bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of School Backpacks on Spine Biomechanics During Daily Activities: A Narrative Review of Literature
Authors: Suri Cazmon , Shojaei Iman , Bazrgari Babak 
Published: July 2019

Objective The purpose of this narrative review is to summarize the effects of carrying school backpacks on spine and low-back biomechanics as a risk factor for low back pain in young individuals. Background Backpacks constitute a considerable daily load for schoolchildren. Consistently, a large number of children attribute their low back pain experience to backpack use. Method A literature search was conducted using a combination of keywords related to the impact of carrying backpacks on lower back biomechanics. The references of each identified study were further investigated to identify additional studies. Results Twenty-two studies met inclusion criteria. A total of 1,159 people aged 7 to 27 years were included in the studies. The added load of a backpack and the changes in spinal posture when carrying a backpack impose considerable demand on internal tissues and likely result in considerable spinal loads. The findings included results related to the effects of backpack weight and position on trunk kinematics and spine posture as well as trunk muscle activity during upright standing, walking, and ascending and descending stairs. Conclusion Backpack-induced changes in trunk kinematics for a given activity reflect alterations in mechanical demand of the activity on the lower back that should be balanced internally by the active and passive responses of lower back tissues. Although the reported alterations in trunk muscle activities and lumbar posture are indications of changes in the active and passive response of the lower back tissues, the resultant effects on spinal load, that is, an important causal factor for low back pain, remains to be investigated in the future. A knowledge of backpack-induced changes in spinal loads can inform design of interventions aimed at reduction of spinal load via improved backpack design or limitation on carrying duration. Application This narrative review is intended to serve as an educational article for students and trainees in ergonomics and occupational biomechanics.
A Classification of Deafness Based on the Effect of Deafness on Efficiency in Life
Authors: Love J. Kerr 
Published: July 2019

The deaf classified from the point of view of incapacity as a result of deafness: ( a) The true deaf-mute; developmental.—( b) The muted or semi-muted, totally deaf because of disease occurring shortly after birth.—( c) The speaking deaf, totally deaf from disease occurring after two years of age.—( d) Partially deaf, hard of hearing. Hearing tests useless except in ( d).—Treatment useless except in ( d). Syphilis: its association with congenital deafness; percentage due to this cause, in children. Incapacity due to deafness.—Aids to hearing.—Prevention of deafness.
Patterns of comorbidities in hospitalised cancer survivors for palliative care and associated in-hospital mortality risk: A latent class analysis of a statewide all-inclusive inpatient data
Authors: Luo Lan , Du Wei , Chong Shanley , Ji Huibo , Glasgow Nicholas 
Published: July 2019

Background: At the end of life, cancer survivors often experience exacerbations of complex comorbidities requiring acute hospital care. Few studies consider comorbidity patterns in cancer survivors receiving palliative care. Aim: To identify patterns of comorbidities in cancer patients receiving palliative care and factors associated with in-hospital mortality risk. Design, Setting/Participants: New South Wales Admitted Patient Data Collection data were used for this retrospective cohort study with 47,265 cancer patients receiving palliative care during the period financial year 2001–2013. A latent class analysis was used to identify complex comorbidity patterns. A regression mixture model was used to identify risk factors in relation to in-hospital mortality in different latent classes. Results: Five comorbidity patterns were identified: ‘multiple comorbidities and symptoms’ (comprising 9.1% of the study population), ‘more symptoms’ (27.1%), ‘few comorbidities’ (39.4%), ‘genitourinary and infection’ (8.7%), and ‘circulatory and endocrine’ (15.6%). In-hospital mortality was the highest for ‘few comorbidities’ group and the lowest for ‘more symptoms’ group. Severe comorbidities were associated with elevated mortality in patients from ‘multiple comorbidities and symptoms’, ‘more symptoms’, and ‘genitourinary and infection’ groups. Intensive care was associated with a 37% increased risk of in-hospital deaths in those presenting with more ‘multiple comorbidities and symptoms’, but with a 22% risk reduction in those presenting with ‘more symptoms’. Conclusion: Identification of comorbidity patterns and risk factors for in-hospital deaths in cancer patients provides an avenue to further develop appropriate palliative care strategies aimed at improving outcomes in cancer survivors.
Long-term impairment of neurovascular coupling following experimental subarachnoid hemorrhage
Authors: Balbi Matilde , Vega Max Jativa , Lourbopoulos Athanasios , Terpolilli Nicole A , Plesnila Nikolaus 
Published: July 2019

CO2-reactivity and neurovascular coupling are sequentially lost within the first 24 h after subarachnoid hemorrhage (SAH). Whether and when these impairments recover is not known. Therefore, we investigated the reactivity of pial and intraparenchymal vessels by in vivo two-photon microscopy one month after experimental SAH. C57BL/6 mice were subjected to either sham surgery or SAH by filament perforation. One month later, cerebral blood flow following CO2-challenge and forepaw stimulation was assessed by laser Doppler fluxmetry. Diameters of pial and intraparenchymal arterioles were quantified by in vivo two-photon microscopy. One month after SAH, pial and parenchymal vessels dilated in response to CO2. Neurovascular coupling was almost completely absent after SAH: vessel diameter did not change upon forepaw stimulation compared to a 20% increase in sham-operated mice. The current results demonstrate that neurovascular function differentially recovers after SAH: while CO2-reactivity normalizes within one month after SAH, neurovascular coupling is still absent. These findings show an acute and persistent loss of neurovascular coupling after SAH that may serve as a link between early brain injury and delayed cerebral ischemia, two distinct pathophysiological phenomena after SAH that were so far believed not to be directly related.
Ethical challenges of obtaining informed consent from surgical patients
Authors: Moeini Sanaz , Shahriari Mohsen , Shamali Mahdi 
Published: July 2019

Background: Informed consent can be obtained by various methods, by various people, and with use of various types of consent forms. Persistent effort is necessary to reveal the practical realities of informed consent to improve ethical and legal standards. Objective: To determine the ethical challenges of obtaining informed consent from surgical patients. Methods: The present study was a descriptive cross-sectional study using two researcher-made questionnaires and a checklist for data collection. Data were collected from nursing personnel ( n = 95) and surgical patients ( n = 203) on the surgical wards of three university hospitals in Isfahan, Iran. Data were analyzed using descriptive statistics, Spearman’s rank correlation, Pearson’s correlation coefficient, and the t-test. Ethical considerations: The study was approved by the Ethics Committee of Isfahan University of Medical Sciences (No: 396478). Results: The mean scores (maximum 100) of awareness, competency, and authority were 36.3, 67.7, and 57.6, respectively. The overall quality of the informed consent was poor (score 53.9 of 100). The higher educational level in patients was correlated with lower awareness of and less authority to give informed consent. Only 12.6% of the nurses stated that patients were given sufficient information to assure informed consent. In 89.2% of the consent forms, the risks of the treatment were mentioned. However, alternative methods and risks and advantages of rejecting the treatment were not mentioned in any of the forms. Conclusion: Ethical challenges to obtaining informed consent include patients’ poor awareness of their rights, a failure to provide adequate information to patients, absence of consideration of patients’ educational level, an unclear definition of who is responsible for obtaining informed consent from the patients, time constraints, and use of unclear language and medical jargon. Constructing an ethical framework may guide nursing staff in dealing with the ethical challenges involved in obtaining informed consent.
Retrospective evaluation of emergency department admissions in patients with ventricular assist device
Authors: Uz Ilhan , Özçete Enver , Öztürk Pelin 
Published: July 2019

Background:Ventricular assist devices, improve morbidity and survival in patients with end‐stage heart failure.Objectives:To evaluate the major causes of emergency department admissions in patients with ventricular assist device support.Methods:The charts of 200,000 adult patients who presented to our emergency department between January 2016 and January 2018 were reviewed retrospectively. A total of 444 emergency department visits made by 99 patients with ventricular assist device were included in the study.Results:The annual incidence of emergency department admissions of patients with ventricular assist device was 0.1%. The mean age was 55.5 ± 11.1 years and 85.9% of the study population were men. The most commonly encountered diagnoses were abnormal international normalized ratio or international normalized ratio follow‐up (18.2%); heart failure, non‐specific chest pain, and chronic obstructive pulmonary disease (15.3%); minor/major bleeding (12.1%); neurological disorders such as ischemic stroke, transient ischemic attack, vertigo, migraine, and syncope (11.2%); non‐device related infections (10.8%); ventricular tachycardia/fibrillation episode (8.5%); musculoskeletal disorders (7.2%); and device‐related complications such as driveline infection and pump thrombosis (6.3%). Of the patients with bleeding, 31.1% had intracranial bleeding, 31.1% had epistaxis, 24% had gastrointestinal bleeding, 11.1% had hematuria, and 1.8% had gingival hemorrhage. Of the 15 patients who died, 73.3% were diagnosed with intracranial hemorrhage.Conclusion:Even though the mortality rates of patients with ventricular assist device tends to decrease, these patients still have significant morbidity due to the increase in the prevalence of ventricular assist device use. Except for device‐related problems, emergency department management of this patient group does not differ much from other patient groups. As early diagnosis of any device‐related problems is mandatory for decreasing mortality, emergency department physicians should be familiar with mechanical support systems.
A Randomized, Double-Blind, Controlled Trial Evaluating the Efficacy of Nd:YAG 1064 nm Short-Pulse Laser Compared With Placebo in the Treatment of Toenail Onychomycosis
Authors: Sabbah Laura , Gagnon Carolanne , Bernier Fanny-Emmanuelle , Maari Catherine 
Published: July 2019

Introduction: Laser and light-based therapies have emerged as interesting treatment options with minimal side effects or contraindications to treat onychomycosis. Although increasing reports of successful treatment exist, few randomized, controlled, prospective studies have evaluated their true efficacy. We conducted a prospective, randomized, double-blind, controlled trial to evaluate the cure rate of onychomycosis treated by laser. Methods: Fifty-one patients were randomized to receive 3 treatments (0, 12, 24 weeks) of 1064 Nd:YAG short-pulse (Cutera GenesisPlus) laser or placebo sham laser. The primary efficacy end point is the proportion of patients with a complete cure rate of the target great toenail at week 52. The secondary efficacy end points, at week 52, were treatment success defined as almost clear nail (≤ 10%) and negative mycology, completely or almost clear nail of the great toenail, negative mycology, improvement from one OSI severity class to another of the target toenail, and the difference in proximal nail plate clearance between baseline and week 52. Results: No patient (0%) in the laser group and 2 patients (7.7%) in the placebo group reached the primary outcome. One patient (4.8%) in the laser group reached treatment success vs 2 (7.7%) in the placebo group. Only 6 patients (33%) had negative cultures in the laser group vs 11 (50%) in the placebo group. None of the secondary end points were met. Conclusions: This study demonstrated that 3 treatments of Nd:YAG 1064 nm laser at 3-month intervals were not effective to treat onychomycosis.
Endovascular equipoise shift in a phase III randomized clinical trial of sonothrombolysis for acute ischemic stroke
Authors: Alexandrov Andrei V. , Tsivgoulis Georgios , Köhrmann Martin , Katsanos Aristeidis H. , Soinne Lauri , Barreto Andrew D. , Rothlisberger Travis , Sharma Vijay K. , Mikulik Robert , Muir Keith W. , Levi Christopher R. , Molina Carlos A. , Saqqur Maher , Mavridis Dimitris , Psaltopoulou Theodora , Vosko Milan R. , Fiebach Jochen B. , Mandava Pitchaiah , Kent Thomas A. , Alexandrov Anne W. , Schellinger Peter D. ,   for the CLOTBUST-ER Trial Investigators
Published: July 2019

Background: Results of our recently published phase III randomized clinical trial of ultrasound-enhanced thrombolysis (sonothrombolysis) using an operator-independent, high frequency ultrasound device revealed heterogeneity of patient recruitment among centers. Methods: We performed a post hoc analysis after excluding subjects that were recruited at centers reporting a decline in the balance of randomization between sonothrombolysis and concurrent endovascular trials. Results: From a total of 676 participants randomized in the CLOTBUST-ER trial we identified 52 patients from 7 centers with perceived equipoise shift in favor of endovascular treatment. Post hoc sensitivity analysis in the intention-to-treat population adjusted for age, National Institutes of Health Scale score at baseline, time from stroke onset to tPA bolus and baseline serum glucose showed a significant (p < 0.01) interaction of perceived endovascular equipoise shift on the association between sonothrombolysis and 3 month functional outcome [adjusted common odds ratio (cOR) in centers with perceived endovascular equipoise shift: 0.22, 95% CI 0.06–0.75; p = 0.02; adjusted cOR for centers without endovascular equipoise shift: 1.20, 95% CI 0.89–1.62; p = 0.24)]. After excluding centers with perceived endovascular equipoise shift, patients randomized to sonothrombolysis had higher odds of 3 month functional independence (mRS scores 0–2) compared with patients treated with tPA only (adjusted OR: 1.53; 95% CI 1.01–2.31; p = 0.04). Conclusion: Our experience in CLOTBUST-ER indicates that increasing implementation of endovascular therapies across major academic stroke centers raises significant challenges for clinical trials aiming to test noninterventional or adjuvant reperfusion strategies.
What evidence exists on the effectiveness of the techniques and management approaches used to improve the productivity of field grown tomatoes under conditions of water-, nitrogen- and/or phosphorus-deficit? A systematic map protocol
Authors: Quesada Nora , Iannetta Pietro P. M. , White Philip J. , Tran Fanny , Begg Graham S. 
Published: July 2019

Abstract
Background
There is an urgent need to ensure that food production is maintained in response to either a reduction in use or lack of availability of natural resources. To this end, several strategies have been investigated to determine which agronomic approaches may improve crop yields under conditions of reduced water and/or nutrients provision, with special attention upon nitrogen (N) and phosphorus (P). New technologies and practices have been developed for key commercial crops, such as tomatoes. However, few of these are widely adopted in the field and evidence of their value in this production setting is limited.

Methods
This protocol sets out a systematic map methodology that aims to provide a coherent synthesis of the available evidence among the literature on the techniques and management approaches that may ensure the productivity of field-grown tomatoes under conditions of water-, N- and/or P-deficits, either as single or combined stresses. To conduct the literature search, a search strategy was produced to define the scope of the systematic map and to allow reproducibility of the approach. A list of published and unpublished sources of literature were selected and a preliminary trial identified best-fit-for-purpose search-terms and -strings. A literature screening process was set with consistency checks amongst reviewers at the title, abstract and full text screening stages. A series of eligibility criteria were defined to ensure objectivity and consistency in the selection of studies that are best suited to address the research question of the systematic map. In addition, a coding strategy was designed to set the means for meta-data extraction out from the literature for review. A drafted structured questionnaire will serve as the base for collating the meta-data to produce a database where variables will be queried for the evidence synthesis. This work is expected to inform stakeholders, researchers and policy makers regarding the extent and nature of the existing evidence base, and so serve as a basis by-which specific approaches may be highlighted as potential focal-areas in future.
Current eating disorder healthcare services – the perspectives and experiences of individuals with eating disorders, their families and health professionals: systematic review and thematic synthesis
Authors: Johns Gemma , Taylor Bridget , John Ann , Tan Jacinta 
Published: July 2019

BackgroundEating disorders have the highest mortality rate of mental disorders and a high incidence of morbidity, but if diagnosed and treated promptly individuals can benefit from full recovery. However, there are numerous problems at the healthcare interface (i.e. primary and secondary care) for eating disorders. It is important to examine these to facilitate appropriate, seamless treatment and improve access to specialist care.AimsTo examine the current literature on the experiences and perspectives of those across healthcare interfaces for eating disorders, to include individuals with eating disorders, people close to or caring for those with eating disorders such as family and friends, and health professionals.MethodTo identify relevant papers, a systematic search of electronic databases was conducted. Other methods, including hand-searching, scanning reference lists and internet resources were also used. Papers that met inclusion criteria were analysed using a systematic methodology and synthesised using an interpretative thematic approach.ResultsSixty-three papers met the inclusion criteria. The methodological quality was relatively good. The included papers were of both qualitative (n= 44) and quantitative studies (n= 24) and were from ten different countries. By synthesising the literature of these papers, three dominant themes were identified, with additional subthemes. These included: ‘the help-seeking process at primary care’; ‘expectations of care and appropriate referrals’ and ‘opposition and collaboration in the treatment of and recovery from eating disorders’.ConclusionsThis review identifies both facilitators and barriers in eating disorder healthcare, from the perspectives of those experiencing the interface first hand. The review provides recommendations for future research and practice.Declaration of interestNone.
Local radio to promote mental health awareness: a public health initiative
Authors: Cocksedge Karen A. , Guliani Joshana , Henley William , Anderson Tamsyn , Roberts Sara , Reed Laurence , Skinnard Daphne , Fisher Sarah , Chapman Beth , Willcox Joanna , Wilkinson Ellen , Laugharne Richard , Shankar Rohit 
Published: July 2019

Background
Public health strategies have focused largely on physical health. However, there is increasing recognition that raising mental health awareness and tackling stigma is crucial to reduce disease burden. National campaigns have had some success but tackling issues locally is particularly important.

Aims
To assess the public's awareness and perception of the monthly BBC Cornwall mental health phone-in programmes that have run for 8.5 years in Cornwall, UK (population 530 000).

Method
A consultation, review and feedback process involving a multiagency forum of mental and public health professionals, people with lived experience and local National Health Service trust's media team was used to develop a brief questionnaire. This was offered to all attendees at two local pharmacies covering populations of 27 000 over a 2-week period.

Results
In total, 14% (95% CI 11.9–16.5) were aware of the radio show, 11% (95% CI 9.0–13.1) have listened and the majority (76%) of those who listened did so more than once. The estimated reach is 70 000 people in the local population, of whom approximately 60 000 listen regularly. The show is highly valued among respondents with modal and median scores of 4 out of 5.

Conclusions
Local radio is a successful, cost-effective and impactful way to reach a significant proportion of the population and likely to raise awareness, reduce stigma and be well received. The format has been adopted in other regions thus demonstrating easy transferability. It could form an essential part of a public health strategy to improve a population's mental well-being.

Declaration of interest
W.H. received support from the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula UK. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. L.R. and D.S. were involved in delivering the programmes but had no role in their evaluation.
Cytocortex-dependent dynamics of Drosophila Crumbs controls junctional stability and tension during germ band retraction
Authors: Bajur Anna T. , Iyer K. Venkatesan , Knust Elisabeth 
Published: July 2019

ABSTRACT
During morphogenesis, epithelia undergo dynamic rearrangements, which requires continuous remodelling of junctions and cell shape, but at the same time mechanisms preserving cell polarity and tissue integrity. Apico-basal polarity is key for the localisation of the machinery that enables cell shape changes. The evolutionarily conserved Drosophila Crumbs protein is critical for maintaining apico-basal polarity and epithelial integrity. How Crumbs is maintained in a dynamically developing embryo remains largely unknown. Here, we applied quantitative fluorescence techniques to show that, during germ band retraction, Crumbs dynamics correlates with the morphogenetic activity of the epithelium. Genetic and pharmacological perturbations revealed that the mobile pool of Crumbs is fine-tuned by the actomyosin cortex in a stage-dependent manner. Stabilisation of Crumbs at the plasma membrane depends on a proper link to the actomyosin cortex via an intact FERM-domain-binding site in its intracellular domain, loss of which leads to increased junctional tension and higher DE-cadherin (also known as Shotgun) turnover, resulting in impaired junctional rearrangements. These data define Crumbs as a mediator between polarity and junctional regulation to orchestrate epithelial remodelling in response to changes in actomyosin activity.
This article has an associated First Person interview with the first author of the paper.