bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group‐based trajectory modelling for BMI trajectories in childhood: A systematic review
Authors: Mattsson Molly , Maher Gillian M. , Boland Fiona , Fitzgerald Anthony P. , Murray Deirdre M. , Biesma Regien 
Published: April 2019

SummaryChildhood obesity is an important public health issue. We aimed to systematically review studies that used group‐based trajectory modelling approaches to investigate body mass index (BMI) trajectories in early childhood, explore associated determinants, and the association with body composition outcomes. Five databases were searched systematically for studies using group‐based trajectory modelling approaches to track BMI trajectories from birth. Fourteen studies using latent class growth analysis or growth mixture modelling to track BMI trajectories were identified. Three or four trajectories were identified in most studies. High maternal pre‐pregnancy BMI was the most frequently identified risk factor for membership of a rapid gain trajectory. Significant associations between rapid weight gain and stable high trajectories and body measures at follow‐up were identified by several studies. Relatively similar trajectories were identified across studies. Trajectories characterized by rapid weight gain were associated with several predictors, as well as body measures at follow‐up, however not with great consistency. Similar associations with body measure outcomes were found for stable high and rapid gain trajectories, suggesting that long‐term outcomes do not differ greatly between children with consistently high BMI and children with rapid increases in BMI. As the shape and timing of the trajectories differed between studies, it is difficult to draw conclusions.
Cash‐for‐care payments in Europe: Changes in resource allocation
Authors: Gori Cristiano , Morciano Marcello 
Published: April 2019

AbstractResource allocation has been a main policy issue in cash‐for‐care schemes (CfCs) for older people in Europe since their inception. It regards how publicly funded care benefits and services are distributed among older people. The raising pressures of an ageing population and the tensions on the financial sustainability of welfare regimes in place have further exacerbated the relevance of this topic over the recent years. Nevertheless, comparative research so far has overlooked changes in resource allocation in CfCs over time.This article contributes to fill this gap, exploring changes in resource allocation of CfCs for older people in a sample of European countries—Austria, England, France, Germany, Italy, and The Netherlands—since the early '90s (or since the introduction of the scheme). It examines three analytical dimensions: (a) The mix of public services and benefits provided to older people (CfCs, community services in kind, residential care); (b) the level of CfCs coverage; and (c) its generosity. A combined view of these dimensions leads to the discussion of two dilemmas: How to allocate the resources devoted to CfCs in the light of the trade‐off between its coverage and intensity? And, within the whole long‐term care system, how to allocate resources between CfCs and services in kind?
Simulation of depth and wind effects on the hydraulic efficiency of sedimentation tanks
Authors: Alighardashi Abolghasem , Goodarzi Danial 
Published: April 2019

AbstractIn this research, we aim to investigate the effects of the depth and wind effect on the surface of water on the hydraulic efficiency of the sedimentation tanks in water and wastewater treatments plants. A verified two‐dimensional numerical study was performed to evaluate hydraulic performance of series settling tanks by four different depths of 2.5, 3, 3.5 and 4 (m). Wind velocities of 5 and 7 (m/s) in co‐current and counter‐current direction of water flow in sedimentation tank were applied on the surface of the water. In this study, k–ε turbulent model and passive scalar tracer were used to perform the simulations. The research confirms that wind influence on the surface of water causes recirculation zones and increases the length of recirculation zones. In both windy and normal situation, the Real Hydraulic Retention Time and the effective volume of sedimentation tanks increases widely as the depth of the tank.
Association of postprandial triglyceride responses with insulin resistance among rotational night shift healthcare workers
Authors: Kiranmala Keithellakpam , Aslam Mohammad , Mishra Brijesh Kumar , Jhamb Rajat , Madhu Sri Venkata 
Published: April 2019

New Findings
What is the central question of this study?
Does long‐term rotational night shift work among healthcare workers alter postprandial triglyceride metabolism, and are the postprandial triglyceride responses associated with insulin resistance?

What is the main finding and its importance?
Rotational night shift duties in healthcare workers might have a negative impact on postprandial triglyceride responses and insulin sensitivity. This is the first study in which postprandial triglyceride responses among shift workers exposed to long‐term night shifts have been studied.

AbstractStudies on the postprandial period demonstrate that in experimental conditions, abrupt or acute changes in sleep timing and work are followed by significantly altered postprandial glucose, insulin secretion and lipid tolerance. Whether shift work results in altered postprandial triglyceride (PPTG) metabolism in the long term is not known. In the present study, we aimed to ascertain the association between PPTG and shift work in relationship to cardiometabolic risks and to compare the PPTG response among healthcare workers with and without night shift duties. Twenty healthcare workers with rotational night shifts (group 2) and 20 age‐ and sex‐matched healthcare workers who had not done night shift duty in the past 1 year or ever (group 1) were recruited. Only subjects with normal glucose tolerance were recruited. A standardized fat challenge test was done in all study subjects. The postprandial triglyceride area under the curve (PPTG AUC) showed overall (n = 40) a significant positive correlation with fasting insulin and homeostatic model assessment of insulin resistance (HOMA‐IR) (r = 0.40, P = 0.01 and r = 0.37, P = 0.01, respectively) and in group 2 (r = 0.49, P = 0.02 and r = 0.44, P = 0.042, respectively). The PPTG peak also showed a significant positive correlation with fasting insulin and HOMA‐IR in group 2 (r = 0.52, P = 0.01 and r = 0.47, P = 0.03, respectively). No significant correlation was found in group 1. The PPTG AUC and PPTG peak were, however, comparable between both groups. The findings of this pilot study suggest that rotational night shift duties in healthcare workers might have a negative impact on metabolic parameters, including postprandial triglyceride responses and insulin sensitivity.
Comparative Study of Wall-Shear Stress at the Ascending Aorta for Different Mechanical Heart Valve Prostheses
Authors: Li Qianhui , Hegner Franziska , Bruecker Christoph H. 
Published: April 2019

AbstractAn experimental study is reported which investigates the wall shear stress (WSS) distribution in a transparent model of the human aorta comparing an St. Jude Medical (SJM) Regent bileaflet mechanical heart valve (BMHV) with the Lapeyre-Triflo FURTIVA trileaflet mechanical heart valve (TMHV) in physiological pulsatile flow. Elastic microcantilever structures, calibrated as micropillar WSS sensors by microparticle-image-velocimetry measurements, are applied to the wall along the ascending aorta (AAo). The peak WSS values in the BMHV are observed to be almost twice that of the values seen in the TMHV. Flow field analysis illuminates that these peaks are linked to the jet-like flows generated in the valves interacting with the aortic wall. Not only the magnitude but also the impact regions are specific for different valve designs. The side-orifice jets generated by the BMHV travel along the aortic wall in the AAo, impacting the wall throughout the AAo. However, the jets generated by TMHV impact further downstream in the AAo and results in a reduced WSS.
Exploring patients’ expectations and preferences of glaucoma surgery outcomes to facilitate healthcare delivery and inform future glaucoma research
Authors: Kulkarni Bina Bhaskar , Leighton Paul , King Anthony J 
Published: April 2019

IntroductionGlaucoma is a lifelong condition often requiring surgical intervention. To allow us to inform patients’ expectations of surgery effectively, it is important to understand patients’ preferences and concerns regarding outcomes from glaucoma treatments including surgery.AimsTo explore what clinical and social outcomes of glaucoma surgery are important to patients.MethodsForty-five glaucoma patients undergoing medical glaucoma treatments or surgery were recruited for focus group interviews to determine their opinions regarding the outcomes of glaucoma treatments. Thematic analysis was performed with NVivo software.ResultsThemes identified were understanding glaucoma, understanding surgery treatments and understanding treatment outcomes. The most important outcomes of the glaucoma surgery reported by the patients were social factors. Patients felt that being able to maintain their driving licence is a strong indicator of successful glaucoma treatment/surgery. Other important outcomes were independent living, ability to care for their family and having a good-quality social life. When considering novel surgical treatments, most patients felt that certainty of successful outcome and proven longevity of the effect are the primary motivators for choosing these treatments.ConclusionsPatients understood that clinical measures were surrogates for maintaining visual function, but ability to maintain independent living was the most important outcome from their treatment. For newer treatments patients wished to know more about long-term outcomes when considering this option.
Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review
Authors: Stillman Mark A , Glick Ira D , McDuff David , Reardon Claudia L , Hitchcock Mary E , Fitch Vincent M , Hainline Brian 
Published: April 2019

Background
Athletes, like non-athletes, suffer from mental health symptoms and disorders that affect their lives and their performance. Psychotherapy, either as the sole treatment or combined with other non-pharmacological and pharmacological strategies, is a pivotal component of management of mental health symptoms and disorders in elite athletes. Psychotherapy takes the form of individual, couples/family or group therapy and should address athlete-specific issues while being embraced as normative by athletes and their core stakeholders.

Main findings
This narrative review summarises controlled and non-controlled research on psychotherapy for elite athletes with mental health symptoms and disorders. In summary, treatment is similar to that of non-athletes—although with attention to issues that are athlete-specific. Challenges associated with psychotherapy with elite athletes are discussed, including diagnostic issues, deterrents to help-seeking and expectations about services. We describe certain personality characteristics sometimes associated with elite athletes, including narcissism and aggression, which could make psychotherapy with this population more challenging. The literature regarding psychotherapeutic interventions in elite athletes is sparse and largely anecdotal.
Cross-sectional study of patients with axial spondyloarthritis fulfilling imaging arm of ASAS classification criteria: baseline clinical characteristics and subset differences in a single-centre cohort
Authors: Bubová Kristyna , Forejtová Šárka , Zegzulková Kateřina , Gregová Monika , Hušáková Markéta , Filková Mária , Hořínková Jana , Gatterová Jindřiška , Tomčík Michal , Szczuková Lenka , Pavelka Karel , Šenolt Ladislav 
Published: April 2019

ObjectiveThis study compared demographic, clinical and laboratory characteristics between patients with radiographic and non-radiographic axial spondyloarthritis (axSpA).MethodsIn this single-centre cross-sectional study, a total of 246 patients with axSpA fulfilling the imaging arm of Assessment of SpondyloArthritis International Society classification criteria were recruited. A total of 140 patients were diagnosed as non-radiographic axial spondyloarthritis (nr-axSpA), and 106 patients had ankylosing spondylitis (AS). Sociodemographic characteristics, disease manifestations, clinical and laboratory disease activity and their differences between subsets were analysed. P values below 0.05 with CI 95% were considered statistically significant.ResultsMore nr-axSpA patients were women (61.4%) compared with 24.7% of AS patients. First symptoms developed earlier in AS patients compared with nr-axSpA (23.0 (IQR 17.5–30.0) vs 27.8 (IQR 21.0–33.7) years, p=0.001). Disease manifestations did not differ, but patients with nr-axSpA experienced peripheral arthritis more frequently (35.7% vs 17.0%, p=0.001) with less hip involvement (8.6% vs 18.9%, p=0.022) compared with patients with AS. Patients with AS exhibited worse spinal mobility and physical function compared with nr-axSpA. AS Disease Activity Scores and CRP levels were significantly higher in patients with AS compared with nr-axSpA (2.4 (IQR 1.7–2.8) vs 2.0 (IQR 1.1–2.3), p=0.022 and 7.1 (IQR 2.6–14.9) vs 2.5 (IQR 0.8–8.2) mg/L, p<0.001, respectively).ConclusionsOur data demonstrated some known and also novel differences between the two imaging arm fulfilling axSpA subgroups. Non-radiographic patients were mostly women who had experienced shorter disease duration, milder disease activity and better functional status with less hip involvement but more peripheral arthritis compared with patients with AS.
Grip strength among Indigenous and non-Indigenous Australian adults: a longitudinal study of the effects of birth size and current size
Authors: Howarth Timothy , Davison Belinda , Singh Gurmeet 
Published: April 2019

ObjectivesIndigenous Australians are born smaller than non-Indigenous Australians and are at an increased risk of early onset of frailty. This study aimed to identify the relationship between birth size, current size and grip strength, as an early marker of frailty, in Indigenous and non-Indigenous young adults.DesignCross sectional data from two longitudinal studies: Aboriginal birth cohort (Indigenous) and top end cohort (non-Indigenous).SettingParticipants reside in over 40 urban and remote communities across the Northern Territory, Australia.ParticipantsYoung adults with median age 25 years (IQR 24–26); 427 participants (55% women), 267 (63%) were remote Indigenous, 55 (13%) urban Indigenous and 105 (25%) urban non-Indigenous.Outcome measuresReliable birth data were available. Anthropometric data (height, weight, lean mass) and grip strength were directly collected using standardised methods. Current residence was classified as urban or remote.ResultsThe rate of low birthweight (LBW) in the non-Indigenous cohort (9%) was significantly lower than the Indigenous cohort (16%) (−7%, 95% CI −14 to 0, p=0.03). Indigenous participants had lower grip strength than non-Indigenous (women, −2.08, 95% CI −3.61 to –0.55, p=0.008 and men, −6.2, 95% CI −9.84 to –2.46, p=0.001). Birth weight (BW) was associated with grip strength after adjusting for demographic factors for both women (β=1.29, 95% CI 0.41 to 2.16, p=0.004) and men (β=3.95, 95% CI 2.38 to 5.51, p<0.001). When current size (lean mass and body mass index [BMI]) was introduced to the model BW was no longer a significant factor. Lean mass was a positive indicator for grip strength, and BMI a negative indicator.ConclusionsAs expected women had significantly lower grip strength than men. Current size, in particular lean mass, was the strongest predictor of adult grip strength in this cohort. BW may have an indirect effect on later grip strength via moderation of lean mass development, especially through adolescence and young adulthood.
Approaches to governance of participant-led research: a qualitative case study
Authors: Grant Azure Dominique , Wolf Gary Isaac , Nebeker Camille 
Published: April 2019

ObjectivesParticipant-led research (PLR) is a rapidly developing form of citizen science in which individuals can create personal and generalisable knowledge. Although PLR lacks a formal framework for ethical review, participants should not be excused from considering the ethical implications of their work. Therefore, a PLR cohort consisting of 24 self-trackers aimed to: (1) substitute research ethics board procedures with engagement in ethical reflection before and throughout the study and (2) draft principles to encourage further development of the governance and ethical review of PLR.MethodsA qualitative case study method was used to analyse the ethical reflection process. Participants discussed study risks, risk management strategies and benefits pre-project, during a series of weekly webinars, via individual meetings with the participant-organisers, and during semi-structured interviews at project completion. Themes arising from discussions and interviews were used to draft prospective principles to guide PLR.ResultsData control, aggregation and identifiability were the most common risks identified. These were addressed by a commitment to transparency among all participants and by establishing participant control via self-collection and self-management of data. Group discussions and resources (eg, assistance with experimental design and data analysis) were the most commonly referenced benefits of participation. Additional benefits included greater understanding of one’s physiology and greater ability to structure an experiment. Nine principles were constructed to encourage further development of ethical PLR practices. All participants expressed interest in participating in future PLR.ConclusionsProjects involving a small number of participants can sustain engagement in ethical reflection among participants and participant-organisers. PLR that prioritises transparency, participant control of data and ongoing risk-to-benefit evaluation is compatible with the principles that underlie traditional ethical review of health research, while being appropriate for a context in which citizen scientists play the central role.
Slow release oral morphine versus methadone for the treatment of opioid use disorder
Authors: Klimas Jan , Gorfinkel Lauren , Giacomuzzi Salvatore M , Ruckes Christian , Socías M Eugenia , Fairbairn Nadia , Wood Evan 
Published: April 2019

ObjectiveTo assess the efficacy of slow release oral morphine (SROM) as a treatment for opioid use disorder (OUD).DesignSystematic review and meta-analysis of randomised controlled trials (RCTs).Data sourcesThree electronic databases were searched through 1 May 2018: the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. We also searched the following electronic registers for ongoing trials: ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Current Controlled Trials and the EU Clinical Trials Register.Eligibility criteria for selecting studiesWe included RCTs of all durations, assessing the effect of SROM on measures of treatment retention, heroin use and craving in adults who met the diagnostic criteria for OUD.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias. Data were pooled using the random-effects model and expressed as risk ratios (RRs) or mean differences with 95% CIs. Heterogeneity was assessed (χ2statistic) and quantified (I2statistic) and a sensitivity analysis was undertaken to assess the impact of particular high-risk trials.ResultsAmong 1315 records screened and four studies reviewed, four unique randomised trials met the inclusion criteria (n=471), and compared SROM with methadone. In the meta-analysis, we observed no significant differences between SROM and methadone in improving treatment retention(RR=0.98; 95%CI: 0.94 to 1.02, p=0.34) and heroin use (RR=0.96; 95% CI: 0.61 to 1.52, p=0.86). Craving data was not amenable to meta-analysis. Available data implied no differences in adverse events, heroin, cocaine or benzodiazepine use.ConclusionsMeta-analysis of existing randomised trials suggests SROM may be generally equal to methadone in retaining patients in treatment and reducing heroin use while potentially resulting in less craving. The methodological quality of the included RCTs was low-to-moderate.
Focused ultrasound to diagnose HIV-associated tuberculosis (FASH) in the extremely resource-limited setting of South Sudan: a cross-sectional study
Authors: Bobbio Flavio , Di Gennaro Francesco , Marotta Claudia , Kok John , Akec Gabriel , Norbis Luca , Monno Laura , Saracino Annalisa , Mazzucco Walter , Lunardi Marta 
Published: April 2019

ObjectiveOur cross-sectional study aimed at evaluating the diagnostic performance of Focused Assessment with Sonography for HIV-associated tuberculosis (FASH) to detect extrapulmonary tuberculosis in extremely resource-limited settings, with visceral leishmaniasis as a differential diagnosis with overlapping sonographic feature.DesignCross-sectional study.SettingVoluntary Counselling and Testing Centre (VCT) of Yirol Hospital, South Sudan.ParticipantsFrom May to November 2017, 252 HIV-positive patients out of 624 newly admitted to VCT Centre were registered for antiretroviral treatment. According to the number of trained doctors available to practise ultrasound (US) scan, a sample of 100 patients were screened using the FASH protocol.InterventionsFollowing a full clinical examination, each patient was scanned with a portable US scanner in six different positions for pleural, pericardial, ascitic effusion, abdominal lymphadenopathy and hepatic/splenic microabscesses, according to the FASH protocol. A k39 antigen test for visceral leishmaniasis was also performed on patients with lymphadenopathy and/or splenomegaly. All demographic, clinical and HIV data, as well as FASH results and therapy adjustments, were recorded following the examination.ResultsThe FASH protocol allowed the detection of pathological US findings suggestive of tuberculosis in 27 out of the 100 patients tested. Overall, FASH results supported tuberculosis treatment indication for 16 of 21 patients, with the treatment being based exclusively on FASH findings in half of them (8 patients). The group of FASH-positive patients had a significantly higher proportion of patients with CD4 count below 0.2 x109/L (n=22, 81%) as compared with FASH-negative patients (n=35, 48%) (p=0.003). Moreover, 48% (n=13) of FASH-positive patients had CD4 below 100 cells/mm3. All patients tested had a negative result on k39 antigen test.ConclusionFASH was found to be a relevant diagnostic tool to detect signs of tuberculosis. Further research is needed to better define a patient profile suitable for investigation and also considering diagnostic accuracy.