bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Comprehensive School Health Program on Elementary Student Academic Achievement
Authors: Centeio Erin E. , Somers Cheryl , Moore E. Whitney G. , Kulik Noel , Garn Alex , McCaughtry Nate 
Published: January 2021

ABSTRACTBACKGROUNDImproving the academic achievement of youth in the United States is an area of interest and a critical indicator of the future success of the youth. The purpose of this study was to examine the impact of a comprehensive school physical activity and healthy eating program on 5th‐grade students' academic achievement, specifically reading and math.METHODSOverall, 628 (intervention: 377, 54% girls; comparison: 251, 49% girls) 5th‐grade children participated across the 6 schools in a year‐long comprehensive health intervention, completing curriculum‐based academic achievement measures at 2 time‐points.RESULTSResults showed that even after controlling for class clustering, age, sex, race, and T1 reading and math variables, students' T2 reading and math achievement were significantly higher in the intervention group than the comparison group.CONCLUSIONSComprehensive health programming can enhance the health and academic achievement of youth.
Ecology and spatial distribution of sand fly species in low endemic areas for American Tegumentary Leishmaniasis in the municipality of Seropédica, Rio de Janeiro, Brazil
Authors: Senne N. A. , Vilela T. S. , Sanavria A. , Santos H. A. , Rabello R. S. , Angelo I. C. 
Published: January 2021

AbstractDue to the fundamental role that sand flies (Diptera: Psychodidae) have in Leishmania spp. (Kinetoplastida: Trypanosomatidae) transmission, the objective of this study was to evaluate the ecology and spatial distribution of species circulating in the municipality of Seropédica, Rio de Janeiro, Brazil. A total of 17 371 specimens were collected between August 2016 and July 2017, and five species were identified: Nyssomyia intermedia (Lutz & Neiva, 1912), Migonemyia migonei (França, 1920), Nyssomyia whitmani (Antunes & Coutinho, 1939), Pintomyia pessoai (Coutinho & Barretto, 1940), and Pintomyia fischeri (Pinto, 1926). In relation to the number of sand flies collected, we observed a significant difference between rural and periurban areas and between the neighbourhoods. We observed that N. intermedia has a relatively greater adaptation to the peridomiciliary environment. This is the first report of Pi. pessoai and Pi. fischeri (only females) in Seropédica as well as the first record of the frequency of phlebotomine species focusing on some ecological indices and the spatial distribution of sand flies. The results presented here aimed to provide an insight into the spatial population dynamics of phlebotomine species in low endemic areas of American Tegumentary Leishmaniasis (ATL) in Seropédica, highlighting important areas for entomological surveillance.
Arterial carbon dioxide and bicarbonate rather than pH regulate cerebral blood flow in the setting of acute experimental metabolic alkalosis
Authors: Caldwell Hannah G. , Howe Connor A. , Chalifoux Carter J. , Hoiland Ryan L. , Carr Jay M. J. R. , Brown Courtney V. , Patrician Alexander , Tremblay Joshua C. , Panerai Ronney B. , Robinson Thompson G. , Minhas Jatinder S. , Ainslie Philip N. 
Published: January 2021

Key points
We investigated the influence of arterial () with and without acutely elevated arterial pH and bicarbonate ([HCO3–]) on cerebral blood flow (CBF) regulation in the internal carotid artery and vertebral artery.
We assessed stepwise iso‐oxic alterations in (i.e. cerebrovascular CO2 reactivity) prior to and following i.v. sodium bicarbonate infusion (NaHCO3–) to acutely elevate arterial pH and [HCO3–].
Total CBF was unchanged irrespective of a higher arterial pH at each matched stage of , indicating that CBF is acutely regulated by rather than arterial pH.
The cerebrovascular responses to changes in arterial H+/pH were altered in keeping with the altered relationship between and H+/pH following NaHCO3– infusion (i.e. changes in buffering capacity).
Total CBF was ∼7% higher following NaHCO3– infusion during isocapnic breathing providing initial evidence for a direct vasodilatory influence of HCO3– independent of levels.
AbstractCerebral blood flow (CBF) regulation is dependent on the integrative relationship between arterial (), pH and cerebrovascular tone; however, pre‐clinical studies indicate that intrinsic sensitivity to pH, independent of changes in or intravascular bicarbonate ([HCO3–]), principally influences cerebrovascular tone. Eleven healthy males completed a standardized cerebrovascular CO2 reactivity (CVR) test utilizing radial artery catheterization and Duplex ultrasound (CBF); consisting of matched stepwise iso‐oxic alterations in (hypocapnia: –5, –10 mmHg; hypercapnia: +5, +10 mmHg) prior to and following i.v. sodium bicarbonate (NaHCO3–; 8.4%, 50 mEq 50 mL–1) to elevate pH (7.408 ± 0.020 vs. 7.461 ± 0.030; P < 0.001) and [HCO3–] (26.1 ± 1.4 vs. 29.3 ± 0.9 mEq L–1; P < 0.001). Absolute CBF was not different at each stage of CO2 reactivity (P = 0.629) following NaHCO3–, irrespective of a higher pH (P < 0.001) at each matched stage of (P = 0.927). Neither hypocapnic (3.44 ± 0.92 vs. 3.44 ± 1.05% per mmHg ; P = 0.499), nor hypercapnic (7.45 ± 1.85 vs. 6.37 ± 2.23% per mmHg ; P = 0.151) reactivity to were altered pre‐ to post‐NaHCO3–. When indexed against arterial [H+], the relative hypocapnic CVR was higher (P = 0.019) and hypercapnic CVR was lower (P = 0.025) following NaHCO3–, respectively. These changes in reactivity to [H+] were, however, explained by alterations in buffering between and arterial H+/pH consequent to NaHCO3–. Lastly, CBF was higher (688 ± 105 vs. 732 ± 89 mL min–1, 7% ± 12%; P = 0.047) following NaHCO3– during isocapnic breathing providing support for a direct influence of HCO3– on cerebrovascular tone independent of . These data indicate that in the setting of acute metabolic alkalosis, CBF is regulated by rather than arterial pH.
A Modern Review on Jet Impingement Heat Transfer Methods
Authors: Ekkad Srinath V. , Singh Prashant 
Published: January 2021

Abstract
Jet impingement cooling is considered as one of the most effective heat transfer enhancement techniques. The primary mode of heat transfer enhancement is due to the flow stagnation. The effectiveness of jet impingement as a cooling technique is well documented; however, the application of jet impingement to different problems has been hindered by inability of manufacturing methods to incorporate impingement systems easily into cooling designs. Impingement heat transfer effectiveness can be further improved by improving the jet strength by modifying the jet holes, enhancing surface features, or adding swirl. With an increased usage of this cooling technique and additional modifications in geometry to further enhance the heat transfer capacity to suit different applications, this paper provides a much-needed review of the advancements in the effectiveness of this cooling technique. A comprehensive look at impingement cooling over a variety of modifications and applications with a focus on improved manufacturing techniques impacting novel design and implementation is provided for a variety of heat transfer enhancement applications.
Incidence and phenotypical variation of outer retina-associated hyperreflectivity in macular telangiectasia type 2
Authors: Mueller Stefanie , Gunnemann Frederic , Rothaus Kai , Book Marius , Faatz Henrik , Bird Alan , Pauleikhoff Daniel 
Published: January 2021

BackgroundMacular telangiectasia type 2 (MacTel) is a neurodegenerative disease resulting in photoreceptor loss. Optical coherence tomography (OCT) reveals outer retina-associated hyperreflectivity (ORaH) as part of this process. The purpose of this study was to describe the incidence and phenotypical variation of ORaH.MethodsDifferent parameters of ORaH were analysed: OCT characteristics (Spectralis SD-OCT), correlation with vascular changes (OCT angiography; OCTA 3×3 mm Optovue) and correlation with hyperpigmentation (autofluorescence/fundus images). ORaH was also evaluated regarding the grade of severity of photoreceptor loss (Disease Severity Scale).ResultsOf 220 eyes with MacTel type 2, 106 demonstrated ORaH. On OCT, the size, the extension into the inner retina and the contact with retinal pigment epithelium (RPE) of the ORaH were variable. On OCTA neovascularisation (NV) in the outer retina (OR) was present at the location of the ORaH in 97.6%. Increasing size of NV correlated with progressive photoreceptor loss. In 86.6% with NV, the flow signals were visible between the OR and the choriocapillaris. In 85.7%, the ORaH was associated with hyperpigmentation on autofluorescence and fundus colour images.ConclusionsThe presence of ORaH is associated with increasing photoreceptor loss and disease severity. In these more advanced cases of the present study, a variable presentation of ORaH in respect to size and form was seen, but in most cases, ORaH was in contact to the RPE. Additionally, ORaH was associated with hyperpigmentation and OR NV on OCTA. These results are consistent with the concept of ORaH representing fibrovascular OR-NV with RPE proliferation after contact with the RPE.
Driving medtech innovation and start-up company formation through successful joint academic/commercial fellowship
Authors: Sharif Faisal , Quinn Ian 
Published: January 2021

AimMedical devices (medtech) is a strong driver of innovation and new treatments in healthcare. Straddling the fields of engineering and healthcare, successful medtech development demands critical needs assessment, highly skilled medical engineering professionals, and the successful collaboration between medical and other experts. Optimal development and testing need an efficient dialogue with third parties, including regulators and payers. BioInnovate Ireland was established in 2011 as a multidisciplinary, structured programme to shape the future of medical device therapy based on innovation and interdisciplinary cross-fertilisation.Methods and results107 fellows have completed the programme covering 20 clinical areas. Fellows have funded companies at a rate of more than 1.5 companies per year which have attracted Irish and international seed funding in excess of €40 million, excluding undisclosed investments.ConclusionsA multidisciplinary programme targeting mature, experienced professionals can drive a highly successful medtech start-up culture in the right ecosystem.
Measures of trunk muscle strength and their measurement properties: a protocol for a systematic review and narrative synthesis of clinical measures
Authors: Althobaiti Shouq , Rushton Alison , Falla Deborah , Heneghan Nicola R 
Published: January 2021

IntroductionSpinal musculoskeletal conditions, including low back and neck pain, are leading causes of disability globally. The trunk muscles, which comprise muscles in the thoracic and lumbar regions, are essential for functional activities, necessitating mobility, motor control and strength. To investigate the effectiveness of interventions directed at improving trunk muscle strength, it is essential to have valid, reliable and responsive performance-based outcome measures (PBOM). While isokinetic dynamometry is considered the gold-standard PBOM, the associated costs, size/weight and operational complexity of this equipment preclude its use in a clinical setting. There is, therefore, a need to evaluate the measurement properties of alternative accessible measures of trunk strength. This systematic review therefore aims to investigate the measurement properties of PBOM of trunk muscle strength measures appropriate for use in a clinical setting.Methods and analysisThis protocol has been designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. CINAHL, Web of Science, Pedro, MEDLINE, EMBASE, SPORTDiscuss will be searched systematically from the database start date up to 16 April 2020, along with reference checking and the grey literature searching. Eligibility criteria include studies investigating measurement properties of PROM for trunk muscle strength for use in a clinical setting in adults with and without spinal musculoskeletal complaints. Two independent reviewers will determine the eligibility of the studies through screening process of titles, abstract and the full text. Both reviewers will assess the risk of bias using COnsensus-based Standards for the selection of health status Measurement Instruments risk-of-bias tool and then extract the data from included studies. The overall quality of the included studies will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A narrative synthesis will be carried out if meta-analysis is not applicable. Findings from this systematic review will aid clinicians and practitioners working in the field for example, sport, in using the most appropriate PBOM to measure trunk muscle strength.Ethics and disseminationNo research ethics application is needed as there are no patient data in this study. The results of this study will be submitted to a peer reviewed journal and presented at conferences.PROSPERO registration numberCRD42020167464.
Access to oxytocin and misoprostol for management of postpartum haemorrhage in Kenya, Uganda and Zambia: a cross-sectional assessment of availability, prices and affordability
Authors: Kibira Denis , Ooms Gaby Isabelle , van den Ham Hendrika A. , Namugambe Juliet Sanyu , Reed Tim , Leufkens Hubert GM , Mantel-Teeuwisse Aukje 
Published: January 2021

ObjectiveTo assess access (availability and affordability) to oxytocin and misoprostol at health facilities in Kenya, Uganda and Zambia to improve prevention and management of postpartum haemorrhage (PPH).DesignThe assessment was undertaken using data from Health Action International (HAI) research on sexual and reproductive health commodities based on a cross-sectional design adapted from the standardised WHO/HAI methodology.SettingData were collected from 376 health facilities in in Kenya, Uganda and Zambia in July and August 2017.Outcome measuresAvailability was calculated as mean percentage of sampled medicine outlets where medicine was found on the day of data collection. Medicine prices were compared with international reference prices (IRP) and expressed as median price ratios. Affordability was calculated using number of days required to pay for a standard treatment based on the daily income of the lowest paid government worker.ResultsAvailability of either oxytocin or misoprostol at health facilities was high; 81% in Kenya, 82% in Uganda and 76% in Zambia. Oxytocin was more available than misoprostol, and it was most available in the public sector in the three countries. Availability of misoprostol was highest in the public sector in Uganda (88%). Oxytocin and misoprostol were purchased by patients at prices above IRP, but both medicines cost less than a day’s wages and were therefore affordable. Availability of misoprostol was poor in rural settings where it would be more preferred due to lack of trained personnel and cold storage facilities required for oxytocin.ConclusionAvailability and affordability of either oxytocin or misoprostol at health facilities met the WHO benchmark of 80%. However, countries with limited resources should explore mechanisms to optimise management of PPH by improving access to misoprostol especially in rural areas.
Predicting survival in malignant pleural mesothelioma using routine clinical and laboratory characteristics
Authors: Gunatilake Samal , Lodge David , Neville Daniel , Jones Thomas , Fogg Carole , Bassett Paul , Begum Selina , Kerley Sumita , Marshall Laura , Glaysher Sharon , Elliott Scott , Stores Rebecca , Bishop Lesley , Chauhan Anoop 
Published: January 2021

IntroductionThe prognosis of malignant pleural mesothelioma (MPM) is poor, with a median survival of 8–12 months. The ability to predict prognosis in MPM would help clinicians to make informed decisions regarding treatment and identify appropriate research opportunities for patients. The aims of this study were to examine associations between clinical and pathological information gathered during routine care, and prognosis of patients with MPM, and to develop a 6-month mortality risk prediction model.MethodsA retrospective cohort study of patients diagnosed with MPM at Queen Alexandra Hospital, Portsmouth, UK between December 2009 and September 2013. Multivariate analysis was performed on routinely available histological, clinical and laboratory data to assess the association between different factors and 6-month survival, with significant associations used to create a model to predict the risk of death within 6 months of diagnosis with MPM.Results100 patients were included in the analysis. Variables significantly associated with patient survival in multivariate analysis were age (HR 1.31, 95% CI 1.09 to 1.56), smoking status (current smoker HR 3.42, 95% CI 1.11 to 4.20), chest pain (HR 2.14, 95% CI 1.23 to 3.72), weight loss (HR 2.13, 95% CI 1.18 to 3.72), platelet count (HR 1.05, 95% CI 1.00 to 1.10), urea (HR 2.73, 95% CI 1.31 to 5.69) and adjusted calcium (HR 1.47, 95% CI 1.10 to 1.94). The resulting risk model had a c-statistic value of 0.76. A Hosmer-Lemeshow test confirmed good calibration of the model against the original dataset.ConclusionRisk of death at 6 months in patients with a confirmed diagnosis of MPM can be predicted using variables readily available in clinical practice. The risk prediction model we have developed may be used to influence treatment decisions in patients with MPM. Further validation of the model requires evaluation of its performance on a separate dataset.
Evaluating the utility of tumour mutational signatures for identifying hereditary colorectal cancer and polyposis syndrome carriers
Authors: Georgeson Peter , Pope Bernard J , Rosty Christophe , Clendenning Mark , Mahmood Khalid , Joo Jihoon E , Walker Romy , Hutchinson Ryan A , Preston Susan , Como Julia , Joseland Sharelle , Win Aung Ko , Macrae Finlay A , Hopper John L , Mouradov Dmitri , Gibbs Peter , Sieber Oliver M , O'Sullivan Dylan E , Brenner Darren R , Gallinger Steve , Jenkins Mark A , Winship Ingrid M , Buchanan Daniel D 
Published: January 2021

ObjectiveGermline pathogenic variants (PVs) in the DNA mismatch repair (MMR) genes and in the base excision repair gene MUTYH underlie hereditary colorectal cancer (CRC) and polyposis syndromes. We evaluated the robustness and discriminatory potential of tumour mutational signatures in CRCs for identifying germline PV carriers.DesignWhole-exome sequencing of formalin-fixed paraffin-embedded (FFPE) CRC tissue was performed on 33 MMR germline PV carriers, 12 biallelic MUTYH germline PV carriers, 25 sporadic MLH1 methylated MMR-deficient CRCs (MMRd controls) and 160 sporadic MMR-proficient CRCs (MMRp controls) and included 498 TCGA CRC tumours. COSMIC V3 single base substitution (SBS) and indel (ID) mutational signatures were assessed for their ability to differentiate CRCs that developed in carriers from non-carriers.ResultsThe combination of mutational signatures SBS18 and SBS36 contributing >30% of a CRC’s signature profile was able to discriminate biallelic MUTYH carriers from all other non-carrier control CRCs with 100% accuracy (area under the curve (AUC) 1.0). SBS18 and SBS36 were associated with specific MUTYH variants p.Gly396Asp (p=0.025) and p.Tyr179Cys (p=5×10-5), respectively. The combination of ID2 and ID7 could discriminate the 33 MMR PV carrier CRCs from the MMRp control CRCs (AUC 0.99); however, SBS and ID signatures, alone or in combination, could not provide complete discrimination (AUC 0.79) between CRCs from MMR PV carriers and sporadic MMRd controls.ConclusionAssessment of SBS and ID signatures can discriminate CRCs from biallelic MUTYH carriers and MMR PV carriers from non-carriers with high accuracy, demonstrating utility as a potential diagnostic and variant classification tool.
Written in the stars: did your specialty choose you?
Authors: Morgan Holly , Collins Hannah , Moore Sacha , Eley Catherine 
Published: January 2021

AbstractPurpose of the studyEstablished over 2000 years ago, horoscopes remain a regular feature in contemporary society. We aimed to assess whether there could be a link between zodiac sign and medical occupation, asking the question—did your specialty choose you?Study designA questionnaire-based study was distributed using an online survey tool. Questions explored the zodiac sign, specialty preferences and personality features of physicians.Results1923 physicians responded between February and March 2020. Variations in personality types between different medical specialties were observed, introverts being highly represented in oncology (71.4%) and rheumatology (65.4%), and extroverts in sexual health (55%), gastroenterology (44.4%) and obstetrics and gynaecology (44.2%) (p&lt;0.01). Proportions of zodiac signs in each specialty also varied; for example, cardiologists were more likely to be Leo compared with Aries (14.4% vs 3.9%, p=0.047), medical physicians more likely Capricorn than Aquarius (10.4% vs 6.7%, p=0.02) and obstetricians and gynaecologists more likely Pisces than Sagittarius (17.5% vs 0%, p=0.036). Intensive care was the most commonly reported second choice career, but this also varied between zodiac signs and specialties. Fountain pen use was associated with extroversion (p=0.049) and gastroenterology (p&lt;0.01).ConclusionsPersonality types vary in different specialties. There may be links to zodiac signs which warrant further investigation.
Association between e-cigarette use initiated after cigarette smoking and smoking abstinence: a cross-sectional study among adolescent established smokers in the USA
Authors: Saller Franziska S , Agaku Israel T , Filippidis Filippos T 
Published: January 2021

BackgroundRecent years have seen a rapid increase in the popularity of electronic cigarettes (e-cigarettes) among adolescents in the USA. Evidence on their role in the continuation of or abstinence from cigarette smoking among young smokers remains scarce.ObjectiveTo examine the relationship between e-cigarette use initiated after cigarette smoking and abstinence from cigarette smoking among US adolescent established smokers.MethodsThe data were drawn from the 2015–2018 National Youth Tobacco Survey—a nationally representative survey of US middle and high school students. Multivariable logistic regression was used to assess the association between ever e-cigarette use and past 30-day abstinence from cigarette smoking. The analytical sample comprised ever established cigarette smokers with or without a history of e-cigarette use after smoking initiation.ResultsNeither experimental (adjusted OR 0.67, 95% CI 0.39–1.14) nor prior established (adjusted OR 1.56, 95% CI 0.96–2.56) nor current established (adjusted OR 0.65, 95% CI 0.41–1.03) e-cigarette use was statistically significantly associated with subsequent abstinence from cigarette smoking among adolescent ever established smokers. These findings were largely consistent across sensitivity analyses using alternative key definitions, although experimental and current established e-cigarette use was significantly negatively associated with past 6-month abstinence.ConclusionsWe found no evidence that e-cigarette use among US adolescents already smoking cigarettes is associated with subsequent abstinence from cigarette smoking; there was some evidence of an inverse association among experimental and current established e-cigarette users. These findings could inform future regulatory and public health efforts regarding youth e-cigarette use and the reduction of youth cigarette smoking in the USA.