bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated cerebral perfusion and preserved cognition in elite Brazilian Jiu‐Jitsu athletes: Evidence for neuroprotection
Authors: Stacey Benjamin S. , Campbell Zac , Bailey Damian M. 
Published: August 2021

AbstractBrazilian Jiu‐Jitsu (BJJ) is a popular martial art that exposes participants to recurrent intermittent asphyxiation due to controlled application of neck chokes. To what extent the sport impacts the regulation of cerebral blood flow (CBF) and cognition has not been examined. This study compared eleven elite Brazilian Jiu‐Jitsu athletes (aged 30 ± 8 y) who trained 12 ± 6 hours/week for 8 ± 4 years against eleven cardiorespiratory fitness (CRF)‐ and age‐matched controls. Internal carotid (ICA) and vertebral artery (VA) blood flow were measured via duplex ultrasound to determine global cerebral blood flow (gCBF). Mild cognitive impairment and sub‐domains of memory, attention/concentration/visual motor coordination, and executive function were determined by psychometric testing. There was no evidence of mild cognitive impairment in the athletes, and cognitive function was comparable between groups (all p > 0.05). In contrast, resting gCBF was selectively elevated in the athletes (741 ± 186 mL∙min−1 vs. 573 ± 166 mL∙min−1, p = 0.037) due to combined differences in ICA (+65 mL∙min−1, p = 0.079) and VA (+19 mL∙min−1, p = 0.277) flow. In conclusion, the sustained elevation in resting cerebral perfusion provides preliminary evidence for adaptive neuroprotection that is independent of CRF and likely mediated by choke‐induced cerebral preconditioning and/or lifelong exposure to BJJ‐specific high‐intensity interval training.
Corncob Derived Porous Carbon Anode for Long-Term Cycling in Low-Cost Lithium Storage
Authors: Rehman Waheed Ur , Zhang Fangzhou , Manj Rana Zafar Abbas , Ma Yuanyuan , Yang Jianping 
Published: August 2021

Abstract
Corncob is a biomass waste that has the second cutting-edge abundance on a global scale. As a low cost and feasible agricultural waste byproduct, corncob can be used in the energy sector to produce green and cheap energy. In this research, we used corncob as a raw material to make corncob-derived carbon composites (CDCCs) through a scalable and cost-effective calcination process, without the need of acidic or alkali treatments under different conditions. The obtained CDCC possesses a large number of micropores and mesopores having a slit-like shape. It showed outstanding long-term cycling stability up to 4000 cycles, maintaining stable specific capacity of 230 mA h/g at a current density of 500 mA/g. The obtained composite anode showed outstanding performance at a current density of 1000 mA/g, with specific capacity of around 200 mA h/g up to 10,000 cycles. This method can also be applied to other biomass wastes for sustainable use in different applications.
Effect of unplanned athletic movement on knee mechanics: a systematic review with multilevel meta-analysis
Authors: Giesche Florian , Stief Felix , Groneberg David A , Wilke Jan 
Published: August 2021

ObjectiveTo compare the effects of pre-planned and unplanned movement tasks on knee biomechanics in uninjured individuals.DesignSystematic review with meta-analysis.Data sourcesFive databases (PubMed, Google Scholar, Cochrane Library, ScienceDirect and Web of Science) were searched from inception to November 2020. Cross-sectional, (randomised) controlled/non-controlled trials comparing knee angles/moments of pre-planned and unplanned single-leg landings/cuttings were included. Quality of evidence was assessed using the tool of the Grading of Recommendations Assessment, Development and Evaluation working group.MethodsA multilevel meta-analysis with a robust random-effects meta-regression model was used to pool the standardised mean differences (SMD) of knee mechanics between pre-planned and unplanned tasks. The influence of possible effect modifiers (eg, competitive performance level) was examined in a moderator analysis.ResultsTwenty-five trials (485 participants) with good methodological quality (Downs and Black) were identified. Quality of evidence was downgraded due to potential risk of bias (eg, confounding). Moderate-quality evidence indicates that unplanned tasks evoked significantly higher external knee abduction (SMD: 0.34, 95% CI: 0.16 to 0.51, 14 studies) and tibial internal rotation moments (SMD: 0.51, 95% CI: 0.23 to 0.79, 11 studies). No significant between-condition differences were detected for sagittal plane mechanics (p>0.05). According to the moderator analysis, increased abduction moments particularly occurred in non-professional athletes (SMD: 0.55, 95% CI: 0.14 to 0.95, 5 studies).ConclusionUnplanned movement entails higher knee abduction and tibial internal rotation moments, which could predispose for knee injury. Exercise professionals designing injury-prevention protocols, especially for non-elite athletes, should consider the implementation of assessments and exercises requiring time-constrained decision-making.PROSPERO registration numberCRD42019140331.
Published models that predict hospital readmission: a critical appraisal
Authors: Grossman Liu Lisa , Rogers James R , Reeder Rollin , Walsh Colin G , Kansagara Devan , Vawdrey David K , Salmasian Hojjat 
Published: August 2021

IntroductionThe number of readmission risk prediction models available has increased rapidly, and these models are used extensively for health decision-making. Unfortunately, readmission models can be subject to flaws in their development and validation, as well as limitations in their clinical usefulness.ObjectiveTo critically appraise readmission models in the published literature using Delphi-based recommendations for their development and validation.MethodsWe used the modified Delphi process to createCritical Appraisal of Models that Predict Readmission(CAMPR), which lists expert recommendations focused on development and validation of readmission models. Guided by CAMPR, two researchers independently appraised published readmission models in two recent systematic reviews and concurrently extracted data to generate reference lists of eligibility criteria and risk factors.ResultsWe found that published models (n=81) followed 6.8 recommendations (45%) on average. Many models had weaknesses in their development, including failure to internally validate (12%), failure to account for readmission at other institutions (93%), failure to account for missing data (68%), failure to discuss data preprocessing (67%) and failure to state the model’s eligibility criteria (33%).ConclusionsThe high prevalence of weaknesses in model development identified in the published literature is concerning, as these weaknesses are known to compromise predictive validity. CAMPR may support researchers, clinicians and administrators to identify and prevent future weaknesses in model development.
Increasing postpartum IUCD coverage through a QI initiative: a step towards reducing the unmet need of postpartum contraception
Authors: Agrawal Swati , Puri Manju , Singh Anuradha , Sehrawat Sushma , Sood Shilpa , Choudhary Kavita , Handa Anu , Induja R , Bardhan Apurwa , Luthra Pooja , Pawar Preeti , Singh Nidhi , Tyagi Swati , Antony Jismaria , Arora Priyanka , Ghai Sukriti , Shubham Tanya , Suraiya Vaishali , Sapna Surabhi , Ajithkumar Mani 
Published: August 2021

BackgroundUnintended pregnancies have a negative impact on the health and economy of a nation, which can be prevented by effective family planning (FP) services. Postpartum intrauterine device (PPIUCD) is a safe and effective FP method which allows women to obtain long-acting contraception before discharge from the point of delivery. We observed poor coverage of deliveries with PPIUCD at our facility. This was the trigger to initiate a quality improvement (QI) initiative to increase the PPIUCD coverage from current rate of 4.5%–10% in 3-month period.MethodA fishbone analysis of the problem was done and the following causes were identified: lack of focused counselling for FP, lack of sensitisation and training of resident doctors and inconsistent supply of intrauterine contraceptive devices (IUCDs). A QI team was constituted with representatives from faculty members, residents, interns, nursing officers and FP counsellors. The point of care quality improvement methodology was used.InterventionsDaily counselling of antenatal women was started by the counsellors and interns in antenatal wards. A WhatsApp group of residents was made initially to sensitise them; and later for parking of problems and trouble shooting. The residents were provided hands-on training at skills lab. Uninterrupted supply of IUCDs was ensured by provision of buffer stock of IUCDs with respective store keepers.ResultThe PPIUCD insertion rates improved from 4.5% to 19.2% at 3 months and have been sustained to a current 30%–35% after 1 ½ years of initiation of the project tiding through the turbulence during the COVID-19 pandemic using QI techniques.ConclusionSensitisation and training of residents as well as creation of awareness among antenatal women through targeted counselling helped improve PPIUCD coverage at the facility. QI initiatives have the potential to facilitate effective implementation of the FP programmes by strategic utilisation of the resources.
Rationalising antibiotic use after low-risk vaginal deliveries in a hospital setting in India
Authors: Sharma Shakti , Kumari Nikita , Sengupta Rinku , Malhotra Yashika , Bhartia Saru 
Published: August 2021

BackgroundIn 2017, a postoperative multidrug resistant case of urinary tract infection made obstetricians at Sitaram Bhartia Institute of Science and Research introspect the antibiotic usage in labouring mothers. Random case file reviews indicated overuse and variability of practice among care providers. This prompted us to explore ways to rationalise antibiotic use.MethodsA multidisciplinary team of obstetricians, paediatricians and quality officers was formed to run this improvement initiative at a private hospital facility in India. Review of literature advocated formulating a departmental antibiotic policy. Creating this policy and implementing it using improvement methodology helped us rationalise antibiotic usage.InterventionsWe aimed to reduce the use of antibiotics from 42% to less than 10% in uncomplicated vaginal deliveries. We tested a series of sequential interventions using the improvement methodology of Plan–Do–Study–Act (PDSA) cycles, an approach recommended by the Institute for Healthcare Improvement. Learning from the PDSA cycle of the previous intervention helped decide the subsequent change ideas. The interventions included creation of a departmental antibiotic policy, staff engagement, and modification in documentation, concept of dual responsibility and team huddles as feedback opportunities. Information was analysed to understand the progress and improvement with change ideas.ResultsBackground analysis revealed that antibiotic usage ranged from 24% to 69% and average rate of antibiotic prophylaxis was high (42.28%) in low-risk uncomplicated vaginal deliveries. The sequential changes resulted in reduction in antibiotic usage to 10% in the target population by 4 months. Sustained improvement was noted in the following months.ConclusionWe succeeded in implementing a departmental antibiotic policy aligning it with existing international guidelines and our local challenges. Antibiotic stewardship was one of the first major steps in our journey to avoid multidrug-resistant infections. Sustaining outcomes will involve continuous feedback to ensure engagement of all stakeholders in a hospital setting.
“We have either obsolete knowledge, obsolete equipment or obsolete skills”: policy-makers and clinical managers’ views on maternal health delivery in rural Nigeria
Authors: Udenigwe Ogochukwu , Okonofua Friday E , Ntoimo Lorretta F C , Imongan Wilson , Igboin Brian , Yaya Sanni 
Published: August 2021

ObjectiveThe objective of this paper is to explore policy-makers and clinical managers’ views on maternal health service delivery in rural Nigeria.DesignThis is a qualitative study using key informant interviews. Participants’ responses were audio recorded and reflective field notes supplemented the transcripts. Data were further analysed with a deductive approach whereby themes were organised based on existing literature and theories on service delivery.SettingThe study was set in Esan South East (ESE) and Etsako East (ETE), two mainly rural local government areas of Edo state, Nigeria.ParticipantsThe study participants consisted of 13 key informants who are policy-makers and clinical managers in ESE and ETE in Edo state. Key informants were chosen using a purposeful criterion sampling technique whereby participants were identified because they meet or exceed a specific criterion related to the subject matter.ResultsRespondents generally depicted maternal care services in primary healthcare centres as inaccessible due to undue barriers of cost and geographic location but deemed it acceptable to women. Respondents’ notion of quality of service delivery encompassed factors such as patient-provider relationships, hygienic conditions of primary healthcare centres, availability of skilled healthcare staff and infrastructural constraints.ConclusionThis study revealed that while some key aspects of service delivery are inadequate in rural primary healthcare centres, there are promising policy reforms underway to address some of the issues. It is important that health officials advocate for strong policies and implementation strategies.
Antibiotic use differentially affects the risk of anti-drug antibody formation during anti-TNFα therapy in inflammatory bowel disease patients: a report from the epi-IIRN
Authors: Gorelik Yuri , Freilich Shay , Gerassy-Vainberg Shiran , Pressman Sigal , Friss Chagit , Blatt Alexandera , Focht Gili , Weisband Yiska Loewenberg , Greenfeld Shira , Kariv Revital , Lederman Nathan , Dotan Iris , Geva-Zatorsky Naama , Shen-Orr Shai Shlomo , Kashi Yechezkel , Chowers Yehuda 
Published: August 2021

ObjectiveAnti-drug antibodies (ADA) to anti-tumour necrosis factor (anti-TNF) therapy drive treatment loss of response. An association between intestinal microbial composition and response to anti-TNF therapy was noted. We therefore aimed to assess the implications of antibiotic treatments on ADA formation in patients with inflammatory bowel disease (IBD).DesignWe analysed data from the epi-IIRN (epidemiology group of the Israeli IBD research nucleus), a nationwide registry of all patients with IBD in Israel. We included all patients treated with anti-TNF who had available ADA levels. Survival analysis with drug use as time varying covariates were used to assess the association between antibiotic use and ADA development. Next, specific pathogen and germ-free C57BL mice were treated with respective antibiotics and challenged with infliximab. ADA were assessed after 14 days.ResultsAmong 1946 eligible patients, with a median follow-up of 651 days from initiation of therapy, 363 had positive ADA. Cox proportional hazard model demonstrated an increased risk of ADA development in patients who used cephalosporins (HR=1.97, 95% CI 1.58 to 2.44), or penicillins with β-lactamase inhibitors (penicillin-BLI, HR=1.4, 95% CI 1.13 to 1.74), whereas a reduced risk was noted in patients treated with macrolides (HR=0.38, 95% CI 0.16 to 0.86) or fluoroquinolones (HR=0.20, 95% CI 0.12 to 0.35). In mice exposed to infliximab, significantly increased ADA production was observed in cephalosporin as compared with macrolide pretreated mice. Germ-free mice produced no ADA.ConclusionADA production is associated with the microbial composition. The risk of ADA development during anti-TNF therapy can possibly be reduced by avoidance of cephalosporins and penicillin-BLIs, or by treatment with fluoroquinolones or macrolides.
Anticoagulation trends in adults aged 65 years and over with atrial fibrillation: a cohort study
Authors: Lund Jenny , Saunders Catherine L , Edwards Duncan , Mant Jonathan 
Published: August 2021

ObjectiveTo describe patterns of anticoagulation prescription and persistence for those aged ≥65 years with atrial fibrillation (AF).MethodsDescriptive cohort study using electronic general practice records of patients in England, who attended an influenza vaccination aged ≥65 years and were diagnosed with AF between 2008 and 2018. Patients were stratified by 10-year age group and year of diagnosis. Proportion anticoagulated, type of anticoagulation (direct oral anticoagulant (DOAC) or warfarin) initiated at diagnosis and persistence with anticoagulation over time are reported.Results42 290 patients (49% female), aged 65–74 (n=11 722), 75–84 (n=19 055) and 85+ (n=11 513) years at AF diagnosis are included. Prescription of anticoagulation at diagnosis increased over the time period from 55% to 86% in people aged 65–74 years, from 54% to 86% in people aged 75–84 years and from 27% to 75% in people aged 85 years and over. By 2018, 92% of patients with newly diagnosed AF were started on a DOAC. Survivor function for 5-year persistence in patients prescribed DOAC was 0.80 (95% CI 0.77 to 0.82) and for warfarin 0.71 (95% CI 0.70 to 0.72). Survivor function for any anticoagulation at 5 years was 0.79 (95% CI 0.78 to 0.81), 0.73 (95% CI 0.72 to 0.75) and 0.58 (95% CI 0.59 to 0.64) for people aged 65–74, 75–84 and 85+ years, respectively.ConclusionsRates of anticoagulation in AF in those aged ≥65 years have increased from 2008 to 2018, over which time period there has been a shift from initiating anticoagulation with warfarin to DOAC. Persistence with anticoagulation is higher in people on DOACs than on warfarin and in people aged <85 years.
Patterns of anxiety and distress over 12 months following participation in HPV primary screening
Authors: Marlow Laura A V , McBride Emily , Ridout Deborah , Forster Alice S , Kitchener Henry , Waller Jo 
Published: August 2021

ObjectivesMany countries are now using primary human papillomavirus (HPV) testing for cervical screening, testing for high-risk HPV and using cytology as triage. An HPV-positive result can have an adverse psychological impact, at least in the short term. In this paper, we explore the psychological impact of primary HPV screening over 12 months.MethodsWomen were surveyed soon after receiving their results (n=1133) and 6 (n=762) and 12 months (n=537) later. Primary outcomes were anxiety (Short-Form State Anxiety Inventory-6) and distress (General Health Questionnaire-12). Secondary outcomes included concern, worry about cervical cancer and reassurance. Mixed-effects regression models were used to explore differences at each time point and change over time across four groups according to their baseline result: control (HPV negative/HPV cleared/normal cytology and not tested for HPV); HPV positive with normal cytology; HPV positive with abnormal cytology; and HPV persistent (ie, second consecutive HPV-positive result).ResultsWomen who were HPV positive with abnormal cytology had the highest anxiety scores at baseline (mean=42.2, SD: 15.0), but this had declined by 12 months (mean=37.0, SD: 11.7) and was closer to being within the ‘normal’ range (scores between 34 and 36 are considered ‘normal’). This group also had the highest distress at baseline (mean=3.3, SD: 3.8, scores of 3+ indicate case-level distress), but the lowest distress at 12 months (mean=1.9, SD: 3.1). At 6 and 12 months, there were no between-group differences in anxiety or distress for any HPV-positive result group when compared with the control group. The control group were less concerned and more reassured about their result at 6 and 12 months than the HPV-positive with normal cytology group.ConclusionsOur findings suggest the initial adverse impact of an HPV-positive screening result on anxiety and distress diminishes over time. Specific concerns about the result may be longer lasting and efforts should be made to address them.
Dynamical analysis and statefinder of Barrow holographic dark energy
Authors: Huang Qihong , Huang He , Xu Bing , Tu Feiquan , Chen Jun 
Published: August 2021

AbstractBased on the holographic principle and the Barrow entropy, Barrow holographic dark energy had been proposed. In order to analyze the stability and the evolution of Barrow holographic dark energy, we, in this paper, apply the dynamical analysis and statefinder methods to Barrow holographic dark energy with different IR cutoff and interacting terms. In the case of using Hubble horizon as IR cutoff with the interacting term $$Q=\frac{\lambda }{H}\rho _{m}\rho _{D}$$

Q
=

λ
H

ρ
m

ρ
D

, we find this model is stable and can be used to describe the whole evolution of the universe when the energy transfers from the pressureless matter to the Barrow holographic dark energy. When the dynamical analysis method is applied to this stable model, an attractor corresponding to an accelerated expansion epoch exists and this attractor can behave as the cosmological constant. Furthermore, the coincidence problem can be solved in this case. Then, after using the statefinder analysis method to this model, we find this model can be discriminated from the standard $$\Lambda $$
Λ
CDM model. Finally, we have discussed the turning point of Hubble diagram in Barrow holographic dark energy and find the turning point does not exist in this model.
FDA Approval Summary: Capmatinib and Tepotinib for the Treatment of Metastatic NSCLC Harboring MET Exon 14 Skipping Mutations or Alterations
Authors: Mathieu Luckson N. , Larkins Erin , Akinboro Oladimeji , Roy Pourab , Amatya Anup K. , Fiero Mallorie H. , Mishra-Kalyani Pallavi S. , Helms Whitney S. , Myers Claire E. , Skinner Amy M. , Aungst Stephanie , Jin Runyan , Zhao Hong , Xia Huiming , Zirkelbach Jeanne Fourie , Bi Youwei , Li Yangbing , Liu Jiang , Grimstein Manuela , Zhang Xinyuan , Woods Stacie , Reece Kelie , Abukhdeir Abdelrahmman M. , Ghosh Soma , Philip Reena , Tang Shenghui , Goldberg Kirsten B. , Pazdur Richard , Beaver Julia A. , Singh Harpreet 
Published: August 2021

Abstract
The FDA approved capmatinib and tepotinib on May 6, 2020, and February 3, 2021, respectively. Capmatinib is indicated for patients with metastatic non–small cell lung cancer (mNSCLC) whose tumors have a mutation leading to mesenchymal–epithelial transition (MET) exon 14 skipping as detected by an FDA-approved test. Tepotinib is indicated for mNSCLC harboring MET exon 14 skipping alterations. The approvals were based on trials GEOMETRY mono-1 (capmatinib) and VISION (tepotinib). In GEOMETRY mono-1, overall response rate (ORR) per Blinded Independent Review Committee (BIRC) was 68% [95% confidence interval (CI), 48–84] with median duration of response (DoR) 12.6 months (95% CI, 5.5–25.3) in 28 treatment-naïve patients and 41% (95% CI: 29, 53) with median DoR 9.7 months (95% CI, 5.5–13) in 69 previously treated patients with NSCLC with mutations leading to MET exon 14 skipping. In VISION, ORR per BIRC was 43% (95% CI: 32, 56) with median DoR 10.8 months (95% CI, 6.9–not estimable) in 69 treatment-naïve patients and 43% (95% CI, 33–55) with median DoR 11.1 months (95% CI, 9.5–18.5) in 83 previously-treated patients with NSCLC harboring MET exon 14 alterations. These are the first two therapies to be FDA approved specifically for patients with metastatic NSCLC with MET exon 14 skipping.