bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Risk Factors in Concussion Events: A 5-Season Study in the French Top 14 Rugby Union Championship
Authors: Chéradame Jérémy , Piscione Julien , Carling Christopher , Guinoiseau Jean-Pierre , Dufour Bernard , Jacqmin-Gadda Hélène , Decq Philippe 
Published: April 2021

Background: Concussions are a source of major concern in rugby, and a limited number of studies have attempted to identify risk factors for these injuries. Purpose: To investigate the incidence of match concussion and associated risk factors, including individual workload, anthropometric variables, playing position, and season phase, in elite rugby union players. Study Design: Case-control study; Level of evidence 3. Methods: All concussions and explanatory variables were collected for every match over 5 consecutive seasons (2014-2018) in 1334 professional players participating in the French Top 14 championship. Concussion risk was estimated using mixed effects Poisson regression. Results: Mean match concussion incidence equated to 10.4 (95% CI, 9.3-11.5) concussions for 1000 hours of game exposure. A peak was reached in the 2016-2017 season (13.7; 95% CI, 11.0-16.5). A greater risk was observed in the playoffs as compared with the first phase of the season (incidence rate ratio, 3.96; 95% CI, 2.10-7.35). In comparison with other positions, half-backs incurred the highest rate of concussion events (incidence, 16.1; 95% CI, 11.8-20.3). Irrespective of playing position, those with greater height and lower body mass reported a higher risk of concussions ( P = .02), especially during tackling actions for lighter players ( P = .01) and during other match events for taller players ( P = .03). When adjusted for season phase, players who had accumulated a higher amount of playing time since the beginning of the season demonstrated a lower risk of concussion ( P = .005). Conclusion: Inter- and intraseasonal variations in concussion rates were observed. Within positional groups, lighter and taller players were more at risk, with the highest incidence generally observed in half-backs. Workload was measured by the number of matches played before a concussion event, and it appeared to have a protective rather than deleterious effect on concussion risk.
Perceptions of Peer Support for Victim-Survivors of Sexual Violence and Abuse: An Exploratory Study With Key Stakeholders
Authors: Gregory Alison , Johnson Emma , Feder Gene , Campbell John , Konya Judit , Perôt Concetta 
Published: April 2021

Experiences of sexual violence, childhood sexual abuse, and sexual assault are common across all societies. These experiences damage physical and mental health, coping ability, and relationships with others. Given the breadth and magnitude of impacts, it is imperative that there are effective, accessible services to support victim-survivors, ease suffering, and empower people to cope, recover and thrive. Service provision for this population in the United Kingdom is complex and has been hit substantially by austerity. Since positive social support can buffer against negative impacts, peer support may be an effective approach. The aim of this exploratory study was to capture the views and perspectives of professional stakeholders concerning service provision for victim-survivors, particularly perceptions of peer support. In-depth semistructured interviews were conducted in the UK during 2018 with six professional stakeholders, highly experienced in the field of service provision for victim-survivors of sexual violence and abuse. An abductive approach to analysis was used, applying principles from thematic analysis. Our sample comprised four females and two males, and their roles included psychiatrist, general practitioner, service improvement facilitator, and senior positions within victim-survivor organizations. Interviews highlighted models of peer support for this population, good practice and safety considerations, and a lack of uniformity regarding quality and governance standards across the sector. Findings indicated that current funding models impact negatively on victim-survivor services, and that provision is fragmented and insufficient across statutory and not-for-profit sectors. The influence of the medical model upon service provision was evident, which resulted in apprehension around support delivered in less-usual forms—including peer support. Further research is needed to explore the potential of peer support for victim-survivors of sexual violence and abuse.
Adherence to highly active antiretroviral therapy among people living with HIV and associated high-risk behaviours and clinical characteristics: A cross-sectional survey in Vietnam
Authors: Le Phuong M , Nguyen Phuong T , Nguyen Huy V , Bui Duc H , Vo Son H , Nguyen Nga V , Nguyen Tien V , Tran Anh TN , Le Anh DM , Ha Nguyet MT , Dao An TM , Gilmour Stuart 
Published: April 2021

Although Vietnam has promoted the utilisation of highly active antiretroviral therapy (HAART) towards HIV elimination targets, adherence to treatment has remained under-investigated. We aimed to describe high-risk behaviours and clinical characteristics by adherence status and to identify the factors associated with non-adherence. We included 426 people living with HIV (PLWH) currently or previously involved in HAART. Most participants were men (75.4%), young (33.6 years), with low income and low education levels. Non-adherent PLWH (11.5%) were more likely to have a larger number of sex partners ( p-value = 0.053), sex without condom use ( p-value = 0.007) and not receive result at hospital or voluntary test centre ( p-value = 0.001). Multiple logistic regression analysis showed that demographic (education levels), sexual risk behaviours (multiple sex partners and sex without using condom) and clinical characteristics (time and facility at first time received HIV-positive result) were associated with HAART non-adherence. There are differences in associated factors between women (education levels and place of HIV testing) and men (multiple sex partners). Gender-specific programs, changing risky behaviours and reducing harms among PLWH may benefit adherence. We highlight the need to improve the quantity and quality of HIV/AIDS services in Vietnam, especially in pre- and post-test counselling, to achieve better HAART adherence, working towards ending AIDS in 2030.
The effects of service-learning on physical education teacher education: A case study on the border between Africa and Europe
Authors: Chiva-Bartoll Oscar , Ruiz-Montero Pedro Jesús , Olivencia Juan José Leiva , Grönlund Henrietta 
Published: April 2021

Recent studies, supported by the European project Europe Engage – Developing a Culture of Civic Engagement through Service-Learning within Higher Education in Europe, suggest that service-learning (SL) is an effective approach to develop personal and social learning linked to real contexts. This particular case study analyses the perceived effects of an SL programme implemented in Melilla (on the border between Africa and Europe) by Physical Education Teacher Education (PETE) students. They offered a service focusing on promoting physical activity and sport among different vulnerable groups (unaccompanied foreign minors, migrants and refugees, adults with autism spectrum disorders, women in conditions of social exclusion, ex-drug addicts and vulnerable older people). This case study used a qualitative hermeneutic-phenomenological methodology. A total of 46 PETE students (36 male and 10 female) participated in one of the two editions of SL carried out in 2017–2018 and 2018–2019. Two focus groups and 46 personal reflective journals were analysed, and some interesting outcomes emerged from the thematic analysis, related to the four categories of Butin’s conceptual model, which was used as a benchmark. These findings reveal how SL can promote an inclusive Physical Education (PE) experience in such a multicultural setting. The positive results achieved are consistent with previous SL research and specifically support the applied intervention design based on the phases of Kolb’s experiential learning (1984). In conclusion, SL offers an empowering approach for multicultural education in PETE programmes, supporting the socially critical research developed in PE in recent decades.
Validation of the Danish version of the Second Victim Experience and Support Tool
Authors: Knudsen Tine , Abrahamsen Charlotte , Jørgensen Jan S. , Schrøder Katja 
Published: April 2021

Objective: Health-care professionals (HCPs) who are involved in an unanticipated adverse patient event, a medical error or a patient-related injury can become second victims. Being a second victim can lead to various symptoms, affecting the well-being of HCPs and possible turnover intentions or absenteeism. An increasing number of hospitals have implemented a second-victim support programme. To achieve unique insights into what works and what does not work in second-victim support programmes, HCPs’ perceptions are needed. The aim of this study was to translate the Second Victim Experience and Support Tool (SVEST) into Danish and test the psychometric properties of the Danish version (D-SVEST). Methods: The SVEST self-administered questionnaire was translated into Danish following the World Health Organization’s guidelines. Assessments of the content validity, construct validity and internal consistency were performed based on 171 participants. Results: The study demonstrated that the D-SVEST is content valid and fits the a priori defined structure. Yet, four items revealed unacceptable factor loadings (<0.4) and item-rest correlations <0.3. All Cronbach’s alpha estimates for these five dimensions exceeded 0.70. The dimensions on colleague and institutional support did not contribute to the validity. Conclusions: In conclusion, the D-SVEST is considered relevant and valid for measuring second-victim experiences and the adequacy of support resources. However, we recommend a modification of items 9 and 25 to enhance the measurement scale in a Danish context. The D-SVEST can be used by health-care management at Danish hospitals.
Clear aligner orthodontic treatment: Angle Society of Europe consensus viewpoint
Authors: Johal Ama , Bondemark Lars 
Published: April 2021

Orthodontics has witnessed not only an exponential rise in demand from adult patients but accompanying this, the emergence of alternate aesthetic treatment options to the more traditional fixed labial appliance. The concept of using clear aligners as a means of achieving tooth movement has increased in popularity among both patients and clinicians alike. However, the question over best research evidence as to their clinical effectiveness to treat a range of malocclusion traits remains elusive and controversial among the profession. In an attempt to offer the profession some clear guidance, The Angle Society of Europe reviewed and discussed the current published evidence (2005–2018) on their clinical use, during the annual meeting in January 2020, to help formulate a consensus viewpoint on the clinical applications.
Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters
Authors: Zhang Joanne Y. , Samineni Aneesh V. , Sing David C. , Rothman Alyssa , Stein Andrew B. 
Published: April 2021

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.
Effects of Injury Pattern and Treatment on Case Length and Disposition for Hand Injuries Treated Under a Workers’ Compensation Claim
Authors: Gray Aaron , Young Colby 
Published: April 2021

Background: In treating occupational hand injuries under workers’ compensation, the 2 most important goals are to maximize patient function, ideally to preinjury levels, and permit a timely return to work (RTW). The purpose of this study was to determine factors affecting total case length, that is, the total time from injury until primary closure of a patient’s claim, and disposition among patients with hand injuries treated under workers’ compensation. Methods: All cases treated under workers’ compensation by a single fellowship-trained hand surgeon within a single year were retrospectively reviewed. A case is defined as the entire management and treatment of a single patient related to a single occupational injury incident. Independent variables included age, sex, body mass index, comorbidity, occupation, injury pattern, and treatment modality. Dependent variables included treatment duration from injury to case closure and final case disposition (RTW, functional capacity evaluation [FCE], or loss to follow-up [LTFU]). Comparison between groups was accomplished with analysis of variance. Multivariate linear and logistic regression analysis was performed to predict case length and disposition. Results: In all, 447 cases involving a workers’ compensation claim were reviewed. Among these, 75 (16.8%) were LTFU, 24 (5.4%) required an FCE, and 346 (77.4%) an RTW. The RTW cases averaged 138.5 days, whereas those requiring FCE averaged 331.5 days. Compared with average case length, crush injuries (76.8 days. P < .001) and fractures (111.8 days, P = .0224) had significantly shorter time to closure. In a multivariate linear model, cases of soft tissue and nerve injury were associated with longer case lengths, remaining open for an additional 56.8 and 347.1 days, respectively ( P < .001). Each treatment modality studied, therapy, injections, and surgery, was associated with an increase in case length. Conclusions: Cases requiring FCE were open significantly longer than those resulting in RTW. In addition, injury pattern and treatment modality were associated with significant variations in total case length. These results imply that a specific subset of patients, namely those with soft tissue and nerve injuries, may experience delayed resolution among patients treated under a workers’ compensation claim.
High rates of JCV seroconversion in a large international cohort of natalizumab-treated patients
Authors: Dwyer Christopher M. , Jokubaitis Vilija G. , Stankovich Jim , Baker Josephine , Haartsen Jodi , Butzkueven Helmut , Cartwright Adriana , Shuey Neil , Fragoso Yara Dadalti , Rath Louise , Skibina Olga , Fryer Kylie , Butler Ernest , Coleman Jennifer , MacIntrye Jennifer , Macdonell Richard , Walt Anneke van der 
Published: April 2021

Aims: To retrospectively assess factors associated with John Cunningham virus (JCV) seroconversion in natalizumab-treated patients. Background: Natalizumab is highly effective for the treatment of relapsing–remitting multiple sclerosis (RRMS), but its use is complicated by opportunistic JCV infection. This virus can result in progressive multifocal leukoencephalopathy (PML). Serial assessment of JCV serostatus is mandated during natalizumab treatment. Methods: Patients treated with natalizumab for RRMS at six tertiary hospitals in Melbourne, Australia ( n = 865) and 11 MS treatment centres in Brazil ( n = 136) were assessed for change in JCV serostatus, duration of exposure to natalizumab and prior immunosuppression. Sensitivity analyses examined whether sex, age, tertiary centre, prior immunosuppression or number of JCV tests affected time to seroconversion. Results: From a cohort of 1001 natalizumab-treated patients, durable positive seroconversion was observed in 83 of 345 initially JCV negative patients (24.1%; 7.3% per year). Conversely, 16 of 165 initially JCV positive patients experienced durable negative seroconversion (9.7%; 3.8% per year). Forty patients (3.9%) had fluctuating serostatus. Time-to-event analysis did not identify a relationship between JCV seroconversion and duration of natalizumab exposure. Prior exposure to immunosuppression was not associated with an increased hazard of positive JCV seroconversion. Male sex was associated with increased JCV seroconversion risk [adjusted hazard ratio 2.09 (95% confidence interval 1.17–3.71) p = 0.012]. Conclusion: In this large international cohort of natalizumab-treated patients we observed an annual durable positive seroconversion rate of 7.3%. This rate exceeds that noted in registration and post-marketing studies for natalizumab. This rate also greatly exceeds that predicted by epidemiological studies of JCV seroconversion in healthy populations. Taken together, our findings support emerging evidence that natalizumab causes off-target immune changes that may be trophic for JCV seroconversion. In addition, male sex may be associated with increased positive JCV seroconversion.
Serum-derived extracellular vesicles inhibit osteoclastogenesis in active-phase patients with SAPHO syndrome
Authors: Gao Yanpan , Chen Yanyu , Wang Lun , Li Chen , Ge Wei 
Published: April 2021

Objective: Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare chronic inflammatory disorder and the underlying pathogenesis is unclear. In this study, 88 SAPHO patients and 118 healthy controls were recruited to investigate the role of serum-derived extracellular vesicles (SEVs) in SAPHO syndrome. Methods: Quantitative proteomics was applied for SEVs proteome identification, and ELISA and Western blotting was performed to verify the results of mass spectrum data. In vitro osteoclastogenesis and osteogenesis assay was used to confirm the effects of SEVs on bone metabolism. Results: Tandem mass tagging-based quantitative proteomic analysis of SAPHO SEVs revealed differential expressed proteins involved in bone metabolism. Of these, serum amyloid A-1 (SAA1) and C-reactive protein (CRP) were upregulated. Higher SAA1 levels in SAPHO patients were confirmed by ELISA. In addition, SAA1 levels were positively correlated with CRP, an inflammatory marker related to the condition of patients. In vitro celluler studies confirmed that SAPHO SEVs inhibited osteoclastogenesis in patients mainly in the active phase of the disease. Further analysis demonstrated that Nucleolin was upregulated in osteoclasts of active-phase patients under SAPHO SEVs stimulation. Conclusion: In this study, we identified SAA1 as an additional inflammation marker that can potentially assist the diagnosis of SAPHO syndrome, and speculated that Nucleolin is a key regulator of osteoclastogenesis in active-phase patients.
Development of Evidence-Based Rehabilitation Practice in Botanical Garden for People With Mental Health Disorders
Authors: Vujcic Trkulja Maja , Tomicevic-Dubljevic Jelena , Tosevski Dusica Lecic , Vukovic Olivera , Toskovic Oliver 
Published: April 2021

Aim: This article aims to make clearer, with supporting evidence, the clinical benefits of the nature-based rehabilitation program (NBRP) and the restorative values of visiting botanical garden for people with stress-related mental disorders. Background: Throughout the years, nature-based therapy has been acknowledged as a valuable rehabilitation practice that integrates specially designed natural environments and nature-related activities for people with mental health conditions. Subject and Methods: The comparative analyses of parallel conducted the NBRP at botanical garden and occupational therapy realised at the Day Hospital of the Institute of Mental Health in Belgrade included 27 participants divided into two groups. The data collection employed a mixed method combining a Clinical Global Impression (CGI) Scale and on-site observations. Results: The positive findings on the psychological recovery of the participants seem to be related to NBRP. The restorative potential of the garden was recognized through the observed interaction between participants and the natural entities employed through the various themed activities. The observed landscape elements especially solitary plant specimens or tall and single-form trees within the garden can be embraced as design guidelines for the development of an evidence-based practice that can support the recovery process of people with mental health conditions. Conclusion: Our findings endorse that ongoing social development and progressive urbanization have broadened the interest in scientific research involving nature-based solutions that help preserve the physical and mental health of people in low- and middle-income Western Balkan countries with a high prevalence of mental disorders in the urban environment that relates to social inequalities and natural disasters.
Tolvaptan treatment in an adult Fontan patient with protein-losing enteropathy: a serial 23Na-MRI investigation
Authors: Moosmann Julia , Toka Okan , Linz Peter , Dahlmann Anke , Nagel Armin M. , Schiffer Mario , Uder Michael , Cesnjevar Robert , Dittrich Sven , Kopp Christoph 
Published: April 2021

Background: Protein-losing enteropathy (PLE) is a severe complication of the univentricular Fontan circulation and associated with disturbances in salt and water homeostasis. Fontan patients with PLE have a poor prognosis, with increased morbidity and mortality. Due to limited therapeutic strategies, patients are often treated only symptomatically. Methods: We report our first experience of Tolvaptan (TLV) treatment in a Fontan patient with PLE, severe volume retention and hyponatraemia, refractory to conventional diuretic therapy. In addition to clinical parameters, we monitored drug effects including tissue sodium and volume status via serial 23Na-magnetic resonance imaging (23Na-MRI) and bioimpedance spectroscopy compared with age-matched controls. Results: 23Na-MRI identified elevated tissue sodium, which decreased under TLV treatment, as well as volume status, while serum sodium increased and the patient’s symptoms improved. During long-term treatment, we were able to differentiate between sodium and volume status in our patient, suggesting that TLV uncoupled body sodium from water. Conclusion: TLV in addition to loop diuretics improved clinical symptoms of PLE and lowered tissue sodium overload. Long-term effects should be further evaluated in Fontan patients.