bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low frequency fatigue and changes in muscle fascicle length following eccentric exercise of the knee extensors
Authors: Muanjai Pornpimol , Mickevicius Mantas , Sniečkus Audrius , Sipavičienė Saulė , Satkunskiene Danguole , Kamandulis Sigitas , Jones David A. 
Published: January 2020

New Finding
What is the central question of this study?
Does low frequency muscle fatigue indicate a failure of excitation–contraction coupling after eccentric exercise, or is it simply due to a change in muscle length?

What is the main finding and its importance?
The low to high frequency muscle fatigue ratio was relatively insensitive to changes in muscle length, and any changes in length following eccentric exercise were far too small to account for the high degree of low frequency fatigue. The results strengthen the suggestion that the early loss of force following eccentric exercise is due to a deficit of excitation–contraction coupling.

AbstractDevelopment of long lasting fatigue (low frequency fatigue; LFF), assessed as the ratio of forces at 20 and 100 Hz stimulation, suggests the early phase of muscle damage caused by eccentric exercise is due to a deficit of excitation–contraction coupling. However, this could be caused by a change of muscle length. Eleven men (21.3 ± 2.0 years) performed 200 maximum eccentric knee extensions (30–110 deg flexion). Force generated by 20 and 100 Hz stimulation and maximum isometric force (MIF) were determined at knee angles 50, 70 and 90 deg before and immediately after the exercise. Vastus lateralis fascicle length (FL) was measured by ultrasound of resting and contracting muscle. Peak MIF (829 ± 119 N) was at 70 deg knee flexion, falling to 486 ± 180 N (P < 0.001) after exercise, but with no change in optimum angle. FLs at rest were unaffected by eccentric exercise, but during contraction they were on average 8.8% (95% CI: 4.1, 13.5%, P = 0.002) longer after exercise. Before exercise, the 20/100 ratio increased with muscle length, from 0.69 ± 0.09 at 50 deg, 0.72 ± 0.05 at 70 deg and 0.80 ± 0.08 at knee angle 90 deg (P < 0.001). After eccentric exercise the 20/100 ratio was reduced to 0.29 ± 0.08 at 50 deg, 0.27 ± 0.04 at 70 deg and 0.34 ± 0.04 at 90 deg (P < 0.001). The 20/100 ratio was relatively insensitive to changes in muscle length and the decrease following eccentric exercise was far greater than might be caused by any changes in muscle length after eccentric exercise. The results show that LFF following eccentric exercise is not due to change in muscle length and strengthen the suggestion that it represents a deficit in excitation–contraction coupling.
Dramatic weakening of the East Asian summer monsoon in northern China during the transition from the Medieval Warm Period to the Little Ice Age
Authors: Lan Jianghu , Xu Hai , Lang Yunchao , Yu Keke , Zhou Peng , Kang Shugang , Zhou Kangen , Wang Xulong , Wang Tianli , Cheng Peng , Yan Dongna , Yu Shiyong , Che Ping , Ye Yuanda , Tan Liangcheng 
Published: January 2020

Abstract
Changes in the intensity of the East Asian summer monsoon (EASM) are critical for regulating the regional hydrology, ecology, and human civilization, especially in the vicinity of the summer monsoon limit (SML). However, the detailed spatial variations of the SML in mainland China over the past 2000 years are uncertain due to the lack of high-resolution paleoclimate archives. As a result, the accurate location of the SML during the transition from the Medieval Warm Period (MWP) to the Little Ice Age (LIA), as well as its impacts on ecology and society, are poorly understood. Here, we report a potential location of the SML during the late Holocene by combining data from a lake sedimentary record and a compilation of paleoclimate records from arid northern China. We find that EASM intensity was strong during the MWP and that the SML in arid northern China was roughly located along the Yinshan Mountains, Yabulai Mountains, and north of Lake Qinghai. EASM intensity dramatically weakened during the MWP-LIA transition, and the SML retreated southeastward significantly, which may have primarily but nonlinearly been a response to the reduction in solar irradiance and its associated changes in atmospheric circulation (e.g., El Niño–Southern Oscillation and Siberian High) and could have had profound impacts on hydrology, ecology, and human civilization across northern monsoonal Asia.
Diachronous Tibetan Plateau landscape evolution derived from lava field geomorphology
Authors: Law Robert , Allen Mark B. 
Published: January 2020

Abstract
Evolution of the Tibetan Plateau is important for understanding continental tectonics because of the plateau’s exceptional elevation (∼5 km above sea level) and crustal thickness (∼70 km). Patterns of long-term landscape evolution can constrain tectonic processes, but have been hard to quantify, in contrast to established data sets for strain, exhumation, and paleo-elevation. This study analyzes the relief of the bases and tops of 17 Cenozoic lava fields on the central and northern Tibetan Plateau. Analyzed fields have typical lateral dimensions of tens of kilometers, and so have an appropriate scale for interpreting tectonic geomorphology. Fourteen of the fields have not been deformed since eruption. One field is cut by normal faults; two others are gently folded, with limb dips &lt;6°. Relief of the bases and tops of the fields is comparable to that of modern, internally drained parts of the plateau, and distinctly lower than that of externally drained regions. The lavas preserve a record of underlying low-relief bedrock landscapes at the time they were erupted, which have undergone little change since. There is an overlap in each area between younger published low-temperature thermochronology ages and the age of the oldest eruption in each area, here interpreted as the transition between the end of significant (&gt;3 km) exhumation and plateau landscape development. This diachronous process took place between ∼32.5°N and ∼36.5°N and between ca. 40 Ma and ca. 10 Ma, advancing northwards at a long-term rate of ∼15 km/m.y. Results are consistent with incremental northward growth of the plateau, rather than a stepwise evolution or synchronous uplift.
Syncontractional deposition of the Cretaceous Newark Canyon Formation, Diamond Mountains, Nevada: Implications for strain partitioning within the U.S. Cordillera
Authors: Di Fiori Russell V. , Long Sean P. , Fetrow Anne C. , Snell Kathryn E. , Bonde Joshua W. , Vervoort Jeff 
Published: January 2020

AbstractThe timing of deformation and deposition within syntectonic basins provides critical information for understanding the evolution of strain in mountain belts. In the U.S. Cordillera, contractional deformation was partitioned between the Sevier thrust belt in Utah and several structural provinces in the hinterland in Nevada. One hinterland province, the Central Nevada thrust belt (CNTB), accommodated up to ∼15 km of shortening; however, in most places, this deformation can only be bracketed between Permian and Eocene. Cretaceous deposits of the Newark Canyon Formation (NCF), which are sparsely exposed along the length of the CNTB, offer the opportunity to constrain deformation timing. Here, we present mapping and U-Pb zircon geochronology from the NCF in the Diamond Mountains, which demonstrate deposition of the NCF during proximal CNTB deformation. Deposition of the basal NCF member was under way no earlier than ca. 114 Ma, a tuff in the middle part of the section was deposited at ca. 103 Ma, and the youngest member was deposited no earlier than ca. 99 Ma. Intraformational angular unconformities and abrupt along- and across-strike thickness changes indicate that NCF deposition was related to growth of an east-vergent fault-propagation fold. Clast compositions define unroofing of upper Paleozoic sedimentary rocks, which we interpret as the progressive erosion of an anticline ∼10 km to the west. CNTB deformation was contemporaneous with shortening in the Sevier thrust belt, which defines middle Cretaceous strain partitioning between frontal and interior components of the Cordillera. Strain partitioning may have been promoted by renewed underthrusting during a period of high-flux magmatism.
Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment
Authors: Singh Ospina Naykky , Iñiguez-Ariza Nicole M , Castro M Regina 
Published: January 2020

ABSTRACTThyroid nodules are extremely common and can be detected by sensitive imaging in more than 60% of the general population. They are often identified in patients without symptoms who are undergoing evaluation for other medical complaints. Indiscriminate evaluation of thyroid nodules with thyroid biopsy could cause a harmful epidemic of diagnoses of thyroid cancer, but inadequate selection of thyroid nodules for biopsy can lead to missed diagnoses of clinically relevant thyroid cancer. Recent clinical guidelines advocate a more conservative approach in the evaluation of thyroid nodules based on risk assessment for thyroid cancer, as determined by clinical and ultrasound features to guide the need for biopsy. Moreover, newer evidence suggests that for patients with indeterminate thyroid biopsy results, a combined assessment including the initial ultrasound risk stratification or other ancillary testing (molecular markers, second opinion on thyroid cytology) can further clarify the risk of thyroid cancer and the management strategies. This review summarizes the clinical importance of adequate evaluation of thyroid nodules, focuses on the clinical evidence for diagnostic tests that can clarify the risk of thyroid cancer, and highlights the importance of considering the patient’s values and preferences when deciding on management strategies in the setting of uncertainty about the risk of thyroid cancer.
Public awareness, acceptability and risk perception about infectious diseases dual-use research of concern: a cross-sectional survey
Authors: MacIntyre Chandini Raina , Adam Dillon Charles , Turner Robin , Chughtai Abrar Ahmad , Engells Thomas 
Published: January 2020

ObjectivesIn this study, we aimed to measure the awareness, acceptability and perceptions of current issues in biosecurity posed by infectious diseases dual-use research of concern (DURC) in the community. DURC is conducted today in many locations around the world for the benefit of humanity but may also cause harm through either a laboratory accident or deliberate misuse. Most DURC is approved by animal ethics committees, which do not typically consider harm to humans. Given the unique characteristics of contagion and the potential for epidemics and pandemics, the community is an important stakeholder in DURC.DesignSelf-administered web-based cross-sectional survey.ParticipantsParticipants over the age of 18 in Australia and 21 in the USA were included in the survey. A total of 604 participants completed the study. The results of 52 participants were excluded due to potential biases about DURC stemming from their employment as medical researchers, infectious diseases researchers or law enforcement professionals, leaving 552 participants. Of those, 274 respondents resided in Australia and 278 in the USA.OutcomesBaseline awareness, acceptability and perceptions of current issues surrounding DURC. Changes in perception from baseline were measured after provision of information about DURC.ResultsPresurvey, 77% of respondents were unaware of DURC and 64% found it unacceptable or were unsure. Two-thirds of respondents did not change their views. The baseline perception of high risk for laboratory accidents (29%) and deliberate bioterrorism (34%) was low but increased with increasing provision of information (42% and 44% respectively, p<0.001), with men more accepting of DURC (OR=1.79, 95% CI 1.25 to 2.57, p=0.002). Postsurvey, higher education predicted lower risk perception of laboratory accidents (OR=0.56, 95% CI 0.34 to 0.93, p=0.02) and bioterrorism (OR=0.48, 95% CI 0.29 to 0.80, p=0.004).ConclusionThe community is an important stakeholder in infectious diseases DURC but has a low awareness of this kind of research. Only a minority support DURC, and this proportion decreased with increasing provision of knowledge. There were differences of opinion between age groups, gender and education levels. The community should be informed and engaged in decisions about DURC.
Characterising and predicting persistent high-cost utilisers in healthcare: a retrospective cohort study in Singapore
Authors: Ng Sheryl Hui Xian , Rahman Nabilah , Ang Ian Yi Han , Sridharan Srinath , Ramachandran Sravan , Wang Debby Dan , Khoo Astrid , Tan Chuen Seng , Feng Mengling , Toh Sue-Anne Ee Shiow , Tan Xin Quan 
Published: January 2020

ObjectiveWe aim to characterise persistent high utilisers (PHUs) of healthcare services, and correspondingly, transient high utilisers (THUs) and non-high utilisers (non-HUs) for comparison, to facilitate stratifying HUs for targeted intervention. Subsequently we apply machine learning algorithms to predict which HUs will persist as PHUs, to inform future trials testing the effectiveness of interventions in reducing healthcare utilisation in PHUs.Design and settingThis is a retrospective cohort study using administrative data from an Academic Medical Centre (AMC) in Singapore.ParticipantsPatients who had at least one inpatient admission to the AMC between 2005 and 2013 were included in this study. HUs incurred Singapore Dollar 8150 or more within a year. PHUs were defined as HUs for three consecutive years, while THUs were HUs for 1 or 2 years. Non-HUs did not incur high healthcare costs at any point during the study period.Outcome measuresPHU status at the end of the third year was the outcome of interest. Socio-demographic profiles, clinical complexity and utilisation metrics of each group were reported. Area under curve (AUC) was used to identify the best model to predict persistence.ResultsPHUs were older and had higher comorbidity and mortality. Over the three observed years, PHUs’ expenditure generally increased, while THUs and non-HUs’ spending and inpatient utilisation decreased. The predictive model exhibited good performance during both internal (AUC: 83.2%, 95% CI: 82.2% to 84.2%) and external validation (AUC: 79.8%, 95% CI: 78.8% to 80.8%).ConclusionsThe HU population could be stratified into PHUs and THUs, with distinctly different utilisation trajectories. We developed a model that could predict at the end of 1 year, whether a patient in our population will continue to be a HU in the next 2 years. This knowledge would allow healthcare providers to target PHUs in our health system with interventions in a cost-effective manner.
Midlife socioeconomic position and old-age dementia mortality: a large prospective register-based study from Finland
Authors: Korhonen Kaarina , Einiö Elina , Leinonen Taina , Tarkiainen Lasse , Martikainen Pekka 
Published: January 2020

ObjectivesTo assess the association between multiple indicators of socioeconomic position and dementia-related death, and to estimate the contribution of dementia to socioeconomic differences in overall mortality at older ages.DesignProspective population-based register study.SettingFinland.Participants11% random sample of the population aged 70–87 years resident in Finland at the end of year 2000 (n=54 964).Main outcome measureIncidence rates, Kaplan-Meier survival probabilities and Cox regression HRs of dementia mortality in 2001–2016 by midlife education, occupational social class and household income measured at ages 53–57 years.ResultsDuring the 528 387 person-years at risk, 11 395 individuals died from dementia (215.7 per 10 000 person-years). Lower midlife education, occupational social class and household income were associated with higher dementia mortality, and the differences persisted to the oldest old ages. Compared with mortality from all other causes, however, the socioeconomic differences emerged later. Dementia accounted for 28% of the difference between low and high education groups in overall mortality at age 70+ years, and for 21% of the difference between lowest and highest household income quintiles. All indicators of socioeconomic position were independently associated with dementia mortality, low household income being the strongest independent predictor (HR=1.24, 95% CI 1.16 to 1.32), followed by basic education (HR=1.14, 1.06 to 1.23). Manual occupational social class was related to a 6% higher hazard (HR=1.06, 1.01 to 1.11) compared with non-manual social class. Adjustment for midlife economic activity, baseline marital status and chronic health conditions attenuated the excess hazard of low midlife household income, although significant effects remained.ConclusionSeveral indicators of socioeconomic position predict dementia mortality independently and socioeconomic inequalities persist into the oldest old ages. The results demonstrate that dementia is among the most important contributors to socioeconomic inequalities in overall mortality at older ages.
Levofloxacin versus placebo for the treatment of latent tuberculosis among contacts of patients with multidrug-resistant tuberculosis (the VQUIN MDR trial): a protocol for a randomised controlled trial
Authors: Fox Greg J , Nguyen Cam Binh , Nguyen Thu Anh , Tran Phuong Thuy , Marais Ben J , Graham Steve M , Nguyen Binh Hoa , Velen Kavi , Dowdy David W , Mason Paul , Britton Warwick J , Behr Marcel A , Benedetti Andrea , Menzies Dick , Nguyen Viet Nhung , Marks Guy B 
Published: January 2020

IntroductionTreatment of latent tuberculosis infection (LTBI) plays a substantial role in the prevention of drug-susceptible tuberculosis (TB). However, clinical trials to evaluate the efficacy of preventive therapy for presumed multidrug-resistant (MDR) LTBI are lacking. This trial aims to evaluate the efficacy of the antibiotic levofloxacin in preventing the development of active TB among latently infected contacts of index patients with MDR-TB.Methods and analysisA double-blind placebo-controlled parallel group randomised controlled trial will be conducted in 10 provinces of Vietnam. Household contacts living with patients with bacteriologically confirmed rifampicin-resistant or MDR-TB will be eligible for recruitment if they have a positive tuberculin skin test or are known to be immunosuppressed, and do not have active TB. Participants will be randomised to receive either levofloxacin or placebo tablets once per day for 6 months. Screening for incident TB will be performed at 6 months intervals. The primary study outcome is the incidence of bacteriologically confirmed TB within 30 months after randomisation. Analysis will be by intention to treat, using Poisson regression.EthicsEthical approval from the University of Sydney Human Research Ethics Committee was obtained on 29 April 2015 (2014/929), and from the Vietnam Ministry of Health Institutional Review Board on 30 September 2015 (4040/QD-BYT).DisseminationFindings of the study will be published in peer-reviewed publications and conference presentations.Trial registration numberACTRN12616000215426.
Economic evaluations of clinical pharmacy services in China: a systematic review
Authors: Mi Xue , Su Xuelong , Jin Ziyan , Zeng Linan , Li Zhuo , Wang Xiaowen , Zhang Peng , Zuo Yan 
Published: January 2020

ObjectiveThis article reviewed research conducted on economic evaluations of clinical pharmacy services (CPS) in China. We aimed to identify the types of CPS and the possible economic effects of these services and to hopefully provide some suggestions for designing future economic evaluations of pharmacy interventions in the region.DesignSystematic review.Data sourcesSeveral English databases (PubMed, Embase, The Cochrane Library, National Health Service Economic Evaluation Database), Chinese databases (China National Knowledge Infrastructure, VIP, Chinese Biomedical Literature Database and WanFang Data) and search engines (Google Scholar and BaiDu Scholar) were searched through December 2017.Eligibility criteria for selecting studiesStudies with an economic assessment of CPSs in China were included.Data extraction and synthesisTwo reviewers independently screened the studies, extracted the data, assessed the quality of the included studies and then qualitatively analysed the results.ResultsForty articles were included in the final analysis. Most studies were performed in hospitals and the intervention populations mainly included adults. The types of pharmaceutical services included antimicrobial management, chronic disease state management and multidimensional clinical pharmaceutical services. A positive economic benefit associated with CPS was noted in 80% (n=32) of these articles, showing that CPS were associated with cost savings and improved patient outcomes. However, only three studies were full economic evaluations, using the method of cost-effectiveness analysis.ConclusionCPS was associated with cost savings and generated positive economic value. With the expanding role of pharmacists in the healthcare sector, it is suggested that new pharmaceutical services be used in future studies and that high-quality full economic evaluations capturing both expenses and cost savings be conducted.
Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions
Authors: Pires Paulo Henrique , Siemens Ronald , Mupueleque Martins 
Published: January 2020

ObjectiveTo increase knowledge, attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in Mozambique.DesignAn implementation research project’s intermediate evaluation, applying two cross-sectional surveys. The surveys were planned for 316 subjects before and after interventions.SettingResearch performed in Natikiri district of Nampula province in northern Mozambique, targeting a suburban and rural populations in their homes.Participants452 people were surveyed (91 before, 361 after), all belonging to the Macua ethnic group.InterventionsA media campaign (2 weekly radio spots, bimonthly theatre performances) was performed for 8 months (2017 to 2018) and family health champions’ teachings (monthly home visits) performed for 3 months, on sexual and reproductive health and family planning. Outcome measures planned and measured were adolescent’s and adult’s knowledge, attitudes and practice about those. Data were analysed by gender, age group and frequencies, using a CI of 95% (p<0.5 statistically significant).ResultsRadio spots, community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family planning. Concerning attitude, results show differences between adults’ proportions before and after: (1) did you hear about sexual and reproductive health (p=0.0425); (2) knows project key messages (p<0.001); (3) knows prenatal visits importance (p=0.0301); (4) access to contraceptives was easy (p<0.001). Adolescents showed statistically significant differences before and after: (1) knows project key messages (p<0.001); (2) access to contraceptives was easy (p=0.0361). Family planning practice did not increase in both groups.ConclusionA health education intervention, using a media campaign and local volunteers, is useful to promote mother and child health. There is an unmet need for family planning and the use of modern contraception is below desired practice, needing further research about cultural barriers. Communication for behaviour change activities will pursue and impact will be assessed to document family planning practice improvement.