bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint production of research priorities to improve the lives of those with childhood onset conditions that impair learning: the James Lind Alliance Priority Setting Partnership for ‘learning difficulties’
Authors: Lim Ai Keow , Rhodes Sinead , Cowan Katherine , O'Hare Anne 
Published: October 2019

ObjectivesTo engage children and young people with conditions that impair learning, their parents/carers and the health, education, social work and third sector professionals to identify and prioritise research questions for learning difficulties.DesignProspective surveys and consensus meeting guided by methods advocated by the James Lind Alliance.SettingScotland.MethodsThe Priority Setting Partnership came together through discussion and collaboration between the University of Edinburgh, Scottish charity The Salvesen Mindroom Centre and partners in the National Health Service, education services and the third sector. A steering group was established. Charity and professional organisations were recruited. Suggested questions were gathered in an open survey and from research recommendations by the National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network Guidance. Suggested questions and recommendations were summarised into 40 indicative research questions. These indicative questions were verified as uncertainties from research evidence. Respondents each nominated up to 10 questions as research priorities in an interim survey. The 25 highest-ranked questions from the interim survey were prioritised at the final priority setting workshop.Participants367 people submitted suggestions (29 individuals affected by learning difficulties, 147 parents/carers and 191 professionals). 361 people participated in the interim prioritisation (41 individuals, 125 parents/carers and 195 professionals). 25 took part in the final workshop (5 young people, 6 parents and 14 professionals).ResultsTop three research priorities related to (1) upskilling education professionals, (2) best education and community environment and (3) multidisciplinary practice and working with parents. Top 10 included best early interventions, upskilling health, social and third sector professionals, support for families, identifying early signs and symptoms, effective assessments and strategies against stigma and bullying and to live independent lives.ConclusionsResults will now be a resource for researchers and funders to understand and resolve learning difficulties and improve the lives of those affected with childhood onset conditions that result in learning difficulties.
Pragmatic cluster randomised cohort cross-over trial to determine the effectiveness of bridging from emergency to regular contraception: the Bridge-It study protocol
Authors: Cameron Sharon Tracey , Baraitser Paula , Glasier Anna , McDaid Lisa , Norrie John , Radley Andrew , Stephenson Judith M , Trussell James , Battison Claire , Cameron Sarah , Cowle Kathleen , Forrest Mark , Gilson Richard , Goulao Beatriz , Johnstone Anne , McDonald Alison , Morelli Alessandra , Patterson Susan , Sally Deirdre , Stewart Nicola 
Published: October 2019

IntroductionOral emergency contraception (EC) can prevent unintended pregnancy but it is important to start a regular method of contraception. Women in the UK usually access EC from a pharmacy but then need a subsequent appointment with a general practitioner or a sexual and reproductive health (SRH) service to access regular contraception. Unintended pregnancies can occur during this time.Methods and analysisBridge-It is a pragmatic cluster randomised cohort cross-over trial designed to determine whether pharmacist provision of a bridging supply of a progestogen-only pill (POP) plus rapid access to a local SRH clinic, results in increased uptake of effective contraception and prevents more unintended pregnancies than provision of EC alone. Bridge-It involves 31 pharmacies in three UK regions (London, Lothian and Tayside) aiming to recruit 626–737 women. Pharmacies will give EC (levonorgestrel) according to normal practice and recruit women to both intervention and the control phases of the study. In the intervention phase, pharmacists will provide the POP (desogestrel) and offer rapid access to an SRH clinic. In the control phase, pharmacists will advise women to attend a contraceptive provider for contraception (standard care).Women will be asked 4 months later about contraceptive use. Data linkage to abortion registries will provide abortion rates over 12 months. The sample size is calculated on the primary outcome of effective contraception use at 4 months (yes/no) with 90% power and a 5% level of significance. Abortion rates will be an exploratory secondary analysis. Process evaluation includes interviews with pharmacists, SRH clinicians and women. Cost-effectiveness analysis will use a healthcare system perspective and be expressed as incremental cost-effectiveness ratio.Ethics and disseminationEthical approval was received from South East Scotland REC June 2017. Results will be published in peer-reviewed journals and conference presentations.Trial registration numberISRCTN70616901.
Can foot angle influence the risk of injury to the lower limb joints during a field hockey hit?
Authors: Feeley Frances E , Arnold Graham P , Nasir Sadiq , Wang Weijie W , Abboud Rami 
Published: October 2019

ObjectivesThe lower limb is widely reported as the most commonly injured body part in the field of hockey, more specifically lateral ankle sprains and internal knee injury. Despite this, there remains limited understanding of how the biomechanics of the sport could be adapted to minimise injury. The aim of this study was to propose a foot position during the hockey hit that results in the smallest joint angles and moments, from a total of four different foot positions: 0°, 30°, 60° and 90°, which may correlate to injury risk.MethodEighteen players from the local University Ladies Hockey Club participated in this study. Each player was required to perform a hit with their lead foot in four different positions: 0°, 30°, 60° and 90°, where 0° was a lead foot position perpendicular to the direction of motion of the ball. Angles and moments were calculated with the Vicon system using force plates and motion analysis.ResultsSignificant differences (p<0.05) were found between the angles and moments of the four foot positions tested, indicating that foot angle can influence the degree of angulation, and moments, produced in the lower limb joints during the hockey hit.ConclusionThere is a relationship between lead foot position and the angles and moments produced in the lower limb joints during the hockey hit, and this may correlate with injury risk.
Anisotropic relativistic fluid spheres: an embedding class I approach
Authors: Tello-Ortiz Francisco , Maurya S. K. , Errehymy Abdelghani , Singh Ksh. Newton , Daoud Mohammed 
Published: October 2019

Abstract
In this work, we present a new class of analytic and well-behaved solution to Einstein’s field equations describing anisotropic matter distribution. It’s achieved in the embedding class one spacetime framework using Karmarkar’s condition. We perform our analysis by proposing a new metric potential $$g_{rr}$$grr which yields us a physically viable performance of all physical variables. The obtained model is representing the physical features of the solution in detail, analytically as well as graphically for strange star candidate SAX J1808.4-3658 ($$Mass=0.9 ~M_{\odot }$$Mass=0.9M⊙, $$radius=7.951$$radius=7.951 km), with different values of parameter n ranging from 0.5 to 3.4. Our suggested solution is free from physical and geometric singularities, satisfies causality condition, Abreu’s criterion and relativistic adiabatic index $$\varGamma $$Γ, and exhibits well-behaved nature, as well as, all energy conditions and equilibrium condition are well-defined, which implies that our model is physically acceptable. The physical sensitivity of the moment of inertia (I) obtained from the solutions is confirmed by the Bejger−Haensel concept, which could provide a precise tool to the matching rigidity of the state equation due to different values of n viz., $$n=0.5, 1.08, 1.66, 2.24, 2.82$$n=0.5,1.08,1.66,2.24,2.82 and 3.4.
Downstream Influence of Coronary Stenoses on Microcirculatory Remodeling
Authors: de Waard Guus A. , Hollander Maurits R. , Ruiter Danique , ten Bokkel Huinink Thomas , Meer Romain , van der Hoeven Nina W. , Meinster Elisa , Beliën Jeroen A.M. , Niessen Hans W. , van Royen Niels 
Published: October 2019

Objective:
Inducible myocardial ischemia is influenced by contributions of both the epicardial artery and the coronary microcirculation. Experimental studies have found adverse microcirculatory remodeling to occur downstream of severe coronary stenoses. Coronary physiology studies in patients contradict the experimental findings, as the minimal microvascular resistance is not modified by stenoses. The objective was to determine whether microcirculatory remodeling occurs downstream of coronary stenoses in the human coronary circulation.

Approach and Results:
Myocardium corresponding to 115 coronary arteries of 55 deceased patients was investigated. Histopathologic staining of the microcirculation was performed using antibodies against SMA-α (smooth muscle actin-α) and CD31, to stain arterioles and capillaries, respectively. The following parameters were analyzed: ratio between lumen and vesel area, ratio between lumen and vessel diameter (both ratios for arterioles of <40, 40–100, and 100–200 µm diameter), arteriolar density, and capillary density. From the 55 patients, 32 pairs of an unobstructed coronary artery and a coronary artery with a stenosis were formed. No statistically significant differences between any of the microcirculatory parameters were found. A confirmatory unpaired analysis compared 3 groups: (1) coronary arteries in patients without coronary artery disease (n=53), (2) unobstructed coronary arteries in patients with a stenosis in one of the other coronary arteries (n=23), and (3) coronary stenoses (n=39). No statistically significant differences were observed between the groups.

Conclusions:
The microcirculation distal to noncritical stenoses does not undergo structural remodeling in the human coronary circulation.
Identification of Markers Associated With Development of Stroke in “Clinically Low‐Risk” Atrial Fibrillation Patients
Authors: Shin Seung Yong , Han Sang‐Jin , Kim Jin‐Seok , Im Sung Il , Shim Jaemin , Ahn Jinhee , Lee Eun Mi , Park Yae Min , Kim Jun Hyung , Lip Gregory Y. H. , Lim Hong Euy 
Published: October 2019

Background

Stroke and thromboembolic events may still occur in “clinically low‐risk” atrial fibrillation (
AF
) patients as categorized by
CHA
2
DS
2
‐
VAS
c score. Our aim was to assess the proportion of “clinically low‐risk” patients using a nongender
CHA
2
DS
2
‐
VAS
c (ie,
CHA
2
DS
2
‐
VA
) score of 0 to 1 among patients who experienced
AF
‐associated stroke and to identify markers associated with stroke in “clinically low‐risk” patients.

Methods and Results

We retrospectively recruited nonvalvular
AF
patients who experienced embolic stroke between 2013 and 2016 from 9 institutes in Korea.
AF
patients with
CHA
2
DS
2
‐
VA
score of 0 to 1 at the time of stroke were analyzed and compared with “clinically low‐risk”
AF
patients without stroke. A total of 3033 subjects with
AF
‐associated stroke were recruited. Of these, 583 patients (19.2%) had
CHA
2
DS
2
‐
VA
score of 0 to 1. On multivariate analysis, age (≥60 years), N‐terminal pro B‐type natriuretic peptide (≥300 pg/mL), creatinine clearance (<50 mL/min), and left atrial dimension (≥45 mm) were independently associated with stroke. With the combined application of these 4 factors (collectively,
ABCD
score) to the “clinically low‐risk” patients, the c‐index was 0.858 (95% CI 0.838–0.877;
P
<0.001).

Conclusions

The present study suggests a new insight into how additional use of markers can further refine stroke risk differentiation among
AF
patients initially classified as “clinically low‐risk.”

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
03147911.
DNA barcoding, phylogeny and phylogeography of the cyst nematode species from the genus Globodera (Tylenchida: Heteroderidae)
Authors: Subbotin Sergei A. , Franco Javier , Knoetze Rinus , Roubtsova Tatiana V. , Bostock Richard M. , Cid del Prado Vera Ignacio 
Published: October 2019

Summary
Globodera presently contains 13 valid and three as yet undescribed species. Three species, G. rostochiensis, G. pallida and G. ellingtonae, the potato cyst nematodes (PCN), cause significant economic losses on potatoes around the world. In our study we provide comprehensive phylogenetic analyses of 455 ITS rRNA, 219 COI and 164 cytb gene sequences of 11 valid and two undescribed species of Globodera using Bayesian inference, maximum likelihood and statistical parsimony. New 205 COI, 116 cytb and 21 ITS rRNA gene sequences were obtained from 148 populations of these species collected from 23 countries. The phylogenetic analysis revealed that Globodera displayed two main clades in the trees: i) Globodera from South and North America parasitising plants from Solanaceae; and ii) Globodera from Africa, Europe, Asia and New Zealand parasitising plants from Asteraceae and other families. Based on the results of phylogeographical analysis and age estimation of clades with a molecular clock approach, it is hypothesised that Globodera species originated and diversified from several centres of speciation located in mountain regions and then dispersed across the world from these regions during the Pleistocene. High genetic diversity of Bolivian populations of G. rostochiensis was observed for both mtDNA genes. Analysis of phylogenetic relationships of G. pallida and G. rostochiensis populations revealed incongruence in topology between networks inferred from mtDNA genes, which might be an indication of possible recombination and selective introgression events through gene flow between previously isolated populations. This puts some limitations on the use of the mtDNA marker as universal DNA barcoding identifier for PCN. Globodera bravoae syn. n. is proposed as a junior synonym of G. mexicana.
Model Improvement via Systematic Investigation of Physics Tendencies
Authors: Wong May , Romine Glen , Snyder Chris 
Published: October 2019

AbstractDeficiencies in forecast models commonly stem from inadequate representation of physical processes; yet, improvement to any single physics component within a model may lead to degradations in other physics components or the model as a whole. In this study, a systematic investigation of physics tendencies is demonstrated to help identify and correct compensating sources of model biases. The model improvement process is illustrated by addressing a commonly known issue in warm-season rainfall forecasts from parameterized convection models: the misrepresentation of the diurnal precipitation cycle over land, especially in its timing. Recent advances in closure assumptions in mass-flux cumulus schemes have made remarkable improvements in this respect. Here, we investigate these improvements in the representation of the diurnal precipitation cycle for a spring period over the United States, and how changes to the cumulus scheme impact the model climate and the behavior of other physics schemes. The modified cumulus scheme improves both the timing of the diurnal precipitation cycle and reduces midtropospheric temperature and moisture biases. However, larger temperature and moisture biases are found in the boundary layer as compared to a predecessor scheme, along with an overamplification of the diurnal precipitation cycle, relative to observations. Guided by a tendency analysis, we find that biases in the diurnal amplitude of the precipitation cycle in our simulations, along with temperature and moisture biases in the boundary layer, originate from the land surface model.
Autologous Osteochondral Transplantation for Large Osteochondral Lesions of the Talus Is a Viable Option in an Athletic Population
Authors: Nguyen Anthony , Ramasamy Arul , Walsh Melanie , McMenemy Louise , Calder James D.F. 
Published: October 2019

Background: Autologous osteochondral transplantation (AOT) has been shown to be a viable treatment option for large osteochondral lesions of the talus. However, there are limited data regarding the management of large lesions in an athletic population, notably with regard to return to sport. Our investigation focused on assessing both qualitative and quantitative outcomes in the high-demand athlete with large (>150 mm2) lesions. Hypothesis: AOT is a viable option in athletes with large osteochondral lesions and can allow them to return to sport at their preinjury level. Study Design: Case series; Level of evidence, 4. Methods: The study population was limited to professional and amateur athletes (Tegner score, >6) with a talar osteochondral lesion size of 150 mm2 or greater. The surgical intervention was AOT with a donor site from the lateral femoral condyle. Clinical outcomes at a minimum of 24 months included return to sport, visual analog scale (VAS) for pain score, and Foot and Ankle Outcome Score (FAOS). In addition, graft incorporation was evaluated by magnetic resonance imaging (MRI) using MOCART (magnetic resonance observation of cartilage repair tissue) scores at 12 months after surgery. Results: A total of 38 athletes, including 11 professional athletes, were assessed. The mean follow-up was 45 months. The mean lesion size was 249 mm2. Thirty-three patients returned to sport at their previous level, 4 returned at a lower level compared with preinjury, and 1 did not return to sport (mean return to play, 8.2 months). The VAS improved from 4.53 preoperatively to 0.63 postoperatively ( P = .002). FAOSs improved significantly in all domains ( P < .001). Two patients developed knee donor site pain, and both had 3 osteochondral plugs harvested. Univariant analysis demonstrated no association between preoperative patient or lesion characteristics and ability to return to sport. However, there was a strong correlation between MOCART scores and ability to return to sport. The area under receiver operating characteristic of the MOCART score and return to play was 0.891 ( P = .005), with a MOCART score of 52.50 representing a sensitivity of 0.85 and specificity of 0.80 in determining ability to return to one’s previous level of activity. Conclusion: Our study suggests that AOT is a viable option in the management of large osteochondral talar defects in an athletic population, with favorable return to sport level, patient satisfaction, and FAOS/VAS scores. The ability to return to sport is predicated upon good graft incorporation, and further research is required to optimize this technique. Our data also suggest that patients should be aware of the increased risk of developing knee donor site pain when 3 osteochondral plugs are harvested.
Photogrammetric Evaluation of Soft Tissue Profile and Frontal Photographs in Repaired Bilateral Cleft Lip and Palate
Authors: Ajami Shabnam , Babanouri Neda , Afshinpoor Roya 
Published: October 2019

Objective: To evaluate the soft tissue profile and frontal photographs of 8- to 12-year-old patients with repaired complete bilateral cleft lip and palate (BCLP). Methods: The profile and frontal photographs obtained from 31 nonsyndromic BCLP children (aged 8-12 years: 14 boys and 17 girls) were analyzed and compared with an age- and sex-matched normal population (18 boys and 32 girls). In each patient, 12 soft tissue angular and proportional parameters on the frontal photograph and 12 angular parameters for the profile photographs were developed and measured. Student t test was used to compare the mean value of the parameters between both sexes. Results: In the frontal view, there was a significant difference between the 2 study groups in the facial symmetry angle ( P < .001), lower facial height proportion ( P < .001), upper lip proportion ( P < .001), and interalar width/distance between the inner canthus of the eyes ( P < .001). In the profile view, there was a significant difference between the control group and the patients with cleft lip and palate in terms of nasofrontal angle ( P < .001), nasal angle ( P < .001), angle of the inferior facial third ( P = .032), head position angle ( P < .001), facial convexity angle ( P < .001), total facial convexity angle ( P < .001), and vertical nasal angle ( P < .001). Conclusion: In comparison with the normal population, the face of patients with repaired BCLP showed several soft tissue deformities, especially in the nasofrontal region, even after a surgical repair.
Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity
Authors: Virgili Gianni , Tosi Gian Marco , Figus Michele , Rizzo Stanislao , Murro Vittoria , Mucciolo Dario Pasquale , Roberto Giuseppe , Gini Rosa 
Published: October 2019

Purpose: We aimed to develop indicators based on electronic administrative data to compare treatment intensity at a hospital level in Tuscany, Italy. Methods: Data from 3 university hospitals (UHs), 11 local hospitals (LHs) and 2 private hospitals were analysed. Patients newly treated with an intravitreal injection were followed up for 365 days. Indicator #1 concerned hospitals with >80% of injections linked to a drug and patients with all injections linked to a drug. Indicator #2 included patients who received ⩾3 injections during the first 90 days, regardless of injection-drug linkage. Results: Indicator #1 was computed on four hospitals and included 3210 patients (48.3%). The average number of injections was 3.24 in the largest UH1. Compared to the latter, indicator #1 was significantly lower in UH2 and UH3 (−0.47 and −0.58, respectively; p < 0.001). Indicator #2 was computed on all hospitals and included 2789 patients (41.9%). UH1 delivered about 4.33 injections. Compared to the latter, LH4 delivered +0.62 injections ( p < 0.001) and nine other hospitals delivered between −0.22 and −0.94 injections ( p < 0.05). Conclusion: The two indicators proved to have the potential for supporting clinicians and policy makers in promoting the appropriate treatment intensity with intravitreal anti-vascular endothelial growth factor drugs.
Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy
Authors: Mugusi Sabina F. , Sando David , Mugusi Ferdinand M. , Hawkins Claudia , Aboud Said , Fawzi Wafaie W. , Sudfeld Christopher R. 
Published: October 2019

Introduction: Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART). Approach: We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild/moderate ALT elevations >40 IU/L and severe ALT elevations >200 IU/L. Results: We found that over a median follow-up of 32.5 months (interquartile range: 19.4-41.5), 44.8% of participants had at least 1 incident ALT elevation >40 IU/L of which 50.1% were persistent elevations. Risk factors for incident ALT elevation >40 IU/L included male sex, CD4 count <100 cells/μL, d4T+3TC+NVP cART, and triglycerides ≥150 mg/dL ( P values <.05). Hepatitis B coinfection and alcohol consumption increased the risk of severe ALT elevations >200 IU/L ( P values: <.05). Conclusion: Incident mild and moderate ALT elevations are common among Tanzanians initiating cART, and the clinical and demographic information can identify patients at increased risk.