bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity during COVID-19 induced lockdown: recommendations
Authors: Füzéki Eszter , Groneberg David A. , Banzer Winfried 
Published: August 2020

AbstractMeasures aiming at containing the Coronavirus disease 2019 (COVID-19) include isolation, social distancing, and quarantine. Quarantine and other lockdown instruments show promise in reducing the number of COVID-19 infections and deaths. It is reasonable to assume that lockdown leads to reduced levels of physical activity in the general population. Potential detrimental health effects of lockdown, such as psychological distress and physical inactivity induced maladaptations must be addressed. The current review summarizes harmful effects of limited physical activity on mental and physical health due to social distancing and quarantine and highlights the effects of simple physical activity regimes counteracting these detrimental effects, with a special emphasis on acute effects.
Protocol for the 3HP Options Trial: a hybrid type 3 implementation-effectiveness randomized trial of delivery strategies for short-course tuberculosis preventive therapy among people living with HIV in Uganda
Authors: Kadota Jillian L. , Musinguzi Allan , Nabunje Juliet , Welishe Fred , Ssemata Jackie L. , Bishop Opira , Berger Christopher A. , Patel Devika , Sammann Amanda , Katahoire Anne , Nahid Payam , Belknap Robert , Phillips Patrick P. J. , Namusobya Jennifer , Kamya Moses , Handley Margaret A. , Kiwanuka Noah , Katamba Achilles , Dowdy David , Semitala Fred C. , Cattamanchi Adithya 
Published: August 2020

AbstractBackgroundRecently, a 3-month (12-dose) regimen of weekly isoniazid and rifapentine (3HP) was recommended by the World Health Organization for the prevention of tuberculosis (TB) among people living with HIV (PLHIV) on common antiretroviral therapy regimens. The best approach to delivering 3HP to PLHIV remains uncertain.MethodsWe developed a three-armed randomized trial assessing optimized strategies for delivering 3HP to PLHIV. The trial will be conducted at the Mulago Immune Suppression Syndrome (i.e., HIV/AIDS) clinic in Kampala, Uganda. We plan to recruit 1656 PLHIV, randomized 1:1 to each of the three arms (552 per arm). Using a hybrid type 3 effectiveness-implementation design, this pragmatic trial aims to (1) compare the acceptance and completion of 3HP among PLHIV under three delivery strategies: directly observed therapy (DOT), self-administered therapy (SAT), and informed patient choice of either DOT or SAT (with the assistance of a decision aid); (2) to identify processes and contextual factors that influence the acceptance and completion of 3HP under each delivery strategy; and (3) to estimate the costs and compare the cost-effectiveness of three strategies for delivering 3HP. The three delivery strategies were each optimized to address key barriers to 3HP completion using a theory-informed approach. We hypothesize that high levels of treatment acceptance and completion can be achieved among PLHIV in sub-Saharan Africa and that offering PLHIV an informed choice between the optimized DOT and SAT delivery strategies will result in greater acceptance and completion of 3HP. The design and planned evaluation of the delivery strategies were guided by the use of implementation science conceptual frameworks.Discussion3HP—one of the most promising interventions for TB prevention—will not be scaled up unless it can be delivered in a patient-centered fashion. We highlight shared decision-making as a key element of our trial design and theorize that offering PLHIV an informed choice between optimized delivery strategies will facilitate the highest levels of treatment acceptance and completion.Trial registrationClinicalTrials.gov:NCT03934931; Registered 2 May 2019.
The psychological impact on an orthopaedic outpatient setting in the early phase of the COVID-19 pandemic: a cross-sectional study
Authors: Wong Khai Cheong , Han Xinyun Audrey , Tay Kae Sian , Koh Suang Bee , Howe Tet Sen 
Published: August 2020

AbstractBackgroundWorld Health Organization declared coronavirus disease-19 (COVID-19) a global pandemic on 11 March 2020, after the coronavirus claimed 4628 lives worldwide. Mental health challenges such as making impossible decisions and working under extreme pressures are expected to be faced by frontline healthcare workers who are directly involved in the care of COVID-19 patients. However, we question if significant stress levels might also be observed in a subspecialty musculoskeletal outpatient department, where staff are not first-line care providers of COVID-19 patients. We hypothesize that these healthcare workers also face significant psychological strain, and we aim to objectively determine the prevalence using a validated caregiver strain index.MethodsA cross-sectional study was conducted in outpatient musculoskeletal clinics in a tertiary hospital in Singapore. We collected basic demographic data and used a 13-question tool adapted from the validated Caregiver Strain Index (CSI) to measure psychological strain in these healthcare workers. Participants were divided into 2 groups depending on the level of strain experienced.ResultsA total of 62 healthcare workers volunteered for this study. There were 32 participants (51.6%) who had 7 or more positive responses (group 1) and the remaining 30 participants (48.4%) were allocated to group 2. There were no significant differences between the two groups in terms of demographic data. “Work adjustments” (74.2%), “changes in personal plans” (72.6%), and finding it “confining” (72.6%) garnered the most positive responses in the questionnaire. On the other hand, “financial concerns” garnered the least positive responses (21.0%).ConclusionThe protracted duration of the COVID-19 outbreak and its resultant prolonged adjustments can have unintended consequences of wearing down healthcare resources otherwise allocated to chronic and elective conditions. Countries should ensure that measures are put in place to safeguard the mental well-being of our healthcare workers to avoid needing another reactive strategy in this battle against COVID-19.
Risk factors for lymph node metastasis and surgical methods in patients with early-stage peripheral lung adenocarcinoma presenting as ground glass opacity
Authors: Wang Yongming , Jing Lijun , Wang Gongchao 
Published: August 2020

AbstractBackgroundIt is difficult to predict lymph node metastasis in patients with early lung cancer. Pure ground glass opacity (GGO) on computed tomography indicates an early-stage adenocarcinoma that can be removed by limited resection or lobectomy without the need for mediastinal lymph node dissection or sampling, and lung adenocarcinoma with GGO therefore has a good prognosis. We examined the incidence and risk factors of lymph node metastasis in patients with clinical stage IA lung adenocarcinoma.MethodsWe retrospectively analyzed clinical data for 327 patients with stage IA peripheral lung cancer treated in our hospital from March 2014 to December 2018. The patients were divided into four groups according to computed tomography signs. Lobectomy and systematic lymph node dissection were performed in all patients. Correlations between lymph node metastasis and clinical pathological factors were analyzed by logistic regression.ResultsAmong the 327 patients, 26 (7.95%) had lymph node metastasis. No patients with pure GGO or GGO-dominant types had lymph node metastasis. Logistic regression identified tumor diameter, solid content, plasma carcinoembryonic antigen (CEA) level, pathological type, lymphovascular invasion, and pleural invasion as factors related to the presence of lymph node metastasis.ConclusionsTumor diameter, solid component ratio, plasma CEA level, pathological type, vascular tumor thrombus, and pleural invasion are possible independent risk factors for lymph node metastasis in patients with stage IA lung adenocarcinoma. In contrast, lymph node metastasis is rare in patients with pure GGO or GGO-dominant lung adenocarcinoma.
A modified Sydney system for the diagnosis of chronic gastritis in dogs
Authors: Spużak Jolanta , Jankowski Marcin , Kubiak Krzysztof , Glińska-Suchocka Kamila , Ciaputa Rafał 
Published: August 2020

Abstract
Background
The Sydney system for assessing inflammatory lesions in the gastric mucosa is based on endoscopic and histological examinations. This study aimed to apply the Sydney system to diagnose gastritis in dogs. The study also compared the results of endoscopic and histological examinations conducted on gastric mucosal biopsy specimens. A total of 56 dogs with chronic vomiting were analyzed in the study. The physical appearance of the gastric mucosa was assessed through endoscopic examination, while the severity of the gastric inflammation, inflammation activity, glandular atrophy, and intestinal metaplasia were assessed by histopathological examination.

Results
The endoscopic examination confirmed the presence of inflammatory lesions affecting the gastric corpus and pylorus in all the dogs, although the severity of these lesions differed between the individuals. Reflux gastritis was the most commonly observed gastric inflammation. In the histopathological examination of the gastric mucosal samples, inflammatory lesions were found in the gastric corpus of 53 dogs, while 55 dogs had lesions in the pylorus. This corresponds to a 96.4% agreement between the methods.

Conclusions
The Sydney system is a useful tool for macroscopic and microscopic assessment of changes in the gastric mucosa as it enables the determination of inflammation type and severity, which helps the canine gastroenterologists to reliably compare the results of the tests performed in different facilities. Besides, the use of the Sydney system in diagnosing lesions facilitates the selection and effective monitoring of treatment. However, despite a high rate of agreement between the results of endoscopic and histopathological examinations, it is recommended to use both these methods for the assessment of the gastric mucosa in dogs.
Targetable ERBB2 mutation status is an independent marker of adverse prognosis in estrogen receptor positive, ERBB2 non-amplified primary lobular breast carcinoma: a retrospective in silico analysis of public datasets
Authors: Kurozumi Sasagu , Alsaleem Mansour , Monteiro Cíntia J. , Bhardwaj Kartikeya , Joosten Stacey E. P. , Fujii Takaaki , Shirabe Ken , Green Andrew R. , Ellis Ian O. , Rakha Emad A. , Mongan Nigel P. , Heery David M. , Zwart Wilbert , Oesterreich Steffi , Johnston Simon J. 
Published: August 2020

AbstractBackgroundInvasive lobular carcinoma (ILC) accounts for 10–15% of primary breast cancers and is typically estrogen receptor alpha positive (ER+) andERBB2non-amplified. Somatic mutations inERBB2/3are emerging as a tractable mechanism underlying enhanced human epidermal growth factor 2 (HER2) activity. We tested the hypothesis that therapeutically targetableERBB2/3mutations in primary ILC of the breast associate with poor survival outcome in large public datasets.MethodsWe performed in silico comparison ofERBB2non-amplified cases of ER+ stage I–III primary ILC (N = 279) and invasive ductal carcinoma (IDC,N = 1301) using METABRIC, TCGA, and MSK-IMPACT information. Activating mutations amenable to HER2-directed therapy with neratinib were identified using existing functional data from in vitro cell line and xenograft experiments. Multivariate analysis of 10-year overall survival (OS) with tumor size, grade, and lymph node status was performed using a Cox regression model. Differential gene expression analyses byERBB2mutation and amplification status was performed using weighted average differences and an in silico model of response to neratinib derived from breast cancer cell lines.ResultsILC tumors comprised 17.7% of all cases in the dataset but accounted for 47.1% ofERBB2-mutated cases. Mutations inERBB2were enriched in ILC vs. IDC cases (5.7%,N = 16 vs. 1.4%,N = 18,p < 0.0001) and clustered in the tyrosine kinase domain of HER2.ERBB3mutations were not enriched in ILC (1.1%,N = 3 vs. 1.8%,N = 23;p = 0.604). Median OS for patients withERBB2-mutant ILC tumors was 66 months vs. 211 months forERBB2wild-type (p = 0.0001), and 159 vs. 166 months (p = 0.733) for IDC tumors. TargetableERBB2mutational status was an independent prognostic marker of 10-year OS—but only in ILC (hazard ratio, HR = 3.7, 95% CI 1.2–11.0;p = 0.021). Findings were validated using a novelERBB2mutation gene enrichment score (HR for 10-year OS in ILC = 2.3, 95% CI 1.04–5.05;p = 0.040).ConclusionsTargetableERBB2mutations are enriched in primary ILC and their detection represents an actionable strategy with the potential to improve patient outcomes. Biomarker-led clinical trials of adjuvant HER-targeted therapy are warranted for patients withERBB2-mutated primary ILC.
Chinese herbal medicine combined with entecavir to reduce the off-therapy recurrence risk in HBeAg-positive chronic hepatitis B patients: a multi-center, double-blind, randomized controlled trial in China
Authors: Li Xiaoke , Zhang Ludan , Qiu Mei , Huang Yi , Xiao Huanming , Lu Bingjiu , Jiang Yuyong , Long Fuli , Lin Hui , He Jinyu , Wu Qikai , Zhang Mingxiang , Wang Li , Zhu Xiaoning , Gong Man , Sun Xuehua , Sun Jianguang , Sun Fengxia , Lu Wei , Xu Weihua , Chen Guang , Li Zhiguo , Gan Danan , Yang Xianzhao , Du Hongbo , Ye Yong’an 
Published: August 2020

AbstractBackgroundNucleos(t)ide analogues (NAs) are the first-line option against chronic hepatitis B (CHB). NAs produce potent suppression of viral replication with a small chance of HBsAg seroclearance and a high risk of virological relapse after discontinuation. The combined therapy of NAs plus traditional Chinese medicine (TCM) is widely accepted and has been recognized as a prospective alternative approach in China. Based on preliminary works, this study was designed to observe the therapeutic effect of TCM plus entecavir (ETV) against HBeAg-positive chronic hepatitis B with respect to reducing the recurrence risk after NA withdrawal.Methods/designThe study is a nationwide, multicenter, double-blind, randomized, placebo-controlled trial with a duration of 120 weeks. A total of 18 hospitals and 490 eligible Chinese HBeAg-positive CHB patients will be enrolled and randomly allocated into the experimental group and control group in a 1:1 ratio. Patients in the experimental group will be prescribed TCM formulae (Tiaogan-BuXu-Jiedu granules) plus ETV 0.5 mg per day for consolidation therapy for 96 weeks. Patients in the control group will be prescribed TCM granule placebo plus ETV 0.5 mg per day for the same course. After consolidation therapy, all patients will discontinue their trial drugs and be closely monitored over the next 24 weeks. Once clinical recurrence (CR) occurs, ETV treatment will be restarted. The primary outcome is the cumulative rate of CR at the end of this trial.ConclusionThis study is the first of its kind to observe therapeutic effects with respect to reducing recurrence after NA withdrawals after unified integrative consolidation therapy in the CHB population.Trial registrationChinese Clinical Trial Registry No.ChiCTR1900021232. Registered on February 2, 2019
The effect of a telerehabilitation virtual reality intervention on functional upper limb activities in people with multiple sclerosis: a study protocol for the TEAMS pilot randomized controlled trial
Authors: Kalron Alon , Achiron Anat , Pau Massimiliano , Cocco Eleonora 
Published: August 2020

Abstract
Background
Approximately 60% of people with multiple sclerosis (PwMS) suffer from upper limb dysfunction. Our primary goal is to implement a single-blind, randomized control trial (RCT) designed to compare the effectiveness of an 8-week home-based telerehab virtual reality (VR) program with conventional therapy in PwMS with manual dexterity difficulties. Secondary aims include (a) evaluating the impact of the programs on quality of life after the intervention and a follow-up 1 month later and (b) evaluating the impact of the programs on adherence and satisfaction.

Methods
Twenty-four PwMS will be recruited to the study which will be conducted at two established MS centers: (1) The Regional Center for Diagnosis and Treatment of Multiple Sclerosis, Binaghi Hospital, Cagliari, Italy, and (2) The Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Participants will complete a total of three assessments focusing on upper limb functions. Both groups will receive 16 training sessions focusing on functional upper limb activities. The home-based telerehab VR intervention will comprise a custom-made software program running on a private computer or laptop. PwMS will perform several activities of daily living (ADL) functions associated with self-care, dressing, and meal preparation. Conventional therapy will focus on task-related upper-limb treatments while in a sitting position, indicative of the standard care in MS. Following 8 weeks of training, participants will complete a further outcome assessment. The same tests will be conducted 1 month (as a follow-up) after completion of the intervention.

Discussion
The outcomes of this study have tremendous potential to improve the quality of evidence and informed decisions of functional upper limb activities in PwMS. If comparable results are found between the treatments in improving upper limb outcomes, this would suggest that PwMS can choose the program that best meets their personal needs, e.g., financial concerns, transportation, or accessibility issues. Secondly, this information can be used by healthcare providers and medical professionals in developing upper limb exercise programs that will most likely succeed in PwMS.

Trial registration
ClinicalTrials.gov NCT04032431. Registered on 19 July 2019.
Novel role of focused airway ultrasound in early airway assessment of suspected laryngeal trauma
Authors: Adi Osman , Sum Kok Meng , Ahmad Azma Haryaty , Wahab Mahathar Abd. , Neri Luca , Panebianco Nova 
Published: August 2020

AbstractBackgroundUpper airway injury secondary to blunt neck trauma can lead to upper airway obstruction and potentially cause a life-threatening condition. The most important aspect in the care of laryngeal trauma is to establish a secure airway. Focused airway ultrasound enables recognition of important upper airway structures, offers early opportunity to identify life-threatening upper airway injury, and allows assessment of the extent of injury. This information that can be obtained rapidly at the bedside has the potential to facilitate rapid intervention.Case presentationWe report a case series that illustrate the diagnostic value of focused airway ultrasound in the diagnosis of laryngeal trauma in patients presenting with blunt neck injury.ConclusionEarly recognition, appropriate triaging, accurate airway evaluation, and prompt management of such injuries are essential. In this case series, we introduce the potential role of focused airway ultrasound in suspected laryngeal trauma, and the correlation of these exam findings with that of computed tomography (CT) scanning, based on the Schaefer classification of laryngeal injury.
Spacelike submanifolds with parallel mean curvature vector in a de Sitter space $S^{n+p}_{q}(c)$
Authors: Chen Junfeng , Liu Sanyang , Shu Shichang 
Published: August 2020

AbstractSpacelike submanifolds usually appear in the study of questions related to causality in general relativity. In this paper, we study an n-dimensional spacelike submanifold in $(n + p)$
(
n
+
p
)
-dimensional connected de Sitter space $S^{n+p}_{q}(c)$

S
q

n
+
p

(
c
)
of index q ($1\leq q \leq p$
1
≤
q
≤
p
) and of constant curvature c, and we obtain some integral inequalities of Simons type and rigidity theorems.
Well-posedness of the solution of the fractional semilinear pseudo-parabolic equation
Authors: Cheng Jiazhuo , Fang Shaomei 
Published: August 2020

AbstractThis article concerns the Cauchy problem for the fractional semilinear pseudo-parabolic equation. Through the Green’s function method, we prove the pointwise convergence rate of the solution. Furthermore, using this precise pointwise structure, we introduce a Sobolev space condition with negative index on the initial data and give the nonlinear critical index for blowing up.
Validation of the Needs Assessment of Family Caregivers-Cancer scale in an Asian population
Authors: Yang Winson Fu Zun , Liu Jianlin , Chan Yiong Huak , Griva Konstadina , Kuparasundram Sangita , Mahendran Rathi 
Published: August 2020

AbstractBackgroundThe Needs Assessment of Family Caregivers- Cancer (NAFC-C) scale is shown to have adequate psychometric properties in assessing family caregiver needs during the cancer journey and its psychometric properties have been studied only in Western populations. This study sought to validate the NAFC-C in an Asian population for wider applicability.MethodsParticipants (n = 363) completed questions on sociodemographics, the Depression Anxiety Stress Scale, the Zarit Burden Interview, the Caregiver Quality of Life Index-Cancer scale, and the NAFC-C.ResultsResults revealed good internal consistency, test-retest reliability, and concurrent validity of the NAFC-C. Confirmatory factor analysis did not demonstrate a good fit of the NAFC-C in our sample. Exploratory factor analysis revealed a similar factor structure in this study’s population. Further reliability and validity analyses with the EFA factor structure demonstrated similar reliability and validity assessments.ConclusionsThe NAFC-C is shown to be applicable in an Asian population. It would be a useful instrument for determining family caregivers’ needs and to inform future interventions to address those needs and improve or maintain quality of life in both patients and their caregivers.
Unloading using Impella CP during profound cardiogenic shock caused by left ventricular failure in a large animal model: impact on the right ventricle
Authors: Josiassen Jakob , Helgestad Ole Kristian Lerche , Udesen Nanne Louise Junker , Banke Ann , Frederiksen Peter Hartmund , Hyldebrandt Janus Adler , Schmidt Henrik , Jensen Lisette Okkels , Hassager Christian , Ravn Hanne Berg , Møller Jacob E. 
Published: August 2020

AbstractBackground and aimThis study aimed to assess right ventricular (RV) function during cardiogenic shock due to acute left ventricular (LV) failure, including during LV unloading with Impella CP and an added moderate dose of norepinephrine.MethodsCardiogenic shock was induced by injecting microspheres in the left main coronary artery in 18 adult Danish Landrace pigs. Conductance catheters were placed in both ventricles and pressure-volume loops were recorded simultaneously.ResultsCardiogenic shock due to LV failure also impaired RV performance, which was partially restored during haemodynamic support with Impella CP, as demonstrated by changes in the ventriculo-arterial coupling (Ea/Ees ratio) (baseline (median [Q1;Q3]) 1.2 [1.1;1.6]), cardiogenic shock (3.0 [2.4;4.5]), Impella CP (2.1 [1.3;2.7]) (pBaseline vs CS< 0.0001, pCS vs Impella= 0.001)). Impella CP support also improved RV stroke work (SW) (cardiogenic shock 333 [263;530] vs Impella CP (830 [717;1121]) (p< 0.001). Moderate norepinephrine infusion concomitant with Impella CP further improved RV SW (Impella CP (818 [751;1065]) vs Impella CP+moderate norepinephrine (1231 [1142;1335]) (p= 0.01)) but at the expense of an increase in LV SW (Impella CP (858 [555;1392]) vs Impella CP+moderate norepinephrine (2101 [1024;2613]) (p= 0.04)).ConclusionsThe Impella CP provided efficient LV unloading, improved RV function, and end-organ perfusion. Moderate doses of norepinephrine during Impella support further improved RV function, but at the expense of an increase in SW of the failing LV.