routine diabetes care for frailty prevention concept: fundamental data with grip strength, gait speed, timed chair stand speed, standing balance, and knee extension strength
Authors: Yokoyama Hiroki , Shiraiwa Toshihiko , Takahara Mitsuyoshi , Iwamoto Masahiro , Kuribayashi Nobuichi , Nomura Takuo , Yamada Minoru , Sone Hirohito , Araki Shin-ichi 
Published: September 2020

IntroductionProgression of muscle strength weakening will lead to a poor physical performance and disability. While this is particularly important in patients with diabetes, the associations of reduced muscle strength measured by grip strength with clinical features and physical performance remain unclear. We investigated clinical features and physical performance measures in association with grip strength in elderly people with diabetes in a primary care setting.Research design and methodsA cross-sectional study was conducted enrolling 634 male and 323 female Japanese patients with type 2 diabetes aged 60 years or older. First, grip strength was measured and the associations of gender-specific grip strength with clinical features were evaluated. Second, in patients with a grip strength below the gender-specific median, physical performance measures, including gait speed, timed chair stand speed, knee extension strength, standing balance, and short physical performance battery scores, were investigated. Patients with and without a low performance defined by Asian Working Group for Sarcopenia were compared in terms of clinical features and physical performance measures.ResultsGrip strength decreased according to aging and longer duration of diabetes and was independently related to body mass index, glycated hemoglobin A1c (HbA1c), serum albumin, albuminuria, neuropathy, and stroke in male patients, and to body mass index and albuminuria in female patients. The physical performance measures became worse proportionally to a decrease in the grip strength. Patients with a low performance exhibited a significantly older age, lower grip strength and serum albumin, higher albuminuria, and poorer physical performance measures than those without.ConclusionsReduced grip strength was associated with glycemic exposure indicators of age-related duration, HbA1c, and vascular complications. The physical performance measures became worse with decreasing grip strength. Measurements of grip strength and physical performance in patients with diabetes may help promote intervention to prevent frailty in future studies.
Genetic prion disease: D178N with 129MV disease modifying polymorphism—a clinical phenotype
Authors: Tan Tracie Huey-Lin , Stark Richard J , Waterston John A , White Owen , Thyagarajan Dominic , Monif Mastura 
Published: September 2020

BackgroundHuman prion diseases are a group of rare neurological diseases with a minority due to genetic mutations in the prion protein (PRNP) gene. The D178N mutation is associated with both Creutzfeldt-Jakob disease and fatal familial insomnia with the phenotype modified by a polymorphism at codon 129 with the methionine/valine (MV) polymorphism associated with atypical presentations leading to diagnostic difficulty.CaseWe present a case of fatal familial insomnia secondary to a PRNP D178N mutation with 129MV disease modifying polymorphism who had no family history, normal MRI, electroencephalography (EEG), cerebrospinal fluid (CSF) and positron emission tomography findings and a negative real-time quaking-induced conversion result.ConclusionPatients with genetic prion disease may have no known family history and normal EEG, MRI brain and CSF findings. PRNP gene testing should be considered for patients with subacute progressive neurological and autonomic dysfunction.
Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment
Authors: Broad Joanna B , Wu Zhenqiang , Bloomfield Katherine , Hikaka Joanna , Bramley Dale , Boyd Michal , Tatton Annie , Calvert Cheryl , Peri Kathy , Higgins Ann-Marie , Connolly Martin J 
Published: September 2020

ObjectivesRetirement villages (RV) have expanded rapidly, now housing perhaps one in eight people aged 75+ years in New Zealand. Health service initiatives might better support residents and offer cost advantages, but little is known of resident demographics, health status or needs. This study describes village residents—their demographics, socio-behavioural and health status—noting differences between participants who volunteered and those who were sampled.DesignCross-sectional study of village residents. The cohort formed will also be used for a longitudinal study and a randomised controlled trial. Village managers (sometimes after consulting residents) decided if representative sampling could be undertaken in each village. Where sampling was not approved, volunteers were sought.Setting33 RV were included from a total of 65 villages in Auckland, New Zealand.ParticipantsResidents (n=578) were recruited either by sampling (n=217) or as volunteers (n=361) during 2016–2018. Each completed a survey and an International Resident Assessment Instrument (interRAI) health needs assessment with a gerontology nurse specialist.ResultsMedian age of residents was 82 years, 158 (27%) were men; 61% lived alone. Downsizing (77%), less stress (63%) and access to healthcare assistance (61%) were most common reasons for entry. During the 2 weeks prior to survey, 34% received home supports and 10% personal care. Hypertension, heart disease, arthritis and pain were reported by over 40%. Most common unmet needs related to managing cardiorespiratory symptoms (50%) and pain (48%). Volunteers and sampled residents differed significantly, mainly in socio-behavioural respects.ConclusionsCommon conditions including hypertension, arthritis and atrial fibrillation, are recorded in interRAI as text, and thus overlooked in interRAI reports. Levels of unmet need indicate opportunities to improve health services to better manage chronic conditions. Healthcare service providers and village operators could cooperate to design and test service initiatives that better meet residents’ needs and offer cost benefits.Trial registration numberACTRN12616000685415.
Lifetime quality of life and cost consequences of delays in endovascular treatment for acute ischaemic stroke: a cost-effectiveness analysis from a Singapore healthcare perspective
Authors: Ni Weiyi , Kunz Wolfgang , Goyal Mayank , Ng Yu Li , Tan Kelvin , De Silva Deidre Anne 
Published: September 2020

ObjectivesEndovascular therapy (EVT) significantly improves clinical outcomes in patients with acute ischaemic stroke (AIS), while the time of EVT initiation after stroke onset influences both patient clinical outcomes and healthcare costs. This study determined the impact of EVT treatment delay on cost effectiveness of EVT in the Singapore healthcare setting.DesignA short-term decision tree and long-term Markov health state transition model was constructed. For each time window of symptom onset to EVT, the probability of receiving EVT or non-EVT treatment was varied, thereby varying clinical outcomes (modified Rankin Scale scores), short-term costs and long-term modelled (lifetime) costs; all of which were used in calculating an incremental cost-effectiveness ratio of EVT vs non-EVT treatment. Clinical outcomes and cost data were derived from clinical trials, literature, expert opinion, electronic medical records and community-based surveys from Singapore. Deterministic one-way and probabilistic sensitivity analyses were performed to assess the uncertainty of the model. The willingness to pay for per quality-adjusted life-year (QALY) was set to Singapore $50 000 (US$36 500).SettingSingapore healthcare perspective.ParticipantsThe model included patients with AIS in Singapore.InterventionsEVT performed within 6 hours of stroke onset.Outcome measuresThe model estimated incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMB) for EVT versus non-EVT treatment, varied by time from symptom onset to time of treatment.ResultsEVT performed between 61 min and 120 min after the stroke onset was most cost-effective time window to perform EVT in the Singapore population, with an ICER of Singapore $7197 per QALY (US$5254) for performing EVT at 61–120 min versus 121–180 min. The resulting incremental NMB associated with receipt of EVT at the earlier time point is Singapore $39 827 (US$29 074) per patient at the willingness-to-pay threshold of Singapore $50 000. Each hour delay in EVT resulted in an average loss of 0.54 QALYs and 195.35 healthy days, with an average net monetary loss of Singapore $26 255 (US$19 166).ConclusionsFrom the Singapore healthcare perspective, although EVT is more expensive than alternative treatments in the short term, the lifetime ICER is below the willingness-to-pay threshold. Thus, healthcare policies and procedures should aim to improve efficiency of pre-hospital and in-hospital workflow processes to reduce the onset-to-puncture duration.
Women’s satisfaction with the quality of antenatal care services rendered at public health facilities in Northwest Ethiopia: the application of partial proportional odds model
Authors: Emiru Amanu Aragaw , Alene GD , Debelew Gurmesa Tura 
Published: September 2020

ObjectivesThe study was aimed: (1) to describe the quality of antenatal care (ANC) at public health facilities in Northwest Ethiopia, including dimensions of the structure, process and outcome; and (2) to assess the relationship between ANC satisfaction and structure and process dimension of ANC quality.DesignCross sectional.SettingHealthcare facilities providing ANC services in Northwest Ethiopia.Participants795 pregnant women attending the antenatal clinics at 15 public health facilities and 41 health workers working for the surveyed facilities.Outcome measuresThe outcome variable, women’s satisfaction with ANC, was constructed from multiple satisfaction items using principal component analysis on an ordered, categorical and three-point Likert scale. The key hypothesised factors considered were structural and process aspects of care. Data were analysed using the partial proportional odds model with 95% CI.ResultsThe result revealed that only 30.3% of the pregnant women were highly satisfied, whereas 31.7% had a lower satisfaction level. The findings showed that process quality indicators better predicted client satisfaction. In relation to this, better scores in history taking (aOR1=aOR2; 1.81 (95% CI 1.25 to 2.60)), counselling (aOR1= aOR2; 1.89 (95% CI 1.33 to 2.69)) and screening (aOR1= aOR2; 18.10 (95% CI 11.52 to 28.39)) were associated with achieving higher satisfaction. We also observed a significant but lower satisfaction among women in the late trimester of pregnancy (aOR1= aOR2; 0.87 (95% CI 0.78 to 0.97)). However, we did not see any significant relationship between structural variables and client satisfaction.ConclusionsThe study demonstrated that women’s satisfaction with ANC was low. The contents of ANC services covered during client–provider interaction were the main factors affecting client satisfaction. This suggests that efforts are required to improve the competencies of health professionals to make them more effective while dealing with clients.
Prevalence of sarcopenia and its associated factors in patients attending geriatric clinics in Vietnam: a cross-sectional study
Authors: Nguyen Tam Ngoc , Nguyen Tu Ngoc , Nguyen Anh Trung , Nguyen Thanh Xuan , Nguyen Huong Thu Thi , Nguyen Thu Thi Hoai , Pham Thang , Vu Huyen Thanh Thi 
Published: September 2020

ObjectivesThis study aims to investigate the prevalence of sarcopenia and its associated factors in patients attending geriatric clinics in Vietnam.Design and settingA cross-sectional study was conducted in consecutive patients aged ≥60 visiting outpatient clinics of the National Geriatric Hospital in Hanoi, Vietnam, from January 2018 to October 2018. Handgrip strength was measured with a hand dynamometer. Whole-body dual-energy X-ray absorptiometry was applied to measure the appendicular skeletal muscle mass. Sarcopenia was defined by the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019) and by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project.ResultsThere were 600 participants, mean age 70.0±8.0, 60.8% female. The prevalence of sarcopenia was 54.7% according to AWGS 2019 criteria and 40.5% according to FNIH. In multivariate logistic regression, age (adjusted OR 1.08, 95% CI 1.05 to 1.11), male (adjusted OR 2.03, 95% CI 1.29 to 3.21), underweight (adjusted OR 2.32, 95% CI 1.22 to 4.41), being malnourished (adjusted OR 3.77, 95% CI 1.19 to 11.91), chronic lung diseases (adjusted OR 3.48, 95% CI 2.10 to 5.77) and lower physical activity were significantly associated with sarcopenia defined by AWGS 2019 criteria. With FNIH definition, the significantly associated factors were age (adjusted OR 1.07, 95% CI 1.04 to 1.11), male (adjusted OR 6.78, 95% CI 4.12 to 11.17), low education (adjusted OR 2.15, 95% CI 1.27 to 3.63), being malnourished (adjusted OR 3.35, 95% CI 1.28 to 8.76), chronic lung diseases (adjusted OR 2.58, 95% CI 1.56 to 4.28) and lower physical activity level.ConclusionThe prevalence of sarcopenia in patients attending geriatric clinics was high. Further studies are needed to examine the impact of sarcopenia on adverse outcomes in this population.
TRIPOD statement: a preliminary pre-post analysis of reporting and methods of prediction models
Authors: Zamanipoor Najafabadi Amir H , Ramspek Chava L , Dekker Friedo W , Heus Pauline , Hooft Lotty , Moons Karel G M , Peul Wilco C , Collins Gary S , Steyerberg Ewout W , van Diepen Merel 
Published: September 2020

ObjectivesTo assess the difference in completeness of reporting and methodological conduct of published prediction models before and after publication of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement.MethodsIn the seven general medicine journals with the highest impact factor, we compared the completeness of the reporting and the quality of the methodology of prediction model studies published between 2012 and 2014 (pre-TRIPOD) with studies published between 2016 and 2017 (post-TRIPOD). For articles published in the post-TRIPOD period, we examined whether there was improved reporting for articles (1) citing the TRIPOD statement, and (2) published in journals that published the TRIPOD statement.ResultsA total of 70 articles was included (pre-TRIPOD: 32, post-TRIPOD: 38). No improvement was seen for the overall percentage of reported items after the publication of the TRIPOD statement (pre-TRIPOD 74%, post-TRIPOD 76%, 95% CI of absolute difference: −4% to 7%). For the individual TRIPOD items, an improvement was seen for 16 (44%) items, while 3 (8%) items showed no improvement and 17 (47%) items showed a deterioration. Post-TRIPOD, there was no improved reporting for articles citing the TRIPOD statement, nor for articles published in journals that published the TRIPOD statement. The methodological quality improved in the post-TRIPOD period. More models were externally validated in the same article (absolute difference 8%, post-TRIPOD: 39%), used measures of calibration (21%, post-TRIPOD: 87%) and discrimination (9%, post-TRIPOD: 100%), and used multiple imputation for handling missing data (12%, post-TRIPOD: 50%).ConclusionsSince the publication of the TRIPOD statement, some reporting and methodological aspects have improved. Prediction models are still often poorly developed and validated and many aspects remain poorly reported, hindering optimal clinical application of these models. Long-term effects of the TRIPOD statement publication should be evaluated in future studies.
Remodelling intravitreal therapy pathways for macular disease during the COVID-19 pandemic and an Austrian national lockdown
Authors: Huemer Josef , Hienert Julius , Hirn Cornelia , Hackl Christoph , Radda Stephan M , Findl Oliver 
Published: September 2020

ObjectiveTo analyse the remodelling and recovery of a relocated intravitreal injection (IVI) service with an adapted treatment regimen in a tertiary referral centre during a nationwide lockdown with initial cancellation of all non-emergency treatments caused by the COVID-19 pandemic.Methods and analysisFor this retrospective observational study at Hanusch Hospital, Vienna, between 16 March 2020 and 5 May 2020, we conducted an analysis of an appointment booking system based on prioritisation incorporating disease class, severity and fellow eye status by evidence-based impact on irreversible structural impairment and survey data from telephone interviews. Recapture time was defined as the time-to-discard the backlog of patients in need for treatment. Non-attendance was stratified as treatment refusal for personal reasons and non-attendance due to lockdown-related restrictions.ResultsOf the 1109 patients, 241 (21.7%) were considered as highly urgent, 269 (24.3%) as urgent, 402 (36.2%) as semiurgent and 197 (17.8%) as non-urgent. Recapture time was 15 days for highly urgent patients, 22 days for urgent patients, 43 days for semiurgent patients and 46 days for non-urgent patients. The proportion of patients who refused treatment due to personal reasons was 5.2%, with a mean age of 82.4 years; 29 patients (2.6%) could not attend due to lockdown-related restrictions.ConclusionBy streamlining treatment based on urgency as well as increasing the number of bilateral IVI, recapture time was fast. We could provide a safe treatment environment for healthcare professionals and patients after resetting the injection service outside of the hospital with increased levels of protection.
Comparative study of transition FLRW and axially symmetric cosmological structures with domain walls in f(R, T) gravity
Authors: Sharma Umesh Kumar , Mishra Ambuj Kumar , Pradhan Anirudh 
Published: September 2020

In the present article, we study the physical and geometric scenario of the inflection of the Friedmann–Lemaître–Robertson–Walker (FLRW) and an axially symmetric perfect fluid Universe with thick domain walls in f(R, T) theory of gravitation (Harko et al. Phys. Rev. D, 84, 024020 (2011)), where R and T represent Ricci scalar and trace of the stress–energy–momentum tensor, respectively, in the scenario of decelerating–accelerating transition phases. To ascertain the exact solution of the corresponding field equations, we use the concept of a time-subordinate deceleration parameter, which brings forth the scale factor [Formula: see text], where n and α are positive parameters. For n ∈ (0.27, 1], a class of accelerating phase is ensured while for n > 1, the Universe attains a phase transition from positive (decelerating) to negative (accelerating), which is uniform with recent observations. The models have been tested for physical feasibility by using stability. Physical and geometric behavior of the models are also explored.
On quintessence star model and strange star
Authors: Estevez-Delgado Gabino , Estevez-Delgado Joaquin 
Published: September 2020

AbstractThe astronomical observations on the accelerated expansion of the universe generate the possibility that the internal matter of the stars is not only formed by ordinary matter but also by matter with negative pressure. We discuss the existence of stars formed by the coexistence of two types of fluids, one associated to quintessence dark matter described by the radial and tangential pressures $$(P_{rq},P_{tq})$$

(

P

rq

,

P

tq

)

and the density $$\rho _{q}$$

ρ
q

characterized by a parameter $$-1<w<-\frac{1}{3}$$

-
1
<
w
<
-

1
3

and ordinary matter described by an anisotropic fluid with radial pressure of a strange star given by the MIT Bag model $$P_r=\frac{1}{3}(c^2\rho -4B_g)$$

P
r

=

1
3

(

c
2

ρ
-
4

B
g

)

and tangential pressure $$P_t=\frac{1}{3}(c^2\rho -4B_g)-\frac{3}{2}(1+w)c^2\rho _q$$

P
t

=

1
3

(

c
2

ρ
-
4

B
g

)

-

3
2

(
1
+
w
)

c
2

ρ
q

, in which the effect is reflected of the quintessence dark matter over the ordinary matter. Via a theorem we show that the geometry that describes this interaction is equivalent to that of a perfect fluid with ordinary matter. Taking as geometry the one associated with a model for neutron stars, a physically acceptable and stable model is obtained. The application to the star Her X-1, as a candidate to a strange quark star, generates for us a value of the MIT Bag constant $$B_g = 97.0048\,\mathrm{Mev}/\mathrm{fm}^3$$

B
g

=
97.0048

Mev
/

fm

3

, which is found to be inside the expected interval.