bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do exercise-based prevention programmes reduce non-contact musculoskeletal injuries in football (soccer)? A systematic review and meta-analysis with 13 355 athletes and more than 1 million exposure hours
Authors: Lemes Italo Ribeiro , Pinto Rafael Zambelli , Lage Vitor N , Roch Bárbara A B , Verhagen Evert , Bolling Caroline , Aquino Cecilia Ferreira , Fonseca Sérgio T , Souza Thales R 
Published: May 2021

ObjectiveThe aim of this systematic review was to investigate the effect of exercise-based programmes in the prevention of non-contact musculoskeletal injuries among football players in comparison to a control group.DesignSystematic review and meta-analysis of randomised controlled trials.Data sourcesMEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SPORTDiscus databases were searched from the earliest record to January 2021.Eligibility criteriaStudies were eligible if they (1) included football players aged 13 years or older, (2) used exercise-based programmes as intervention, (3) presented the number of non-contact musculoskeletal injuries (ie, defined as any acute sudden onset musculoskeletal injury that occurred without physical contact) and exposure hours for each group, and (4) had a control group (eg, usual training, minimal intervention, education). All types of exercise-based prevention programmes were eligible for inclusion. Risk of bias for each included study and overall quality of evidence for the meta-analysis were assessed.ResultsTen original randomised controlled trials with 13 355 football players and 1 062 711 hours of exposure were selected. Pooled injury risk ratio showed very low-quality evidence that exercise-based prevention programmes reduced the risk of non-contact musculoskeletal injuries by 23% (0.77 (95% CI 0.61 to 0.97)) compared with a control group.ConclusionExercise-based prevention programmes may reduce the risk of non-contact musculoskeletal injuries by 23% among football players. Future high-quality trials are still needed to clarify the role of exercise-based programmes in preventing non-contact musculoskeletal injuries among football players.PROSPERO registration numberCRD42020173017.
Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017
Authors: Tamrakar Mamata , Kharel Priti , Traeger Adrian , Maher Chris , O'Keeffe Mary , Ferreira Giovanni 
Published: May 2021

IntroductionCompleteness of Global Burden of Disease (GBD) Study data is acknowledged as a limitation. To date, no study has evaluated this issue for low back pain, a leading contributor to disease burden globally.MethodsWe retrieved reports, in any language, based on citation details from the GBD 2017 study website. Pairs of raters independently extracted the following data: number of prevalence reports tallied across countries, age groups, gender and years from 1987 to 2017. We also considered if studies enrolled a representative sample and/or used an acceptable measure of low back pain.ResultsWe retrieved 488 country-level reports that provide prevalence data for 103 of 204 countries (50.5%), with most prevalence reports (61%) being for high-income countries. Only 16 countries (7.8%) have prevalence reports for each of the three decades of the GBD. Most of the reports (79%) did not use an acceptable measure of low back pain when estimating prevalence.ConclusionWe found incomplete coverage across countries and time, and limitations in the primary prevalence studies included in the GBD 2017 study. This means there is considerable uncertainty about GBD estimates of low back pain prevalence and the disease burden metrics derived from prevalence.
End-of-life care in illicit drug users: mapping medication use
Authors: Ulrick Phoebe , Panozzo Stacey , Marco David , Collins Anna , Philip Jennifer 
Published: May 2021

BackgroundWhile clinical wisdom has long provided suggested guidance around caring for people who use illicit drugs (referred to as PWUD) at the end of life, there is striking paucity of empirical evidence underpinning these practices. Understanding medications and doses required to manage symptoms at the end of life is essential to provide effective end-of-life care for these patients. This study aimed to examine the type and dose of medications prescribed to hospitalised patients who use illicit drugs at the end of life, compared with patients without previous or current illicit drug use.MethodA retrospective medical record review was conducted on consecutive patient deaths between 2012 and 2017 at a metropolitan hospital. PWUD were identified using the International Classification of Diseases 10th Revision codes for illicit drug use. Daily dosage of opioids, benzodiazepines and antipsychotics was documented for the last 3 days of life and compared with a matched comparator group.ResultsPWUD patients (n=55) received higher doses of opioids, midazolam and antipsychotics than comparator patients (n=55) for each day, significant for opioids in the last 24 hours (p=0.01). PWUD patients received a significantly higher total opioid dose (median=480.0 mg vs 255.0 mg) and midazolam (median=15.0 mg vs 5.0 mg) (both p<0.05). Rates of dose escalation did not differ.ConclusionsResults suggest that PWUD require greater doses of symptom-controlling medications, particularly opioids and midazolam, at the end of life but that rates of dose escalation do not differ greatly. This study provides a foundation for future research to inform clinical guidelines for this cohort of palliative care patients.
General features of Nash equilibria in combinations of elementary interactions in symmetric two-person games
Authors: Szabó György , Király Balázs 
Published: May 2021

AbstractTwo-person games are used in many multi-agent mathematical models to describe pair interactions. The type (pure or mixed) and the number of Nash equilibria affect fundamentally the macroscopic behavior of these systems. In this paper, the general features of Nash equilibria are investigated systematically within the framework of matrix decomposition for n strategies. This approach distinguishes four types of elementary interactions that each possess fundamentally different characteristics. The possible Nash equilibria are discussed separately for different types of interactions and also for their combinations. A relation is established between the existence of infinitely many mixed Nash equilibria and the zero-eigenvalue eigenvectors of the payoff matrix.
Efficient Deep Learning Models for Categorizing Chenopodiaceae in the Wild
Authors: Heidary-Sharifabad Ahmad , Zarchi Mohsen Sardari , Emadi Sima , Zarei Gholamreza 
Published: May 2021

The Chenopodiaceae species are ecologically and financially important, and play a significant role in biodiversity around the world. Biodiversity protection is critical for the survival and sustainability of each ecosystem and since plant species recognition in their natural habitats is the first process in plant diversity protection, an automatic species classification in the wild would greatly help the species analysis and consequently biodiversity protection on earth. Computer vision approaches can be used for automatic species analysis. Modern computer vision approaches are based on deep learning techniques. A standard dataset is essential in order to perform a deep learning algorithm. Hence, the main goal of this research is to provide a standard dataset of Chenopodiaceae images. This dataset is called ACHENY and contains 27030 images of 30 Chenopodiaceae species in their natural habitats. The other goal of this study is to investigate the applicability of ACHENY dataset by using deep learning models. Therefore, two novel deep learning models based on ACHENY dataset are introduced: First, a lightweight deep model which is trained from scratch and is designed innovatively to be agile and fast. Second, a model based on the EfficientNet-B1 architecture, which is pre-trained on ImageNet and is fine-tuned on ACHENY. The experimental results show that the two proposed models can do Chenopodiaceae fine-grained species recognition with promising accuracy. To evaluate our models, their performance was compared with the well-known VGG-16 model after fine-tuning it on ACHENY. Both VGG-16 and our first model achieved about 80% accuracy while the size of VGG-16 is about 16[Formula: see text] larger than the first model. Our second model has an accuracy of about 90% and outperforms the other models where its number of parameters is 5[Formula: see text] than the first model but it is still about one-third of the VGG-16 parameters.
Strong Association of Waist Circumference (WC), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist-to-Hip Ratio (WHR) with Diabetes: A Population-Based Cross-Sectional Study in Jilin Province, China
Authors: Zhang Fu-Liang , Ren Jia-Xin , Zhang Peng , Jin Hang , Qu Yang , Yu Yao , Guo Zhen-Ni , Yang Yi 
Published: May 2021

Backgrounds. The prevalence of diabetes has increased with the increase of obesity, and finding indicators to predict diabetes risk has become an urgent need. The purpose of this study is to compare the correlation between four anthropometric indices and the prevalence of diabetes. Methods. A total of 4052 participants aged 40 years and above were selected in Dehui City, Jilin Province, using a multistage stratified whole group sampling method. Face-to-face interviews and physical examinations were conducted. Multivariate logistic analysis was used. The values of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were divided into quartiles (Q1: <25%; Q2: ~25%; Q3: ~50%; and Q4: ~75%). The median of each quartile was used for a linear trend test. Results. For all four body fat-measuring indices of body mass index (adjusted OR: 3.300, 95% CI: 2.370, 4.595), WC (adjusted OR: 5.131, 95% CI: 3.433, 7.669), WHR (adjusted OR: 3.327, 95% CI: 2.386, 4.638), and WHtR (adjusted OR: 5.959, 95% CI: 3.922, 9.054), patients in the highest quartile were more likely to have diabetes than those in the lowest quartile. The areas under the curve of WHtR, WC, WHR, and BMI for diabetes were 0.683, 0.669, 0.654, and 0.629, respectively. In female participants, the areas under the curve of the waist-height ratio and WC were 0.710 (95% CI: 0.679-0.741) and 0.701 (95% CI: 0.670-0.732), respectively. Conclusions. The WC and WHtR were more closely related to diabetes than BMI and WHR among

study

participants
≥
40

years

of age, especially in females.
Age at Diagnosis of Heart Failure in United States Veterans With and Without HIV Infection
Authors: Erqou Sebhat , Jiang Lan , Choudhary Gaurav , Lally Michelle , Freiberg Matthew , Lin Nina H. , Shireman Theresa I. , Rudolph James L. , Wu Wen‐Chih 
Published: May 2021

Background
Although HIV is associated with increased risk of heart failure (HF), it is not known if people living with HIV develop HF at a younger age compared with individuals without HIV. Crude comparisons of age at diagnosis of HF between individuals with and without HIV does not account for differences in underlying age structures between the populations.

Methods and Results

We used Veterans Health Administration data to compare the age at HF diagnosis between veterans with and without HIV, with adjustment for difference in population age structure. Statistical weights, calculated for each 1‐year strata of veterans with HIV in each calendar year from 2000 to 2018, were applied to the veterans without HIV to standardize the age structure. We identified 5093 veterans with HIV (98% men, 34% White) with first HF episode recorded after HIV diagnosis (median age at incidence of HF, 58 years), and 1 425 987 veterans without HIV (98% men, 78% White) with HF (corresponding age, 72 years), with an absolute difference of 14 years. After accounting for difference in age structure, the adjusted median age at HF diagnosis for veterans without HIV was 63 years, 5 years difference with veterans with HIV (
P
<0.001). The age differences were consistent across important subgroups such as preserved versus reduced ejection fraction and inpatient versus outpatient index HF.

Conclusions
Veterans with HIV are diagnosed with HF at a significantly younger age compared with veterans without HIV. These findings may have implications for HF prevention in individuals with HIV. Future studies are needed to make the findings more generalizable.
Changes in Cardiovascular Risk Factors and Cardiovascular Events in the Elderly Population
Authors: Yang Pil‐Sung , Jang Eunsun , Yu Hee Tae , Kim Tae‐Hoon , Pak Hui‐Nam , Lee Moon‐Hyoung , Joung Boyoung 
Published: May 2021

Background
This study examines changes in the ideal cardiovascular health (CVH) status and whether these changes are associated with incident cardiovascular disease (CVD) and mortality in the elderly Asian population.

Methods and Results
In the Korea National Health Insurance Service–Senior cohort aged ≥60 years, 208 673 participants without prior CVD, including 109 431 who showed changes in CVH status, were assessed. The association of the changes in cardiovascular risk factors with incident CVD was assessed from 2004 to 2014 in the elderly (aged 60–74 years) and very elderly (≥75 years) groups. During the follow‐up period (7.1 years for CVD and 7.2 years for mortality), 19 429 incident CVD events and 24 225 deaths occurred. In both the elderly and very elderly participants, higher CVH status resulted in a lower risk of CVD and mortality. In the very elderly participants, compared with consistently low CVH, consistently high CVH (subhazard ratio, 0.41; 95% CI, 0.23–0.73) was associated with a lower risk of CVD. This trend was consistently observed in the elderly population. In the very elderly participants, total cholesterol level was not informative enough for the prediction of CVD events. In both the elderly and very elderly groups, body mass index and total cholesterol were not informative enough for the prediction of all‐cause mortality.

Conclusions
In both the elderly and very elderly Asian populations without CVD, a consistent relationship was observed between the improvement of a composite metric of CVH and the reduced risk of CVD. Body mass index and total cholesterol were not informative enough for the prediction of all‐cause mortality in both the elderly and very elderly groups.
Comparing Effect Estimates in Randomized Trials and Observational Studies From the Same Population: An Application to Percutaneous Coronary Intervention
Authors: Matthews Anthony A. , Szummer Karolina , Dahabreh Issa J. , Lindahl Bertil , Erlinge David , Feychting Maria , Jernberg Tomas , Berglund Anita , Hernán Miguel A. 
Published: May 2021

Background
To understand when results from observational studies and randomized trials are comparable, we performed an observational emulation of a target trial designed to ask similar questions as the VALIDATE (Bivalirudin Versus Heparin in ST‐Segment and Non–ST‐Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy) randomized trial. The VALIDATE trial compared the effect of bivalirudin and heparin during percutaneous coronary intervention on the risk of death, myocardial infarction, and bleeding across Sweden.

Methods and Results
We specified the protocol of a target trial similar to the VALIDATE trial, then emulated the target trial in the period before the VALIDATE trial took place using data from the SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) registry—the same registry in which the trial was undertaken. The target trial emulation and the VALIDATE trial both estimated little or no effect of bivalirudin versus heparin on the risk of death or myocardial infarction by 180 days (target trial emulation risk ratio for death, 1.21 [95% CI, 0.88 – 1.54]; VALIDATE trial hazard ratio for death, 1.05 [95% CI, 0.78 – 1.41]). The observational data, however, could not capture less severe cases of bleeding, resulting in an inability to define a bleeding outcome like the trial, and could not accurately estimate the comparative risk of death by 14 days, which may be the result of intractable confounding early in follow‐up or the inability to precisely emulate the trial’s eligibility criteria.

Conclusions
Using real‐world data to emulate a target trial can deliver accurate effect estimates. Yet, even with rich observational data, it is not always possible to estimate the short‐term effect of interventions or the effect on outcomes for which data are not routinely collected.
Long-term results of triple valve repair in rheumatic heart disease
Authors: Kaskar Ameya , Rao Rahul , Mehra Siddhant , Bohra Deepak , Makwana Rohan , Rao Parachuri V 
Published: May 2021

Background The aim of this study is to analyze the clinical outcomes of triple valve repair for rheumatic heart disease in terms of both early results and long-term benefits. Methods Between January 2008 and December 2016, all the patients who underwent triple valve repair for rheumatic heart disease were included in this study. Results Thirty-eight patients underwent triple valve repair procedure for rheumatic heart disease at our institute. Mean age was 33 years; 60.5% were females. Techniques used to achieve mitral valve repair were: commisurotomy (n = 26), prosthetic ring annuloplasty (n = 9), posterior teflon annuloplasty (n = 23), leaflet shaving (n = 14), implantation of neochordae (n = 5) and pericardial patch augmentation of mitral valve leaflets (n = 6). For aortic valve repair, the techniques used were: commisurotomy (n = 23), leaflet shaving (n = 16), pericardial patch augmentation (n = 3), subcommisural plication (n = 10), free margin plication (n = 2) and free margin resuspension (n = 1). Tricuspid valve repair was performed using modified Devega's technique (n = 32), commisurotomy (n = 9) and posterior annular plication (bicuspidization) (n = 5). The operative mortality was 0%. There was no primary repair failure. Estimated survival at the end of 1 year, 5 years and 10 years was 100%, 91.6% and 65.8%, respectively. Overall freedom from reintervention at 1, 5 and 10 years was 100%, 96.4% and 61.4, respectively. Conclusion Triple valve repair provided satisfactory early and long-term results in this challenging subset of patients and can be considered as an acceptable option for significant triple valve disease due to the absence of anticoagulation-related events.
To Jurassic Park via Australia: A case study showing how dramatherapy enabled the creation and maintenance of embodied metaphors to support recovery from early psychosis
Authors: Combes Louise , A Bradley Lauren 
Published: May 2021

This case study shows how Dramatherapy can engage clients with communication difficulties, which exclude them from standard mental health pathways in early intervention in psychosis services. Deliberately prioritising the client’s newfound modes of expression to shape the narrative within, it is evident Dramatherapy processes; embodiment, projection and role enabled this client to create and then inhabit his own playful metaphors. These metaphors continued to facilitate every-day life challenges. During his Dramatherapy relationship, the client within this case study transitioned from supported accommodation to his own property, progressed to residential rehabilitation for alcohol misuse and finally engaged in cognitive behavioural therapy. From feedback interviews we know he continued to create and use his own protective metaphors 10 months after drama therapy ended. He returned to education as part of his plan to seek appropriate employment and was discharged to his GP.
Peripheral cannulation for extracorporeal membrane oxygenation yields superior neurologic outcomes in adult patients who experienced cardiac arrest following cardiac surgery
Authors: Levy Lauren E , Kaczorowski David J , Pasrija Chetan , Boyajian Gregory , Mazzeffi Michael , Krause Eric , Shah Aakash , Madathil Ronson , Deatrick Kristopher B , Herr Daniel , Griffith Bartley P , Gammie James S , Taylor Bradley S , Ghoreishi Mehrdad 
Published: May 2021

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest has improved mortality in post-cardiac surgery patients; however, loss of neurologic function remains one of the main and devastating complications. We reviewed our experience with ECPR and investigated the effect of cannulation strategy on neurologic outcome in adult patients who experienced cardiac arrest following cardiac surgery that was managed with ECPR. Methods: Patients were categorized by central versus percutaneous peripheral VA-extracorporeal membrane oxygenation (ECMO) cannulation strategy. We reviewed patient records and evaluated in-hospital mortality, cause of death, and neurologic status 72 hours after cannulation. Results: From January 2010 to September 2019, 44 patients underwent post-cardiac surgery ECPR for cardiac arrest. Twenty-six patients received central cannulation; 18 patients received peripheral cannulation. Mean post-operative day of the cardiac arrest was 3 and 9 days (p = 0.006), and mean time between initiation of CPR and ECMO was 40 ± 24 and 28 ± 22 minutes for central and peripheral cannulation, respectively. After 72 hours of VA-ECMO support, 30% of centrally cannulated patients versus 72% of peripherally cannulated patients attained cerebral performance status 1–2 (p = 0.01). Anoxic brain injury was the cause of death in 26.9% of centrally cannulated and 11.1% of peripherally cannulated patients. Survival to discharge was 31% and 39% for central and peripheral cannulation, respectively. Conclusions: Peripheral VA-ECMO allows for continuous CPR and systemic perfusion while obtaining vascular access. Compared to central cannulation, a peripheral cannulation strategy is associated with improved neurologic outcomes and decreased likelihood of anoxic brain death.
Spectrum of uropathogens and their susceptibility to antimicrobials in pregnant women: a retrospective analysis of 5-year hospital data
Authors: Matalka Ala’a , Al-Husban Naser , Alkuran Oqba , Almuhaisen Lama , Basha Asma , Eid Mahmoud , Elmuhtaseb Mohammad S , Al Oweidat Khaled 
Published: May 2021

Objective Urinary tract infections (UTI) are common during pregnancy. Identification of antimicrobial susceptibility patterns of microorganisms in pregnant women is important to select the most appropriate antimicrobial. We assessed common uropathogens in pregnant women with UTI and antimicrobial susceptibility, to guide empirical antibiotic selection. Methods In this retrospective study, we analyzed mid-stream urine culture and antibiotic susceptibility data from pregnant women who attended Jordan University Hospital during 2014 to 2018. Data were collected from patients’ charts and urine cultures, and sensitivity results were extracted from the laboratory electronic system. We calculated descriptive statistics and determined correlations among pathogens and antibiotics. Results We examined 612 positive urine cultures from 559 pregnant women, including 163 (29.2%) inpatients. Escherichia coli (29.4%) was the most frequently identified microorganism, followed by coagulase-negative staphylococci (CoNS) (21.6%). All bacterial isolates were sensitive to aztreonam, chloramphenicol, fosfomycin, ofloxacin, pefloxacin, piperacillin, and colistin sulfate; 87.5% were sensitive to amikacin. Only 15.79%, 18.93%, and 17.91% were sensitive to oxacillin, nalidixic acid, and erythromycin, respectively. Conclusion E. coli and CoNS were the most commonly identified microorganisms in this study. We found increased antibiotic resistance in Enterobacter species. The chosen antimicrobial therapy in pregnancy should be determined by sensitivity/resistance and fetomaternal safety.