bluuebunny/crossref_metadata_2025_split huggingface dataset:
Test–Retest Reliability and the Effects of Walking Speed on Stride Time Variability During Continuous, Overground Walking in Healthy Young Adults
Authors: Ryan Nicholas S. , Bruno Paul A. , Barden John M. 
Published: December 2020

Studies have investigated the reliability and effect of walking speed on stride time variability during walking trials performed on a treadmill. The objective of this study was to investigate the reliability of stride time variability and the effect of walking speed on stride time variability, during continuous, overground walking in healthy young adults. Participants completed: (1) 2 walking trials at their preferred walking speed on 1 day and another trial 2 to 4 days later and (2) 1 trial at their preferred walking speed, 1 trial approximately 20% to 25% faster than their preferred walking speed, and 1 trial approximately 20% to 25% slower than their preferred walking speed on a separate day. Data from a waist-mounted accelerometer were used to determine the consecutive stride times for each trial. The reliability of stride time variability outcomes was generally poor (intraclass correlations: .167–.487). Although some significant differences in stride time variability were found between the preferred walking speed, fast, and slow trials, individual between-trial differences were generally below the estimated minimum difference considered to be a real difference. The development of a protocol to improve the reliability of stride time variability outcomes during continuous, overground walking would be beneficial to improve their application in research and clinical settings.
Feasibility, Reliability, and Validity of the MotionWatch 8 to Evaluate Physical Activity Among Older Adults With and Without Cognitive Impairment in Assisted Living Settings
Authors: Resnick Barbara , Boltz Marie , Galik Elizabeth , Fix Steven , Zhu Shijun 
Published: December 2020

This study tested the feasibility, reliability, and validity of the MotionWatch 8 among assisted living residents with and without cognitive impairment. Data from the Dissemination and Implementation of Function Focused Care in Assisted Living Using the Evidence Integration Triangle study were used. The sample included 781 individuals from 85 facilities with a mean age of 89.48 (SD = 7.43) years. The majority were female (71%), White (97%), and overall (44%) had cognitive impairment. A total of 70% were willing to wear the MotionWatch 8. Reliability was supported as there was no difference in time spent in activity across three consecutive wear days. Validity was based on hypothesis testing, and function was associated with counts of activity at baseline (p = .001) and 4 months (p = .001). Those with cognitive impairment engaged in less physical activity (p = .04). The MotionWatch 8 is a useful option for measuring physical activity in older adults with and without cognitive impairment.
Acute Effect of Ankle Kinesio™ Taping on Lower-Limb Biomechanics During Single-Legged Drop Landing
Authors: Sarvestan Javad , Needle Alan R. , Ataabadi Peyman Aghaie , Kovačíková Zuzana , Svoboda Zdeněk , Abbasi Ali 
Published: December 2020

Context: Chronic ankle instability is documented to be followed by a recurrence of giving away episodes due to impairments in mechanical support. The application of ankle Kinesiotaping (KT) as a therapeutic intervention has been increasingly raised among athletes and physiotherapists. Objectives: This study aimed to investigate the impacts of ankle KT on the lower-limb kinematics, kinetics, dynamic balance, and muscle activity of college athletes with chronic ankle instability. Design: A crossover study design. Participants: Twenty-eight college athletes with chronic ankle sprain (11 females and 17 males, 23.46 [2.65] y, 175.36 [11.49] cm, 70.12 [14.11] kg) participated in this study. Setting: The participants executed 3 single-leg drop landings under nontaped and ankle Kinesio-taped conditions. Ankle, knee, and hip kinematics, kinetics, and dynamic balance status and the lateral gastrocnemius, medial gastrocnemius, tibialis anterior, and peroneus longus muscle activity were recorded and analyzed. Results: The application of ankle KT decreased ankle joint range of motion (P = .039) and angular velocities (P = .044) in the sagittal plane, ground reaction force rate of loading (P = .019), and mediolateral time to stability (P = .035). The lateral gastrocnemius (0.002) and peroneus longus (0.046) activity amplitudes also experienced a significant decrease after initial ground contact when the participants’ ankles were taped, while the application of ankle KT resulted in an increase in the peroneus longus (0.014) activity amplitudes before initial ground contact. Conclusions: Ankle lateral supports provided by KT potentially decreases mechanical stresses applied to the lower limbs, aids in dynamic balance, and lowers calf muscle energy consumption; therefore, it could be offered as a suitable supportive means for acute usage in athletes with chronic ankle instability.
Synthesis and Optimization of a Molecularly Imprinted Membrane as a Specific Absorbent to Assess the Occupational Exposure to the 5-Fluorouracil Drug
Authors: Beigzadeh Zahra , Golbabaei Farideh , Khadem Monireh , Pourhassan Bahman , Pourbabaki Reza , Kalantari Saba , Shahtaheri Seyed Jamaleddin 
Published: December 2020

Objectives: Over the last decades, antineoplastic drugs have resulted in concerns about health care and pharmacy because of the increased incidence of neoplasm due to occupational exposure. Therefore, there is a need for accurate and valid methods to detect and evaluate the trace amount of these drugs in occupational assessment programs. In this study, for occupational exposure assessment of 5-fluorouracil (5-FU), molecularly imprinted membranes (MIMs) were synthesized and optimized as appropriate absorbents for selective determination of trace amount of this antineoplastic drug. Methods: To synthesize MIMs as Specific adsorbent for 5-FU, First, 5-FU molecularly imprinted polymers (MIPs) were prepared by the precipitation polymerization method, and then MIPs encapsulated into PET nanofibers, as the matrix polymer, by electrospinning. Finally, MIMs were fabricated from collection nanofibers. Optimization of electrospinning parameters (e.g., MIP amount, tip needle to the collector, electrospinning voltage and flow rate) was performed by the Central Composite Design (CCD) method using the experimental design software. The diameter of the fiber was analyzed using image analysis software. The applicability of the synthesized membranes for absorbing 5-FU drug was evaluated for assessing occupational exposure to the drug of interest. Results: In this study, MIP particles were successfully encapsulated into PET nanofibers. The optimization process showed that the molecularly imprinted nanofibers diameter of 276.38[Formula: see text]nm could be obtained in 57.4%[Formula: see text]w, 13.9[Formula: see text]cm, 25[Formula: see text]KV and 0.55[Formula: see text]ml/h. The extraction efficacy of 5-FU drugs by synthesized membranes was [Formula: see text]. Conclusion: The optimized MIMs presented in this study can be used as a specific absorbent for occupational and environmental monitoring of the 5-FU drug.
Vitamin D testing: Impact of changes to testing guidelines on detection of patients at risk of vitamin D deficiency
Authors: John Andrew St , Morris Howard , Richardson Alice , Lidbury Brett , Ward Greg , Badrick Tony 
Published: December 2020

Background Changes were made to the Australian guidelines for vitamin D testing in November 2014 which restricted the patients who could be tested and reimbursed under the Medical Benefits Schedule. A retrospective study was conducted to assess the impact of the changes. Methods Data from 588,021 cases tested for vitamin D over the period of 2014 to 2017 were obtained and the results in 149,808 cases tested before the change in guidelines were compared to 438,213 cases tested afterwards. Results The results showed an initial fall in requests took place after the introduction of changes, but request numbers had returned to pre-change levels by November 2016. Furthermore, following the intervention, there was a significant reduction in the number of cases of vitamin D deficiency (<50 nmol/L) detected after November 2014 ( P < 0.001) with odds ratio (OR) calculations showing the strongest effect for the sub-cohort of 0–20 nmol/L (OR = 1.77). For patient vitamin D levels >71 nmol/L, the pattern of detection inverted with more cases of sufficiency being detected after the intervention than before (OR from 0.84 to 0.48, P <0.001). Conclusions The failure to show a sustained reduction in vitamin D testing is a common finding with demand management strategies to limit test requesting. More significant is the failure of the intervention to improve the detection of vitamin D deficiency. These failures highlight the need for better tools to manage test requesting including the use of audit and outcomes measurement to guide future interventions.
Facilitators, challenges and usefulness of an asthma educational programme
Authors: Naeem Muhammad , Dailah Hamad Ghalib 
Published: December 2020

Background: This study explored the role of hospitals, specialised doctors and staff in developing patient awareness, participation and motivation concerning asthma control. It also looked at the challenges that undermine the value of asthma educational programmes, especially in an Arab cultural context. Methods: Semi-structured interviews were used to collect data from 30 asthma patients who had been living with asthma for a long period of time. Results: Findings highlight how an asthma educational programme can increase patient knowledge about the causes of asthma. Following the programme, patients had a better understanding of levels of medication, breathing techniques and rest and relaxation. Awareness of support from health professionals for managing depression and frustration also increased. However, some patients felt that the asthma educational programme content and delivery was not very interactive and was too lengthy. Conclusion: Findings can help policy makers, researchers, hospitals, doctors and the national Ministry of Health improve the content of future asthma educational programmes. They can also inform the development of a research framework to extend understanding of relevant issues in an Arabian context.
Full core technology versus notch sampling technology: evaluation of the diagnostic accuracy and the risk of a pneumothorax after transthoracic needle biopsy of suspicious lung lesions
Authors: Schroeder Christophe , Loebelenz Laura I , Heverhagen Johannes T , Noeldge Gerd , Brönnimann Michael P , Kim Soung Yung 
Published: December 2020

Background Percutaneous needle biopsy of the lung (PCBL) under image guidance has become a safe and effective minimal invasive method to obtain a specimen related histological diagnosis of pulmonary lesions. Purpose To evaluate the diagnostic yield and safety of two different coaxial biopsy technologies: full core and notch sampling technology. The former allowing the removal of full punch cylinders and the latter using a cutting-edge mechanism. Material and Methods A retrospective analysis of 48 consecutive PCBL procedures has been carried out for this prognostic study, involving patients with a documented pulmonary nodule or mass lesion on previous computed tomography (CT) scans. The study population included 38 men and 10 women (mean age = 67 years). Of these 48 patients who underwent a procedure with a co-axial cutting system, 24 have been performed with notch sampling technology and 24 with full core technology. Results Out of the 48 biopsy procedures, 46 yielded specimens were adequate for histopathological evaluation, consistent with a technical success rate of 96%. The most common induced image-guided biopsy complication was a pneumothorax, occurring in 14 patients (35%). Seven patients with a pneumothorax were attributed to the full core technology and seven to the notch sampling technology (odds ratio = 1, 95% confidence interval = 0.28–3.51, P = 1). Conclusion In the setting of full core versus notch sampling percutaneous CT-guided coaxial needle biopsy of the lung, no significant difference in the diagnostic accuracy and the incidence of pneumothoraces could be shown, while both technologies have an excellent diagnostic performance.
Staff dose evaluation by application of radiation protection during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed with a mobile C-arm
Authors: Österlund Andreas , Drohn Wilfried , Hoedlmoser Herbert , Greiter Matthias , Schmid Martin , Källman Hans-Erik 
Published: December 2020

Background The radiation dose to staff performing endoscopic retrograde cholangiopancreatography (ERCP) is not negligible. Purpose To evaluate the shielding effect of a table-suspended lower-body radiation shield for the positions in the room occupied by the operator, assisting nurse, and anesthesiologist, used during ERCP procedures with a mobile C-arm. Material and Methods Eye lens dose, whole body dose, and extremity dose were measured with and without a table-suspended lower-body radiation shield in a phantom model and in clinical routine work. The effect of the shield was evaluated for each scenario and compared, and a projection was made for when shielding should be required from a regulatory point of view. Results In the phantom measurements, the shield provided significant shielding effects on the body and lower extremities for the operator but no significant shielding of the eye lens. The shielding effect for the assisting nurse was limited to the lower extremity. The clinical measurements yielded the same general result as the phantom measurements, with the major difference that the shield provided no significant reduction in the whole-body dose to the operator. Conclusion The table-suspended shield has a significant shielding effect for the lower extremities of the operator and assisting nurse. For annual dose–area product values >300,000 cGycm2, the protection of the operator should be reinforced with a ceiling-suspended shield to avoid doses to the eye lens and body in excess of regulatory dose restrictions.
Prostate Cancer: People Transforming A Diagnosis, A Diagnosis Transforming People
Authors: Aronowitz Robert 
Published: December 2020

Prostatic specific antigen (PSA) screening has been controversial since its inception. Controversy has persisted despite more and higher quality clinical evidence. Attention to lead and length time biases, overdiagnosis, overtreatment, medicalisation, iatrogenesis and financial conflict of interest has had limited impact. I undertook a social history of the prostate cancer diagnosis to reassess the causes of controversy and suggest different clinical and policy responses. For much of the twentieth century, clinicians were uninterested in early detection and radical treatment, believing that cancers revealed after obstruction-relieving surgery or autopsy could be ignored. In 1985, the FDA approved PSA diagnostic tests, which rapidly catalysed two self-reinforcing cycles of action and perception. One occurred when the increased diagnoses made the disease more prevalent and feared, and efforts at prevention and treatment seem more efficacious, leading to more screening, and so on. The other cycle occurred among men with screening detected cancer who initially eschewed radical treatments or imagined doing so, whose lives were often consumed with fear and surveillance, increasing demand for radical cures. This history underscores the need for novel clinical and policy responses to the looping effects—self-reinforcing cycles of action and perception—which can radically transform so much of what we believe and do about disease.
Comparison of oncologic outcomes between partial nephrectomy and radical nephrectomy in patients who were upstaged from cT1 renal tumor to pT3a renal cell carcinoma: an updated systematic review and meta-analysis
Authors: Chung Doo Yong , Kang Dong Hyuk , Kim Jong Won , Kim Do Kyung , Lee Joo Yong , Cho Kang Su 
Published: December 2020

Aim: Owing to the limited ability of current imaging modalities, several clinical T1 renal cell carcinomas (cT1 RCCa) can be pathologically upstaged to T3a (pT3a) after surgery. There have been some controversies regarding the oncological safety of partial nephrectomy (PNx) compared with radical nephrectomy (RNx) in these patients. We compared oncological outcomes of PNx and RNx in patients with upstaged pT3a RCCa. Methods: A systematic review was performed following the PRISMA guideline. PubMed, MEDLINE, Embase were searched. Oncological outcomes [recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS)] between PNx and RNx were compared. The GRADE approach was used to rate the certainty of evidence. Results: A total of 7406 patients in 12 articles related to upstaged pT3a RCCa were included. In adjusted analysis, no difference was observed in RFS [hazard ratios (HR) 0.87; 95% confidence intervals (CI), 0.57–0.95; p = 0.88] and CSS (HR, 0.78; 95% CI, 0.59–1.04; p = 0.09) for PNx and RNx. Meanwhile, PNx was significantly associated with favorable OS compared with RNx (HR, 0.74; 95% CI, 0.57–0.95; p = 0.02). Conclusions: Our meta-analysis shows that patients treated with PNx have better or at least similar oncological outcomes compared with RNx in patients with upstaged pT3a RCCa from cT1. In particular, patients who had undergone PNx show a significantly improved OS. If PNx is available, we recommend performing PNx for all cT1 RCCa, even in patients with upstaging potential. However, due to the low level of evidence, large-scale randomized trials are required.
Modification of systemic anti-cancer therapies and weight loss, a population-level real-world evidence study
Authors: Shaw Clare , Starling Naureen , Reich Adam , Wilkes Emily , White Rebecca , Shepelev Julian , Narduzzi Silvia 
Published: December 2020

Background: Involuntary weight loss may occur during systemic anti-cancer therapy (SACT), causing treatment disruption and poorer prognoses. There remain gaps in clinical awareness as to which patients may benefit from nutritional interventions that aim to prevent unintended weight loss during SACT. We utilised England’s population-level cancer registry data, conducting a pan-cancer assessment of patient weight loss during SACT. We aimed to identify cancers with weight loss-associated treatment modifications, potential beneficiaries of nutritional intervention. Methods: This cross-sectional study used England’s Cancer Analysis System database, including SACT-treated adults with one tumour and ⩾2 weight recordings between 2014 and 2018. Binary weight loss (threshold: 2.5%) was derived from patients’ most negative weight change from first SACT weight recording. The Martin et al. body mass index-adjusted weight loss grading system (BMI-WLG) was assigned. We describe binary weight loss, BMI-WLG and treatment modification status by cancer. Multivariate logistic regression models of weight loss (binary and BMI-WLG) and a composite outcome of patient treatment-modification status by cancer were produced. Results: Our study population contained 200,536 patients across 18 cancers; 28% experienced binary weight loss during SACT. Weight loss patients were more likely to have multiple types of treatment modifications recorded across all cancers. Regression analyses included 86,991 patients. Binary weight loss was associated ( p < 0.05) with higher likelihood of treatment modification in; colon [Odds Ratio (OR) = 1.72, 95% confidence interval (CI): 1.42, 2.07]; gynaecologic (excl. ovarian) (OR = 1.48, 95% CI: 1.08, 2.01); stomach (OR = 1.46, 95% CI: 1.04, 2.06); lung (OR = 1.38, 95% CI: 1.21, 1.58); leukaemia (OR = 1.30, 95% CI: 1.09, 1.55); head and neck (OR = 1.30, 95% CI: 1.02, 1.65) and oesophageal (OR = 1.29, 95% CI: 1.01, 1.64) cancers. In lung, colon, and grouped gastro-intestinal cancers, association between BMI-WLG and treatment modification increased by WLG. Discussion: Our study is a wide assessment of weight loss during SACT using England’s cancer registry data. Across different cancers we found patients have weight loss-associated treatment modifications during SACT, a precursor to poorer prognoses. Our findings highlight cancers that may benefit from improved nutritional intervention during SACT.
Immune-checkpoint inhibitor plus chemotherapy versus conventional chemotherapy for treatment of recurrent or metastatic head and neck squamous cell carcinoma: a systematic review and network meta-analysis
Authors: Jin Zhe , Zhang Bin , Zhang Lu , Huang Wenhui , Mo Xiaokai , Chen Qiuyin , Wang Fei , Chen Zhuozhi , Li Minmin , Zhang Shuixing 
Published: December 2020

Background: Multiple therapies including immune-checkpoint inhibitors are emerging as effective treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSSC). However, the optimal first-line and second-line treatments remains controversial. Methods: We systematically searched databases and conducted a systematic review of phase II/III randomized controlled trials (RCTs) that compared two or more treatments for R/M HNSSC. Progression-free survival (PFS), overall survival (OS) and adverse events (AEs) ⩾3 with hazard ratios (HRs) were extracted and synthesized based on a frequentist network meta-analysis. Results: Twenty-six trials involving 8908 patients were included. Of first-line treatments, pembrolizumab plus cisplatin plus 5-fluorouracil is associated with significantly improved OS (P-score = 0.91) and TPEx ranked first for prolonging PFS (0.91). EXTREME plus docetaxel (0.18) ranked lowest for AEs ⩾3. Of second-line treatments, nivolumab was the highest-ranked treatment for prolonging OS (0.95), while buparlisib plus paclitaxel was the highest-ranked treatment for PFS (0.94). Subgroup analyses suggested that nivolumab was significantly associated with improvement of OS in patients with high PD-L1 expression (HR 0.55, 0.43–0.70), whereas its OS benefit is similar with conventional chemotherapy for those with low PD-L1 expression. Buparlisib plus paclitaxel showed the best OS benefit in subgroups of patients with HPV-negative status, and with oral cavity or larynx as primary tumor sites. Conclusions: Pembrolizumab plus cisplatin plus 5-fluorouracil is likely to be the best first-line treatment when OS is a priority. Otherwise, TPEx should be the optimal first-line option due to its superior PFS prolongation efficacy, best safety profile, and similar OS benefit with pembrolizumab plus cisplatin plus 5-fluorouracil. Nivolumab appears to be the best second-line option with best OS prolongation efficacy and outstanding safety profile in the overall population. Future RCTs with meticulous grouping of patients and detailed reporting are urgently needed for individualized treatment.