bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? A protocol for a systematic review
Authors: Devecchi Valter , Gallina Alessio , Heneghan Nicola R , Rushton Alison B , Falla Deborah 
Published: December 2019

IntroductionThe course of spinal pain (neck or low back pain) is often described as episodic and intermittent, with more than one-third of people continuing to experience episodic symptoms 1 year after first onset. Although ongoing neuromuscular adaptations could contribute to recurrent episodes of pain, no systematic review has synthesised evidence of ongoing neuromuscular changes in people with recurrent spinal pain during a period of symptom remission.Methods and analysisThis protocol is developed and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-P, the Update of the Cochrane Back and Neck Group guidelines and the Methodological Expectations of Cochrane Intervention Reviews. PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, ZETOC, Google Scholar, grey literature sources and key journals will be searched up to September 2019. Observational studies investigating neuromuscular changes in people with recurrent spinal pain during a period of remission will be included. Neuromuscular function will be considered under five outcome domains of muscle activity, spine kinematics, muscle properties, sensorimotor control and neuromuscular performance. Two independent reviewers will search, screen studies, extract data and assess risk of bias (Newcastle-Ottawa Scale). Data will be synthesised per outcome domain. Where clinical and methodological homogeneity across studies exists, a random-effects meta-analysis will be conducted. Otherwise, results will be synthesised narratively. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines.Ethics and disseminationFindings of this review may aid the identification of factors that could contribute to spinal pain recurrence and aid the development of interventions for secondary prevention aimed at the restoration of optimal neuromuscular function. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. No ethical approval was required.PROSPERO registration numberCRD42019141527.
Cluster randomised controlled trial to determine the effect of peer delivery HIV self-testing to support linkage to HIV prevention among young women in rural KwaZulu-Natal, South Africa: a study protocol
Authors: Adeagbo Oluwafemi Atanda , Mthiyane Nondumiso , Herbst Carina , Mee Paul , Neuman Melissa , Dreyer Jaco , Chimbindi Natsayi , Smit Theresa , Okesola Nonhlanhla , Johnson Cheryl , Hatzold Karin , Seeley Janet , Cowan Frances , Corbett Liz , Shahmanesh Maryam 
Published: December 2019

IntroductionA cluster randomised controlled trial (cRCT) to determine whether HIV self-testing (HIVST) delivered by peers either directly or through incentivised peer-networks, could increase the uptake of antiretroviral therapy and pre-exposure prophylaxis (PrEP) among young women (18 to 24 years) is being undertaken in an HIV hyperendemic area in KwaZulu-Natal, South Africa.Methods and analysisA three-arm cRCT started mid-March 2019, in 24 areas in rural KwaZulu-Natal. Twenty-four pairs of peer navigators working with ~12 000 young people aged 18 to 30 years over a period of 6 months were randomised to: (1) incentivised-peer-networks: peer-navigators recruited participants ‘seeds’ to distribute up to five HIVST packs and HIV prevention information to peers within their social networks. Seeds receive an incentive (20 Rand = US$1.5) for each respondent who contacts a peer-navigator for additional HIVST packs to distribute; (2) peer-navigator-distribution: peer-navigators distribute HIVST packs and information directly to young people; (3) standard of care: peer-navigators distribute referral slips and information. All arms promote sexual health information and provide barcoded clinic referral slips to facilitate linkage to HIV testing, prevention and care services. The primary outcome is the difference in linkage rate between arms, defined as the number of women (18 to 24 years) per peer-navigators month of outreach work (/pnm) who linked to clinic-based PrEP eligibility screening or started antiretroviral, based on HIV-status, within 90 days of receiving the clinic referral slip.Ethics and disseminationThis study was approved by the Institutional Review Boards at the WHO, Switzerland (Protocol ID: STAR CRT, South Africa), London School of Hygiene and Tropical Medicine, UK (Reference: 15 990–1), University of KwaZulu-Natal (BFC311/18) and the KwaZulu-Natal Department of Health (Reference: KZ_201901_012), South Africa. The findings of this trial will be disseminated at local, regional and international meetings and through peer-reviewed publications.Trial registration numberNCT03751826; Pre-results.
Breast cancer patients’ return to work (B-CARE): protocol of a longitudinal mixed-methods study aiming to explore medical and occupational rehabilitation of patients with breast cancer in Germany
Authors: Hiltrop Kati , Heidkamp Paula , Kowalski Christoph , Ernstmann Nicole 
Published: December 2019

IntroductionIn recent years, research has been done on determinants of return to work (RTW) in cancer survivors and their long-term work outcomes. Nevertheless, little is known about the survivors’ evaluation of these outcomes in terms of job satisfaction and voluntariness. Hence, B-CARE aims at filling the research gap by providing a longitudinal cohort study investigating medical and occupational rehabilitation including an evaluation by breast cancer survivors.Methods and analysisA mixed-methods approach, combining a quantitative survey with qualitative semi-structured interviews, is used to study breast cancer survivors 5–6 years after diagnosis. These data will be linked to data from prior waves of patients during hospitalisation and 10 and 40 weeks after hospital discharge as well as routine data from the German Statutory Pension Insurance Scheme and German Cancer Society if available. The actual survey focuses on determinants of medical rehabilitation use, RTW, subsequent employment patterns post care as well as the voluntariness of and satisfaction with job changes.Ethics and disseminationA positive vote from the ethics committee of the Medical Faculty of the University of Bonn has been obtained. Data protection regulations will be adhered to for all handled data. Personal identifiers of participants will be pseudonymised. Dissemination strategies include a workshop to discuss results among stakeholders such as representatives of the German Statutory Pension Insurance Scheme, social workers and self-help groups.Trial registration numberGerman Clinical Trials Register (DRKS00016982); Pre-results.
Active commute to school: does distance from school or walkability of the home neighbourhood matter? A national cross-sectional study of children aged 10–11 years, Scotland, UK
Authors: Macdonald Laura , McCrorie Paul , Nicholls Natalie , Olsen Jonathan R 
Published: December 2019

ObjectivesTo study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10–11 years old.DesignCross-sectional study.SettingData were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study.Participants713 children (male (n=330) and female (n=383) 10–11 years old) from Studying Physical Activity in Children’s Environments across Scotland.Primary and secondary outcome measuresChildren who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (<0.5 km, 0.5 to <1 km, 1 to <1.5 km, 1.5 to <2 km, 2 km+); home neighbourhood walkability (i.e., composite measure of road/path intersection density and dwelling density) (in quintiles).ResultsDistance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with ‘most’ walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60%+ were significantly less in Q2–Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys).ConclusionWalkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children’s ATS.
Progression of the Radiologic Severity Index is associated with increased mortality and healthcare resource utilisation in acute leukaemia patients with pneumonia
Authors: Sheshadri Ajay , Godoy Myrna , Erasmus Jeremy J , Gruschkus Stephen , Hasan Arain , Evans Scott E , Barreda-Garcia Javier , Chemaly Roy F , Dickey Burton , Ost David 
Published: December 2019

BackgroundPneumonia is a major cause of mortality and morbidity, but the development of new antimicrobials is lacking. Radiological assessment of pneumonia severity may serve as an effective intermediate endpoint to reduce barriers to successful completion of antimicrobial trials. We sought to determine whether the Radiologic Severity Index (RSI) correlated with mortality and healthcare resource utilisation in patients with acute leukaemia undergoing induction chemotherapy.MethodsWe measured RSI (range 0–72) on all chest radiographs performed within 33 days of induction chemotherapy in 165 haematological malignancy patients with pneumonia. Peak RSI was defined as the highest RSI score within 33 days of induction. We used extended Cox proportional hazards models to measure the association of time-varying RSI with all-cause mortality within the first 33 days after induction chemotherapy, and logistic regression or generalised models to measure the association of RSI with total daily cost and healthcare resource utilisation.ResultsAfter adjustment for clinical variables, each one-point increase in RSI was associated with a 7% increase in all-cause 33-day mortality (HR 1.07, 95% CI 1.05 to 1.09, p<0.0001). Peak RSI values of 37.5 or higher were associated with 86% higher daily direct costs (p<0.0001), more days in intensive care unit (9.9 vs 4.8 days, p=0.001) and higher odds for mechanical ventilation (OR 12.1, p<0.0001).ConclusionsGreater radiological severity as measured by RSI was associated with increased mortality and morbidity in acute leukaemia patients with pneumonia. RSI is a promising intermediate marker of pneumonia severity and is well suited for use in antimicrobial trials.
Influence of HIV status on the management of acute asthma exacerbations
Authors: Adrish Muhammad , Roa Gomez Gabriella , Cancio Rodriguez Enny , Mantri Nikhitha 
Published: December 2019

BackgroundAn increased incidence of asthma has been suggested in patients with HIV. We aimed to compare the outcomes of HIV-positive and HIV-negative patients following hospital admission for asthma exacerbation.MethodsA retrospective chart review of patients hospitalised between January 2015 and December 2017 owing to asthma exacerbation with a known HIV status was conducted.ResultsDuring the study period, 1242 patients with asthma were admitted. Of these, 462 patients had a known HIV status (358 HIV-negative, 104 HIV-positive) and were included. No differences in baseline demographics, including age, sex, body mass index and underlying comorbid conditions, were identified between the groups except that HIV-negative patients had higher incidence of underlying congestive heart failure. HIV-positive group had a significantly higher serum creatinine levels (1.117 (1.390) vs 0.813 (0.509), p=0.001), higher serum eosinophil levels (492.91 (1789.09) vs 243.70 (338.66), p=0.013) but had lower serum neutrophils (5.74 (3.18) vs 7.194 (3.59), p=0.0002) and lower serum albumin levels (3.754 (0.480) vs 3.94 (0.443), p=0.003) than the HIV-negative group, respectively. Non-invasive positive pressure ventilation (NIPPV) use was more frequent (54.8% vs 25.4%, p≤0.001) and the length of in-hospital stay (LOS) was longer in HIV-positive vs HIV-negative patients (3.346 days vs 2.813 days, p=0.015); no differences in mechanical ventilation use or intensive care unit admission were noted between the groups. In a subgroup analysis comparing HIV-negative with HIV-positive patients stratified by CD4 count, NIPPV use was more frequent and the LOS was longer in HIV-positive patients with CD4 counts≥200 cellsx 10∧6/L. In a multivariable regression model, HIV-positive status was independently associated with NIPPV use (OR 2.52; 95% CI 1.43 to 4.46) and a 0.55 day (95% CI 0.02 to 1.08) longer LOS in hospital.ConclusionsHIV-positive patients admitted with asthma exacerbation are more likely to require NIPPV and have longer LOS.
Diagnostic computed tomography in acute interscapular pain
Authors: Joshi Shruti S , Hamra Mardi , Newby David E 
Published: December 2019

Clinical introductionA man in his 60s with no medical history presented with sudden-onset, severe interscapular pain. He was in circulatory shock with a blood pressure of 65/30 mm Hg, heart rate of 115 beats per minute, respiratory rate of 32 breaths per minute and a room air oxygen saturation of 89%. Examination demonstrated weak peripheral pulses, an elevated jugular venous pressure, faint dual heart sounds, no cardiac murmurs and bilateral lung crepitations. An ECG was recorded which showed a broad QRS (figure 1A). There were no previous ECGs to compare this with. In view of his presentation with acute-onset interscapular pain, CT of the aorta was organised by the emergency department clinicians (figure 1B–D). After the CT result was obtained, the on-call cardiologist was contacted and a bedside echocardiogram performed. This demonstrated severe left ventricular systolic dysfunction with akinesia of the apex and lateral walls. The patient was then transferred to the catheter laboratory for an emergency invasive coronary angiogram.Figure 1ECG and CT images at presentation (A) 12 lead ECG. (B) Contrast enhanced CT aorta - coronal view. (C) Contrast enhanced CT aorta - axial view. (D) CT aorta showing 4 chamber view of the heart.What is the most likely diagnosis?Pulmonary embolism.Aortic dissection.Acute myocardial infarction.Cardiac tamponade.
Synthesis of powder metallurgy Ti-3Fe-2Al alloy using high-frequency induction heating
Authors: Raynova Stella , Alsharedah Khaled , Yang Fei , Bolzoni Leandro 
Published: December 2019

A powder metallurgy approach was applied for the synthesis of an [Formula: see text] Ti-2Al-3Fe alloy. Blends of the elemental Ti, Al and Fe powders were compacted and subsequently sintered. High-frequency induction heating (HFIH) instead of conventional high-vacuum furnace heating was used for the sintering, due to its high efficiency. The effect of temperature on the level of densification, residual porosity and mechanical properties was studied. Electron dispersive spectrum analysis was used to study the dissolution and homogenization of the alloying elements. The results showed that a short induction sintering (IS) cycle in the range of 10–15 min is sufficient to achieve significant powder consolidation, evident by the increase of the density and mechanical properties. The residual porosity diminishes with the increase of the sintering temperature. Full dissolution of the alloying powders is completed after sintering at temperatures above those of [Formula: see text]- to [Formula: see text]-phase transformation.
Cheyne–Stokes respiration and cardiovascular oscillations ending abruptly when deploying transfemoral aortic valve
Authors: Kahn David , Baele Philippe , Pasquet Agnès , Liistro Giuseppe 
Published: December 2019

A 86-yr-old man was referred for transfemoral aortic valve implantation. Transthoracic echocardiography revealed a severe stenosis (mean gradient: 58 mmHg, aortic valve area: 0.4 cm2), and after multidisciplinary discussion, the risk of surgery was judged too high (logistic Euroscore: 51%), and the patient was proposed for a transfemoral aortic valve implantation (TAVI). On arrival in the operating room, the patient, fully conscious, was noted to have Cheyne–Stokes breathing (CSB), which persisted after 40% oxygen administration. TAVI procedure was successful, and the CSB pattern was interrupted within 8 s. To the best of our knowledge, this report is the first to show an acute disappearance of CSB, occurring only seconds after TAVI and restoration of a normal hemodynamic situation. To explain such rapid changes in breathing pattern, we hypothesize a role played by the acute release of pulmonary hypertension and pulmonary volume overload. NEW & NOTEWORTHY Acute disappearance of Cheyne–Stokes breathing after transfemoral aortic valve implantation suggests a reflex pathway originating from the fall in pulmonary vessels congestion.
Análise da assimetria de força de preensão manual entre os sexos
Authors: Fernandes Lidiane Aparecida , Bruno Mateus Gonçalves , Lage Guilherme Menezes , Matos Cíntia De Oliveira , Walker Paula Carolina Leite , Souza Tércio Apolinário 
Published: December 2019

É da natureza dos seres humanos apresentarem preferências na realização de tarefas do dia-a-dia. Esta preferência está associada à lateralidade. Um dos campos de estudo sobre a lateralidade é a assimetria lateral, que está presente tanto na dimensão da preferência quanto no desempenho. Objetivo: Este estudo teve como objetivo comparar a assimetria de força de preensão manual entre os sexos, e identificar se há associação entre assimetria de desempenho e assimetria de preferência. Método: A amostra foi composta por 50 estudantes universitários que realizaram teste de força de preensão manual máxima. Resultados: Os resultados indicaram que o os homens apresentaram valores absolutos maiores, maior índice de assimetria e menor consistência quando comparados às mulheres. Além disso, a mão preferida apresentou valores maiores de força em ambos os sexos. Conclusão: Em linhas gerais, sugere-se que fatores genéticos, sociais, culturais e sexo influenciam o comportamento motor dos indivíduos e, consequentemente, as assimetrias de desempenho.
Association of Body Mass Index With Clinical Outcomes in Patients With Atrial Fibrillation: A Report From the FANTASIIA Registry
Authors: Bertomeu‐Gonzalez Vicente , Moreno‐Arribas José , Esteve‐Pastor María Asunción , Roldán‐Rabadán Inmaculada , Muñiz Javier , Raña‐Míguez Paula , Ruiz‐Ortiz Martín , Cequier Ángel , Bertomeu‐Martínez Vicente , Badimón Lina , Anguita Manuel , Lip Gregory Y. H. , Marín Francisco ,   FANTASIIA Study Investigators
Published: December 2019

Background

Obesity and atrial fibrillation (
AF
) frequently coexist and independently increase mortality. We sought to assess the association between obesity and adverse events in patients receiving oral anticoagulants for
AF
.

Methods and Results

Consecutive
AF
outpatients receiving anticoagulant agents (both vitamin K antagonists and direct oral anticoagulants) were recruited into the
FANTASIIA
(Atrial fibrillation: influence of the level and type of anticoagulation on the incidence of ischemic and hemorrhagic stroke) registry. This observational, multicenter, and prospective registry of
AF
patients analyzes the quality of anticoagulation, incidence of events, and differences between oral anticoagulant therapies. We analyzed baseline patient characteristics according to body mass index, normal: <25 kg/m
2
, overweight: 25–30 kg/m
2
, and obese: ≥30 kg/m
2
), assessing all‐cause mortality, stroke, major bleeding and major adverse cardiovascular events (a composite of ischemic stroke, myocardial infarction, and total mortality) at 3 years’ follow‐up. In this secondary prespecified substudy, the association of weight on prognosis was evaluated. We recruited 1956 patients (56% men, mean age 73.8±9.4 years): 358 (18.3%) had normal body mass index, 871 (44.5%) were overweight, and 727 (37.2%) were obese. Obese patients were younger (
P
<0.01) and had more comorbidities. Mean time in the therapeutic range was similar across body mass index categories (
P
=0.42). After a median follow‐up of 1070 days, 255 patients died (13%), 45 had a stroke (2.3%), 146 a major bleeding episode (7.5%) and 168 a major adverse cardiovascular event (8.6%). Event rates were similar between groups for total mortality (
P
=0.29), stroke (
P
=0.90), major bleeding (
P
=0.31), and major adverse cardiovascular events (
P
=0.24). On multivariate Cox analysis, body mass index was not independently associated with all‐cause mortality, cardiovascular mortality, stroke, major bleeding, or major adverse cardiovascular events.

Conclusions

In this prospective cohort of patients anticoagulated for
AF
, obesity was highly prevalent and was associated with more comorbidities, but not with poor prognosis.