bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Placement budgets’ for supported employment: impact on employment rates in a multicentre randomised controlled trial
Authors: Rössler Wulf , Kawohl Wolfram , Nordt Carlos , Haker Helene , Rüsch Nicolas , Hengartner Michael P. 
Published: July 2019

BackgroundThe most effective rehabilitation model for job (re-)entry of people with mental illness is supported employment. A barrier to introducing supported employment into standard care is its temporally unlimited provision, which conflicts with health and social legislation in many European countries.AimsTo test the impact of different ‘placement budgets’, i.e. a predefined maximum time budget for job seeking until take-up of competitive employment.MethodParticipants (116) were randomly assigned to 25 h, 40 h or 55 h placement budgets in an intent-to-treat analysis. We applied the individual placement and support model over 24 months, following participants for 36 months. Primary outcome was employment in the labour market for at least 3 months.ResultsThe proportion of participants obtaining competitive employment was 55.1% in the 25 h group, 37.8% in the 40 h group and 35.8% in the 55 h group. In a Cox regression analysis, time to employment was slightly lower in the 25 h group relative to the 40 h (hazard ratio 1.78, 95% CI 0.88–3.57, P = 0.107) and 55 h groups (hazard ratio 1.74, 95% CI 0.86–3.49, P = 0.122), but this was not statistically significant. The vast majority of all participants who found a job did so within the first 12 months (80.4%).ConclusionA restricted time budget for job finding and placement does not affect the rate of successful employment. In accordance with legislation, a restriction of care provision seems justified and enhances the chances of supported employment being introduced in statutory services.
Determinants of mental and physical health treatment-seeking among military personnel
Authors: Britt Thomas W. , Sipos Maurice L. , Klinefelter Zachary , Adler Amy B. 
Published: July 2019

BackgroundAlthough research has documented factors influencing whether military personnel seek treatment for mental health problems, less research has focused on determinants of treatment-seeking for physical health problems.AimsTo explicitly compare the barriers and facilitators of treatment-seeking for mental and physical health problems.MethodUS soldiers (n = 2048) completed a survey with measures of barriers and facilitators of treatment-seeking for mental and physical health problems as well as measures of somatic symptoms and mental health.ResultsThe top barrier for both mental and physical health treatment-seeking was a preference for handling problems oneself. The top facilitators for both symptom types were related to treatment improving quality of life. Differential endorsement of barriers occurred for treatment of mental versus physical health symptoms. In contrast, facilitators were endorsed more for physical than for mental health treatment. While there were few gender differences, officers reported more barriers and facilitators than did enlisted personnel. Screening positive for mental or physical health problems was associated with greater endorsement of both barriers and facilitators for physical and mental health treatment, respectively.ConclusionsThe leading barriers and facilitators for seeking treatment for mental health and physical problems are relatively similar, suggesting that health education should consider decision-making in seeking both mental and physical healthcare. Interventions should be tailored to reduce barriers for officers and improve facilitators for junior enlisted personnel, and address barriers and facilitators for service members screening positive for a mental or physical health problem.
Metronomic Chemotherapy for Children in Low- and Middle-Income Countries: Survey of Current Practices and Opinions of Pediatric Oncologists
Authors: Revon-Rivière Gabriel , Banavali Shripad , Heississen Laila , Gomez Garcia Wendy , Abdolkarimi Babak , Vaithilingum Manickavallie , Li Chi-Kong , Leung Ping Chung , Malik Prabhat , Pasquier Eddy , Epelman Sidnei , Chantada Guillermo , André Nicolas 
Published: July 2019

PURPOSE Low- and middle-income countries (LMICs) experience the burden of 80% of new childhood cancer cases worldwide, with cure rates as low as 10% in some countries. Metronomics combines frequent administrations of low-dose chemotherapy with drug repurposing, which consists of using already-approved drugs for new medical applications. With wide availability, limited costs, and little infrastructure needs, metronomics can be part of constraint-adapted regimens in these resource-limited settings—with the understanding that metronomics shall not be a substitute for standard treatments when available and doable. Our study aims to describe the experience, practices, opinions, and needs in metronomics of physicians working in LMICs. METHODS An online questionnaire was sent to more than 1,200 physicians in pediatric oncology networks in LMICs. Items included the type of center, physician’s demographics, experience in pediatric oncology, and experience with current knowledge of metronomics. Opinions and perspectives were explored using multiple-answer and open questions. RESULTS Of physicians, 17% responded. Of respondents, 54.9% declared that they had already used a metronomic regimen. The most frequently cited repositioned drugs were celecoxib (44%) followed by propranolol and valproic acid (17%). Respondents highlighted the advantages of outpatient use (20%) and expected low toxicity (24%). In considering the drawbacks of metronomics, 47% of responses highlighted the lack of scientific evidence or guidelines, 33% the availability or affordability of drugs, and 18% the problem of acceptance or compliance. Of physicians, 79% believed that use of metronomics will spread in LMICs in the near future and 98% of them were willing to participate in international metronomic protocols or registries. CONCLUSION Metronomics is already used in LMICs and is a potential answer to unmet needs in pediatric oncology. There is room for improvement in the availability of drugs and a necessity to develop collaborative protocols and research to generate level A evidence.
Breast Cancer Care in South India: Is Practice Concordant With National Guidelines?
Authors: Vijaykumar D.K. , Arun Sujana , Abraham Aswin G. , Hopman Wilma , Robinson Andrew G. , Booth Christopher M. 
Published: July 2019

PURPOSE The National Cancer Grid (NCG) of India has recently published clinical practice guidelines that are relevant in the Indian context. We evaluated the extent to which breast cancer care at a teaching hospital in South India was concordant with NCG guidelines. METHODS All patients who had surgery for breast cancer at a single center from January 2014 to December 2015 were included. Demographic, pathologic, and treatment characteristics were extracted from the electronic medical record. Patients were classified as being concordant with six elements selected from the NCG guideline. The indicators related to appropriate use of sentinel lymph node (SLN) biopsy, lymph node harvest, adjuvant radiotherapy, adjuvant chemotherapy, human epidermal growth factor receptor 2 (HER2) testing, and delivery of adjuvant trastuzumab. RESULTS A total of 401 women underwent surgery for breast cancer; mean age (standard deviation) was 57 (12) years. Lymph node involvement was present in 47% (188 of 401) of the cohort; 23% (94 of 401) had T1 disease. Ninety-two percent (368 of 401) underwent radical modified mastectomy. SLN biopsy was performed in 75% (167 of 222) of eligible patients. Eighty percent (208 of 261) of patients with a positive SLN biopsy or no SLN biopsy had a lymph node harvest of more than 10. Adjuvant chemotherapy with an anthracycline and a taxane was delivered to 67% of patients (118 of 177) with node-positive disease. Adjuvant radiotherapy was delivered to 84% (180 of 213) of patients with breast-conserving surgery, T4 tumors, or 3+ positive lymph nodes. Fluorescent in situ hybridization testing was performed in 59% of patients (43 of 73) with 2+ HER2-positive lymph nodes on immunohistochemistry. Among patients with HER2 overexpression, 40% (36 of 91) received adjuvant trastuzumab. CONCLUSION Concordance with NCG guidelines for breast cancer care ranged from 40% to 84%. Guideline concordance was lowest for those elements of care associated with the highest direct costs to patients.
Emerging links between cell competition and Alzheimer's disease
Authors: Coelho Dina S. , Moreno Eduardo 
Published: July 2019

ABSTRACT
Alzheimer's disease (AD) causes a progressive loss of memory and other cognitive functions, which inexorably debilitates patients. There is still no cure for AD and effective treatments to delay or revert AD are urgently needed. On a molecular level, the excessive accumulation of amyloid-β (Aβ) peptides triggers a complex cascade of pathological events underlying neuronal death, whose details are not yet completely understood. Our laboratory recently discovered that cell competition may play a protective role against AD by eliminating less fit neurons from the brain of Aβ-transgenic flies. Loss of Aβ-damaged neurons through fitness comparison with healthy counterparts is beneficial for the organism, delaying cognitive decline and motor disability. In this Review, we introduce the molecular mechanisms of cell competition, including seminal works on the field and latest advances regarding genetic triggers and effectors of cell elimination. We then describe the biological relevance of competition in the nervous system and discuss how competitive interactions between neurons may arise and be exacerbated in the context of AD. Selection of neurons through fitness comparison is a promising, but still emerging, research field that may open new avenues for the treatment of neurological disorders.
Maintenance Properties of Enzyme Molecule Stereostructure at High Temperature by Adsorption on Organo-Modified Magnetic Nanoparticle Layer Template
Authors: Yunoki Takeru , Kimura Yusuke , Fujimori Atsuhiro 
Published: July 2019

Abstract
The transition behavior of Gibbs monolayers of biomolecules at the air/water interface, and the sustainability of their three-dimensional structure during heating by adsorption/immobilization on inorganic particle nanosheets were investigated. Lysozyme (enzyme), cytochrome C (protein), trypsin (digestive enzyme), and luciferase (luminescent enzyme) were the biomolecules used in this study. The surface pressure-time isotherms of these biomolecules showed that the crystal transition of the Gibbs monolayer corresponding to denaturation and deactivation was systematically different. The Gibbs monolayers of these biomolecules were observed to become increasingly unstable with an increase in the number of apparent hydrophobic units, and were susceptible to denaturation by crystal transition. These biomolecules were adsorbed/immobilized on a nanosheet of organo-modified magnetic fine particles. After forming a monolayer on the water surface of the organo-magnetic nanoparticles, these biomolecules were introduced into the subphase and electrostatic interaction between the nanoparticle hydrophilic surface and the biomolecules was induced. When the bio-adsorbed single particle layer was transferred onto the solid substrate, an infra-red (IR) band derived from the adsorbed species was confirmed in this multi-particle layer. In addition, shapeless adsorbed matter was observed by atomic force microscopy images. From the IR measurement under heating, it was found that the secondary structure of the adsorbed lysozyme enzyme was maintained up to about 100 °C by substrate adsorption. This is probably because the three-dimensional structure of biomolecules is less likely to be denatured by using inorganic nanosheets with high density and low defects as the templates.
Data-informed Intervention Improves Football Technique and Reduces Head Impacts
Authors: CHAMPAGNE ALLEN A. , DISTEFANO VINCENT , BOULANGER MARIE-MICHELLE , MAGEE BLAIRE , COVERDALE NICOLE S. , GALLUCCI DANIEL , GUSKIEWICZ KEVIN , COOK DOUGLAS J. 
Published: July 2019

ABSTRACT

Introduction
Although sport participation is a key contributor to the physical and mental health of children and youth, exposure to subconcussive head impacts in football has raised concerns about safety for athletes.

Purpose
To demonstrate the efficacy of incorporating targeted football drills into a team’s practice routine with the goal of improving players’ technique and reduce exposure to subconcussive head impacts.

Methods
Seventy high school football players (age, 16.4 ± 1.1 yr) were tested PRE season using a sport-specific functional assessment. Results from the testing were used to inform the design of a prepractice intervention aimed at improving tackling and blocking techniques while reducing exposure to head impacts. The assessment included drills which evaluated the players’ ability to safely tackle, and block while simulating game-like situations. Testing was repeated at MID season (internal control) without an intervention, and again at POST season (experimental), after introduction of the prepractice intervention between these timepoints, administered twice weekly. All testing sessions were recorded, and subsequently reviewed by trained graders based on selected criteria defined by football coaches. A subset of 19 participants wore in-helmet accelerometers to assess the effectiveness of the intervention in decreasing head impacts during practice.

Results
Significant improvements in blocking and tackling techniques were observed after the introduction of the intervention (P < 0.0001). Participating athletes also showed better techniques when evaluated in new game-like situations, postseason, providing evidence for proper acquisition and generalizability of these safer habits. Finally, frequency of head impacts (>15g) per practice was significantly reduced by ~30% after 1 month of training.

Conclusion
Our results suggest that data-informed methods can be used to improve coaching practices and promote safer play, which can have a positive public health impact moving forward.
The Physiology of Auto Racing
Authors: REID MICHAEL B. , LIGHTFOOT J. TIMOTHY 
Published: July 2019

ABSTRACT

Introduction
Auto racing poses a unique set of physiologic challenges for athletes who compete in this sport. These challenges are not widely recognized due to the limited amount of original research in this field and the diffuse nature of this literature. The purpose of this article is to review the major physiologic challenges of auto racing and summarize what is currently known about athletes in this sport.

Conclusions
The physical stressors of either driving or servicing the race car are overlaid with particular environmental challenges associated with racing (e.g., thermal, noise, carbon monoxide exposure) that increase the physiological stress on motorsport athletes. Physical stress reflects the muscular work required for car control and control of posture during high gravitational (g) loads: factors that predispose athletes to fatigue. The physiologic effects of these stressors include cardiovascular stress as reflected by prolonged elevation of heart rate, cardiac output, and oxygen consumption in both driver and pit athletes during competition. Psychological stress is evident in autonomic and endocrine responses of athletes during competition. The thermal stress of having to compete wearing multilayer fire suits and closed helmets in ambient temperatures of 50°C to 60°C results in the ubiquitous risk of dehydration. Published data show that both drivers and pit crew members are accomplished athletes with distinct challenges and abilities. There are gaps in the literature, especially in regard to female, older adult, and child participants. Additionally, minimal literature is available on appropriate training programs to offset the physiological challenges of auto racing.
Methodological Recommendations for Menstrual Cycle Research in Sports and Exercise
Authors: JANSE DE JONGE XANNE , THOMPSON BELINDA , HAN AHREUM 
Published: July 2019

ABSTRACT

Introduction
The aim of this review is to provide methodological recommendations for menstrual cycle research in exercise science and sports medicine based on a review of recent literature. Research in this area is growing but often reports conflicting results, and it is proposed that some of this may be explained by methodological issues.

Methods
This review examined the menstrual cycle verification methods used in recent literature on exercise performance over the menstrual cycle identified through a literature search of PubMed and SportDiscus from 2008 until 2018.

Results
Potential changes over the menstrual cycle are likely related to hormone fluctuations; however, only 44% of the selected studies measured the actual concentrations of the female steroid hormones estrogen and progesterone. It was shown that the likely inclusion of participants with anovulatory or luteal phase–deficient cycles in combination with small participant numbers has affected results in recent menstrual cycle research and, consequently, our understanding of this area.

Conclusion
To improve the quality of future menstrual cycle research, it is recommended that a combination of three methods is used to verify menstrual cycle phase: the calendar-based counting method combined with urinary luteinizing hormone surge testing and the measurement of serum estrogen and progesterone concentrations at the time of testing. A strict luteal phase verification limit of >16 nmol·L−1 for progesterone should be set. It is also recommended that future research should focus on the inclusion of the late follicular estrogen peak. It is envisaged that these methodological recommendations will assist in clarifying some of the disagreement around the effects of the menstrual cycle on exercise performance and other aspects of exercise science and sports medicine.
Reduced Active Muscle Stiffness after Intermittent Submaximal Isometric Contractions
Authors: MOREL BAPTISTE , HUG FRANÇOIS , NORDEZ ANTOINE , POURNOT HERVÉ , BESSON THIBAULT , MATHEVON LAURE , LAPOLE THOMAS 
Published: July 2019

ABSTRACT

Purpose
Whether muscle stiffness is influenced by fatigue remains unclear. Classical methods used to assess muscle stiffness provide a global measure at the joint level. As fatigue may selectively affect specific muscles, a joint-level approach may not be sensitive enough to detect potential changes in muscle stiffness. Taking advantage of ultrasound shear wave elastography, this study aimed to determine the influence of a fatiguing protocol involving intermittent submaximal isometric contractions on muscle shear modulus (an index of stiffness).

Methods
Shear modulus was measured on either the vastus lateralis (n = 9) or the abductor digiti minimi (n = 10) before and after 15 min of intermittent submaximal isometric contractions at 60% of maximal voluntary contraction (MVC) (4 s ON, 4 s OFF). An index of active muscle stiffness was estimated PRE- and POST-fatigue as the slope of the linear regression established between shear modulus and absolute joint force up to 60% MVC.

Results
After the fatiguing exercise, MVC was significantly decreased by 22% ± 7% and 32% ± 15% for knee extension and little finger abduction, respectively (P < 0.001). When compared to PRE-fatigue, the index of active muscle stiffness was 12% ± 15% lower for the vastus lateralis (P < 0.031) and 44% ± 19% lower for the abductor digiti minimi (P < 0.001) POST-fatigue.

Conclusions
Although the present results cannot clearly determine the involved mechanisms, they demonstrate a decreased active muscle stiffness after a fatiguing task involving intermittent submaximal isometric contractions. Further studies should now determine whether this change in stiffness affects performance and risk of injury.
Areca nut extract demonstrated apoptosis-inducing mechanism by increased caspase-3 activities on oral squamous cell carcinoma
Authors: Sari Liza Meutia , Subita Gus Permana , Auerkari Elza Ibrahim 
Published: July 2019

Background: Oral squamous cell carcinoma is a neoplasm of keratinocyte cells of oral mucosa epithelium that can potentially spread through lymphatic tissue or blood vessel. Although areca nut is one of the plants with a risk of inducing that cancer, areca nut is believed to have high antioxidant properties. Due to the current interest in the apoptosis effects from areca nut for oral cancer treatment, we investigated its ability to induce apoptosis and caspase-3 activity in oral cancer cell lines: HSC-2 and HSC-3. Methods: We examined the effect of areca nut on apoptosis and caspase-3 activity in HSC-2 and HSC-3 cells. Flow cytometry was conducted for the quantification of the cells that were apoptotic and expressing the caspase-3 enzyme for 24 and 48 hours. Results: Areca nut induced a significant increase (p<0.01) in late apoptosis of HSC-2 cells and mostly occurred over 48 hours. The study also found that in HSC-3, there were significant increases (p<0.01) the percentage of cells in early apoptosis after 24 hours and late apoptosis at 48 hours. Caspase-3 activity increased after 24 and 48 hours of areca nut exposure in both cells. Conclusions: The study showed that areca nut could be considered as a potential anticancer agent through its capability in inducing a caspase-dependent apoptosis.
When a patient complains
Authors: Croser David 
Published: July 2019

In the second of the two-part CPD paper, David Croser offers readers a checklist to help keep the management of complaints in-house Aim Part 1 was published in the previous issue of Dental Nursing. It discussed why people might complain about their dental treatment and how the dental team should respond. When read together, these two articles will: Update an understanding of a CPD topic recommended by the General Dental Council Objectives To describe communication skills that support best practice complaints management To understand the risk management strategies behind the steps involved in handling a complaint To understand the benefits of an informal in-house practice complaints procedure so patients can raise issues at an early opportunity.