bluuebunny/crossref_metadata_2025_split huggingface dataset:
Athlete availability and incidence of overuse injuries over an athletics season in a cohort of elite Swedish athletics athletes - a prospective study
Authors: Lundberg Zachrisson Andreas , Ivarsson Andreas , Desai Pia , Karlsson Jon , Grau Stefan 
Published: May 2020

Abstract
Background
Athletics is a sport with a high incidence of injury, where most injuries are caused by overuse. Research on injury incidence and the occurrence of overuse injuries during a season in athletics is scarce. An athlete availability (unrestricted ability to participate in training or competition) of less than 80% has been linked with athletes being less likely to reach their performance goals. The purpose of this study was to estimate the monthly injury incidence rates, athlete availability, and the overuse injury incidence rate per 1000 athletics-hours of training in a cohort of Swedish elite athletics athletes.

Methods
The cohort consisted of 59 male and female elite athletes competing in either middle or long-distance running, sprint, or jumping events. Injury and training data were collected during one athletics season, from October to the end of August. All injury data were collected by medical professionals. Training data were collected monthly, and consisted of event-specific training diaries covering training sessions, training days, and non-training or non-competition days. Monthly injury incidence rates were based on the number of new injuries per month in relation to the number of exposed (injury-free) athletes.

Results
The overall injury incidence rate for all athletes was highest in October (22.0%). Monthly injury incidence rate for middle and long-distance runners was highest in October (26.1%), for sprinters in April (19.0%), and for jumpers in October (21.4%). The overall athlete availability was 78.0% for the cohort. Sprinters had the lowest athlete availability (71.4%), followed by jumpers (77.3%), and middle-distance and long-distance runners (82.7%). Female athletes (76.5%) had a lower athlete availability than male athletes (79.7%). The injury incidence rate was 1.81 injuries per 1000 athletics hours of training. Middle and long-distance runners had the highest injury incidence rate (2.38), followed by jumpers (1.62), and sprinters (1.34).

Conclusion
Monthly injury incidence rates during a season appears to correspond to periods of high training volume (conditioning phases and training camps). The low overall athlete availability (> 80%) indicates that many Swedish elite athletes are less likely to reach their full potential.
Associations between early childhood caries, malnutrition and anemia: a global perspective
Authors:   Early Childhood Caries Advocacy Group, Folayan Morenike Oluwatoyin , El Tantawi Maha , Schroth Robert J. , Vukovic Ana , Kemoli Arthur , Gaffar Balgis , Obiyan Mary 
Published: May 2020

Abstract
Background
Malnutrition is the main risk factor for most common communicable diseases. The aim of this study is to determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children.

Methods
Matched country-level ECC, malnutrition and anemia prevalence were generated from databases covering the period 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for gross national income per capita. Adjusted regression coefficients (B) and partial eta squared were computed.

Results
The mean (standard deviation (SD)) ECC prevalence was 23.8 (14.8)% for 0–2 year-olds and 57.3 (22.4)% for 3–5-year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight 7.2 (4.9)%, stunting 24.3 (13.5)%, and anemia 37.8 (18.1)%. For 0–2-year-olds, the strongest and only significant association was between the prevalence of ECC and overweight (η2 = 0.21): 1 % higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B = 0.12, P = 0.03). In 3–5-year-olds, the strongest and only significant association was between the prevalence of ECC and anemia (η2 = 0.08): 1 % higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B = − 0.14, P = 0.048).

Conclusion
Country-level prevalence of ECC was associated with malnutrition in 0–2-year-olds and with anemia in 3–5-year-olds. The pathway for the direct relationship between ECC and overweight may be diet related. The pathway for the inverse relationship between ECC and anemia is less clear and needs further investigations.
123I-FP-CIT SPECT validation of nigro-putaminal MRI tractography in dementia with Lewy bodies
Authors:   the Disease Management Team on Dementia of the IRCCS Ospedale Policlinico San Martino, Genoa, Pardini Matteo , Nobili Flavio , Arnaldi Dario , Morbelli Silvia , Bauckneht Matteo , Rissotto Roberto , Serrati Carlo , Serafini Gianluca , Lapucci Caterina , Ghio Lucio , Amore Mario , Massucco Davide , Sassos Davide , Bonzano Laura , Mancardi Giovanni Luigi , Roccatagliata Luca 
Published: May 2020

Abstract
Background
Assessment of nigrostriatal degeneration is a key element to discriminate between dementia with Lewy bodies (DLB) and Alzheimer disease (AD), and it is often evaluated using ioflupane (123I-FP-CIT) single-photon emission computed tomography (SPECT). Given the limited availability of 123I-FP-CIT SPECT, we evaluated if a mask-based approach to nigroputaminal magnetic resonance imaging (MRI) diffusion-weighted tractography could be able to capture microstructural changes reflecting nigroputaminal degeneration in DLB.

Methods
A nigroputaminal bundle mask was delineated on 12 healthy volunteers (HV) and applied to MRI diffusion-weighted data of 18 subjects with DLB, 21 subjects with AD and another group of 12 HV. The correlation between nigroputaminal fractional anisotropy (FA) values and 123I-FP-CIT SPECT findings was investigated. Shapiro-Wilk, ANOVA, ANCOVA, and parametric correlation statistics as well as receiver operating characteristic (ROC) analysis were used.

Results
DLB patients showed a higher nigroputaminal FA values compared with both AD and HV-controls groups (p = 0.001 for both comparisons), while no difference was observed between HV-controls and AD groups (p = 0.450); at ROC analysis, the area under the curve for the discriminating DLB and AD subjects was 0.820; FA values correlated with 123I-FP-CIT values (on the left, r = -0.670; on the right, r = -720). No significant differences were observed for the FA of the corticospinal tract across the three groups (p = 0.740).

Conclusions
In DLB, nigroputaminal degeneration could be reliably assessed on MRI diffusion scans using a mask of nigroputaminal bundle trajectory. Nigroputaminal FA in DLB patients correlated with 123I-FP-CIT values data may allow to differentiate these patients from AD patients and HV-controls.
Embolization of medium-sized vessels with the penumbra occlusion device: evaluation of anchoring function
Authors: Kato Kenichi , Kawashima Kazuya , Suzuki Tomohiro , Hamano Makoto , Yoshida Sohei , Yoshioka Kunihiro 
Published: May 2020

Abstract
Background
The penumbra occlusion device (POD) is a recently developed metallic coil with a unique anchor segment. The purpose of this study was to investigate the anchoring function of the POD for embolization of medium-sized vessels in detail.

Materials and methods
We reviewed a series of cases of proximal embolization of medium-sized vessels in which the POD was used. Endovascular outcomes and complications were assessed. The distance between the distal end of the first-indwelled POD and the microcatheter tip was defined as the “landing distance,” and this was also evaluated via fluoroscopic analysis.

Results
POD deployment was successful in 17 of 18 patients. The median landing distance was 9.6 mm, and no distal POD migration was observed after the formation of anchor loops.

Conclusions
The specific anchoring function of the POD enables effective proximal occlusion of medium-sized vessels.
Propionate metabolism in a human pathogenic fungus: proteomic and biochemical analyses
Authors: Santos Luiz Paulo Araújo , Assunção Leandro do Prado , Lima Patrícia de Souza , Tristão Gabriel Brum , Brock Matthias , Borges Clayton Luiz , Silva-Bailão Mirelle Garcia , Soares Célia Maria de Almeida , Bailão Alexandre Melo 
Published: May 2020

AbstractFungi of the complex Paracoccidioides spp. are thermodimorphic organisms that cause Paracoccidioidomycosis, one of the most prevalent mycoses in Latin America. These fungi present metabolic mechanisms that contribute to the fungal survival in host tissues. Paracoccidioides lutzii activates glycolysis and fermentation while inactivates aerobic metabolism in iron deprivation, a condition found during infection. In lungs Paracoccidioides brasiliensis face a glucose poor environment and relies on the beta-oxidation to support energy requirement. During mycelium to yeast transition P. lutzii cells up-regulate transcripts related to lipid metabolism and cell wall remodeling in order to cope with the host body temperature. Paracoccidioides spp. cells also induce transcripts/enzymes of the methylcitrate cycle (MCC), a pathway responsible for propionyl-CoA metabolism. Propionyl-CoA is a toxic compound formed during the degradation of odd-chain fatty acids, branched chain amino acids and cholesterol. Therefore, fungi require a functional MCC for full virulence and the ability to metabolize propionyl-CoA is related to the virulence traits in Paracoccidioides spp. On this way we sought to characterize the propionate metabolism in Paracoccidioides spp. The data collected showed that P. lutzii grows in propionate and activates the MCC by accumulating transcripts and proteins of methylcitrate synthase (MCS), methylcitrate dehydratase (MCD) and methylisocitrate lyase (MCL). Biochemical characterization of MCS showed that the enzyme is regulated by phosphorylation, an event not yet described. Proteomic analyses further indicate that P. lutzii yeast cells degrades lipids and amino acids to support the carbon requirement for propionate metabolism. The induction of a putative propionate kinase suggests that fungal cells use propionyl-phosphate as an intermediate in the production of toxic propionyl-CoA. Concluding, the metabolism of propionate in P. lutzii is under regulation at transcriptional and phosphorylation levels and that survival on this carbon source requires additional mechanisms other than activation of MCC.
Localization and immunohistochemical detection of swine influenza A virus subtype H1N1 antigen in formalin-fixed, paraffin-embedded lung tissues from naturally infected pigs
Authors: Olaniyi Moshood O. , Adebiyi Adeniyi A. , Ajayi Olusola L. , Alaka Olugbenga O. , Akpavie Stephen O. 
Published: May 2020

AbstractBackgroundSwine influenza A viruses (SIV) infection is among the leading causes of respiratory diseases in a number of animal species and human, and has been reported to cause substantial losses to pig industry. Previous reports of serological, molecular, and surveillance studies in commercial piggeries in Nigeria indicated the presence of SIV subtypes H1N1 and H3N2 in infected pigs; hitherto, there exists lack of studies on the pulmonary pathology and pathogenicity of SIV in Nigeria. This study investigates the presence of SIV subtype H1N1 antigen in the formalin-fixed paraffin-embedded lung sections obtained from apparently healthy pigs slaughtered at abattoirs located in Lagos, Ogun, and Oyo States, Southwest Nigeria using a streptavidin-biotin (ABC) immunoperoxidase (IP) staining. Two hundred four lungs consisting of 144 grossly pneumonic lungs and 60 apparently normal lungs were randomly collected, fixed in 10% neutral-buffered formalin, embedded in paraffin wax, and processed for histopathological examination and immunohistochemistry.ResultsThe main gross lesions were marked pulmonary edema and mild bilateral consolidation of cranial lobes. Histopathology revealed suppurative bronchitis, and bronchiolitis with or without concurrent widespread degeneration and necrosis of epithelial cells (52.08%) and thickening of alveolar septa due to cellular infiltration consisting predominantly of neutrophils and mononuclear cells (macrophages and plasma cells) (39.58%). The lumina of most airways contained exudate consisting of neutrophils, desquamated epithelia cells, and necrotic debris. SIV antigen was immunohistochemically detected in 7/204 (3.43%) samples using SIV-specific (H1N1) monoclonal antibody. Positive cells exhibited a typical dark-brown reaction in the infected cells. A strong positive immunohistochemical staining was detected mainly in the alveolar macrophages and bronchial submucosal glandular epithelial cells while less intense staining was observed in the bronchiolar epithelial cells.ConclusionsThe present study describes the distribution and localization of SIV subtype H1N1 antigens in the lung tissues of the infected pigs and provides public awareness on the presence of the virus in pig population in Nigeria and the risk factors associated with the infection. Therefore, people working in pig farms should maintain high level of biosafety and personal hygiene. This is the first report of immunohistochemical detection of SIV subtype H1N1 antigen in naturally infected pigs in Nigeria and may indicate rapid dissemination of the virus in susceptible pigs in the study area. A further molecular epidemiological study to investigate other SIV subtypes circulating in Nigerian pig population is warranted.
Evaluation of the early outcomes of partial urogenital sinus mobilization in females with congenital adrenal hyperplasia
Authors: Oshiba Ahmed , Ashour Khaled , Khairi Ahmed , Shehata Sameh , ElSayed Shaymaa , Elhalaby Essam 
Published: May 2020

Abstract
Background
Congenital adrenal hyperplasia (CAH) is the most common cause of ambiguous genitalia with an incidence of 1 in 15,000 live births. Surgical reconstruction for girls with CAH and urogenital sinus (UGS) is a great challenge to create normal appearing and functional external genitalia. The purpose of this study is to evaluate the early outcomes of using partial urogenital sinus mobilization in feminizing genitoplasty in females with congenital adrenal hyperplasia regarding vaginal caliber, urinary continence, and genital appearance.

Results
Patient age at surgery ranged from 4 to 96 months (mean 19.4 months), with a mean follow-up of 15 months. Degree of virilization was Prader type III in 2 children (8%), type IV in 18 (72%), and type V in 5 (20%). Urogenital sinus length was 2.5 cm or less in 18 children. Cosmetic results were good in 19 patients (76%) and satisfactory in 6 (24%). Adequate caliber of the mobilized vagina was achieved in 24 patients (96%). Seven toilet trained children were assessed for bladder function. Only 1 patient was daytime incontinent and improved after few months with regular voiding. Urodynamics was done in toilet trained children and showed normal results.

Conclusions
The surgical procedure in general is consisting of clitoroplasty, labioplasty, urethroplasty, and vaginoplasty. Separation of the vagina from the urethra is a highly challenging surgical step and need good experience to perform. Partial urogenital sinus mobilization (PUM) has good results regarding the urinary continence, vaginal diameter, and cosmetic results in CAH patients.
Transitions in mental health care: The European Psychiatric Association contribution to reform in Bulgaria
Authors: Beezhold Julian , Stoyanov Drozdstoy , Nakov Vladimir , Killaspy Helen , Gaebel Wolfgang , Zarkov Zahari , Hinkov Hristo , Galderisi Silvana 
Published: May 2020

Abstract

Background:
The Bulgarian Ministry of Health invited the European Psychiatric Association (EPA) to evaluate Bulgarian mental health care service provision in 2018. Bulgarian mental health services face very significant challenges including a legacy of historic underfunding, internal conflicts, poor planning, and the emigration of very high numbers of younger skilled staff that had followed accession to the European Union. There were significant disputes between stakeholders regarding the way forward and had been at least two unsuccessful previous external agency interventions that had attempted to find solutions.

Method:
This EPA position paper describes in detail the EPA mission to Bulgaria including methodology, findings, recommendations, and finally the positive actions and changes that are now underway as a result of the EPA report and intervention aimed at contributing towards improving Bulgarian mental health services.

Results:
After meetings with multiple stakeholders in the Bulgarian mental health system and analysis of data on service delivery, workforce, funding and configuration the EPA Panel agreed a list of twenty recommendations for change.

Conclusions:
The EPA mission, with the collaboration of multiple stakeholders in Bulgaria, was successful in stimulating high level government action to improve mental health services. Despite longstanding differences, it was possible to involve the stakeholders in constructive dialogue. The importance of “speaking with one voice” was a key lesson learned.
Association Between Marital Status and Racial Disparities in Esophageal Cancer Care
Authors: Paniagua Cruz Alan , Haug Karlie L. , Zhao Lili , Reddy Rishindra M. 
Published: May 2020

PURPOSE: This study was designed to examine the impact of marital status on racial disparities in esophageal cancer care. PATIENTS AND METHODS: We performed a secondary analysis of data collected from the state cancer registry maintained by the Michigan Department of Health and Human Services. We identified patients with an esophageal cancer diagnosis between January 1, 2000, and December 31, 2013. χ2 test and logistics regression were used to analyze 6,809 patients who met our eligibility criteria. Statistical significance was defined as P ≤ .05. RESULTS: Approximately 88.4% of our patients were White and 11.6% were Black. A significantly higher number of White patients were married when compared with Blacks (62.9% v 31.8%, respectively; P < .0001). There was no significant difference in cancer staging between the 2 groups ( P = .0671). Married Blacks had similar rates of esophagectomy, chemotherapy, and radiation as married Whites. Both single groups had lower rates of esophagectomy and chemotherapy than married Whites, but single Blacks were the least likely to undergo esophagectomy. Single patients were more likely to refuse treatment. CONCLUSION: Marital status differs significantly in Black and White patients with esophageal cancer and may help explain racial disparities in cancer care. Further research is needed to explore reasons for care underutilization in single patients and whether these differences translate into clinical outcomes.
Endogenous Testosterone Levels Are Associated with Risk of Type 2 Diabetes in Women without Established Comorbidity
Authors: Rasmussen Jon J , Selmer Christian , Frøssing Signe , Schou Morten , Faber Jens , Torp-Pedersen Christian , Gislason Gunnar H , Køber Lars , Hougaard David M , Cohen Arieh S , Kistorp Caroline 
Published: May 2020

Abstract

Purpose
The impact of endogenous androgen levels on the risk of type 2 diabetes in women remains uncertain. The objective was to investigate associations between endogenous androgen levels and risk of type 2 diabetes in young women without established comorbidity.

Methods
In this retrospective cohort study, women aged 18 to 50 years who underwent measurement of plasma testosterone, dehydroepiandrosterone-sulfate (DHEA-S), dihydrotestosterone (DHT), and sex hormone-binding globulin (SHBG) for the first time from January 2007 to December 2015 were included. Androgens were analyzed using tandem liquid chromatography mass spectrometry. Women with established comorbidity were excluded, using Danish healthcare registries. We calculated incidence rate ratios (IRRs, 95% confidence intervals) of type 2 diabetes according to quartiles of plasma androgens using multivariate Poisson regression models.

Results
A total of 8876 women, with a mean ± SD age of 38.5 ± 4.6 years and a median (interquartile range [IQR]) follow-up duration of 8.1 (6.6-9.4) years, were eligible for analyses. During 69 728 person-years, 69 women were diagnosed with type 2 diabetes. Women in the highest quartile of plasma total testosterone and calculated free testosterone displayed increased risk of type 2 diabetes compared with the lowest quartile: IRR 1.97 (1.01; 3.85), P = .048 and IRR 7.32 (2.84; 18.83), P &lt; .001. SHBG was inversely associated with type 2 diabetes, Q4 versus Q1; IRR 0.06 (0.02; 0.21), P &lt; .001. Plasma DHEA-S and DHT were not associated with incident type 2 diabetes.

Conclusions
Higher levels of plasma total and free testosterone were associated with increased risk of type 2 diabetes among women.
Steps Ahead: optimising physical activity and health in people with cystic fibrosis: Study Protocol for a pilot randomised trial
Authors: Curran Maire , Tierney Audrey C. , Collins Louise , Kennedy Lauren , McDonnell Ciara , Jurascheck Andrew J. , Sheikhi Ali , Walsh Cathal , Button Brenda , Galvin Rose , Casserly Brian , Cahalan Roisin 
Published: May 2020

Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; fitness tracking, smartphone use and remote monitoring, all of which may have potential to impact on positive health outcomes in people with CF. The objective of this pilot randomised trial is to explore the potential efficacy of a fitness tracker, which is remotely monitored, combined with personalised text message feedback and goal setting, on lung function, aerobic capacity and PA in adults with CF. Secondary endpoints include quality of life, body composition and wellbeing. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of a fitness tracker (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) for data collection purposes that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set short- and long-term goals with participants and will send one-way text message feedback on Fitbit data and weekly progress. This message will consist of positive reinforcement and re-assess participant goals. The active comparator group will receive a fitness tracker which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on health outcomes in people with CF. Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018)