bluuebunny/crossref_metadata_2025_split huggingface dataset:
When separation is not the answer: Breastfeeding mothers and infants affected by COVID‐19
Authors: Tomori Cecília , Gribble Karleen , Palmquist Aunchalee E.L. , Ververs Mija‐Tesse , Gross Marielle S. 
Published: May 2020

AbstractThe World Health Organization (WHO) has provided detailed guidance on the care of infants of women who are persons under investigation (PUI) or confirmed to have COVID‐19. The guidance supports immediate post‐partum mother–infant contact and breastfeeding with appropriate respiratory precautions. Although many countries have followed WHO guidance, others have implemented infection prevention and control (IPC) policies that impose varying levels of post‐partum separation and discourage or prohibit breastfeeding or provision of expressed breast milk. These policies aim to protect infants from the potential harm of infection from their mothers, yet they may fail to fully account for the impact of separation. Global COVID‐19 data are suggestive of potentially lower susceptibility and a typically milder course of disease among children, although the potential for severe disease in infancy remains. Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding—a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post‐discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long‐standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS‐CoV‐2‐positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world. Health services must consider the short‐andlong‐term impacts of separating mothers and infants in their policies.
Outcomes of Hip Arthroscopy for Femoroacetabular Impingement in Chinese Patients Aged 50 Years or Older
Authors: Gao Feng , Zhang Baiqing , Hu Bo , Lu Ming , An Mingyang , Liu Yufeng , Fang Yehan , Zhao Gang , Shi Chao , Zhou Jingbin , Liu Yujie , Li Chunbao 
Published: May 2020

ObjectiveTo investigate the outcomes of hip arthroscopy for femoroacetabular impingement (FAI) in patients over the age of 50 years.MethodThis is a therapeutic case series study. A total of 27 FAI patients over the age of 50 years who met inclusion and exclusion criteria and were being followed up for at least 2 years in the orthopaedics department at our hospital between January 2015 and October 2017 were recruited for a prospective analysis on the outcomes of hip arthroscopy. All patients underwent unilateral surgery. Of the patients included, there were 15 men and 12 women, who were aged 50–74 years old (57 ± 6.4 years). The outcomes were assessed using the visual analog scale (VAS), the modified Harris hip score (mHHS), and the International Hip Outcome Tool (iHOT‐12).ResultsA total of 27 patients were followed up for at least 2 years. The postoperative center‐edge angle, the alpha angle, and the offset decreased significantly compared with preoperative measurements (P < 0.01). The mHHS before surgery and at 1 year and 2 years after surgery was 62.19 ± 7.47, 86.70 ± 5.80, and 87.89 ± 5.08, respectively; iHOT‐12 scores were 30.44 ± 4.22, 73.56 ± 3.89, and 73.77 ± 3.72, respectively; VAS scores were 6.07 ± 0.78, 1.93 ± 0.73, and 1.59 ± 0.64, respectively. As compared with the condition before surgery, there was a significant improvement in the mHHS, iHOT‐12, and VAS scores at 1 year and 2 years after surgery (P < 0.01). The mHHS score at 2‐year follow up after surgery was higher than that at 1 year after surgery, and the difference observed was statistically significant (P = 0.04). One patient with severe acetabular and femoral cartilage damage underwent total hip replacement 11 months after surgery.ConclusionHip arthroscopy considerably improved hip symptoms and function in Chinese FAI patients aged 50 years or older who did not have severe radiographic osteoarthritis. The conversion to THA and complications were low. Strict surgical indications and appropriate surgical strategies lay the foundation for satisfactory postoperative results in elderly patients with FAI.
Esophageal contraction during cryoablation: A possible protective mechanism
Authors: Cai Dongsheng , Liu Qiang , Shehata Michael , Jiang Ruhong , Yu Lu , Zhang Pei , Sun Yaxun , Chen Shiquan , Zhang Zuwen , Fu Guosheng , Jiang Chenyang , Wang Xunzhang 
Published: May 2020

AbstractBackgroundContraction of the esophagus was observed during cryoablation for paroxysmal atrial fibrillation (PAF). The purpose of this study is to investigate the mechanism of esophageal contraction and the correlation between the contraction and esophageal thermal lesions.MethodsThis prospective study enrolled 64 patients with PAF undergoing second‐generation cryoballoon (CB2) ablation for pulmonary vein isolation (PVI). During PVI for the left inferior pulmonary vein, contrast esophagography was performed before and during cryoablation. The sample population was divided into two groups: A (31 patients) and B (33 patients). Group A consisted of patients in whom the distal half of the CB was in proximity to the esophagus, while for group B the esophagus was away from the distal half of the CB. Esophageal contraction was recorded as a variation in the width of the esophageal lumen during PVI. Postablation esophageal endoscopy was done on all patients.ResultsThe reduction in the width of the esophageal lumen in group A was greater than in group B during freezing (40.12 ± 23.24% vs 8.14 ± 10.35%, P < .001). Following endoscopy, no apparent esophageal lesion was detected in all patients.ConclusionThe extent of esophageal contraction is correlated with the positioning of the esophagus at the distal half of the CB. The findings of this study indicate that esophageal contraction during freezing may be a self‐protective mechanism.
Ophthalmic examination, biometry, and histologic findings in captive inland bearded dragons (Pogona vitticeps)
Authors: Martin de Bustamante Michelle G. , Johnson Alanna N. , Shippy Sarah G. , Allgood Hillary , Plummer Caryn E. 
Published: May 2020

AbstractObjectiveTo report ophthalmic examination, biometry, phenol red thread test (PRTT), intraocular pressure (IOP), and histologic findings from a private collection of inland bearded dragons (Pogona vitticeps).Animals studiedFourteen inland bearded dragons.ProceduresComplete ophthalmic examinations were performed on all animals, including slit‐lamp biomicroscopy, indirect ophthalmoscopy, fluorescein stain, phenol red thread test, and rebound tonometry. B‐mode ultrasonography was used to measure anterior chamber depth, axial lens thickness, vitreal chamber depth, and axial globe length. Horizontal corneal diameter was estimated using ImageJ software. Histologic assessment was obtained for one of the bearded dragons that died following the study period.ResultsThe median PRTT value was 7.27 mm/15 seconds. Mean IOP was 6.29 ± 1.60 mm Hg and 2.14 ± 1.37 mm Hg using the dog and undefined calibration settings, respectively. Median axial globe length was 11.75 mm. Mean anterior chamber depth and mean lens thickness were 2.06 ± 0.35 mm and 3.38 ± 0.45 mm, respectively. Median vitreal chamber depth was 6.79 mm. Mean horizontal corneal diameter was 5.138 ± 0.346 mm. Two distinct ocular phenotypes were observed, with two of the bearded dragons having corneal globosa, deep anterior chambers, and tufts of iridal vessels and fibrillar material extending into the anterior chamber.ConclusionsThe ultrasound biometry, PRTT, and rebound tonometry results may serve as a guideline for ophthalmic parameters in healthy bearded dragons. Examination and testing of greater numbers of animals are necessary to establish true reference ranges and determine if the observed ocular phenotypes represent normal variants or pathologic changes.
Acute Testicular Fracture in a National Collegiate Athletic Association (NCAA) Division I Baseball Catcher: A Case Study
Authors: Platt Brandon C. , Falsone Sue , Lam, Kenneth C. 
Published: May 2020

A 21-year-old male baseball catcher sustained an injury to the right testicle from a foul ball that ricocheted from the ground to his groin. The athlete was removed from competition when testicular pain began to increase. Ice was applied to the affected area and nonsteroidal anti-inflammatory drugs (NSAIDs) were utilized through the evening. Further diagnosis and treatment were warranted the following morning. Diagnostic ultrasound revealed a fracture to the right testicle, necessitating surgical repair. The athlete followed a return-to-play progression and returned to play 20 days postinjury. This case describes evaluation and treatment of a rare acute condition and the need for early recognition and diagnosis.
Talent Development in Football—A Holistic Perspective: The Case of KRC Genk
Authors: Ryom Knud , Ravn Mads , Düring Rune , Henriksen Kristoffer 
Published: May 2020

Interest in talent identification and the development of professional footballers has markedly increased in the past decade. Research in football has primarily focused on individual development and external factors affecting performance. In other sports, research from a holistic and ecological approach has examined successful environments, suggesting that such environments are not only unique, but also share features. Using a single case study design and a holistic ecological approach, this study investigated the youth department of the Belgium elite club KRC Genk (the Jos Vaessen Talent Academy). Results suggest that this environment, in many regards, is consistent with the shared features found in other successful environments in other sports (such as support of sporting goals by the wider environment and support for long-term development). However, three features were also observed as unique. These were (a) cultural awareness, openness, and sharing of knowledge; (b) the club’s ability to accommodate a broad diversity of players in the academy; and (c) an openness toward new ideas and learning on all levels of the organization. Collectively, our results indicate that Genk, in some respects, not only shares features with successful environments in other sports, but also bears unique features.
Comparison of retinal vessel diameter measurements from swept-source OCT angiography and adaptive optics ophthalmoscope
Authors: Yao Xinwen , Ke Mengyuan , Ho Yijie , Lin Emily , Wong Damon W K , Tan Bingyao , Schmetterer Leopold , Chua Jacqueline 
Published: May 2020

Background/imsTo compare the retinal vessel diameter measurements obtained from the swept-source optical coherence tomography angiography (OCTA; Plex Elite 9000, Carl Zeiss Meditec, USA) and adaptive optics ophthalmoscope (AOO; RTX1, Imagine Eyes, France).MethodsFifteen healthy subjects, 67% women, mean age (SD) 30.87 (6.19) years, were imaged using OCTA and AOO by a single experienced operator on the same day. Each eye was scanned using two OCTA protocols (3×3 mm2 and 9×9 mm2) and two to five AOO scans (1.2×1.2 mm2). The OCTA and AOO scans were scaled to the same pixel resolution. Two independent graders measured the vessel diameter at the same location on the region-of-interest in the three coregistered scans. Differences in vessel diameter measurements between the scans were assessed.ResultsThe inter-rater agreement was excellent for vessel diameter measurement in both OCTA protocols (ICC=0.92) and AOO (ICC=0.98). The measured vessel diameter was widest from the OCTA 3×3 mm2 (55.2±16.3 µm), followed by OCTA 9×9 mm2 (54.7±14.3 µm) and narrowest by the AOO (50.5±15.6 µm; p<0.001). Measurements obtained from both OCTA protocols were significantly wider than the AOO scan (OCTA 3×3 mm2: mean difference Δ=4.7 µm, p<0.001; OCTA 9×9 mm2: Δ=4.2 µm, p<0.001). For vessels >45 µm, it appeared to be larger in OCTA 3×3 mm2 scan than the 9×9 mm2 scan (Δ=1.9 µm; p=0.005), while vessels <45 µm appeared smaller in OCTA 3×3 mm2 scan (Δ=−1.3 µm; p=0.009)ConclusionsThe diameter of retinal vessels measured from OCTA scans were generally wider than that obtained from AOO scans. Different OCTA scan protocols may affect the vessel diameter measurements. This needs to be considered when OCTA measures such as vessel density are calculated.
Retrospective cohort study to characterise the blood pressure response to spironolactone in patients with apparent therapy-resistant hypertension using electronic medical record data
Authors: Shuey Megan , Perkins Bradley , Nian Hui , Yu Chang , Luther James M , Brown Nancy 
Published: May 2020

ObjectiveIdentify blood pressure (BP) response to spironolactone in patients with apparent therapy-resistant hypertension (aTRH) using electronic medical records (EMRs) in order to estimate response in a real-world clinical setting.DesignDeveloped an algorithm to determine BP and electrolyte response to spironolactone for use in a retrospective cohort study.SettingAn academic medical centre in Nashville, Tennessee.PopulationPatients with aTRH prescribed spironolactone.Main outcome measuresBaseline BP and BP response, determined as the change in mean systolic BP (SBP) and diastolic BP (DBP) following spironolactone initiation. Additional response measures were serum sodium, potassium and creatinine, estimated glomerular filtration rate, haemoglobin A1c (HbA1c), glucose, high-density lipoprotein, low-density lipoprotein and triglycerides. Demographic characteristics included race, age, gender, body mass index (BMI), diabetes mellitus, chronic kidney disease stage 3, ischaemic heart disease and smoking.ResultsThe mean decreases in SBP and DBP were 8.1 and 3.4 mm Hg, consistent with clinical trial data. Using a mean decrease in SBP of 5 mm Hg or in DBP of 2 mm Hg to define ‘responders’, 30.3% of patients did not respond. In univariable analyses, responders had higher BMI, baseline SBP, DBP, sodium and HbA1c, and lower creatinine. In multivariable analysis, responders were older and had significantly higher BMI and baseline SBP and DBP, and lower potassium. Increases in potassium and creatinine following spironolactone were larger in responders. When BP was evaluated as a continuous variable, decreases in SBP and DBP correlated with baseline BP, decrease in sodium and increases in potassium and creatinine following spironolactone. The decrease in SBP was associated with decreasing glucose in European Americans.ConclusionsWe developed an algorithm to assess BP response to a commonly prescribed medication for aTRH using EMRs. Electrolyte changes associated with the BP response to spironolactone are consistent with its mechanism of action of blocking the mineralocorticoid receptor and decreasing epithelial sodium channel activity.
Prevalence of smoking, quit attempts and access to cessation treatment among adults with mental illness in Brazil: a cross-sectional analysis of a National Health Survey
Authors: Cruvinel Erica , Liebman Edward , Leite Isabel , Hu Jinxiang , Richter Kimber P 
Published: May 2020

ObjectivesDetermine the national prevalence of smoking and factors related to smoking among adults with mental illness (PLWMI; people living with mental illness) in Brazil.DesignCross-sectional study.SettingWe used data from the nationally representative general health survey Pesquisa Nacional de Saude of 2013, which included the Global Adult Tobacco Survey (GATS) module.ParticipantsThe survey used a complex probabilistic sample to collect data from 60 202 Brazilians 18 years or older. Primary and secondary outcomes: smoking prevalence and access to smoking cessation treatment. We also assessed past tobacco use, quit attempts and quit ratio among people with and without mental illness. Analyses were conducted in R and were weighted to account for the survey design and generate national estimates.ResultsIn Brazil, the 2013 smoking prevalence among PLWMI was 28.4% and among people with no mental illness was 12.8%. Both groups had high rates of past-year quit attempts (51.6% vs 55.3%) but the lifetime quit ratio among PLWMI was much lower than those with no mental illness (37% vs 54%). Adjusted odds showed PLWMI were more likely to be current smokers (OR (95% CI)=2.60 (2.40 to 2.82), less likely to be former smokers (OR (95% CI)=0.62 (0.55 to 0.70)) and as likely to have tried to quit in the past year (OR (95% CI)=0.90 (0.78 to 1.02)). Very few (3.7%) PLWMI and fewer with no mental illness (2.6%) received cessation treatment.ConclusionSmoking rates among PLWMI are roughly double the rate in the general population. Compared with Brazilian smokers without mental illness, those with mental illness were significantly less likely to quit even though as many tried to. Few Brazilians appear to be using publicly available cessation services. Expanding utilisation of treatment might be a good place to start for Brazil to further decrease the prevalence of smoking among PLWMI.
Asylum seekers’ and Refugees’ Changing Health (ARCH) study protocol: an observational study in Lebanon and Denmark to assess health implications of long-distance migration on communicable and non-communicable diseases and mental health
Authors: Eiset Andreas Halgreen , Aoun Michaelangelo P , Haddad Ramzi S , Naja Wadih J , Fuursted Kurt , Nielsen Henrik Vedel , Stensvold Christen Rune , Nielsen Monica Stougaard , Gottlieb Annemarie , Frydenberg Morten , Wejse Christian 
Published: May 2020

IntroductionBy end of 2018, the European Union countries hosted approximately 2.5 million refugees and Lebanon alone hosted more than 1 million. The majority of refugees worldwide came from Syria. The prevailing study design in published studies on asylum seekers’ and refugees’ health leaves a number of fundamental research questions unanswerable. In the Asylum seekers’ and Refugees’ Changing Health (ARCH) study, we examine the health of a homogeneous group of refugees and asylum seekers in two very different host countries with very different migration histories. We aim to study the health impact of the migration process, living conditions, access to healthcare, gene–environment interactions and the health transition.Methods and analysisARCH is an international multisite study of the health of adult (>18 years old) Syrian refugees and asylum seekers in Lebanon and Denmark. Using a standardised framework, we collect information on mental and physical health using validated scales and biological samples. We aim to include 220 participants in Danish asylum centres and 1100 participants in Lebanese refugee camps and settlements. We will use propensity score weights to control for confounding and multiple imputation to handle missing data.Ethics and disseminationEthical approval has been obtained in Lebanon and Denmark. In the short term, we will present the cross-sectional association between long-distance migration and the results of the throat and wound swab, blood and faeces samples and mental health screenings. In the longer term, we are planning to follow the refugees in Denmark with collection of dried blood spots, mental health screenings and semistructured qualitative interviews on the participant’s health and access to healthcare in the time lived in Denmark. Here, we present an overview of the background for the ARCH study as well as a thorough description of the methodology.
Protocol for hypofractionated adaptive radiotherapy to the bladder within a multicentre phase II randomised trial: radiotherapy planning and delivery guidance
Authors: Hafeez Shaista , Patel Emma , Webster Amanda , Warren-Oseni Karole , Hansen Vibeke , McNair Helen , Miles Elizabeth , Lewis Rebecca , Hall Emma , Huddart Robert 
Published: May 2020

IntroductionPatients with muscle invasive bladder cancer (MIBC) who are unfit and unsuitable for standard radical treatment with cystectomy or daily radiotherapy present a large unmet clinical need. Untreated, they suffer high cancer specific mortality and risk significant disease-related local symptoms. Hypofractionated radiotherapy (delivering higher doses in fewer fractions/visits) is a potential treatment solution but could be compromised by the mobile nature of the bladder, resulting in target misses in a significant proportion of fractions. Adaptive ‘plan of the day’ image-guided radiotherapy delivery may improve the precision and accuracy of treatment. We aim to demonstrate within a randomised multicentre phase II trial feasibility of plan of the day hypofractionated bladder radiotherapy delivery with acceptable rates of toxicity.Methods and analysisPatients with T2-T4aN0M0 MIBC receiving 36 Gy in 6-weekly fractions are randomised (1:1) between treatment delivered using a single-standard plan or adaptive radiotherapy using a library of three plans (small, medium and large). A cone beam CT taken prior to each treatment is used to visualise the anatomy and select the most appropriate plan depending on the bladder shape and size. A comprehensive radiotherapy quality assurance programme has been instituted to ensure standardisation of radiotherapy planning and delivery. The primary endpoint is to exclude >30% acute grade >3 non-genitourinary toxicity at 3 months for adaptive radiotherapy in patients who received >1 fraction (p0=0.7, p1=0.9, α=0.05, β=0.2). Secondary endpoints include local disease control, symptom control, late toxicity, overall survival, patient-reported outcomes and proportion of fractions benefiting from adaptive planning. Target recruitment is 62 patients.Ethics and disseminationThe trial is approved by the London-Surrey Borders Research Ethics Committee (13/LO/1350). The results will be disseminated via peer-reviewed scientific journals, conference presentations and submission to regulatory authorities.Trial registration numberNCT01810757.