bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Climbing Speed on Pulmonary Oxygen Uptake and Muscle Oxygen Saturation Dynamics in the Finger Flexors
Authors: Gajdošík Jan , Baláš Jirˇí , Krupková Dominika , Psohlavec Lukáš , Draper Nick 
Published: September 2021

Purpose: Although sport climbing is a self-paced whole-body activity, speed varies with climbing style, and the effect of this on systemic and localized oxygen responses is not well understood. Therefore, the aim of the present study was to determine muscle and pulmonary oxygen responses during submaximal climbing at differing speeds of ascent. Methods: Thirty-two intermediate and advanced sport climbers completed three 4-minute-long ascents of the same route at 4, 6, and 9 m·min−1 on a motorized climbing ergometer (treadwall) on separate laboratory visits. Gas analysis and near-infrared spectroscopy were used to determine systemic oxygen uptake () and muscle oxygen saturation (StO2) of the flexor digitorum profundus. Results: Increases in ascent speed of 1 m·min−1 led to increases of by 2.4 mL·kg−1·min−1 (95% CI, 2.1 to 2.8 mL·kg−1·min−1) and decreases in StO2 by −1.3% (95% CI, 1.9% to −0.7%). There was a significant interaction of climbing ability and speed for StO2 (P < .001, ). The results revealed that the decrease of StO2 was present for intermediate but not advanced climbers. Conclusions: In this study, the results suggest that demand during climbing was largely determined by climbing speed; however, the ability level of the climber appeared to mitigate StO2 at a cellular level. Coaches and instructors may prescribe climbing ascents with elevated speed to improve generalized cardiorespiratory fitness. To stimulate localized aerobic capacity, however, climbers should perhaps increase the intensity of training ascents through the manipulation of wall angle or reduction of hold size.
Isometric Hip Strength and Patient-Reported Outcomes of Individuals With and Without Chronic Ankle Instability
Authors: Bain Katherine A. , Clawson Paige A. , Slone Stacey A. , Gribble Phillip A. , Hoch Johanna M. , Hoch Matthew C. , Kosik Kyle B. 
Published: September 2021

Context: Strength deficits and decreased scores on generic, dimension-specific, and region-specific health-related quality of life (HRQL) PRO measures are commonly documented among individuals with chronic ankle instability (CAI). However, it is unknown if there is a relationship between hip strength and self-reported patient-reported outcome (PRO) scores. Objective: To compare isometric peak torque for hip-extension (H-EXT) and hip-abduction (H-ABD), as well as PRO scores between CAI, lateral ankle sprain copers (LAS copers), and uninjured controls (UC). The secondary purpose was to examine the relationship between isometric hip peak torque and PROs in participants with CAI. Design: Cross-sectional. Setting: Laboratory. Participants: Sixty-three individuals, 45 women (23.02 [3.83] y, 165.91 [7.55] cm, 67.28 [11.95] kg) and 18 men (26.28 [5.43] y, 179.28 [9.01] cm, 83.87 [13.26] kg), grouped as uninjured control (n = 26), LAS coper (n = 15), or CAI (n = 22). Main Outcome Measures: The Foot and Ankle Ability Measure was used to assess region-specific HRQL. The Fear Avoidance Beliefs Questionnaire was used to assess injury-related fear. The Disablement in Physically Active was used to assess global HRQL. Isometric peak torque was measured with a handheld dynamometer for H-EXT and H-ABD. Results: No group differences were observed for H-ABD (P = .34) or H-EXT (P = .35). The CAI group had significantly worse scores on all PROs compared with LAS coper (P < .001) and HC (P < .001). Moderate–weak correlations were found between H-ABD and Foot and Ankle Ability Measure—activities of daily living (P = .047; ρ = .392) and Foot and Ankle Ability Measure-Sport (P = .013; ρ = .482) and H- EXT and Fear Avoidance Beliefs Questionnaire-Work (P = .007; ρ = −.517). Conclusions: Individuals with CAI displayed lower HRQL based on worse scores on generic, dimension-specific, and region-specific PROs compared with LAS copers and uninjured controls. There were no significant between-group differences for H-EXT and H-ABD isometric peak torque production, but there was a moderate positive relationship between isometric H-ABD and self-reported ankle disability in individuals with CAI.
Variscan intracrustal recycling by melting of Carboniferous arc-like igneous protoliths (Évora Massif, Iberian Variscan belt)
Authors: Rodríguez Carmen , Pereira Manuel Francisco , Castro Antonio , Gutiérrez-Alonso Gabriel , Fernández Carlos 
Published: September 2021

Abstract
Bulk rock geochemistry and sensitive high-resolution ion microprobe zircon geochronology of igneous and metaigneous rocks of the Évora gneiss dome, located to the north of the reworked Rheic Ocean suture zone in the southwest Iberian Variscan belt, reveal a succession of magmatic and melting events lasting ~30 m.y. between ca. 341–314 Ma. The study of detailed field relationships of orthomigmatites (i.e., migmatites from igneous protoliths) and host granitic rocks proved to be crucial to reconstruct the complex sequence of tectono-thermal events of the Évora gneiss dome. The older igneous protoliths, with marked geochemical arc-like signatures, are represented by 338 ± 3 Ma tonalites and 336 ± 3 Ma diorites. These tonalites and diorites appear as mesosomes of igneous orthomigmatites containing new melts (leucosomes) of monzogranite composition and silica-poor trondhjemites formed in a melting episode at 329 ± 4/6 to 327 ± 3 Ma. The absence of peritectic phases (e.g., pyroxene), together with shearing associated with migmatization, imply the existence of water-rich fluids during melting of the older igneous rocks of the Évora gneiss dome. This melting event is coeval with the second magmatic event of the Évora gneiss dome represented by the neighboring Pavia pluton. A porphyritic monzogranite dated at 314 ± 4 Ma defines a later magmatic event. The porphyritic monzogranite encloses large blocks of the orthomigmatites and contains magmatic mafic enclaves (autoliths) dated at 337 ± 4 Ma that are ~23 m.y. older than the host rock. All studied rocks of the Évora gneiss dome show arc-like, calc-alkaline geochemical signatures. Our results support recycling of intermediate-mafic plutonic rocks, representing the root of an early magmatic arc that formed at the time of Gondwana-Laurussia convergence (after the closure of the Rheic Ocean) and coeval subduction of the Paleotethys. A geodynamic model involving ridge subduction is proposed to explain the Early Carboniferous intra-orogenic crustal extension, dome formation, exhumation of high-grade rocks, compositional variations of magmatism and formation of new granitic magmatism in which, arc-like signatures were inherited from the crustal source.
Does pre-existing morbidity influences risks and benefits of total hip replacement for osteoarthritis: a prospective study of 6682 patients from linked national datasets in England
Authors: Ferguson Rory , Prieto-Alhambra Daniel , Peat George , Delmestri Antonella , Jordan Kelvin P , Strauss Vicky Y , Valderas Jose Maria , Walker Christine , Yu Dahai , Glyn-Jones Sion , Silman Alan 
Published: September 2021

Total hip arthroplasty (THA) surgery for elderly people with multimorbidity increases the risk of serious health hazards including mortality. Whether such background morbidity reduces the clinical benefit is less clear.ObjectiveTo evaluate how pre-existing health status, using multiple approaches, influences risks of, and quality of life benefits from, THA.SettingLongitudinal record linkage study of a UK sample linking their primary care to their secondary care records.ParticipantsA total of 6682 patients were included, based on the recording of the diagnosis of hip osteoarthritis in a national primary care register and the recording of the receipt of THA in a national secondary care register.Data were extracted from the primary care register on background health and morbidity status using five different constructs: Charlson Comorbidity Index, Electronic Frailty Index (eFI) and counts of comorbidity disorders (from list of 17), prescribed medications and number of primary care visits prior to recording of THA.Outcome measures(1) Postoperative complications and mortality; (2) postoperative hip pain and function using the Oxford Hip Score (OHS) and health-related quality of life using the EuroQoL (EQ)-5D score.ResultsPerioperative complication rate was 3.2% and mortality was 0.9%, both increased with worse preoperative health status although this relationship varied depending on the morbidity construct: the eFI showing the strongest relationship but number of visits having no predictive value. By contrast, the benefits were not reduced in those with worse preoperative health, and improvement in both OHS and EQ-5D was observed in all the morbidity categories.ConclusionsIndependent of preoperative morbidity, THA leads to similar substantial improvements in quality of life. These are offset by an increase in medical complications in some subgroups of patients with high morbidity, depending on the definition used. For most elderly people, their other health disorders should not be a barrier for THA.
Contribution of lung ultrasound in diagnosis of community-acquired pneumonia in the emergency department: a prospective multicentre study
Authors: Javaudin François , Marjanovic Nicolas , de Carvalho Hugo , Gaborit Benjamin , Le Bastard Quentin , Boucher Estelle , Haroche Denis , Montassier Emmanuel , Le Conte Philippe 
Published: September 2021

Lung ultrasound (LUS) can help clinicians make a timely diagnosis of community-acquired pneumonia (CAP).ObjectivesTo assess if LUS can improve diagnosis and antibiotic initiation in emergency department (ED) patients with suspected CAP.DesignA prospective observational study.SettingsFour EDs.ParticipantsThe study included 150 patients older than 18 years with a clinical suspicion of CAP, of which 2 were subsequently excluded (incorrect identification), leaving 148 patients (70 women and 78 men, average age 72±18 years). Exclusion criteria included a life-threatening condition with do-not-resuscitate-order or patient requiring immediate intensive care.InterventionsAfter routine diagnostic procedure (clinical, radiological and laboratory tests), the attending emergency physician established a clinical CAP probability according to a four-level Likert scale (definite, probable, possible and excluded). An LUS was then performed, and another CAP probability was established based on the ultrasound result. An adjudication committee composed of three independent experts established the final CAP probability at hospital discharge.Primary and secondary outcome measuresPrimary objective was to assess concordance rate of CAP diagnostic probabilities between routine diagnosis procedure or LUS and the final probability of the adjudication committee. Secondary objectives were to assess changes in CAP probability induced by LUS, and changes in antibiotic treatment initiation.ResultsOverall, 27% (95% CI 20 to 35) of the routine procedure CAP classifications and 77% (95% CI 71 to 84) of the LUS CAP classifications were concordant with the adjudication committee classifications. Cohen’s kappa coefficients between routine diagnosis procedure and LUS, according to adjudication committee, were 0.07 (95% CI 0.04 to 0.11) and 0.61 (95% CI 0.55 to 0.66), respectively. The modified probabilities for the diagnosis of CAP after LUS resulted in changes in antibiotic prescriptions in 32% (95% CI 25 to 40) of the cases.ConclusionIn our study, LUS was a powerful tool to improve CAP diagnosis in the ED, reducing diagnostic uncertainty from 73% to 14%.Trial registration numberNCT03411824.
BESPOKE study protocol: a multicentre, prospective observational study to evaluate the impact of circulating tumour DNA guided therapy on patients with colorectal cancer
Authors: Kasi Pashtoon Murtaza , Sawyer Sarah , Guilford Jessica , Munro Michelle , Ellers Sascha , Wulff Jacob , Hook Nicole , Krinshpun Shifra , Koyen Malashevich Allyson , Malhotra Meenakshi , Rodriguez Angel , Moshkevich Solomon , Grothey Axel , Kopetz Scott , Billings Paul , Aleshin Alexey 
Published: September 2021

IntroductionColorectal cancer (CRC) is a highly prevalent disease, wherein, ~30%–40% of patients with CRC relapse postresection. In some patients with CRC, adjuvant chemotherapy can help delay recurrence or be curative. However, current biomarkers show limited clinical utility in determining if/when chemotherapy should be administered, to provide benefit. Circulating tumour DNA (ctDNA) can measure molecular residual disease (MRD) and relapse with high specificity and sensitivity. This study protocol investigates the clinical utility of ctDNA for optimal use of adjuvant chemotherapy in patients with surgically resected CRC and to detect early disease progression in the surveillance setting.Methods and analysisThis is a multicentre prospective, observational cohort study. A total of 2000 stage I–IV patients will be enrolled in up to 200 US sites, and patients will be followed for up to 2 years with serial ctDNA analysis, timed with the standard-of-care visits. The primary endpoints are to observe the impact of bespoke ctDNA testing on adjuvant treatment decisions and to measure CRC recurrence rates while asymptomatic and without imaging correlate. The secondary endpoints are MRD clearance rate (MRD+ to MRD−) during or after adjuvant chemotherapy, percentage of patients that undergo surgery for oligometastatic recurrence, survival of MRD-negative patients treated with adjuvant chemotherapy versus no adjuvant chemotherapy (active surveillance), overall survival, examine the number of stage I CRC that have recurrent disease detected postsurgery, and patient-reported outcomes.Ethics and disseminationThis study has received ethical approval from the Advarra Institutional Review Board (IRB) protocol: Natera—20-041-NCP/3766.01, BESPOKE Study of ctDNA Guided Therapy in Colorectal Cancer (BESPOKE CRC) (Pro00041473) on 10 June 2021. Data protection and privacy regulations will be strictly observed in the capturing, forwarding, processing and storing of patients’ data. Publication of any study results will be approved by Natera in accordance with the site-specific contract.Trial registration numberNCT04264702.
Impact of restricted visitation policies in hospitals on patients, family members and healthcare providers during the COVID-19 pandemic: a scoping review protocol
Authors: Moss Stephana J , Stelfox Henry T , Krewulak Karla D , Ahmed Sofia , Anglin Melanie C , Bagshaw Sean M , Barnes Tavish , Burns Karen E A , Cook Deborah J , Crowe Sarah , Doig Christopher J , Foster Nadine , Fox-Robichaud Alison , Fowler Robert , Kredenster Maia , Murthy Srinivas , Niven Daniel , Olafson Kendiss , Parhar Ken Kuljit S , Patten Scott B , Rewa Oleksa , Rochwerg Bram , Sept Bonnie G , Soo Andrea , Spence Krista , Spence Sean , Straus Sharon E , West Andrew , Parsons Leigh Jeanna , Fiest Kirsten M 
Published: September 2021

IntroductionFlexible visitation policies in hospitals are an important component of care that contributes to reduced stress and increased satisfaction among patients and their family members. Early evidence suggests restricted visitation policies enacted in hospitals during the COVID-19 pandemic are having unintended consequences on patients, family members and healthcare providers. There is a need for a comprehensive summary of the impacts of restricted visitation policies on key stakeholders and approaches to mitigate that impact.Methods and analysisWe will conduct a scoping review as per the Arksey-O’Malley 5-stage scoping review method and the Scoping Review Methods Manual by the Joanna Briggs Institute. We will search relevant electronic databases (eg, CINAHL, MEDLINE, PsycINFO), grey literature and preprint repositories. We will include all study designs including qualitative and quantitative methodologies (excluding protocols) as well as reports, opinions and editorials, to identify the broad impact of restricted hospital visitation policies due to the COVID-19 pandemic on patients, family members or healthcare providers of hospitalised patients, and approaches taken or proposed to mitigate this impact. Two reviewers will calibrate the screening criteria and data abstraction form and will independently screen studies and abstract the data. Narrative synthesis with thematic analysis will be performed.Ethics and disseminationEthical approval is not applicable as this review will be conducted on published literature only. This scoping review will identify, describe and categorise impacts of restricted hospital visitation policies due to the COVID-19 pandemic on patients, family members and healthcare providers of hospitalised patients, and approaches that have been taken to mitigate impact. We will provide a comprehensive synthesis by developing a framework of restricted visitation policies and associated impacts. Our results will inform the development of consensus statements on restricted visitation policies to be implemented in future pandemics.PROSPERO registration numberCRD42020221662.
Is patient participation in multidisciplinary tumour conferences associated with their information needs? A multicentre prospective observational study
Authors: Reck Sebastian , Diekmann Annika , Heuser Christian , Schellenberger Barbara , Ansmann Lena , Wirtz Markus Antonius , Ernstmann Nicole 
Published: September 2021

ObjectivesTo determine the association between participation of patients with breast cancer and patients with gynaecological cancer in their own multidisciplinary tumour conference (MTC) and their information needs with regard to their disease and treatment options.MethodsThis is a prospective observational study that took place at six breast cancer and gynaecological cancer centres in North Rhine-Westphalia, Germany. Patient inclusion criteria included a minimum age of 18 years and at least one diagnosis of breast cancer or gynaecological cancer. Three surveys were administered. T0 (shortly before MTC), T1 (directly after MTC) and T2 (4 weeks after MTC). Patient information needs were measured using two three-item subscales of the Cancer Patients Information Needs scale. Analysis of change was done by one-way repeated measures analysis of variance (ANOVA). To control for sampling bias, a further one-way repeated measures analysis of covariance (ANCOVA) included a propensity score as a covariate.ResultsData from 81 patients in the participation group and 120 patients in the non-participation group were analysed. The patient groups did not differ in their levels of information needs at T0 or T2. From T0 to T2, information needs increased statistically significantly in both groups with regard to both disease-related information (η²=0.354) and treatment-related information (η²=0.250). The increase in both types of information needs lost its statistical significance when the propensity score was included as a covariate. Neither ANOVA nor ANCOVA revealed a statistically significant association between patients’ participation in the MTC and their self-reported information needs.Conclusion and clinical implicationsAs concerns patients’ information needs, findings do not support a general recommendation for or against the participation of patients in their MTCs. Future research should focus on the different ways of patients’ participation in their MTCs facilitated at different cancer centres. Further research should also aim to establish which patient and disease characteristics predispose patients to benefit from participating in their MTCs.
Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA
Authors: Littman Alyson J , Bratman Gregory N , Lehavot Keren , Engel Charles C , Fortney John C , Peterson Alexander , Jones Alex , Klassen Carolyn , Brandon Joshua , Frumkin Howard 
Published: September 2021

ObjectivesTo evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD).Design and settingA pilot randomised controlled trial conducted in the US Pacific Northwest.ParticipantsVeterans with PTSD due to any cause.InterventionsTwenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13).Primary and secondary outcome measuresFeasibility was assessed based on recruitment, retention and attendance. Questionnaires and postintervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up.ResultsOf 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group.ConclusionsThis pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes.Trial registration numberNCT03997344.