bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proprioceptive Training on Dynamic Neuromuscular Control in Fencers: A Clinical Trial
Authors: de Vasconcelos Gabriela Souza , Cini Anelize , Lima Cláudia Silveira 
Published: May 2020

Context: Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. Objective: To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. Design: The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. Setting: The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. Participants: The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14–35 years, from a multisport club. Interventions: The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. Main Outcome Measures: Dynamic neuromuscular control. Results: The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. Conclusions: The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.
Factors affecting the diagnostic performance of circumpapillary retinal nerve fibre layer measurement in glaucoma
Authors: Wong Damon , Chua Jacqueline , Baskaran Mani , Tan Bingyao , Yao Xinwen , Chan Samuel , Tham Yih Chung , Chong Rachel , Aung Tin , Lamoureux Ecosse Luc , Vithana Eranga N , Cheng Ching Yu , Schmetterer Leopold 
Published: May 2020

Background/aimsTo identify factors that influence the diagnostic performance of circumpapillary retinal nerve fibre layer (RNFL) thickness measurements in the detection of primary open-angle glaucoma (POAG).Methods1592 eyes from 1076 healthy controls and 758 eyes from 502 patients with POAG underwent optical coherence tomography (OCT) imaging to assess RNFL parameters. Visual field (VF) mean deviation (MD) from standard automated perimetry was used to indicate severity in subjects with glaucoma.ResultsRNFL thickness significantly decreased with age (ρ=−0.10 to −0.16, p<0.001) and increased with spherical equivalent (SE) refractive error (ρ=0.23–0.29, p<0.001) in healthy and glaucoma groups but showed a significant reduction with SE (ρ=−0.20, p<0.001) in the temporal RNFL of healthy subjects. RNFL measurements significantly decreased with VF MD (ρ=0.08–0.53, p<0.05) in subjects with POAG. When healthy subjects and subjects with glaucoma were matched to subgroups within a factor, significant differences in area under the curve (AUC) between subgroups were only found with SE AUCs increased significantly with disease severity, particularly in the global, inferior and superior measurements (p<0.001). Overall, the diagnostic performance of the inferior and global RNFL measurements were found to be more resilient to different factors.ConclusionDiagnostic accuracy in glaucoma was influenced by SE but could be mitigated by using controls with similar refractive characteristics. Increasing disease severity led to significantly better diagnostic accuracy. These factors should be considered when using OCT for glaucoma diagnosis in practice.
Decreased arterial distensibility and postmeal hyperinsulinemia in young Japanese women with family history of diabetes
Authors: Takeuchi Mika , Wu Bin , Honda Mari , Tsuboi Ayaka , Kitaoka Kaori , Minato Satomi , Kurata Miki , Kazumi Tsutomu , Fukuo Keisuke 
Published: May 2020

IntroductionTo assess vascular function and characterize insulin secretion using a physiological approach in Japanese women with family history of type 2 diabetes (FHD).Research design and methodsStandardized mixed-meal tests were performed with multiple postprandial glucose, insulin and free fatty acids (FFA) measurements over a 30–120 min period in 31 Japanese women aged 21–24 years. Arterial distensibility was assessed as well.ResultsFasting glucose, triglyceride and insulin averaged <90 mg/dL, <60 mg/dL and <5 μU/mL, respectively, and did not differ cross-sectionally between 10 with (FHD+) and 21 without FHD (FHD–). FHD+ showed higher insulin responses not only during the first 30 min (p=0.005) but also during the second hour (60–120 min, p<0,05) in spite of identical postprandial suppression of FFA and identical fasting and postprandial glucose and FFA concentrations, except for higher 60 min FFA in FHD+. Further, FHD+ had decreased arterial distensibility (p=0.003). On multivariate regression analysis, arterial distensibility emerged as the only significant independent predictor of FHD+. Endurance training in FHD+ did not alter decreased arterial distensibility whereas it abolished postprandial hyperinsulinemia.ConclusionsFHD was associated with decreased arterial distensibility and postprandial hyperinsulinemia despite nearly identical postprandial glycemia and postprandial FFA suppression, suggesting that impaired vascular insulin sensitivity may precede glucose and lipid dysmetabolism in normal weight Japanese women aged 22 years.
Effect of an intensive patient educational programme on the quality of bowel preparation for colonoscopy: a single-blind randomised controlled trial
Authors: Janahiraman Sivakami , Tay Chan Yen , Lee Jie Min , Lim Wen Ling , Khiew Chun Hoe , Ishak Irina , Onn Zakry Yahya , Ibrahim Mohd Razali , Chew Chun Keat 
Published: May 2020

ObjectivePreprocedural bowel preparation is necessary for optimal colonoscopy visualisation. However, it is challenging to achieve high-quality bowel preparation among patients scheduled for colonoscopy. This study aims to evaluate the impact of an intensive patient educational programme on the quality of bowel preparation.DesignAn accessor-blinded randomised controlled trial was carried out at the outpatient surgical clinic of a tertiary hospital. Patients were randomly assigned to the control group (received standard written and verbal instructions) or the experimental group (received an intensive and structured educational programme). All subjects completed a questionnaire before colonoscopy to assess their compliance, acceptability, and tolerability towards bowel preparation regime. Quality of bowel preparation was determined using the Boston Bowel Preparation Scale (BBPS).ResultsA total of 300 subjects who fulfilled the inclusion criteria were recruited. The experimental group had a significantly higher proportion of good quality bowel preparation than the control group (98.7% vs 52.3%, p<0.001). The median total BBPS score was also significantly higher in the experimental group (8 vs 5, p<0.001). Factors associated with good quality of bowel preparation included educational programme (OR: 22.79, 95% CI: 4.23 to 122.85, p<0.001), compliance to bowel cleansing agent (OR: 24.98, 95% CI 3.12 to 199.71, p<0.001), very difficult acceptability of preparation (OR: 0.11, 95% CI 0.03 to 0.38, p<0.001), tolerability towards bowel preparation (OR: 4.98, 95% CI 1.44 to 17.20, p<0.011) and hypomotility drugs (OR: 3.03, 95% CI 0.12 to 0.91, p<0.05).ConclusionAn intensive patient educational programme can significantly improve the quality of bowel preparation for colonoscopy.
Country adherence to WHO recommendations to improve the quality of HIV diagnosis: a global policy review
Authors: Fonner Virginia A , Sands Anita , Figueroa Carmen , Baggaley Rachel , Quinn Caitlin , Jamil Muhammad S , Johnson Cheryl 
Published: May 2020

IntroductionEnsuring a correct and timely HIV diagnosis is critical. WHO publishes guidelines on HIV testing strategies that maximise the likelihood of correctly determining one’s HIV status. A review of national HIV testing policies in 2014 found low adherence to WHO guidelines. We updated this review to determine adherence to current recommendations.MethodsWe conducted a comprehensive policy review through April 2018. We extracted data on HIV testing strategies, recommendations on HIV retesting prior to antiretroviral therapy (ART) initiation and pre-exposure prophylaxis (PrEP)-related HIV testing information. Descriptive analyses disaggregated by region were conducted to ascertain adherence to recommendations and to describe testing strategy characteristics.ResultsOf 91 policies included, 26% (n=24/91) adhered to WHO recommendations. Having a two-assay testing strategy to rule-in HIV infection as opposed to the recommended three-assay testing strategy was a major reason for non-adherence. Of 72 country policies providing sufficient information, 31% (n=22) recommended retesting for HIV prior to initiating ART. Of 25 countries and two regions reporting PrEP-related HIV testing guidelines, almost all recommended testing prior to initiating PrEP and every 3 months during PrEP use.ConclusionsGlobal adherence to WHO recommendations for HIV testing strategies have improved since 2014 but remain low. We found adherence existed on a continuum. Such a system provides insights into how countries can move towards adherence by making relatively minor changes to testing strategies. Guidance from WHO on the role of new HIV testing technologies within testing algorithms and identifying ways to simplify testing guidance is warranted.
Orthokeratology with increased compression factor (OKIC): study design and preliminary results
Authors: Wan Kin , Lau Jason Ki-kit , Cheung Sin Wan , Cho Pauline 
Published: May 2020

ObjectiveTo present the study design and the baseline data of a prospective cohort study investigating the safety, refractive correction and effectiveness of myopia control in subjects fitted with orthokeratology (ortho-k) lenses of different compression factors.Methods and analysisThis study is a 2-year longitudinal, double-masked, partially randomised study. Myopic children aged between 6 and 10 years are recruited and they may choose to participate in either the ortho-k or spectacle-wearing group. Subjects in the ortho-k group are randomly assigned to wear ortho-k lenses of either conventional compression factor (CCF, 0.75 D) or increased compression factor (ICF, 1.75 D). For the ortho-k subjects, the time and between-group effects within the first month of lens wear were analysed.ResultsSixty-nine ortho-k subjects (CCF: 34; ICF: 35) and 30 control subjects were recruited. There were no significant differences in baseline demographic data among the three groups of subjects (p>0.19). At the 1-month visit, the first fit success rates were 97% and 100% in the CCF and ICF ortho-k group, respectively. A higher percentage of ICF subjects could achieve full correction (CCF: 88.2%; ICF: 94.3%). The change in axial length was significantly higher in the ICF group (CCF, 0.003 mm; ICF, −0.031 mm) (p<0.05). No significant between-group differences in daytime vision or in the coverage and depth of corneal staining between the two ortho-k groups (p>0.05) were observed at any visit.ConclusionICF did not compromise the corneal integrity and the lens centration within the first month of lens wear. The preliminary performance of ortho-k lenses with ICF of 1.00D shows that it was safe to be used in the longer term for the investigation of myopia control.Trial registration numberNCT02643342.
Advanced late-onset retinitis pigmentosa with dominant-acting D477G RPE65 mutation is responsive to oral synthetic retinoid therapy
Authors: Kenna Paul F , Humphries Marian M , Kiang Anna-Sophia , Brabet Philippe , Guillou Laurent , Ozaki Ema , Campbell Matthew , Farrar G Jane , Koenekoop Robert , Humphries Pete 
Published: May 2020

ObjectivesNo therapeutic interventions are currently available for autosomal dominant retinitis pigmentosa (adRP). An RPE65 Asp477Gly transition associates with late-onset adRP, reduced RPE65 enzymatic activity being one feature associated with this dominant variant. Our objective: to assess whether in a proof-of-concept study, oral synthetic 9cis-retinyl acetate therapy improves vision in such advanced disease.Methods and analysisA phase 1b proof-of-concept clinical trial was conducted involving five patients with advanced disease, aged 41–68 years. Goldmann visual fields (GVF) and visual acuities (VA) were assessed for 6–12 months after 7-day treatment, patients receiving consecutive oral doses (40 mg/m2) of 9-cis-retinyl acetate, a synthetic retinoid replacement.ResultsPathological effects of D477G variant were preliminarily assessed by electroretinography in mice expressing AAV-delivered D477G RPE65, by MTS [3-(4,5-dimethylthiazol-2-yl)−5-(3-carboxyme- thoxyphenyl)−2-(4-sulfophenyl)−2H-tetrazolium] assays on RPE viability and enzyme activity in cultured cells. In addition to a mild dominant effect reflected in reduced electroretinographics in mice, and reduced cellular functionin vitro, D477G exhibited reduced enzymatic RPE65 activityin vitro. In patients, significant improvements were observed in GVF from baseline ranging from 70% to 200% in three of five subjects aged 67–68 years, with largest improvements at 7–10 months. Of two GVF non-responders, one had significant visual acuity improvement (5–15 letters) from baseline after 6 months.ConclusionFamilies with D477G variant have been identified in Ireland, the UK, France, the USA and Canada. Effects of single 7-day oral retinoid supplementation lasted at least 6 months, possibly giving visual benefit throughout remaining life in patients with advanced disease, where gene therapy is unlikely to prove beneficial.
A cohort study of the service-users of online contraception
Authors: Rezel-Potts Emma , Palmer Melissa J , Free Caroline , Baraitser Paula 
Published: May 2020

Background
In January 2017, the first free service providing oral contraceptive
pills (OCPs) ordered online and posted home became available in the
London boroughs of Lambeth and Southwark – ethnically and
socioeconomically diverse areas with high rates of unplanned pregnancy.
There are concerns that online services can increase health
inequalities; therefore, we aimed to describe service-users according to
age, ethnicity and Index of Multiple Deprivation (IMD) quintile of area
of residence and to examine the association of these with repeated
use.

Methods
We analysed routinely collected data from January 2017 to April 2018
and described service-users using available sociodemographic factors and
information on patterns of use. Logistic regression analysis examined
factors associated with repeat ordering of OCPs.

Results
The service was accessed by 726 individuals; most aged between 20
and 29 years (72.5%); self-identified as being of white ethnic group
(58.8%); and residents of the first and second most deprived IMD
quintiles (79.2%). Compared with those of white ethnic group, those of
black ethnic group were significantly less likely to make repeat orders
(adjusted OR 0.53, 95% CI 0.31 to 0.89; p=0.001), as were those of Asian
and mixed ethnic groups.

Conclusions
These are the first empirical findings on free, online contraception
and suggest that early adopters broadly reflect the population of the
local area in terms of ethnic diversity and deprivation as measured by
IMD. Ongoing service development should prioritise the identification
and removal of barriers which may inhibit repeat use for black and
minority ethnic groups.
Improving estimation of the association between alcohol use and intimate partner violence in low-income and middle-income countries
Authors: Greene M Claire , Heise Lori , Musci Rashelle J , Wirtz Andrea L , Johnson Renee , Leoutsakos Jeannie-Marie , Wainberg Milton L , Tol Wietse A 
Published: May 2020

BackgroundAlcohol use is a consistent correlate of intimate partner violence (IPV) in low-income and middle-income countries (LMICs). However, the magnitude of this association differs across studies, which may be due to contextual and methodological factors. This study aims to estimate and explore sources of heterogeneity in the association between alcohol use and IPV in 28 LMICs (n=109 700 couples).MethodsIn nationally representative surveys, partnered women reported on IPV victimisation and male partner’s alcohol use. We estimated the relationship between alcohol use and IPV using logistic regression and full propensity score matching to account for confounding. Country-specific ORs were combined using a random-effects model. Country-level indicators of health and development were regressed on ORs to examine sources of variability in these estimates.ResultsPartner alcohol use was associated with a 2.55-fold increase in the odds of past-year IPV victimisation (95% CI 2.27 to 2.86) with substantial variability between regions (I2=70.0%). Countries with a low (<50%) prevalence of past-year alcohol use among men displayed larger associations between alcohol use and IPV. Exploratory analyses revealed that colonisation history, religion, female literacy levels and substance use treatment availability may explain some of the remaining heterogeneity observed in the strength of the association between alcohol use and IPV across countries.ConclusionPartner alcohol use is associated with increased odds of IPV victimisation in LMICs, but to varying degrees across countries. Prevalences of male alcohol use and cultural factors were related to heterogeneity in these estimates between countries.
Impact of a preceding radiotherapy on the outcome of immune checkpoint inhibition in metastatic melanoma: a multicenter retrospective cohort study of the DeCOG
Authors: Knispel Sarah , Stang Andreas , Zimmer Lisa , Lax Hildegard , Gutzmer Ralf , Heinzerling Lucie , Weishaupt Carsten , Pföhler Claudia , Gesierich Anja , Herbst Rudolf , Kaehler Katharina C , Weide Benjamin , Berking Carola , Loquai Carmen , Utikal Jochen , Terheyden Patrick , Kaatz Martin , Schlaak Max , Kreuter Alexander , Ulrich Jens , Mohr Peter , Dippel Edgar , Livingstone Elisabeth , Becker Jürgen C , Weichenthal Michael , Chorti Eleftheria , Gronewold Janine , Schadendorf Dirk , Ugurel Selma 
Published: May 2020

BackgroundImmune checkpoint inhibition (ICI) is an essential treatment option in melanoma. Its outcome may be improved by a preceding radiation of metastases. This study aimed to investigate the impact of a preceding radiotherapy on the clinical outcome of ICI treatment.MethodsThis multicenter retrospective cohort study included patients who received anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or anti-programmed cell death protein 1 (PD-1) ICI with or without preceding radiotherapy for unresectable metastatic melanoma. ICI therapy outcome was measured as best overall response (BOR), progression-free (PFS) and overall survival (OS). Response and survival analyses were adjusted for confounders identified by directed acyclic graphs. Adjusted survival curves were calculated using inverse probability treatment weighting.Results835 patients who received ICI (anti-CTLA-4, n=596; anti-PD-1, n=239) at 16 centers were analyzed, whereof 235 received a preceding radiotherapy of metastatic lesions in stage IV disease. The most frequent organ sites irradiated prior to ICI therapy were brain (51.1%), lymph nodes (17.9%) and bone (17.9%). After multivariable adjustment for confounders, no relevant differences in ICI therapy outcome were observed between cohorts with and without preceding radiotherapy. BOR was 8.7% vs 13.0% for anti-CTLA-4 (adjusted relative risk (RR)=1.47; 95% CI=0.81 to 2.65; p=0.20), and 16.5% vs 25.3% for anti-PD-1 (RR=0.93; 95% CI=0.49 to 1.77; p=0.82). Survival probabilities were similar for cohorts with and without preceding radiotherapy, for anti-CTLA-4 (PFS, adjusted HR=1.02, 95% CI=0.86 to 1.25, p=0.74; OS, HR=1.08, 95% CI=0.81 to 1.44, p=0.61) and for anti-PD-1 (PFS, HR=0.84, 95% CI=0.57 to 1.26, p=0.41; OS, HR=0.73, 95% CI=0.43 to 1.25, p=0.26). Patients who received radiation last before ICI (n=137) revealed no better survival than those who had one or more treatment lines between radiation and start of ICI (n=86). In 223 patients with brain metastases, we found no relevant survival differences on ICI with and without preceding radiotherapy.ConclusionsThis study detected no evidence for a relevant favorable impact of a preceding radiotherapy on anti-CTLA-4 or anti-PD-1 ICI treatment outcome in metastatic melanoma.
Complete Epstein-Barr virus seropositivity in a large cohort of patients with early multiple sclerosis
Authors: Abrahamyan Sargis , Eberspächer Bettina , Hoshi Muna-Miriam , Aly Lilian , Luessi Felix , Groppa Sergiu , Klotz Luisa , Meuth Sven G , Schroeder Christoph , Grüter Thomas , Tackenberg Björn , Paul Friedemann , Then-Bergh Florian , Kümpfel Tania , Weber Frank , Stangel Martin , Bayas Antonios , Wildemann Brigitte , Heesen Christoph , Zettl Uwe , Warnke Clemens , Antony Gisela , Hessler Nicole , Wiendl Heinz , Bittner Stefan , Hemmer Bernhard , Gold Ralf , Salmen Anke , Ruprecht Klemens 
Published: May 2020

ObjectiveTo determine the prevalence of antibodies to Epstein-Barr virus (EBV) in a large cohort of patients with early multiple sclerosis (MS).MethodsSerum samples were collected from 901 patients with a clinically isolated syndrome (CIS) or early relapsing–remitting multiple sclerosis (RRMS) participating in the German National MS cohort, a prospective cohort of patients with early MS with stringent inclusion criteria. Epstein-Barr nuclear antigen (EBNA)-1 and viral capsid antigen (VCA) antibodies were measured in diluted sera by chemiluminescence immunoassays (CLIAs). Sera of EBNA-1 and VCA antibody-negative patients were retested undiluted by an EBV IgG immunoblot. For comparison, we retrospectively analysed the EBV seroprevalence across different age cohorts, ranging from 0 to >80 years, in a large hospital population (N=16 163) from Berlin/Northern Germany.ResultsEBNA-1 antibodies were detected by CLIA in 839 of 901 patients with CIS/RRMS. Of the 62 patients without EBNA-1 antibodies, 45 had antibodies to VCA as detected by CLIA. In all of the remaining 17 patients, antibodies to EBV were detected by immunoblot. Altogether, 901 of 901 (100%) patients with CIS/RRMS were EBV-seropositive. EBV seropositivity increased with age in the hospital population but did not reach 100% in any of the investigated age cohorts.ConclusionThe complete EBV seropositivity in this large cohort of patients with early MS strengthens the evidence for a role of EBV in MS. It also suggests that a negative EBV serology in patients with suspected inflammatory central nervous system disease should alert clinicians to consider diagnoses other than MS.