bluuebunny/crossref_metadata_2025_split huggingface dataset:
The muscle anabolic effect of protein ingestion during a hyperinsulinaemic euglycaemic clamp in middle‐aged women is not caused by leucine alone
Authors: van Vliet Stephan , Smith Gordon I. , Porter Lane , Ramaswamy Raja , Reeds Dominic N. , Okunade Adewole L. , Yoshino Jun , Klein Samuel , Mittendorfer Bettina 
Published: July 2018

Key points
It has been suggested that leucine is primarily responsible for the increase in muscle protein synthesis after protein ingestion because leucine uniquely activates the mTOR‐p70S6K signalling cascade.
We compared the effects of ingesting protein or an amount of leucine equal to that in the protein during a hyperinsulinaemic‐euglycaemic clamp (to eliminate potential confounding as a result of differences in the insulinogenic effect of protein and leucine ingestion) on muscle anabolic signalling and protein turnover in 28 women.
We found that protein, but not leucine, ingestion increased muscle p‐mTORSer2448 and p‐p70S6KThr389, although only protein, and not leucine, ingestion decreased muscle p‐eIF2αSer51 and increased muscle protein synthesis.
AbstractIt has been suggested that leucine is primarily responsible for the increase in muscle protein synthesis (MPS) after protein ingestion because leucine uniquely activates the mTOR‐p70S6K signalling cascade. We tested this hypothesis by measuring muscle p‐mTORSer2448, p‐p70S6KThr389 and p‐eIF2αSer51, as well as protein turnover (by stable isotope labelled amino acid tracer infusion in conjunction with leg arteriovenous blood and muscle tissue sampling), in 28 women who consumed either 0.45 g protein kg−1 fat‐free mass (containing 0.0513 g leucine kg−1 fat‐free mass) or a control drink (n = 14) or 0.0513 g leucine kg−1 fat‐free mass or a control drink (n = 14) during a hyperinsulinaemic‐euglycaemic clamp procedure (HECP). Compared to basal conditions, the HECP alone (without protein or leucine ingestion) suppressed muscle protein breakdown by ∼20% and increased p‐mTORSer2448 and p‐p70S6KThr389 by >50% (all P < 0.05) but had no effect on p‐eIF2αSer51 and MPS. Both protein and leucine ingestion further increased p‐mTORSer2448 and p‐p70S6KThr389, although only protein, and not leucine, ingestion decreased (by ∼35%) p‐eIF2αSer51 and increased (by ∼100%) MPS (all P < 0.05). Accordingly, leg net protein balance changed from negative (loss) during basal conditions to equilibrium during the HECP alone and the HECP with concomitant leucine ingestion and to positive (gain) during the HECP with concomitant protein ingestion. These results provide new insights into the regulation of MPS by demonstrating that leucine and mTOR signalling alone are not responsible for the muscle anabolic effect of protein ingestion during physiological hyperinsulinaemia, most probably because they fail to signal to eIF2α to initiate translation and/or additional amino acids are needed to sustain translation.
Recent intimate partner violence against women and health: a systematic review and meta-analysis of cohort studies
Authors: Bacchus Loraine J , Ranganathan Meghna , Watts Charlotte , Devries Karen 
Published: July 2018

ObjectiveWe reviewed cohort studies to determine the magnitude and temporal direction of the association between recent intimate partner violence (IPV) and a range of adverse health outcomes or health risk behaviours.DesignSystematic review and meta-analysis.MethodsMedline, EMBASE and PsycINFO were searched from the first record to November 2016. Recent IPV was defined as occurring up to and including the last 12 months; all health outcomes were eligible for inclusion. Results were combined using random-effects meta-analysis.Results35 separate cohort studies were retrieved. Eight studies showed evidence of a positive association between recent IPV and subsequent depressive symptoms, with a pooled OR from five estimates of 1.76 (95% CI 1.26 to 2.44, I2=37.5%, p=0.172). Five studies demonstrated a positive, statistically significant relationship between depressive symptoms and subsequent IPV; the pooled OR from two studies was 1.72 (95% CI 1.28 to 2.31, I2=0.0%, p=0.752). Recent IPV was also associated with increased symptoms of subsequent postpartum depression in five studies (OR=2.19, 95% CI 1.39 to 3.45, p=0.000), although there was substantial heterogeneity. There was some evidence of a bidirectional relationship between recent IPV and hard drug use and marijuana use, although studies were limited. There was no evidence of an association between recent IPV and alcohol use or sexually transmitted infections (STIs), although there were few studies and inconsistent measurement of alcohol and STIs.ConclusionsExposure to violence has significant impacts. Longitudinal studies are needed to understand the temporal relationship between recent IPV and different health issues, while considering the differential effects of recent versus past exposure to IPV. Improved measurement will enable an understanding of the immediate and longer term health needs of women exposed to IPV. Healthcare providers and IPV organisations should be aware of the bidirectional relationship between recent IPV and depressive symptoms.PROSPERO registration numberCRD42016033372.
Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review
Authors: Buja Alessandra , Toffanin Roberto , Claus Mirko , Ricciardi Walter , Damiani Gianfranco , Baldo Vincenzo , Ebell Mark H 
Published: July 2018

ObjectivesOur goal is to conceptualise a clinical governance framework for the effective management of chronic diseases in the primary care setting, which will facilitate a reorganisation of healthcare services that systematically improves their performance.SettingPrimary care.ParticipantsChronic Care Model by Wagneret aland Clinical Governance statement by Scallyet alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both.InterventionsWe conducted an umbrella review of all systematic reviews published by the Cochrane Effective Practice and Organisation of Care Group to identify organisational interventions in primary care with demonstrated evidence of efficacy.ResultsAll primary healthcare systems should be patient-centred. Interventions for patients and their families should focus on their values; on clinical, professional and institutional integration and finally on accountability to patients, peers and society at large. These interventions should be shaped by an approach to their clinical management that achieves the best clinical governance, which includes quality assurance, risk management, technology assessment, management of patient satisfaction and patient empowerment and engagement. This approach demands the implementation of a system of organisational, functional and professional management based on a population health needs assessment, resource management, evidence-based and patient-oriented research, professional education, team building and information and communication technologies that support the delivery system. All primary care should be embedded in and founded on an active partnership with the society it serves.ConclusionsA framework for clinical governance will promote an integrated effort to bring together all related activities, melding environmental, administrative, support and clinical elements to ensure a coordinated and integrated approach that sustains the provision of better care for chronic conditions in primary care setting.
Stability of home-based care arrangements for people living with dementia: protocol of a meta-study on mixed research
Authors: Dreyer Jan , Köhler Kerstin , Hochgraeber Iris , Holle Bernhard , von Kutzleben Milena 
Published: July 2018

IntroductionWorldwide, most people with dementia live at home and are cared for by informal carers. During the dementia care trajectory, creating and maintaining a stable care situation is a guiding principle of informal carers and a desirable outcome of contemporary healthcare policies. However, though there is an extensive body of research focusing on the course of dementia care trajectories, it remains unclear how stability of home-based care arrangements is constituted and what are the essential factors that influence this stability. This paper outlines a protocol of a systematic review that aims to address these gaps in knowledge.Methods and analysisTo theorise the complex phenomenon of stability of home-based care arrangements for people with dementia, we will conduct a meta-study. Meta-studies include three analytical components (meta-data analysis, meta-method and meta-theory) that are combined and finally culminate in an integrative knowledge synthesis. Originally, meta-study was designed to include qualitative studies only. To capture relevant contributions to our target phenomenon from all types of evidence, we will extend the original methodology and apply it to studies with qualitative, quantitative and mixed-methods designs and to (systematic) reviews. Eligible studies will be identified by systematic database searches (PubMed, CINAHL and PsycINFO), backward/forward citation tracking, snowballing and theoretical sampling. All identified studies will be screened against predefined inclusion criteria. The main analytical approach for all analyses is thematic synthesis. The meta-study will generate a more comprehensive understanding of dementia care trajectories and will be used to identify research gaps, develop future research questions and define relevant outcomes.DisseminationThe findings of the meta-study will be published in a series of articles in peer-reviewed scientific journals and will be presented at national and international scientific conferences.PROSPERO registration numberCRD42016041727.
Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016
Authors: Navarro Albert , Salas-Nicás Sergio , Moncada Salvador , Llorens Clara , Molinero-Ruiz Emilia 
Published: July 2018

ObjectivesThe aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the ‘healthy’ workers.DesignPopulation-based cross-sectional study.SettingSalaried population in Spain.ParticipantsData were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615.Main outcome measuresSelf-reported episodes of SP and their reasons.Results23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker’s wage to the total household income and downsizing; factors among the ‘unhealthy’ workers are working more than 48 hours and not having a contract. The most common reason for SP is ‘did not want to burden my colleagues’, 45.7% (95% CI 37.3 to 54.4), whereas ‘I could not afford it for economic reasons’ ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report ‘worried about being laid off’ as a reason for going to work despite being ill.ConclusionsThe estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding ‘healthy’ workers). The reason ‘I was worried about being laid off’ was much more common than the estimates for Sweden or Norway.
Balancing the risk of the evacuation and sheltering-in-place options: a survival study following Japan’s 2011 Fukushima nuclear incident
Authors: Shimada Yuki , Nomura Shuhei , Ozaki Akihiko , Higuchi Asaka , Hori Arinobu , Sonoda Yuki , Yamamoto Kana , Yoshida Izumi , Tsubokura Masaharu 
Published: July 2018

ObjectiveThe decision to evacuate or shelter-in-place is fundamental to emergency response, especially for a vulnerable population. While an elevated risk of mortality due to a hasty, unplanned evacuation has been well documented, there is little research on and knowledge about the health consequences of sheltering-in-place in disaster contexts. We compared hospital mortality in patients who sheltered-in-place (non-evacuees) after the incident with the baseline preincident mortality and articulated postincident circumstances of the hospital while sheltering-in-place.ParticipantsWe considered all 484 patients admitted to Takano Hospital (located 22 km South of the Fukushima Daiichi nuclear power plant) from 1 January 2008 to 31 December 2016.MethodsSignificant differences in mortality rates between preincident baseline and three postincident groups (evacuees, non-evacuees (our major interest) and new admittees) were tested using the Bayesian survival analysis with Weibull multivariate regression and survival probability using the Kaplan-Meier product limit method. All the analyses were separately performed by the internal and psychiatry department.ResultsAfter adjusting for covariates, non-evacuees in the internal department had a significantly higher mortality risk with an HR of 1.57 (95% credible intervals 1.11 to 2.18) than the baseline preincident. Of them, most deaths occurred within the first 100 days of the incident. No significant increase in mortality risk was identified in evacuees and new admittees postincident in the department, which were adjusted for covariates. In contrast, for the psychiatry department, statistical difference in mortality risk was not identified in any groups.ConclusionsThe mortality risk of sheltering-in-place in a harsh environment might be comparable to those in an unplanned evacuation. If sheltering-in-place with sufficient resources is not guaranteed, evacuation could be a reasonable option, which might save more lives of vulnerable people if performed in a well-planned manner with satisfactory arrangements for appropriate transportation and places to safely evacuate.
Metagenomic analysis of gut microbial communities from a Central Asian population
Authors: Kushugulova Almagul , Forslund Sofia K , Costea Paul Igor , Kozhakhmetov Samat , Khassenbekova Zhanagul , Urazova Maira , Nurgozhin Talgat , Zhumadilov Zhaxybay , Benberin Valery , Driessen Marja , Hercog Rajna , Voigt Anita Yvonne , Benes Vladimir , Kandels-Lewis Stefanie , Sunagawa Shinichi , Letunic Ivica , Bork Peer 
Published: July 2018

ObjectiveChanges in the gut microbiota are increasingly recognised to be involved in many diseases. This ecosystem is known to be shaped by many factors, including climate, geography, host nutrition, lifestyle and medication. Thus, knowledge of varying populations with different habits is important for a better understanding of the microbiome.DesignWe therefore conducted a metagenomic analysis of intestinal microbiota from Kazakh donors, recruiting 84 subjects, including male and female healthy subjects and metabolic syndrome (MetS) patients aged 25–75 years, from the Kazakh administrative centre, Astana. We characterise and describe these microbiomes, the first deep-sequencing cohort from Central Asia, in comparison with a global dataset (832 individuals from five countries on three continents), and explore correlations between microbiota, clinical and laboratory parameters as well as with nutritional data from Food Frequency Questionnaires.ResultsWe observe that Kazakh microbiomes are relatively different from both European and East Asian counterparts, though similar to other Central Asian microbiomes, with the most striking difference being significantly more samples falling within thePrevotella-rich enterotype, potentially reflecting regional diet and lifestyle. We show that this enterotype designation remains stable within an individual over time in 82% of cases. We further observe gut microbiome features that distinguish MetS patients from controls (eg, significantly reduced Firmicutes to Bacteroidetes ratio,BifidobacteriaandSubdoligranulum, alongside increasedPrevotella), though these overlap little with previously published reports and thus may reflect idiosyncrasies of the present cohort.ConclusionTaken together, this exploratory study describes gut microbiome data from an understudied population, providing a starting point for further comparative work on biogeography and research on widespread diseases.Trial registration numberISRCTN37346212; Post-results.
Life after breast cancer: moving on, sitting down or standing still? A prospective study of Canadian breast cancer survivors
Authors: Sabiston Catherine M , Wrosch Carsten , Fong Angela J , Brunet Jennifer , Gaudreau Patrick , O’Loughlin Jennifer , Meterissian Sarkis 
Published: July 2018

IntroductionBreast cancer (BC) is associated with serious physical and psychological health sequelae that affect quality and quantity of life. Physical activity (PA) and sedentary behaviour can prevent or diminish these sequelae; yet, little is known about how these lifestyle behaviours change after cancer treatment and if these changes affect post-treatment health. The first aim of this study is to describe natural trends in lifestyle behaviours (ie, PA, sedentary behaviour) in women treated for BC. The second aim is to examine the longitudinal associations between lifestyle behaviour changes and (1) physical health (eg, acute symptoms, chronic conditions, body composition, patient-reported fatigue, pain and functioning), (2) psychological health and illness (eg, depression, stress, affect, post-traumatic growth, cancer worry, mood, body image) and (3) biological functioning (eg, cortisol and C-reactive protein). The third aim is to examine modifiable self-regulation (ie, goal adjustment strategies) and motivation constructs (ie, self-determined regulations) that predict trends in lifestyle behaviours.Method and analysisThis is a prospective longitudinal study of 201 women treated for BC. Data (eg, surveys, accelerometers, saliva, blood) are collected every 3 months during the first year after women complete systemic treatment for a first diagnosis of BC, and once every year for 4 years thereafter. Data analyses assess trends and changes in PA and sedentary lifestyle behaviours, examine associations between these trends and changes in health outcomes and identify modifiable predictors of PA and sedentary lifestyle behaviours using multilevel modelling.Ethics and disseminationEthical approval was obtained from the University of Toronto (REB# 28180) and has been funded by the Canadian Institutes of Health Research (#186128). Study findings will be disseminated through peer-reviewed publications, academic conferences, local community-based presentations such as the Canadian Cancer Society and similar organisations.
Trial of feasibility and acceptability of routine low-dose aspirin versusEarlyScreeningTest indicated aspirin for pre-eclampsia prevention (TESTstudy): a multicentre randomised controlled trial
Authors: Mone Fionnuala , Mulcahy Cecilia , McParland Peter , Breathnach Fionnuala , Downey Paul , McCormack Dorothy , Culliton Marie , Stanton Alice , Cody Fiona , Morrison John J , Daly Sean , Higgins John , Cotter Amanda , Hunter Alyson , Tully Elizabeth C , Dicker Patrick , Alfirevic Zarko , Malone Fergal D , McAuliffe Fionnuala M 
Published: July 2018

ObjectiveEvaluate the feasibility and acceptability of routine aspirin in low-risk women, compared with screening-test indicated aspirin for the prevention of pre-eclampsia and fetal growth restriction.DesignMulticentre open-label feasibility randomised controlled trial.SettingTwo tertiary maternity hospitals in Dublin, Ireland.Participants546 low-risk nulliparous women completed the study.InterventionsWomen underwent computerised randomisation to: Group 1—routine aspirin 75 mg from 11 until 36 weeks; Group 2—no aspirin and; Group 3—aspirin based on the Fetal Medicine Foundation screening test.Primary and secondary outcome measures(1) Proportion agreeing to participate; (2) compliance with protocol; (3) proportion where first trimester uterine artery Doppler was obtainable and; (4) time taken to issue a screening result. Secondary outcomes included rates of pre-eclampsia and small-for-gestational-age fetuses.Results546 were included in the routine aspirin (n=179), no aspirin (n=183) and screen and treat (n=184) groups. 546 of 1054 were approached (51.8%) and enrolled. Average aspirin adherence was 90%. The uterine artery Doppler was obtained in 98.4% (181/184) and the average time to obtain a screening result was 7.6 (0–26) days. Of those taking aspirin, vaginal spotting was greater; n=29 (15.1%), non-aspirin n=28 (7.9%), OR 2.1 (95% CI 1.2 to 3.6). Postpartum haemorrhage >500 mL was also greater; aspirin n=26 (13.5%), no aspirin n=20 (5.6%), OR 2.6 (95% CI 1.4 to 4.8).ConclusionLow-risk nulliparous women are open to taking aspirin in pregnancy and had high levels of adherence. Aspirin use was associated with greater rates of vaginal bleeding. An appropriately powered randomised controlled trial is now required to address the efficacy and safety of universal low-dose aspirin in low-risk pregnancy compared with a screening approach.Trial registration numberISRCTN (15191778); Post-results.
JACK trial protocol: a phase III multicentre cluster randomised controlled trial of a school-based relationship and sexuality education intervention focusing on young male perspectives
Authors: Lohan Maria , Aventin Áine , Clarke Mike , Curran Rhonda M , Maguire Lisa , Hunter Rachael , McDowell Clíona , McDaid Lisa , Young Honor , White James , Fletcher Adam , French Rebecca , Bonell Christopher , Bailey Julia V , O’Hare Liam 
Published: July 2018

IntroductionTeenage pregnancy remains a worldwide health concern which is an outcome of, and contributor to, health inequalities. The need for gender-aware interventions with a focus on males in addressing teenage pregnancy has been highlighted as a global health need by WHO and identified in systematic reviews of (relationship and sexuality education (RSE)). This study aims to test the effectiveness of an interactive film-based RSE intervention, which draws explicit attention to the role of males in preventing an unintended pregnancy by reducing unprotected heterosexual teenage sex among males and females under age 16 years.Methods and analysisA phase III cluster randomised trial with embedded process and economic evaluations.If I Were Jackencompasses a culturally sensitive interactive film, classroom materials, a teacher-trainer session and parent animations and will be delivered to replace some of the usual RSE for the target age group in schools in the intervention group. Schools in the control group will not receive the intervention and will continue with usual RSE. Participants will not be blinded to allocation. Schools are the unit of randomisation stratified per country and socioeconomic status. We aim to recruit 66 UK schools (24 in Northern Ireland; 14 in each of England, Scotland and Wales), including approximately 7900 pupils. A questionnaire will be administered at baseline and at 12–14 months postintervention. The primary outcome is reported unprotected sex, a surrogate measure associated with unintended teenage pregnancy. Secondary outcomes include knowledge, attitudes, skills and intentions relating to avoiding teenage pregnancy in addition to frequency of engagement in sexual intercourse, contraception use and diagnosis of sexually transmitted infections.Ethics and disseminationEthical approval was obtained from Queen’s University Belfast. Results will be published in peer-reviewed journals and disseminated to stakeholders. Funding is from the National Institute for Health Research.Trial registration numberISRCTN99459996