bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progressive Resistance Training for Improving Health-Related Outcomes in People at Risk of Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Ponzano Matteo , Rodrigues Isabel B , Hosseini Zeinab , Ashe Maureen C , Butt Debra A , Chilibeck Philip D , Stapleton Jackie , Thabane Lehana , Wark John D , Giangregorio Lora M 
Published: December 2020

Abstract

Objective
Osteoporosis clinical practice guidelines recommend exercise to prevent fractures, but the efficacy of exercise depends on the exercise types, population studied, or outcomes of interest. The purpose of this systematic review was to assess the effects of progressive resistance training (PRT) on health-related outcomes in people at risk of fracture.

Methods
Multiple databases were searched in October 2019. Eligible articles were randomized controlled trials of PRT interventions in men and women ≥50 years with low bone mineral density (BMD) or fracture history. Descriptive information and mean difference (MD) and SD were directly extracted for included trials. A total of 53 studies were included.

Results
The effects of PRT on the total number of falls (incidence rate ratio [IRR] = 1.05; 95% CI = 0.91 − 1.21; 7 studies) and on the risk of falling (risk ratio [RR] = 1.23; 95% CI = 1.00 − 1.51; 5 studies) are uncertain. PRT improved performance on the Timed “Up and Go” test (MD = −0.89 seconds; 95% CI = −1.01 to −0.78; 13 studies) and health-related quality of life (standardized MD = 0.32; 95% CI = 0.22–0.42; 20 studies). PRT may increase femoral neck (MD = 0.02 g/cm2; 95% CI = 0.01–0.03; 521 participants, 5 studies) but not lumbar spine BMD (MD = 0.02 g/cm2; 95% CI = −0.01–0.05; 4 studies), whereas the effects on total hip BMD are uncertain (MD = 0.00 g/cm2; 95% CI = 0.00–0.01; 435 participants, 4 studies). PRT reduced pain (standardized MD = −0.26; 95% CI = −0.37 to −0.16; 17 studies). Sensitivity analyses, including PRT-only studies, confirmed these findings.

Conclusion
Individuals at risk of fractures should be encouraged to perform PRT, as it may improve femoral neck BMD, health-related quality of life, and physical functioning. PRT also reduced pain; however, whether PRT increases or decreases the risk of falls, the number of people experiencing a fall, or the risk of fall-related injuries is uncertain.

Impact
Individuals at risk of fractures should be encouraged to perform PRT, as it may have positive effects on femoral neck BMD, health-related quality of life, physical functioning, and pain, and adverse events are rare.

Lay Summary
Exercise is recommended for people at risk of osteoporotic fractures. Our study showed that progressive resistance training improves physical functioning, quality of life, and reduces pain. The effects of progressive resistance training on the risk of falling are unclear. Adverse events are rare, and often minor (eg, soreness, pain, musculoskeletal injury). Considering the benefits and safety, people at risk of fractures should engage in progressive resistance training interventions.
What Does it Take to Get Ahead? Individual Characteristics, Community Contexts, and Stratification Beliefs among Youth in China
Authors: Lei Lei , Yu Wei-hsin 
Published: December 2020

Abstract
Research on youth in disadvantaged neighborhoods suggests that community contexts can affect youth’s beliefs about what it takes to get ahead. Nevertheless, a systematic analysis of such beliefs across a variety of communities remains rare. Using data from the China Family Panel Study from 2010 to 2014, we examine how individual characteristics, community socioeconomic status (SES), and their interplay are linked to young adolescents’ views on the importance of meritocratic, structural, and fatalistic contributors to future success. Results show that being in school for more years, having better-educated parents, having a higher family income, and being in communities with elevated SES generally lead youth to place greater importance on meritocratic elements and less emphasis on structural and fatalistic elements. Parental education is more strongly associated with the dismissal of a fatalistic view about who gets ahead in higher-SES communities. Meanwhile, the positive influence of community SES on meritocratic beliefs is stronger for poorer youth. Finally, we find that meritocratic beliefs are conducive to greater future progress in verbal and math skills, suggesting that such beliefs have important consequences for youth.
Quantifying the clonality and dynamics of the within-host HIV-1 latent reservoir
Authors: Ferreira Roux-Cil , Prodger Jessica L , Redd Andrew D , Poon Art F Y 
Published: December 2020

AbstractAmong people living with human immunodeficiency virus type 1 (HIV-1), the long-term persistence of a population of cells carrying transcriptionally silent integrated viral DNA (provirus) remains the primary barrier to developing an effective cure. Ongoing cell division via proliferation is generally considered to be the driving force behind the persistence of this latent HIV-1 reservoir. The contribution of this mechanism (clonal expansion) is supported by the observation that proviral sequences sampled from the reservoir are often identical. This outcome is quantified as the ‘clonality’ of the sample population, e.g. the fraction of provirus sequences observed more than once. However, clonality as a quantitative measure is inconsistently defined and its statistical properties are not well understood. In this Reflections article, we use mathematical and phylogenetic frameworks to formally examine the inherent problems of using clonality to characterize the dynamics and proviral composition of the reservoir. We describe how clonality is not adequate for this task due to the inherent complexity of how infected cells are ‘labeled’ by proviral sequences—the outcome of a sampling process from the evolutionary history of active viral replication before treatment—as well as variation in cell birth and death rates among lineages and over time. Lastly, we outline potential directions in statistical and phylogenetic research to address these issues.
New causes of immunologic occupational asthma 2014–2020
Authors: Cartier André 
Published: December 2020

Purpose of review
The purpose of this review was to list all new confirmed cases of immunological occupational asthma (IOA) described between mid-2014 and April 2020.

Recent findings
Several new agents, both of high and low molecular weight, have been identified in the last 6 years as potential respiratory sensitizers being able to induce immunological occupational asthma. This review confirms that new causes of IOA are still identified regularly, particularly in subjects exposed to high molecular agents, in the food industry (farming, pest control, food processing), pharmaceutical industry (antibiotics, various drugs) and cosmetic environment (dyes, powders).

Summary
It stressed the need for clinicians to stay alert and suspect occupational asthma in any adult with new onset asthma or newly uncontrolled asthma.
Medical Education in Nepal: Impact and Challenges of the COVID-19 Pandemic
Authors: Sigdel Shailendra , Ozaki Akihiko , Dhakal Rachana , Pradhan Bishwas , Tanimoto Tetsuya 
Published: December 2020

During the COVID-19 pandemic, there has been a global shift toward online distance learning due to travel limitations and physical distancing requirements as well as medical school and university closures. In low- and middle-income countries like Nepal, where medical education faces a range of challenges—such as lack of infrastructure, well-trained educators, and advanced technologies—the abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries.
In this article, the authors discuss the COVID-19-related changes and challenges in Nepal that may have a drastic impact on the career progression of current medical students. Outside the major cities, Nepal lacks dependable Internet services to support medical education, which frequently requires access to and transmission of large files and audiovisual material. Thus, students who are poor, who are physically disadvantaged, and who do not have a home situation conducive to online study may be affected disproportionately. Further, the majority of teachers and students do not have sufficient logistical experience and knowledge to conduct or participate in online classes. Moreover, students and teachers are unsatisfied with the digital methodologies, which will ultimately hamper the quality of education. Students’ clinical skills development, research activities, and live and intimate interactions with other individuals are being affected.
Even though Nepal’s medical education system is struggling to adapt to the transformation of teaching methodologies in the wake of the pandemic, it is important not to postpone the education of current medical students and future physicians during this crisis. Looking ahead, medical schools in Nepal should ensure that mechanisms are proactively put into place to embrace new educational opportunities and technologies to guarantee a regular supply of high-quality physicians capable of both responding effectively to any future pandemic and satisfying the nation’s future health care needs.
Parents' Perceptions of Infants' Nighttime Sleep Patterns Predict Mothers' Negativity: A Longitudinal Study
Authors: Vertsberger Dana , Tikotzky Liat , Baruchi Oriya , Knafo-Noam Ariel 
Published: December 2020

ABSTRACT:

Objective:
Infants' sleeping patterns can influence parents' sleep and their well-being. Infants' sleeping problems can evoke negative emotions from their parents because of the influence the problems have on parents' lives. However, little is known regarding the associations between infants' night sleep patterns and parents' overall negativity toward their children. The objective of this study was to study this association.

Methods:
In a longitudinal design, we followed infants and their parents from 9 to 18 months. Overall, 392 families participated in the study. Parents' negativity and children's sleeping patterns were assessed with questionnaires.

Results:
Parents' negativity and children's sleeping problems showed moderate continuity through the study's 9-month period. Children's sleeping problems at 9 months predicted an increase in mothers' (but not fathers') negativity at 18 months. Parents' negativity was not associated with infants' sleep problems.

Conclusion:
The results of this study suggest that already in infancy, children's tendencies, in this case sleep, can evoke negative emotions in their mothers and highlight infants' roles in the intricate parent-child relationship.
Management of Malignant Colon Polyps
Authors: Pedraza Rodrigo , Siddharthan Ragavan 
Published: December 2020

Case Summary:
A 54-year-old otherwise healthy woman presented for screening colonoscopy, during which 4 pedunculated 5- to 12-mm polyps distributed throughout the colon were found (Fig. 1). The 12-mm sigmoid polyp was removed with hot snare polypectomy in a nonpiecemeal fashion. Pathology demonstrated 3 tubular adenomas and a poorly differentiated invasive carcinoma in a sigmoid polyp without tumor budding, invading 0.8 mm into the submucosa, with lymphovascular invasion and with a deep margin of 0.6 mm. The next week, she underwent repeat flexible sigmoidoscopy with tattooing of the polypectomy site. She had a normal staging CT chest/abdomen/pelvis as well as CEA level and later underwent uneventful laparoscopic sigmoid resection, which included the area of endoscopic tattoo. Final pathology confirmed the presence of the tattooed area and polypectomy scar and showed no residual primary tumor and 2/18 positive lymph nodes (Fig, 2). She was referred to medical oncology for adjuvant chemotherapy.
Risk-adapted adjuvant therapy of luminal early breast cancer in 2020
Authors: Harbeck Nadia 
Published: December 2020

Purpose of review
The present review summarizes recent original publications addressing the topic of risk-adapted adjuvant therapy in early breast cancer (EBC). As neoadjuvant therapy has become a standard for triple negative and HER2+ EBC, it focusses on luminal EBC.

Recent findings
Gene expression assays have become standard of care in luminal EBC, at least for patients with node negative disease. Two prospective randomized clinical trials, TAILORx (Oncotype DX) and MINDACT (MammaPrint) have presented additional analyses underlining the clinical utility of the tests. In times of COVID-19, immunohistochemically determined ER, PR, and Ki67 and early Ki67 response to endocrine therapy can be used to safely allocate patients for preoperative endocrine therapy and delay surgeries if resources are scarce. In patients with luminal high-risk disease, adding a CDK 4/6 inhibitor (abemaciclib) improves patient outcome already after short-term follow-up.

Summary
Determination of recurrence risk will remain important in luminal EBC for optimal therapy decisions. In the future, risk-adapted treatment concepts will include decision making for chemotherapy but also for endocrine-based approaches.
Optical Quality in Keratoconus Is Associated With Corneal Biomechanics
Authors: Shugyo Akiko , Koh Shizuka , Inoue Ryota , Ambrósio Renato , Miki Atsuya , Maeda Naoyuki , Nishida Kohji 
Published: December 2020

Purpose:
To evaluate the correlations between corneal biomechanical indices from dynamic Scheimpflug assessment and optical quality assessed as higher-order aberrations (HOAs) using a Hartmann–Shack ocular wavefront sensor in patients with keratoconus (KC).

Methods:
In this prospective, observational case series, the eyes with KC or KC suspect (KCS) from Osaka University Hospital, Osaka, Japan, were analyzed. Corneal biomechanical assessment was performed using Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany), and ocular wavefront aberrations were measured using the KR-1W (Topcon Corp, Tokyo, Japan). Correlations between the biomechanical indices and ocular HOAs were assessed. Corneal biomechanical indices included the deformation amplitude ratio within 2 mm, integrated radius, stiffness parameter at the first applanation, and the linear Corvis Biomechanical Index. Wavefront data of the central 4-mm region were expanded up to the sixth order of Zernike polynomials. The magnitudes of trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration were calculated by Zernike vector analysis and then used as ocular HOA parameters along with total HOAs.

Results:
Thirty-four KC eyes and 37 KCS eyes were included. KC eyes showed significant correlations between ocular HOAs and biomechanics, whereas there were few significant correlations in KCS eyes. In KC eyes, deformation amplitude ratio within 2 mm, integrated radius, and Corvis Biomechanical Index beta showed stronger correlations with coma among the wavefront parameters.

Conclusions:
Corneal biomechanical indices correlated with ocular HOAs in patients with KC. In particular, there was a strong association with the increase in coma caused by inferosuperior asymmetry of the shape of the cornea in patients with KC.
Body Weight–Supported Treadmill Training in the Acute Care Setting
Authors: Bakowski (White) Roxanne L. , Hill Lauren , Goslar Pamela W. 
Published: December 2020

Purpose:
While previous studies have investigated the use of body weight–supported treadmill training (BWSTT) at various stages post-stroke, a greater focus has been on subacute and chronic stroke populations and less on how this training intervention could be implemented in the acute stages post-stroke. The purpose of our study is to demonstrate the safety and feasibility of implementing BWSTT in the very early acute phase following ischemic stroke.

Methods:
One-hundred and two subjects participated in BWSTT in addition to conventional therapy sessions while in the acute care hospital. Training was initiated, on average, 3.15 days from diagnosis to the initial treadmill session. Outcome measures included heart rate, blood pressure, Mobility Scale for Acute Stroke, Trunk Control Test, gait speed, and the SF-12v2.

Results:
Three hundred and six sessions were completed with 102 participants. Of the sessions completed, 13 were stopped due to blood pressure measurements above set parameters and did not return to within parameters during provided rest breaks. One thousand one hundred and nineteen systolic blood pressures (SBPs) were obtained during the study. Twenty-eight SBPs fell below 100, with 2 of the 28 resulting in an adverse event. Three total adverse events occurred out of 306 individual sessions, including 2 vasovagal events and an age-indeterminate peroneal tendon tear. The adverse events noted were transient and without harmful effects, and patients could complete future BWSTT sessions. Therefore, we consider 3 stopped sessions out of 306, 0.98%, as an acceptable rate of adverse events for future studies in BWSTT in patients with very early poststroke.

Conclusions:
BWSTT is a safe and feasible intervention to assist with higher-level physical activity in the acute stroke population during the early recovery stages.
An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital
Authors: Johnson Joshua K. , Young Daniel L. , Marcus Robin L. 
Published: December 2020

Purpose:
The aim of the study was to understand how acute care physical therapists' perceptions of the value of physical therapy inform their decisions regarding which patients to treat.

Methods:
This was a qualitative study using a grounded theory approach. Data were collected using semistructured interviews with a purposive sample of acute hospital physical therapists in the United States. Interview transcriptions were analyzed to derive codes and identify an explanatory model.

Results:
Participants included 16 physical therapists from 4 hospital systems. Their descriptions indicate that care prioritization is influenced by a self-perception of value informed by both patient- and system-driven thinking. Patient-driven thinking prioritizes factors considered most important to individual patients (eg, improved functional independence). System-driven thinking prioritizes factors most important to the health system (eg, a certain patient population or productivity expectation). The relative contribution of system- and patient-driven thinking in prioritization decisions was variable from one participant to another.

Conclusions:
In addition to the perceived value of physical therapy for individual patients, acute hospital physical therapists integrate organization-level factors into prioritization decisions. Future research should seek to understand how this may influence practice variation and identify practice patterns that simultaneously optimize outcomes considered important by both patients and organizations.
Objective Vestibular Test Battery and Patient Reported Outcomes in Cochlear Implant Recipients
Authors: West Niels , Tian Luchen , Vang Petersen Laura Katrine , Bille Michael , Klokker Mads , Cayé-Thomasen Per 
Published: December 2020

Objective:
Cochlear implantation (CI) may have undesired effects on the vestibular apparatus. However, the literature holds no consensus on vestibular affection and the testing tools applied to test for vestibular dysfunction after cochlear implantation are inconsistent. We aimed to investigate the impact of CI on vestibular function by an extensive test battery including patient-reported outcomes.

Study Design:
Prospective observational study.

Setting:
University hospital.

Patients:
Forty adult unilateral first-time CI recipients.

Intervention:
Vestibular function was evaluated pre- and post-implantation with the video head impulse test (VHIT), the caloric test and cervical vestibular evoked myogenic potentials (cVEMPs), and the patient-reported dizziness handicap inventory (DHI).

Results:
Mean VHIT gain decreased from preoperative 0.92 to 0.84 postoperative (p = 0.018); mean caloric unilateral weakness increased from 20.5% preoperative to 42.9% postoperative (p < 0.0001); cVEMP responses were present on 10 operated ears preoperative and five ears postoperative, and compared with non-implanted ears, cVEMP responses on implanted ears were impaired (p = 0.023). 50% of patients reported early postoperative dizziness, but the mean DHI score remained unchanged (p = 0.94). The DHI scores correlated poorly with the objective outcomes (r
s = 0.19 and r
s = –0.22).

Conclusion:
Vestibular function is significantly affected after cochlear implantation, but vestibular hypofunction varies with the test used. Although early dizziness after implantation is common, later DHI scores are not significantly higher than before the implantation, indicating that central compensation plays a major role for these patients.
A roadmap of six different pathways to improve survival in laryngeal cancer patients
Authors: Bradley Patrick J. , Piazza Cesare , Paderno Alberto 
Published: December 2020

Purpose of review
Laryngeal cancer continues to require improvement in earlier stage diagnosis and better imaging delineation of disease, and hence ‘more evidence-based’ selection of treatment, as recent evidence suggests that related mortality, in the last decades, has not significantly decreased worldwide. Even though the reasons are not fully understood, there persists an urgency for a review and development of future strategies to embrace such clinical and diagnostic challenges from a political, societal, as well as scientific and clinical points of view.

Recent findings
This review of the published literature suggests that survival improvement in laryngeal cancer may be achieved by fuelling and combining at least some or all of six targeted agendas: documentation of disease global incidence and national burden monitoring; development and implementation of high-quality cancer registries; education on risk factors and hazardous habits associated with laryngeal cancer for the general population; active modification of proven at-risk population lifestyles; centralization of treatment; and use of machine learning of gathered ‘big data’ and their integration into approaches for the optimization of prevention and treatments strategies.

Summary
Laryngeal cancer should be tackled on several fronts, commencing with disease monitoring and prevention, up to treatment optimisation. Available modern resources offer the possibility to generate significant advances in laryngeal cancer management. However, each nation needs to develop a comprehensive approach, which is an essential prerequisite to obtain meaningful improvement on results.
Repeated kidney re-transplantation in times of organ shortage – a critical review
Authors: Assfalg Volker , Hüser Norbert 
Published: December 2020

Purpose of review
Organ shortage forces those responsible to streamline allocation rules to provide a maximum of candidates with a graft and to optimize transplant outcome. Recently, repeated kidney re-transplantation was investigated in several studies with different analytic settings concerning the control group, the donors, parameters influencing outcome, and demographic characteristics. This review gives an overview on the candidates awaiting a repeated re-transplantation, summarizes the outcome, and comments on the relevance of these findings in the context of sustained organ shortage.

Recent findings
Repeated kidney re-transplantation is technically and immunologically feasible and the recipients’ survival is better compared to candidates remaining on dialysis or on the waiting-list. However, the outcome is mainly reported to be worse as compared to first or second kidney transplantation. Kidneys from living donors seem to have a favorable impact on outcome in this setting.

Summary
The survival benefit of repeated re-transplantation recipients over patients on dialysis demands for continuation of this procedure. Comprehensive registries are essential to continuously optimize allocation. Governmental authorities are obliged to set the course to increase organ donation rather than forcing transplant decision makers to withhold a third or fourth graft from any candidate.