bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of exercising before breakfast on the health of T2DM patients—A randomized controlled trial
Authors: Brinkmann Christian , Weh‐Gray Olivier , Brixius Klara , Bloch Wilhelm , Predel Hans-Georg , Kreutz Thorsten 
Published: August 2019

This is the first study to examine whether training before breakfast in the overnight‐fasted state is more effective in improving the health of patients with type 2 diabetes mellitus (T2DM) than after breakfast in the fed state. Thirty T2DM patients (60 ± 8 years, 33.7 ± 4.6 kg/m2) were randomly assigned to the F group (training in the overnight‐fasted state (n = 15)) and to the C group (training in the fed state (control group, n = 15)). All patients completed an 8‐week combined endurance/strength training program. Physical training significantly increased time to physical exhaustion during an endurance test (+10.4%), power output during strength tests (chest presses: +36.7% and seated rows: +37.8%), and fat‐free mass (+1.7 kg). Body fat mass (−1.9 kg), glycated hemoglobin (HbA1c) values (absolute change: −0.3%), serum insulin values (−2.5 microU/mL), the homeostatic model assessment for insulin resistance (HOMA‐IR) index (−1.1), and circulating triglyceride levels (−31 mg/dL) decreased significantly from pre‐ to post‐training. The training had no effect on body mass index, serum fasting glucose, total cholesterol, low‐density lipoprotein/high‐density lipoprotein ratio or interleukin (IL)‐6, IL‐10 and tumor necrosis factor (TNF)α levels. Analyses of variance revealed no time × group interaction for any variable (P > .05). The training was effective in improving the health of T2DM patients. However, the preliminary study's data do not provide any evidence that the nutritional state (overnight‐fasted or fed) in regular physical training plays a significant role for training‐induced adaptations in T2DM patients. Full trials (using other training protocols as well) should be conducted to gain further knowledge about the relevance of pre‐exercise breakfast ingestion.
The coordinated action of PPR4 and EMB2654 on each intron half mediates trans‐splicing of rps12 transcripts in plant chloroplasts
Authors: Lee Kwanuk , Park Su Jung , Colas des Francs‐Small Catherine , Whitby Michael , Small Ian , Kang Hunseung 
Published: August 2019

SummaryThe pentatricopeptide repeat proteins PPR4 and EMB2654 have been shown to be required for the trans‐splicing of plastid rps12 transcripts in Zea mays (maize) and Arabidopsis, respectively, but their roles in this process are not well understood. We investigated the functions of the Arabidopsis and Oryza sativa (rice) orthologs of PPR4, designated AtPPR4 (At5g04810) and OsPPR4 (Os4g58780). Arabidopsis atppr4 and rice osppr4 mutants are embryo‐lethal and seedling‐lethal 3 weeks after germination, respectively, showing that PPR4 is essential in the development of both dicot and monocot plants. Artificial microRNA‐mediated mutants of AtPPR4 displayed a specific defect in rps12 trans‐splicing, with pale‐green, yellowish or albino phenotypes, according to the degree of knock‐down of AtPPR4 expression. Comparison of RNA footprints in atppr4 and emb2654 mutants showed a similar concordant loss of extensive footprints at the 3′ end of intron 1a and at the 5′ end of intron 1b in both cases. EMB2654 is known to bind within the footprint region in intron 1a and we show that AtPPR4 binds to the footprint region in intron 1b, via its PPR motifs. Binding of both PPR4 and EMB2654 is essential to juxtapose the two intron halves and to maintain the RNAs in a splicing‐competent structure for the efficient trans‐splicing of rps12 intron 1, which is crucial for chloroplast biogenesis and plant development. The similarity of EMB2654 and PPR4 orthologs and their respective binding sites across land plant phylogeny indicates that their coordinate function in rps12 trans‐splicing has probably been conserved for 500 million years.
Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy
Authors: Reints Bok Tjarda E. , Willemsen Koen , van Rijen Mattie H. P. , Grinwis Guy C. M. , Tryfonidou Marianna A. , Meij Björn P. 
Published: August 2019

AbstractObjectiveTo report the long‐term outcome of nine dogs treated for caudal cervical spondylomyelopathy (CCSM) with surgical spinal fusion.Study designShort case series.AnimalsNine large‐breed dogs.MethodsMedical records of dogs treated for disc‐associated CCSM (2013‐2016) were reviewed. The surgery objective was spinal distraction by implantation of a SynCage and fixation with two Unilock plates. Follow‐up included the Helsinki pain score questionnaire, neurological grading, radiography, computed tomography (CT), and micro‐CT (μCT) with subsequent histopathology (two dogs).ResultsClinical follow‐up was obtained between 9 and 51 months (27.4 ± 13.4 months). The Helsinki pain score and neurological Griffith score improved (P < .01) in all dogs and in eight of nine dogs, respectively. According to CT, the volume of bone (mean ± SD) through the cage was 79.5% ± 14.3%, including compact bone (53.0% ± 23.4%). Subsidence was seen in one of nine dogs. Implant failure was evident in four dogs, and plates were removed in two dogs. In seven of nine dogs, infraclinical pathology was observed in adjacent segment, associated with implants engaging adjacent intervertebral discs. Radiographic evidence of bony fusion between vertebral bodies was noted in all dogs. Spinal fusion was confirmed by μCT and histopathology in two cervical spine segments that became available at 22 and 40 months postoperatively.ConclusionInstrumented spinal fusion in dogs with disc‐associated CCSM resulted in owner satisfaction and radiographic evidence of interbody spinal fusion in all dogs.Clinical significanceThe fusion distraction technique reported here can be used to achieve spinal fusion with a good long‐term outcome.
The Initial Intentions for Social Leveraging of a Mega Sport Event Among Stakeholders of a Newly Formed Interorganizational Relationship
Authors: Gao Fei , Heere Bob , Todd Samuel Y. , Mihalik Brian 
Published: August 2019

Although the concept of social leverage has been a key component of research on mega sport events, authors know little about how the initial partnership between stakeholders of the event allows for social leveraging prior to the event. Thus, the purpose of this study is to understand what intentions stakeholders of a newly formed interorganizational relationship for the 2019 Federation of International Basketball Associations World Cup have toward social leverage initiatives and whether they coordinate such efforts with other stakeholders. Data were collected through two rounds of interviews with high-ranking leaders in the stakeholder organizations. The authors found that social leverage is not part of the early planning for the event because (a) different stakeholders/organizations have little knowledge of social leverage, (b) the media amplifies current values and beliefs of the interorganizational relationship stakeholders, and (c) the Chinese culture has an implicit/explicit influence on the interorganizational relationship. The study contributes to our understanding of challenges surrounding social leveraging.
Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children
Authors: Kaufman Jonathan , Knight Andrew Joshua , Bryant Penelope A , Babl Franz E , Dalziel Kim 
Published: August 2019

BackgroundUrinary tract infection (UTI) is a common childhood infection. Many febrile children require a urine sample to diagnose or exclude UTI. Collecting urine from young children can be time-consuming, unsuccessful or contaminated. Cost-effectiveness of each collection method in the emergency department is unknown.ObjectiveTo determine the cost-effectiveness of urine collection methods for precontinent children.MethodsA cost-effectiveness analysis was conducted comparing non-invasive (urine bag, clean catch and 5 min voiding stimulation for clean catch) and invasive (catheterisation and suprapubic aspirate (SPA)) collection methods, for children aged 0–24 months in the emergency department. Costs included equipment, staff time and hospital bed occupancy. If initial collection attempts were unsuccessful subsequent collection using catheterisation was assumed. The final outcome was a definitive sample incorporating progressive dipstick, culture and contamination results. Average costs and outcomes were calculated for initial collection attempts and obtaining a definitive sample. One-way and probabilistic sensitivity analyses were performed.ResultsFor initial collection attempts, catheterisation had the lowest cost per successful collection (GBP£25.98) compared with SPA (£37.80), voiding stimulation (£41.32), clean catch (£52.84) and urine bag (£92.60). For definitive collection, catheterisation had the lowest cost per definitive sample (£49.39) compared with SPA (£51.84), voiding stimulation (£52.25), clean catch (£64.82) and urine bag (£112.28). Time occupying a hospital bed was the most significant determinant of cost.ConclusionCatheterisation is the most cost-effective urine collection method, and voiding stimulation is the most cost-effective non-invasive method. Urine bags are the most expensive method. Although clinical factors influence choice of method, considering cost-effectiveness for this common procedure has potential for significant aggregate savings.
Outcomes associated with peripherally inserted central catheters in hospitalised children: a retrospective 7-year single-centre experience
Authors: Badheka Aditya , Bloxham Jodi , Schmitz April , Freyenberger Barbara , Wang Tong , Rampa Sankeerth , Turi Jennifer , Allareddy Veerasathpurush , Auslender Marcelo , Allareddy Veerajalandhar 
Published: August 2019

ObjectivesThe use of peripherally inserted central catheters (PICCs) are an integral part of caring for hospitalised children. We sought to estimate the incidence of and identify the risk factors for complications associated with PICCs in an advanced registered nurse practitioners (ARNP)-driven programme.DesignRetrospective cohort study.SettingSingle-centre, large quaternary children's hospital.ParticipantsHospitalised children who had PICC inserted from 1 January 2010 to 31 December 2016.InterventionsNone.Measurement and main resultsA total of 2558 PICCs were placed during the study period. Mean age at PICC insertion was 8.7 years, mean dwell time was 17.7 days. The majority of PICCs (97.8%) were placed by ARNP. Most were placed in a single attempt (79.6%). Mean PICC residual external length outside was 2.1±2.7 cm. The rate of central line-associated bloodstream infection (CLABSI), thrombosis and significant bleeding were 1.9%, 1% and 0.2%, respectively. The CLABSI rate in infants and early childhood was higher than those aged ≥5 years (2.8%, 3.1%, respectively vs 1.3%). In a multivariate analysis after adjustment of confounding effects of race and gender, infants (OR= 2.24, CI=1.14 to 4.39, p=0.02) and early childhood cohort (OR=2.37, CI=1.12 to 5.01, p=0.02) were associated with significantly higher odds of developing CLABSI compared with ≥5 years old. In the early childhood cohort, PICCs with longer residual external catheter length (OR=1.30, 95% CI=1.07 to 1.57, p=0.008) and those placed in the operating room (OR=5.49, 95% CI=1.03 to 29.19, p=0.04), were associated with significantly greater risk of developing CLABSI.ConclusionsThe majority of PICCs were successfully placed by ARNPs on the first attempt and had a low incidence of complications. Infants required more attempts for successful PICC placement than older children. The presence of residual external catheter length and placement in the operating room were independent predictors of CLABSI in younger children.
Physical activity, sedentary time and their associations with clustered metabolic risk among people with type 2 diabetes in Jiangsu province: a cross-sectional study
Authors: Chen Yijia , Yang Jie , Su Jian , Qin Yu , Shen Chong , Li Ying , Lu Shurong , Pan Enchun , Gao Yan , Miao Dandan , Zhang Ning , Zhou Jinyi , Wu Ming 
Published: August 2019

ObjectiveInvestigating the association between total physical activity, physical activity in different domains and sedentary time with clustered metabolic risk in patients with type 2 diabetes from Jiangsu province, China.DesignInterview-based cross-sectional study conducted between December 2013 and January 2014.Setting44 selected townships across two cities, Changshu and Huai’an, in Jiangsu province.Participants20 340 participants selected using stratified cluster-randomised sampling and an interviewer-managed questionnaire.MethodsWe constructed clustered metabolic risk by summing sex-specific standardised values of waist circumference, fasting triacylglycerol, fasting plasma glucose, systolic blood pressure and the inverse of blood high-density lipoprotein cholesterol (HDL-cholesterol). Self-reported total physical activity included occupation, commuting and leisure-time physical activity. The un-standardised regression coefficient [B] and its 95% CI were calculated using multivariate linear regression analyses.ResultsThis study included 17 750 type 2 diabetes patients (aged 21–94 years, 60.3% female). The total (B=−0.080; 95% CI: −0.114 to −0.046), occupational (B=−0.066; 95% CI: −0.101 to− 0.031) and leisure-time physical activity (B=−0.041; 95% CI: −0.075 to −0.007), and sedentary time (B=0.117; 95% CI: 0.083 to 0.151) were associated with clustered metabolic risk. Total physical activity, occupational physical activity and sedentary time were associated with waist circumference, triacylglycerol and HDL-cholesterol, but not with systolic blood pressure. Commuting physical activity and sedentary time were significantly associated with triacylglycerol (B=−0.012; 95% CI: −0.019 to −0.005) and fasting plasma glucose (B=0.008; 95% CI: 0.003 to 0.01), respectively. Leisure-time physical activity was only significantly associated with systolic blood pressure (B=−0.239; 95% CI: −0.542 to− 0.045).ConclusionsTotal, occupational and leisure-time physical activity were inversely associated with clustered metabolic risk, whereas sedentary time increased metabolic risk. Commuting physical activity was inversely associated with triacylglycerol. These findings suggest that increased physical activity in different domains and decreased sedentary time may have protective effects against metabolic risk in type 2 diabetes patients.
Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study
Authors: Molina-Soberanes Daniel , Martínez-Ruiz Virginia , Lardelli-Claret Pablo , Pulido-Manzanero José , Martín-delosReyes Luis Miguel , Moreno-Roldán Elena , Jiménez-Mejías Eladio 
Published: August 2019

ObjectiveTo quantify the magnitude of associations between cyclist fatalities and both cyclist and environment related characteristics in Spain during the first 24 hours after a crash.DesignCohort study.SettingSpain.Participants65 977 cyclists injured in road crashes recorded between 1993 and 2013 in the Spanish Register of Road Crashes with Victims.Main outcomeDeath within the first 24 hours after the crash.MethodsA multiple imputation procedure was used to mitigate the effect of missing values. Differences between regions were assumed and managed with multilevel analysis at the cyclist and province levels. Incidence density ratios (IDR) with 95% CI were calculated with a multivariate Poisson model.ResultsNon-use of a helmet was directly associated with death (IDR 1.43, 95% CI 1.25 to 1.64). Among other cyclist characteristics, age after the third decade of life was also directly associated with death, especially in older cyclists (‘over 74’ category, IDR 4.61, 95% CI 3.49 to 6.08). The association with death did not differ between work-related cycling and other reasons for cycling.There was an inverse association with death for crashes in urban areas and on community roads. Any adverse meteorological condition also showed a direct association with death, whereas altered road surfaces showed an inverse association. Crashes during nighttime were directly associated with death, with a peak between 3:00 and 5:59 am (IDR 1.58, 95% CI 1.03 to 2.41).ConclusionsWe found strong direct and inverse associations between several cyclist and environment related variables and death. These variables should be considered in efforts to prioritise public health measures aimed at reducing the number of cycling-related fatalities.
An exploratory spatial analysis of overweight and obesity among children and adolescents in Shandong, China
Authors: Qin Wenzhe , Wang Lu , Xu Lingzhong , Sun Long , Li Jiajia , Zhang Jiao , Shao Hui 
Published: August 2019

ObjectiveIdentifying the spatial patterns of childhood overweight/obesity (OW/OB) can help to guide resource allocation for preventive intervention in China. This study aims to estimate rates of childhood OW/OB across counties within Shandong Province, using geographic techniques to identify sex-specific spatial patterns of childhood OW/OB as well as the presence of spatial clusters.DesignCross-sectional study.SettingShandong Province in China.Participants and methodsData on 6 216 076 children and adolescents aged 7–18 years from the Primary and Secondary Schoolchildren Physical Examination Database for Shandong Province were used in this study. Spatial patterns of sex-specific prevalence of childhood OW/OB were mapped. Global autocorrelation statistic (Moran’s I) and the Local Indicator of Spatial Association (LISA) were applied to assess the degree of spatial autocorrelation.ResultsThe overall prevalence of childhood OW/OB in Shandong province were 15.05% and 9.23%, respectively. Maps of the sex-specific prevalence of OW/OB demonstrate a marked geographical variation of childhood OW/OB in different regions. Prevalence of childhood OW/OB had a significant positive spatial autocorrelation among both boys and girls. LISA analysis identified significant clusters (or ‘hot spots’) of childhood OW/OB in the eastern coastal region, central region and southwestern region.ConclusionsThe prevalence of childhood OW/OB is highly spatially clustered. Geographically focused appropriate intervention should be introduced in current childhood OW/OB prevention and control strategy.
Clinical and cost-effectiveness of teen online problem-solving for adolescents who have survived an acquired brain injury in the UK: protocol for a randomised, controlled feasibility study (TOPS-UK)
Authors: Limond Jenny , Wade Shari L. , Vickery Patricia Jane , Jeffery A , Warren Fiona C , Hawton Annie , Smithson Janet , Ford Tamsin , Haworth Sarah , Adlam Anna-Lynne Ruth 
Published: August 2019

IntroductionPaediatric acquired brain injury is a leading cause of mortality in children in the UK. Improved treatment during the acute phase has led to increased survival rates, although with life-long morbidity in terms of social and emotional functioning. This is the protocol for a feasibility randomised controlled trial with an embedded qualitative study and feasibility economic evaluation. If feasible, a later definitive trial will test the effectiveness and cost-effectiveness of an online intervention to enhance problem solving ability versus treatment as usual.Methods and analysisTwenty-five adolescents and their families identified by primary or secondary care clinicians at participating UK National Health Service Trusts will be recruited and individually randomised in a 1:1 ratio to receive the online intervention or treatment as usual. Participants will be followed up by online questionnaires 17 weeks after randomisation to capture acceptability of the study and intervention and resource use data. Qualitative interviews will capture participants’ and clinicians’ experiences of the study.Ethics and disseminationThis study has been granted ethical approval by the South West-Exeter Research Ethics Committee (ref 17/SW/0083). Results will be disseminated via peer-reviewed publications and will inform the design of a larger trial.Trial registration numberISRCTN10906069
Choosing Healthy Eating for Infant Health (CHErIsH) study: protocol for a feasibility study
Authors: Matvienko-Sikar Karen , Toomey Elaine , Queally Michelle , Flannery Caragh , O Neill Kate , Dinan Ted G , Doherty Edel , Harrington Janas M , Hayes Catherine , Heary Caroline , Hennessy Marita , Kelly Colette , Mc Hugh Sheena M , McSharry Jenny , Stanton Catherine , Heffernan Tony , Byrne Molly , Kearney Patricia M 
Published: August 2019

IntroductionChildhood obesity is a public health challenge. There is evidence for associations between parents’ feeding behaviours and childhood obesity risk. Primary care provides a unique opportunity for delivery of infant feeding interventions for childhood obesity prevention. Implementation strategies are needed to support infant feeding intervention delivery. The Choosing Healthy Eating for Infant Health (CHErIsH) intervention is a complex infant feeding intervention delivered at infant vaccination visits, alongside a healthcare professional (HCP)-level implementation strategy to support delivery.Methods and analysisThis protocol provides a description of a non-randomised feasibility study of an infant feeding intervention and implementation strategy, with an embedded process evaluation and economic evaluation. Intervention participants will be parents of infants aged ≤6 weeks at recruitment, attending a participating HCP in a primary care practice. The intervention will be delivered at the infant’s 2, 4, 6, 12 and 13 month vaccination visits and involves brief verbal infant feeding messages and additional resources, including a leaflet, magnet, infant bib and sign-posting to an information website. The implementation strategy encompasses a local opinion leader, HCP training delivered prior to intervention delivery, electronic delivery prompts and additional resources, including a training manual, poster and support from the research team. An embedded mixed-methods process evaluation will examine the acceptability and feasibility of the intervention, the implementation strategy and study processes including data collection. Qualitative interviews will explore parent and HCP experiences and perspectives of delivery and receipt of the intervention and implementation strategy. Self-report surveys will examine fidelity of delivery and receipt, and acceptability, suitability and comprehensiveness of the intervention, implementation strategy and study processes. Data from electronic delivery prompts will also be collected to examine implementation of the intervention. A cost–outcome description will be conducted to measure costs of the intervention and the implementation strategy.Ethics and disseminationThis study received approval from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Study findings will be disseminated via peer-reviewed publications and conference presentations.