bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of intensive care unit-specific virtual reality (ICU-VR) to improve psychological well-being and quality of life in COVID-19 ICU survivors: a study protocol for a multicentre, randomized controlled trial
Authors: Vlake Johan H. , Van Bommel Jasper , Wils Evert-Jan , Korevaar Tim I. M. , Hellemons Merel E. , Schut Anna F. C. , Labout Joost A. M. , Schreuder Lois L. H. , Gommers Diederik , Van Genderen Michel E. 
Published: May 2021

AbstractBackgroundThe SARS-CoV-2 outbreak has resulted in a tremendous increase in hospital and intensive care unit (ICU) admissions all over the world. Patients with severe coronavirus disease 2019 (COVID-19) warranting ICU treatment usually have prolonged mechanical ventilation and are expected to be prone to develop psychological impairments, such as post-traumatic stress disorder (PTSD), anxiety and depression, which negatively impact quality of life. To date, no effective treatment strategy is available. In the current trial, we aim to assess the effect of an ICU-specific virtual reality (ICU-VR) intervention on psychological well-being and quality of life after COVID-19 ICU treatment.MethodsIn this multicentre, randomized controlled trial, we aim to examine whether COVID-19-specific ICU-VR, offered 3 months after hospital discharge, improves psychological well-being and quality of life. Secondary objectives are, firstly, to examine the intra-group changes in psychological well-being and quality of life and the inter-group differences in psychological well-being and quality of life during follow-up, up to 12 months after hospital discharge, and secondly, to examine patients’ satisfaction with and rating of ICU care and aftercare and patients’ perspectives on ICU-VR. Eighty adult patients treated for COVID-19 in the mixed-surgical ICUs of four hospitals in Rotterdam, the Netherlands, will be included and randomized (1:1) to either early or late ICU-VR between June 29 and December 31, 2020. Patients randomized to early ICU-VR will receive the ICU-VR intervention during an outpatient clinic visit 3 months after hospital discharge, whereas patients randomized to late ICU-VR will receive ICU-VR 6 months after hospital discharge. Primary outcomes of this study are psychological well-being, assessed using the Impact of Event Scale–Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), and quality of life, assessed using the European Quality of Life 5 Dimensions (EQ-5D) and RAND-36 questionnaires, up to 6 months after hospital discharge.DiscussionCurrently, an effective treatment for psychological sequelae after ICU treatment for specific illnesses is unavailable. Results from this study will provide insight whether virtual reality is a modality that can be used in ICU aftercare to improve psychological well-being and quality of life, or satisfaction, after ICU treatment for specific illnesses such as COVID-19.Trial registrationThis trial has been retrospectively registered on the Netherlands Trial Register on August 14, 2020 (NL8835).
Effects of different ischemic preconditioning occlusion pressures on muscle damage induced by eccentric exercise: a study protocol for a randomized controlled placebo clinical trial
Authors: Pizzo Junior Eduardo , de Souza Cavina Allysiê Priscilla , Lemos Leonardo Kesrouani , Biral Taíse Mendes , Pastre Carlos Marcelo , Vanderlei Franciele Marques 
Published: May 2021

Abstract
Introduction
Due to its greater generation of muscle strength and less metabolic demand, eccentric exercise has been widely used in rehabilitation and for improving physical fitness. However, eccentric exercise can induce muscle damage by providing structural changes and reduced muscle function, so even with the protection caused by the repeated bout effect from eccentric exercise, it is necessary to seek alternatives to reduce this damage caused by stress. Thus, ischemic preconditioning could represent an aid to reduce the damage muscle or increase the protective effect caused by eccentric exercise.

Objectives
To compare the effects of ischemic preconditioning, using different occlusion pressures, on acute and delayed responses to perceptual outcomes, markers of muscle damage, and performance in post-eccentric exercise recovery.

Methods
A randomized controlled placebo clinical trial will be carried out with 80 healthy men aged 18 to 35 years who will be randomly divided into four groups: ischemic preconditioning using total occlusion pressure, ischemic preconditoning with 40% more than total occlusion pressure, placebo (10 mmHg), and control. The ischemic preconditioning protocol will consist of four cycles of ischemia and reperfusion of five minutes each. All groups will perform an eccentric exercise protocol, and assessments will be carried out before, immediately after, and 24, 48, 72, and 96 h after the end of the eccentric exercise to evaluate creatine kinase, blood lactate, perception of recovery using the Likert scale, being sequentially evaluated, pain by the visual analog scale, pain threshold using a pressure algometer, muscle thickness by ultrasound, muscle tone, stiffness and elasticity by myotonometry, vectors of cell integrity through electrical bioimpedance, and maximal voluntary isometric contraction using the isokinetic dynamometer. The trial was registered at ClinicalTrials.gov (NCT04420819).

Discussion
The present study aims to present an alternative technique to reduce muscle damage caused by eccentric exercise, which is easy to apply and low cost. If the benefits are proven, ischemic preconditioning could be used in any clinical practice that aims to minimize the damage caused by exercise, presenting an advance in the prescription of eccentric exercise and directly impacting on the results of post-exercise recovery.

Trial registration
ClinicalTrials.gov NCT04420819. Registered on 19 May 2020; Last update 24 March 2021.
Mental health specialist video consultations versus treatment as usual in patients with depression or anxiety disorders in primary care: study protocol for an individually randomised superiority trial (the PROVIDE-C trial)
Authors: Haun Markus W. , Tönnies Justus , Krisam Regina , Kronsteiner Dorothea , Wensing Michel , Szecsenyi Joachim , Vomhof Markus , Icks Andrea , Wild Beate , Hartmann Mechthild , Friederich Hans-Christoph 
Published: May 2021

Abstract
Background
Most people with mental disorders, including those with severe and chronic disorders, are treated solely by their general practitioner (GP). Nevertheless, specialised mental health care may be required for specific patients. Notably, the accessibility of mental health specialist care is mainly complicated by (a) long waiting times for an appointment with specialists, (b) long travel distances to specialists, particularly in rural and remote areas, and (c) patients’ reservations about mental health specialist care (including fear of being stigmatised by seeking such care). To mitigate those barriers, technology-based integrated care models have been proposed. The purpose of this study is to examine the effectiveness and cost-effectiveness of a mental health specialist video consultations model versus treatment as usual in patients with depression or anxiety disorders in primary care.

Methods
In an individually randomised, prospective, two-arm superiority trial with parallel group design, N = 320 patients with anxiety and/or depressive disorder will be recruited in general practices in Germany. The intervention includes a newly developed treatment model based on video consultations with focus on diagnostics, treatment planning, and short-term intervention by mental health specialists. We will systematically compare the effectiveness, cost-effectiveness, and adverse effects of this new model with usual care by the GP: the primary outcome is the absolute change in the mean depressive and anxiety symptom severity measured on the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) from baseline to 6 months after baseline assessment. Follow-up in both groups will be conducted by blinded outcome assessors at 6 months and 12 months after baseline. The main analysis will be based on the intention-to-treat principle. We will optimise the likelihood of treatment effectiveness by strict inclusion criteria for patients, enhanced intervention integrity, and conducting a process evaluation.

Discussion
To the best of our knowledge, this is the first confirmatory study on a video-based, integrated care model for the treatment of anxiety and depressive disorders in GP patients in Germany.

Trial registration
ClinicalTrials.gov, United States National Institutes of Health NCT04316572. Prospectively registered on 20 March 2020.
Phylogroup stability contrasts with high within sequence type complex dynamics of Escherichia coli bloodstream infection isolates over a 12-year period
Authors:   COLIBAFI and SEPTICOLI groups, Royer Guilhem , Darty Mélanie Mercier , Clermont Olivier , Condamine Bénédicte , Laouenan Cédric , Decousser Jean-Winoc , Vallenet David , Lefort Agnès , de Lastours Victoire , Denamur Erick 
Published: May 2021

AbstractBackgroundEscherichia coliis the leading cause of bloodstream infections, associated with a significant mortality. Recent genomic analyses revealed that few clonal lineages are involved in bloodstream infections and captured the emergence of some of them. However, data on within sequence type (ST) population genetic structure evolution are rare.MethodsWe compared whole genome sequences of 912E.coliisolates responsible for bloodstream infections from two multicenter clinical trials that were conducted in the Paris area, France, 12 years apart, in teaching hospitals belonging to the same institution (“Assistance Publique-Hôpitaux de Paris”). We analyzed the strains at different levels of granularity, i.e., the phylogroup, the ST complex (STc), and the within STc clone taking into consideration the evolutionary history, the resistance, and virulence gene content as well as the antigenic diversity of the strains.ResultsWe found a mix of stability and changes overtime, depending on the level of comparison. Overall, we observed an increase in antibiotic resistance associated to a restricted number of genetic determinants and in strain plasmidic content, whereas phylogroup distribution and virulence gene content remained constant. Focusing on STcs highlighted the pauci-clonality of the populations, with only 11 STcs responsible for more than 73% of the cases, dominated by five STcs (STc73, STc131, STc95, STc69, STc10). However, some STcs underwent dramatic variations, such as the global pandemic STc131, which replaced the previously predominant STc95. Moreover, within STc131, 95 and 69 genomic diversity analysis revealed a highly dynamic pattern, with reshuffling of the population linked to clonal replacement sometimes coupled with independent acquisitions of virulence factors such as thepapgene cluster bearing apapGIIallele located on various pathogenicity islands. Additionally, STc10 exhibited huge antigenic diversity evidenced by numerous O:H serotype/fimHallele combinations, whichever the year of isolation.ConclusionsAltogether, these data suggest that the bloodstream niche is occupied by a wide but specific phylogenetic diversity and that highly specialized extra-intestinal clones undergo frequent turnover at the within ST level. Additional worldwide epidemiological studies overtime are needed in different geographical and ecological contexts to assess how generalizable these data are.
Anticancer drugs repurposed for Alzheimer’s disease: a systematic review
Authors: Ancidoni Antonio , Bacigalupo Ilaria , Remoli Giulia , Lacorte Eleonora , Piscopo Paola , Sarti Giulia , Corbo Massimo , Vanacore Nicola , Canevelli Marco 
Published: May 2021

Abstract
Background
The relationship between cancer and dementia is triggering growing research interest. Several preclinical studies have provided the biological rationale for the repurposing of specific anticancer agents in Alzheimer’s disease (AD), and a growing number of research protocols are testing their efficacy and safety/tolerability in patients with AD.

Methods
The aim of the present systematic review was to provide an overview on the repurposing of approved anticancer drugs in clinical trials for AD by considering both ongoing and completed research protocols in all phases. In parallel, a systematic literature review was conducted on PubMed, ISI Web, and the Cochrane Library to identify published clinical studies on repurposed anticancer agents in AD.

Results
Based on a structured search on the ClinicalTrials.gov and the EudraCT databases, we identified 13 clinical trials testing 11 different approved anticancer agents (five tyrosine kinase inhibitors, two retinoid X receptor agonists, two immunomodulatory agents, one histone deacetylase inhibitor, and one monoclonal antibody) in the AD continuum. The systematic literature search led to the identification of five published studies (one phase I, three phase II, and one phase IIb/III) reporting the effects of antitumoral treatments in patients with mild cognitive impairment or AD dementia. The clinical findings and the methodological characteristics of these studies are described and discussed.

Conclusion
Anticancer agents are triggering growing interest in the context of repurposed therapies in AD. Several clinical trials are underway, and data are expected to be available in the near future. To date, data emerging from published clinical studies are controversial. The promising results emerging from preclinical studies and identified research protocols should be confirmed and extended by larger, adequately designed, and high-quality clinical trials.
An electrical conductivity model of a coastal geothermal field in southeastern China based on 3D magnetotelluric imaging
Authors: Han Qi , Kelbert Anna , Hu Xiangyun 
Published: May 2021

The hydrology and geology of the Xinzhou geothermal field in South China and its surrounding area have been well studied. Previous studies have indicated that mantle heat, granite radioactive heat, and partial melting are the likely key thermal sources. However, neither the geometry of the geothermal reservoir nor the groundwater circulation pattern has been fully characterized. Toward that aim, a grid of magnetotelluric (MT) data has been acquired to reveal the subsurface distribution of electrical conductivity and to detect the geothermal reservoir. An analysis of the phase tensors suggests that 3D MT inversion is essential for accurate interpretation of the data. We perform a 3D full-impedance MT inversion and observe pronounced low electrical conductivity zones in the inverse model. We interpret these materials as widely developed granites that form the bedrock, which is cut by a crisscross of faults. The cracks in the bedrock provide pathways for the vertical and lateral movement of the hydrothermal fluid. The geothermal reservoir appears as a prominent high electrical conductivity anomaly beneath the hot spring. A northwest-dipping zone of enhanced electrical conductivity reaching approximately 6–7 km in depth is found in the southeast part of the study area, and it is interpreted as the geothermal reservoir recharge channel. We develop an inferred underground fluid circulation model, informed by the electrical conductivity of the area, in combination with hydrologic data. We suggest that the water supply of the Xinzhou geothermal field mainly comes from meteoric water, which is mixed with the invading seawater and shallow cold groundwater as it rises along the fault. The results of our MT study confirm earlier inferences that the Xinzhou geothermal field belongs to an intraplate deep-circulation type originated from the mantle heat flow.
Stress-dependent elasticity and wave propagation — New insights and connections
Authors: Sripanich Yanadet , Vasconcelos Ivan , Tromp Jeroen , Trampert Jeannot 
Published: May 2021

To establish a consistent framework for seismic wave propagation that accommodates the effects of stress changes, it is critical to take into account the different definitions of stress and their corresponding effects on seismic quantities (e.g., wave speeds) as dictated by continuum mechanics. Revisiting this fundamental theoretical foundation, we first emphasize the role of stress within various forms of the wave equation resulting from different choices of stress definitions. Subsequently, using this basis, we investigate connections among existing theories that describe the variation of elastic moduli as a function of changes in stress. We find that there is a direct connection between predicting stress-induced elastic changes with the well-known third-order elasticity tensor and the recently proposed adiabatic pressure derivatives of elastic moduli. However, each of these approaches has different merits and drawbacks in terms of experimental validation as well as in their use. In addition, we investigate the connection with another general approach that relies on micromechanical structures (e.g., cracks and pores). Although this can be done algebraically, it remains unclear as to which definition of stress and which corresponding constitutive relationship should be considered in practical scenarios. We support our analysis with validations using previously published benchmark experimental data.
The Smarter Sleep educational interventions: an initiative to reduce hypnotic prescribing in in-patient psychiatric care
Authors: Paterson Alastair , Khundakar Martina , Young Anthony , Ling Jonathan , Chakraborty Samantha , Rathbone Adam Pattison , Watson Stuart , Donaldson Tim , Anderson Kirstie N. 
Published: May 2021

Aims and methodIn-patients on mental health wards are commonly prescribed hypnotics for the long-term management of disturbed sleep. Specific sleep disorders remain underdiagnosed and effective behavioural interventions are underused. We developed a suite of three educational interventions (a video, poster and handbook) about sleep, sleep disorders, the safe prescribing of hypnotics and use of psychological strategies (sleep hygiene and cognitive–behavioural therapy for insomnia, CBTi) using co-design and multiprofessional stakeholder involvement. This controlled before-and-after study evaluated the effectiveness of these interventions across seven in-patient psychiatric wards, examining their impact on hypnotic prescribing rates and staff confidence scores (data collected by retrospective drug chart analysis and survey respectively).ResultsA marked reduction was seen in the percentage of patients prescribed hypnotics on in-patient prescription charts (−24%), with a 41% reduction in the number of hypnotics administered per patient (mean reduction −1.142 administrations/patient).Clinical implicationsThese simple educational strategies about the causes and treatment of insomnia can reduce hypnotic prescribing rates and increase staff confidence in both the medical and psychological management of insomnia.
Prospective Statewide Study of Universal Screening for Hereditary Colorectal Cancer: The Ohio Colorectal Cancer Prevention Initiative
Authors: Pearlman Rachel , Frankel Wendy L. , Swanson Benjamin J. , Jones Dan , Zhao Weiqiang , Yilmaz Ahmet , Miller Kristin , Bacher Jason , Bigley Christopher , Nelsen Lori , Goodfellow Paul J. , Goldberg Richard M. , Paskett Electra , Shields Peter G. , Freudenheim Jo L. , Stanich Peter P. , Lattimer Ilene , Arnold Mark , Prior Thomas W. , Haut Mitchell , Kalady Matthew F. , Heald Brandie , Paquette Ian , Draper David J. , Brell Joanna M. , Mahesh Sameer , Weeman Kisa , Bastola Shyamal , Zangmeister Jeffrey , Gowda Aruna , Kencana Filix , Malcolm Albert , Liu Yinong , Cole Sharon , Bane Charles , Li Chaoyang , Rehmus Esther , Pritchard Colin C. , Shirts Brian H. , Jacobson Angela , Cummings Shelly A. , de la Chapelle Albert , Hampel Heather 
Published: May 2021

PURPOSE Hereditary cancer syndromes infer high cancer risks and require intensive surveillance. Identification of high-risk individuals among patients with colorectal cancer (CRC) needs improvement. METHODS Three thousand three hundred ten unselected adults who underwent surgical resection for primary invasive CRC were prospectively accrued from 51 hospitals across Ohio between January 1, 2013, and December 31, 2016. Universal Tumor screening (UTS) for mismatch repair (MMR) deficiency was performed for all, and pathogenic germline variants (PGVs) were identified using multigene panel testing (MGPT) in those who met at least one inclusion criterion: MMR deficiency, diagnosed < 50 years, multiple primary tumors (CRC or endometrial cancer), or with a first-degree relative with CRC or endometrial cancer. RESULTS Five hundred twenty-five patients (15.9%) had MMR deficiency. Two hundred thirty-four of 3,310 (7.1%; 16% of the 1,462 who received MGPT) had 248 PGVs in cancer susceptibility genes. One hundred forty-two (4.3%) had a PGV in an MMR gene, and 101 (3.1%) had a PGV in a non-MMR gene. Ten with Lynch syndrome (LS) also had a non-MMR PGV and were included in both groups. Two (0.06%) had constitutional MLH1 hypermethylation. Of unexplained MMR-deficient patients, 88.4% (76 of 86) had double somatic MMR mutations. Testing for only MMR genes in MMR-deficient patients would have missed 18 non-MMR gene PGVs (7.3% of total PGVs identified). Had UTS been the only method used to screen for hereditary cancer syndromes, 38.6% (91 of 236) would have been missed, including 6.3% (9 of 144) of those with LS. These results have treatment implications as 5.3% (175 of 3,310) had PGVs in genes with therapeutic targets. CONCLUSION UTS alone is insufficient for identifying a large proportion of CRC patients with hereditary syndromes, including some with LS. At a minimum, 7.1% of individuals with CRC have a PGV and pan-cancer MGPT should be considered for all patients with CRC.
Thyroid Function During Pregnancy in A Multiethnic Population in Norway
Authors: Sletner Line , Jenum Anne Karen , Qvigstad Elisabeth , Hammerstad Sara Salehi 
Published: May 2021

Abstract

Context
Ethnic differences in thyroid function during pregnancy have been reported. However, it is unclear if this is equally valid across ethnic groups within multiethnic populations.

Objective
We aimed to assess ethnic differences in thyrotropin (TSH) and free thyroxine (FT4), and the prevalence of thyroid dysfunction and thyroid autoimmunity during pregnancy.

Methods
In a population-based cohort of 785 pregnant women in Oslo, Norway, TSH, FT4, and thyroid peroxidase antibodies (TPO Abs) were measured twice: at gestational week (GW) 15 and 28, and urine iodine concentration at GW 15. Associations were assessed using multivariate linear regression.

Results
We found ethnic differences in TSH levels at both time points, but not for fT4. South Asians had 0.42 mU/L (95% CI, 0.20-0.64) higher TSH than Europeans in GW 15. This difference persisted after adjusting for covariates (including TPO Ab positivity and iodine status), and increased further as pregnancy progressed. In contrast, East Asians had the lowest TSH. No new cases of overt hypothyroidism were detected in early pregnancy, but subclinical hypothyroidism was found in 6.6% among all, highest in South Asians (14.2%). Hyperthyroidism early in pregnancy was observed in 3.7% (almost all subclinical), highest in East Asians (11.9%). The prevalence of TPO Ab positivity was 4%, highest in South Asians (8%).

Conclusion
In a multiethnic population of presumably healthy women, we found ethnic variations in TSH but not FT4 levels throughout pregnancy. South Asians had higher TSH and more subclinical hypothyroidism, not explained by their higher prevalence of TPO Ab positivity. Larger studies are needed to define ethnic- and trimester-specific reference ranges in pregnancy.