bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database
Authors: Lombardi Carolina , Parati Gianfranco , Soranna Davide , Zambon Antonella , Sliwinski Paweł , Roisman Gabriel , Pepin Jean‐Louis , Schiza Sophia , Riha Renata , Joppa Pavol , Fietze Ingo , Hedner Jan , Grote Ludger ,   the European Sleep Apnoea Database (ESADA) Collaborators
Published: December 2019

ABSTRACTBackground and objectiveOSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.MethodsThis cross‐sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).ResultsThe univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.ConclusionPLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.
Assessing Heterogeneity in Transition Propensity in Multistate Capture–Recapture Data
Authors: Jeyam Anita , McCrea Rachel , Pradel Roger 
Published: December 2019

SummaryMultistate capture–recapture models are a useful tool to help to understand the dynamics of movement within discrete capture–recapture data. The standard multistate capture–recapture model, however, relies on assumptions of homogeneity within the population with respect to survival, capture and transition probabilities. There are many ways in which this model can be generalized so some guidance on what is really needed is highly desirable. Within the paper we derive a new test that can detect heterogeneity in transition propensity and show its good power by using simulation and application to a Canada goose data set. We also demonstrate that existing tests which have traditionally been used to diagnose memory are in fact sensitive to other forms of transition heterogeneity and we propose modified tests which can distinguish between memory and other forms of transition heterogeneity.
Systematically variable geometry and architecture of incised‐valley fills controlled by orbital forcing: A conceptual model from the Pennsylvanian Breathitt Group (Kentucky,USA)
Authors: Le Cotonnec Aymeric , Ventra Dario , Hudson Sam , Moscariello Andrea 
Published: December 2019

AbstractIncised‐valley fills preserved within ancient coastal to shallow‐marine successions represent important archives of environmental and sea‐level change. Most current knowledge about the origin of incised valleys stems from Quaternary case studies; however, research on pre‐Quaternary examples can shed light on valley formation and evolution across longer timespans. This article describes different types of incised‐valley fills from Lower to Middle Pennsylvanian fluvio‐deltaic successions of the Breathitt Group (eastern Kentucky), accumulated in the Central Appalachian Foreland under prevalent glacioeustatic forcing driven by Gondwanan glaciations. Based on well‐established criteria for their recognition, numerous incised‐valley fills were identified from outcrop and subsurface data through more than 300 m of clastic successions consisting of fourth‐order stratigraphic sequences stacked into third‐order composite sequences. Incised‐valley fills were categorized into three archetypes based on lateral extent and aspect ratio (relatively wide versus narrow valley fills), nature of infill (fully continental versus mixed marine and continental facies associations) and relationships to underlying coal zones (truncating versus non‐truncating). The systematic occurrence of each incised‐valley fill type at specific stratigraphic positions within every third‐order sequence suggests control by a periodic allogenic factor. Valley‐fill archetypes are interpreted in terms of variable accommodation‐supply ratios driven by variable duration of formative base‐level cycles. For example, relatively wide incised‐valley fills with alluvial infill evolved during long‐lived cycles whose prolonged base‐level drawdown maintained low accommodation/supply ratios. Deeper valleys with low aspect ratios and mixed marine‐continental infills were generated by short‐lived base‐level drawdown that forced higher accommodation/supply ratios. Available chronological data for the studied successions consent to estimate base‐level cycles spanning 104–5 years that were likely modulated by interference patterns of orbital parameters (obliquity and eccentricity) via global climate and glacioeustatic fluctuations. This conceptual model, relating incised‐valley fill morphometry and internal architecture to orbital forcing patterns, provides a possible approach to predicting and interpreting incised‐valley fill variability through successions accumulated during icehouse conditions.
Cardiorespiratory and muscular fitness in young adult Finnish men between 2003 and 2015
Authors: Vaara Jani P. , Santtila Matti , Vasankari Tommi , Fogelholm Mikael , Mäntysaari Matti , Pihlainen Kai , Vaara Elina , Kyröläinen Heikki 
Published: December 2019

IntroductionPhysical fitness is strongly related to health and may offer valuable information about public health. We investigated trends in physical fitness, leisure‐time physical activity (LTPA), and anthropometry of young healthy adult Finnish men in representative population‐based samples between 2003 and 2015.MethodsThree independent cross‐sectional samples of 18‐ to 35‐year‐old Finnish men were assessed in 2003 (n = 889), 2008 (n = 803), and 2015 (n = 690). Cardiorespiratory (VO2max) and muscular fitness (1‐minute sit‐ups and push‐ups), body mass, and height were measured. Self‐reported LTPA was assessed.ResultsAfter adjusting for age, education, and smoking, cardiorespiratory fitness was higher in 2003 (mean: 43.5, 95%CI: 42.9‐44.1 mL/kg/min) compared to 2008 (41.3, 95%CI: 40.7‐41.9 mL/kg/min) and 2015 (40.6, 95%CI: 40.0‐41.2 mL/kg/min) (P < .001), whereas no difference was observed between 2008 and 2015. The lowest values in muscular fitness were observed in 2003, while no clear trends were further noticed. The adjusted BMI was higher in 2008 (25.1, 95%CI: 24.9‐25.4) and 2015 (25.3, 95%CI: 25.3, 95%CI: 25.0‐25.6) compared to 2003 (24.5, 95%CI: 24.3‐24.8) (P < .005). In 2015, a higher proportion of individuals exercised at least four times per week compared to 2003 and 2008 (P < .05).ConclusionThe decrease in cardiorespiratory fitness that took place between 2003 and 2008 plateaued after 2008. The plateau is in accordance with the previously observed trend of 5‐10 years younger Finnish men. Moreover, muscular fitness was for the most part higher in 2008 and 2015 compared to 2003. Efforts directed to promote regular physical activity and improve physical fitness are needed.
Quantity vs. quality: an assessment of the current pipeline for rabies
Authors: Neevel Anne M. G. , Urias Eduardo , Claassen Eric , van de Burgwal Linda H. M. 
Published: December 2019

AbstractObjectivesTo gain insight in the potential of the current pipeline for rabies to decrease the burden of disease by evaluating its relevance to high‐risk countries.MethodsRabies‐related patent documents and clinical trials were retrieved from Espacenet and the WHO ICTRP, respectively. Data were cleaned, modulated and categorised into a pre‐defined set of indicators those were used for (statistical) analyses on the number of patent applications, patent quality and type of stakeholders involved for different geographical areas.ResultsAnalysis of 583 unique patent families applied for in the period 1954–2017 showed a steep growth in the yearly number of patent applications. A significant portion of new patent applications concern Chinese patents with relatively low quality that are filed by a dispersed group of applicants. Excluding these patents, the number of patent applications has been virtually stable over the years. A shift is seen in public stakeholders becoming more prolific as patent applicants. This shift is also reflected in clinical trials; key sponsors of clinical trials include public and private stakeholders originating from high‐risk rabies countries. The majority of clinical trials investigate adjustments to existing vaccines that may improve accessibility.ConclusionThe results show a discrepancy between the quantity and quality of rabies patent applications that reflects national patent regulations rather than real progress in decreasing the burden of disease. This is in contrast to clinical trials, which focus on incremental innovations that are tested in clinical trials but may nevertheless have a potentially strong impact in high‐risk countries.
Factors associated with HIV in younger and older adult men in South Africa: findings from a cross-sectional survey
Authors: Govender Kaymarlin , Beckett Sean Edward , George Gavin , Lewis Lara , Cawood Cherie , Khanyile David , Tanser Frank , Kharsany Ayesha BM 
Published: December 2019

ObjectiveThis study investigated the behavioural, psychosocial and biological factors associated with HIV in a younger group of men (15 to 24 years) compared with an older group of men (25 to 35 years).DesignA household-based, cross-sectional study was conducted.SettingMen were randomly selected using a two-stage random sampling method in KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsOverall, we interviewed 1472 younger men and 1138 older men. Only participants who could speak English or Zulu, were able to provide informed consent and who were expected to be living in the study area for the next 12 months were enrolled into the study.Primary and secondary outcomesHIV status was the primary outcome for the study. Men’s HIV status was derived from blood samples collected in the study which were tested for HIV antibodies.ResultsHIV prevalence was higher among older men (35.4%, 95% CI: 31.7 to 39.1) than younger men (7.6%, 95% CI: 6.2 to 9.4, p<0.01). Older men, who completed secondary school had a lower likelihood of being HIV positive (adjusted OR (AOR): 0.41, 95% CI: 0.27 to 0.63, p<0.001) and those with greater food insecurity had a higher likelihood of being HIV positive (AOR: 1.57, 95% CI: 1.05 to 2.34, p=0.04). Younger men with a higher number of lifetime sexual partners had a higher likelihood of being HIV positive (AOR: 1.04, 95% CI: 0.99 to 1.09, p=0.09).ConclusionGiven that the HIV prevalence is higher in the older men, community based interventions need to target older men for medical circumcision and support HIV positive men to improve their material conditions early. For younger men intervening to reduce HIV risk behaviours at a young age before these behaviours become entrenched should be central to HIV prevention programmes.
Validation study of randomly selected cases of PTSD diagnoses identified in a Swedish regional database compared with medical records: is the validity sufficient for epidemiological research?
Authors: Hollander Anna-Clara , Askegård Klara , Iddon-Escalante Claudia , Holmes Emily A , Wicks Susanne , Dalman Christina 
Published: December 2019

ObjectivesIn Sweden, the patients’ diagnoses are recorded in administrative registers. The research value of these registers is determined by their diagnostic validity, that is, if the diagnosis recorded meets the relevant diagnostic criteria. The aim of the study was to assess the validity of post-traumatic stress disorder (PTSD)-diagnoses as compared with case notes in medical records (MRs) and to test if there was a difference in validity by gender, migration status and those with and without psychotic symptoms. We hypothesised that the validity would be sufficient, using bothDiagnostic and Statistical Manual of Mental Disorders(DSM)-IV and DSM-5 but higher according to DSM-IV than DSM-5, and that the validity would be the same for men and women, but different for Swedish-born and migrants, and for those with and without psychotic symptoms.Design and settingA validation of the register-diagnoses using MRs from treatment centres within the Region of Stockholm to examine whether patients with a register-diagnosis of PTSD fulfilled DSM criteria of PTSD according to the case notes in their MRs.ParticipantsA random sample of 187 patients aged 18–64, who had been diagnosed with PTSD (F43.1 in the ICD-10) were drawn from the Region of Stockholm’s MR database 2013–2015.Primary outcome measureValidity of the PTSD diagnoses according to DSM-IV and DSM-5 as proportions of true positives with 95% CI.ResultsThe hypothesised sufficient validity of the PTSD diagnoses was confirmed. Although the point-estimates for DSM-IV were higher than for DSM-5, the hypothesis that there would be significant differences in validity between DSM-IV and DSM-5 was not confirmed. There were no significant validity differences by gender, migration status and for those with and without psychotic symptoms.ConclusionsThis study has found that validity of the PTSD diagnoses in the register of the Region of Stockholm to be sufficient for epidemiological research.
Study design and protocol for a comprehensive evaluation of a UK massive open online course (MOOC) on quality improvement in healthcare
Authors: Smith-Lickess Sian K , Woodhead Tricia , Burhouse Anna , Vasilakis Christos 
Published: December 2019

IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners’ professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, ‘QualityImprovement (QI) inHealthcare: the Case for Change’, which aims to improve learner’s knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects.Methods and analysisA pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) models will be used to guide the evaluation. All learners who register for the course will be invited to participate in the QI MOOC evaluation study. Those who consent will be asked to complete a presurvey to assess baseline QI knowledge (self-report and objective) and perceived confidence in engaging in QI activities. On completion of the course, participants will complete a postsurvey measuring again knowledge and perceived confidence. Feedback on the course content and how it can be improved. A subset of participants will be invited to take part in a follow-up qualitative interview, 3 months after taking the course, to explore in depth how the MOOC impacted their behaviour in practice.Ethics and disseminationThe study has been approved by the University of Bath Human Research Ethics Committee (reference: 2958). Study findings will be published in peer-reviewed journals, and disseminated at conference and departmental presentations, and more widely using social media, microblogging sites and periodicals aimed at healthcare professionals.
Assessment of the use of Unna boot in the treatment of chronic venous leg ulcers in adults: systematic review protocol
Authors: Paranhos Thalita , Paiva Caroline S B , Cardoso Fernanda C I , Apolinário Priscila P , Figueiredo Azevedo Flavia , Saidel Maria G B , Oliveira Henrique C , Dini Ariane P , Kumakura Ana R S O , Melo Lima Maria H 
Published: December 2019

IntroductionChronic venous insufficiency (CVI) is an anomaly of the normal functioning of the venous system caused by valvular incompetence with or without the obstruction of venous flow. This condition can affect either or both of the superficial and the deep venous systems. Venous dysfunction can even result in congenital or acquired disorders, and its complications include venous leg ulcers (VLUs). The objective of this systematic review is to determine the effectiveness of Unna boot in the treatment of wound healing of VLU by assessing the quality of the available evidence.Methods and analysisA literature search in PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, BVS/BIREME, Embase, ProQuest, BDTD, Thesis and Dissertation Catalog, Sao Paulo Research Foundation/Thesis and dissertation, OPEN THESIS, A service of the US National Institute of Health, Center for Reviews and Dissemination-University of New York and SciElo published in the last 10 years, the period from January 1999 to March 2019. The review will include primary studies (original), and Controlled Trials or Observational studies (cross-sectional, case–control or longitudinal studies) with VLU. The exclusion will include leg ulceration due to different causes, such as pressure, arterial, diabetic or mixed-aetiology leg ulcers. Data synthesis will be performed using a narrative summary and quantitative analysis.Ethics and disseminationThis systematic review does not require approval by the ethics committee, as individual patient data will not be collected. Dissemination of findings will be through publications in peer-reviewed journals and/or via conference presentations.PROSPERO registration numberCRD42019127947
Qualitative exploration of women’s experiences of intramuscular pethidine or remifentanil patient-controlled analgesia for labour pain
Authors: Moran Victoria Hall , Thomson Gillian , Cook Julie , Storey Hannah , Beeson Leanne , MacArthur Christine , Wilson Matthew 
Published: December 2019

ObjectivesTo explore women’s experiences of remifentanil or pethidine for labour pain and infant feeding behaviours at 6weeks post partum.DesignQualitative postnatal sub-study to the randomised controlled trial of remifentanil intravenous patient controlled analgesia (PCA) versus intramuscular pethidine for pain relief in labour (RESPITE). Semistructured telephone interviews were conducted at 6 weeks post partum, and thematic analysis was undertaken.SettingWomen recruited to the RESPITE trial from seven UK hospitals.ParticipantsEighty women consented and 49 (30 remifentanil group and 19 pethidine group) completed the interview.ResultsEight themes emerged which encompassed women’s antenatal plans for pain management (Birth Expectations) through to their future preferences for pain relief (Reflections for Future Choices). Many women who used remifentanil felt it provided effective pain relief (Effectiveness of Pain Relief), whereas women in the pethidine group expressed more mixed views. Both groups described side effects, with women using pethidine frequently reporting nausea (Negative Physiological Responses) and women using remifentanil describing more cognitive effects (Cognitive Effects). Some women who used remifentanil reported restricted movements due to technical aspects of drug administration and fear of analgesia running out (Issues with Drug Administration). Women described how remifentanil enabled them to maintain their ability to stay focused during the birth (Enabling a Sense of Control). There was little difference in reported breastfeeding initiation and continuation between pethidine and remifentanil groups (Impact on Infant Behaviour and Breastfeeding).ConclusionsQualitative insights from a follow-up study to a trial which explored experiences of intravenous remifentanil PCA with intramuscular pethidine injection found that remifentanil appeared to provide effective pain relief while allowing women to remain alert and focused during labour, although as with pethidine, some side effects were noted. Overall, there was little difference in reported breastfeeding initiation and duration between the two groups.Trial registration numberISRCTN29654603.
Association between Carbohydrate Quality Index and general and abdominal obesity in women: a cross-sectional study from Ghana
Authors: Suara Sufyan Bakuri , Siassi Fereydoun , Saaka Mahama , Rahimi Foroshani Abbas , Sotoudeh Gity 
Published: December 2019

ObjectivesThe relationships between carbohydrate intake and risk of obesity have been widely investigated. However, there are limited data on the associations between their relative proportions and quality contained in the same diet on risk of obesity, especially in low-income and middle-income countries. The aim of this study was to assess the relationship between an overall Carbohydrate Quality Index (CQI) and general and abdominal obesity in women.Setting and participantsIn this cross-sectional study, data from 277 women in Ghana were analysed. Dietary information was obtained from 2-day 24 hours dietary recalls. CQI was calculated from the four indices dietary fibre, Glycaemic Index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio.Outcome measuresBody mass index, waist circumference (WC), waist-to-height ratio (WHtR) and Conicity Index were measured.ResultsAfter adjusting for covariates, the chance for general obesity (OR 0.25, 95% CI 0.10 to 0.65) and abdominal obesity measured by WC (OR 0.22, 95% CI 0.08 to 0.58) were significantly lower in the topmost quintile of CQI in comparison with the lowest quintile. In addition, the OR for higher WHtR (OR 0.27, 95% CI 0.11 to 0.69) was significantly lower among participants in the fifth quintile of CQI compared with those in the first quintile.ConclusionsThe present study demonstrates that there is an inverse association between dietary CQI and both general and abdominal obesity. These findings suggest that CQI may be used for the improvement of dietary intake to prevent obesity.