bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sports injuries aligned to predicted mature height in highly trained Middle-Eastern youth athletes: a cohort study
Authors: Rejeb Abdallah , Johnson Amanda , Farooq Abdulaziz , Verrelst Ruth , Pullinger Samuel , Vaeyens Roel , Witvrouw Erik 
Published: March 2019

ObjectivesTo investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes.DesignProspective cohort study.SettingFour consecutive seasons (2010–2014), Aspire Academy, Qatar.ParticipantsMale athletes (age range: 11–18 years) representing four disciplines enrolled and grouped into two categories: individual sports and racquet sports.Outcome measuresInjury data collected over four seasons. Athletes’ anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA).ResultsFor the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006).Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37).ConclusionSA early maturity and PMH gradient were significant predictors of injury in youths.
Effectiveness of the Communities Care programme on change in social norms associated with gender-based violence (GBV) with residents in intervention compared with control districts in Mogadishu, Somalia
Authors: Glass Nancy , Perrin Nancy , Marsh Mendy , Clough Amber , Desgroppes Amelie , Kaburu Francesco , Ross Brendan , Read-Hamilton Sophie 
Published: March 2019

ObjectiveDetermine the effectiveness of the Communities Care programme (CCP) on change in harmful social norms associated with gender-based violence (GBV) and confidence in provision of services with residents in intervention compared with control district. We hypothesised that residents in the intervention district would report a decrease in support for harmful social norms and increase in confidence in services in comparison with control district.SettingThe study was conducted in Mogadishu, Somalia.ParticipantsIn the intervention district, 192 community members (50% women) completed baseline surveys with 163 (84.9%) retained at endline. In the control district, 195 community members (50% women) completed baseline surveys with 167 (85.6%) retained at endline.InterventionCCP uses facilitated dialogues with community members to catalyse GBV prevention actions and provides training to diverse sectors to strengthen response services for GBV survivors.ResultsResidents in the intervention district had significantly greater improvement in change in social norms: (1) response to sexual violence (b=−0.214, p=0.041); (2) protecting family honour (b=−0.558, p<0.001); and (3) husband’s right to use violence (b=−0.309, p=0.003) compared with control district participants. The greatest change was seen in the norm of ‘protecting family honour’ with a Cohen’s d effect size (ES) of 0.70, followed by the norm ‘husband’s right to use violence’ (ES=0.38), and then the norm of ‘response to sexual violence’ (ES=0.28). Residents in intervention district had a significantly greater increase in confidence in provision of GBV services across diverse sectors than the control district (b=0.318, p<0.001) with an associated effect size of 0.67. There were no significant differences between residents in intervention and control districts on change in personal beliefs on the norms.ConclusionThe evaluation showed the promise of CCP in changing harmful social norms associated with GBV and increasing confidence in provision of services in a complex humanitarian setting.
Validated methods to identify patients with asthma–COPD overlap in healthcare databases: a systematic review protocol
Authors: Amegadzie Joseph Emil , Badejo Oluwatosin , Gamble John-Michael , Wright Mark , Farrell Jamie , Jackson Brooke , Sultana Kirin , Hashmi Maimoona , Gao Zhiwei 
Published: March 2019

IntroductionAsthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) is characterised by patients presenting symptoms of both asthma and COPD. Many efforts have been made to validate different methods of identifying asthma–COPD overlap cases based on symptoms, spirometry and medical history in epidemiological studies using healthcare databases. There are various coding algorithm strategies that can be used and selection depends on targeted validation. The primary objectives of this systematic review are to identify validated methods (or algorithms) that identify patients with ACO from healthcare databases and summarise the reported validity measures of these methods.MethodsMEDLINE, EMBASE databases and the Web of Science will be systematically searched by using appropriate search strategies that are able to identify studies containing validated codes and algorithms for the diagnosis of ACO in healthcare databases published, in English, before October 2018. For each selected study, we require the presence of at least one test measure (eg, sensitivity, specificity etc). We will also include studies, in which the validated algorithm is compared with an external reference standard such as questionnaires completed by patients or physicians, medical charts review, manual review or an independent second database. For all selected studies, a uniform table will be created to summarise the following vital information: name of author, publication year, country, data source, population, clinical outcome, algorithms, reference standard method of validation and characteristics of the test measure used to determine validity.PROSPERO registration numberCRD42018087472.
Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case–control analysis from Canada
Authors: Redelmeier Donald A , Manzoor Fizza 
Published: March 2019

ImportanceDrunk driving is a major cause of death in North America, yet physicians rarely counsel patients on the risks of drinking and driving.ObjectiveTo test whether the risks of a life-threatening alcohol-related traffic crash were further accentuated by adverse weather.DesignDouble matched case–control analysis of hospitalised patients.SettingCanada’s largest trauma centre between 1 January 1995 and 1 January 2015.ParticipantsPatients hospitalised due to a life-threatening alcohol-related traffic crash.ExposureRelative risk of a crash associated with adverse weather estimated by evaluating the weather at the place and time of the crash (cases) compared with the weather at the same place and time a week earlier and a week later (controls).ResultsA total of 2088 patients were included, of whom the majority were drivers injured at night. Adverse weather prevailed among 312 alcohol-related crashes and was significantly more frequent compared with control circumstances. The relative risk of a life-threatening alcohol-related traffic crash was 19% higher during adverse weather compared with normal weather (95% CI: 5 to 35, p=0.006). The absolute increase in risk amounted to 43 additional crashes, extended to diverse groups of patients, applied during night-time and daytime, contributed to about 793 additional patient-days in hospital and was distinct from the risks for drivers who were negative for alcohol.ConclusionsAdverse weather was associated with an increased risk of a life-threatening alcohol-related traffic crash. An awareness of this risk might inform warnings to patients about traffic safety and counselling alternatives to drinking and driving.
Online decision aids for primary cardiovascular disease prevention: systematic search, evaluation of quality and suitability for low health literacy patients
Authors: Bonner Carissa , Patel Pinika , Fajardo Michael Anthony , Zhuang Ruixuan , Trevena Lyndal 
Published: March 2019

ObjectivesRecent guideline changes for cardiovascular disease (CVD) prevention medication have resulted in calls to implement shared decision-making rather than arbitrary treatment thresholds. Less attention has been paid to existing tools that could facilitate this. Decision aids are well-established tools that enable shared decision-making and have been shown to improve CVD prevention adherence. However, it is unknown how many CVD decision aids are publicly available for patients online, what their quality is like and whether they are suitable for patients with lower health literacy, for whom the burden of CVD is greatest. This study aimed to identify and evaluate all English language, publicly available online CVD prevention decision aids.DesignSystematic review of public websites in August to November 2016 using an environmental scan methodology, with updated evaluation in April 2018. The decision aids were evaluated based on: (1) suitability for low health literacy populations (understandability, actionability and readability); and (2) International Patient Decision Aids Standards (IPDAS).Primary outcome measuresUnderstandability and actionability using the validated Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P scale), readability using Gunning–Fog and Flesch–Kincaid indices and quality using IPDAS V.3 and V.4.ResultsA total of 25 unique decision aids were identified. On the PEMAT-P scale, the decision aids scored well on understandability (mean 87%) but not on actionability (mean 61%). Readability was also higher than recommended levels (mean Gunning–Fog index=10.1; suitable for grade 10 students). Four decision aids met criteria to be considered a decision aid (ie, met IPDAS qualifying criteria) and one sufficiently minimised major bias (ie, met IPDAS certification criteria).ConclusionsPublicly available CVD prevention decision aids are not suitable for low literacy populations and only one met international standards for certification. Given that patients with lower health literacy are at increased risk of CVD, this urgently needs to be addressed.
Barriers to cervical cancer screening among rural women in eastern China: a qualitative study
Authors: Yang Huan , Li Shun-Ping , Chen Qing , Morgan Christopher 
Published: March 2019

ObjectivesTo explore barriers to free cervical cancer screening among rural women in China from the perspective of women, healthcare providers and women’s husbands to inform intervention planning.DesignA qualitative study framed around potential policy and practice options, drawing on the concepts of descriptive phenomenology and implementation research.SettingThis study was carried out at township level within two counties in Jining Prefecture of eastern China.Participants and data collectionSemi-structured in-depth interviews with 21 women and five healthcare providers, focus group discussions with nine healthcare providers and key informant interviews with four husbands of women eligible for screening.ResultsThematic analysis generated five major themes: (1) gaps in knowledge of cervical cancer and health awareness, (2) fear of cancer and screening outcomes, (3) cultural barriers including reticence for intimate examinations, (4) influence of close contacts on screening decisions and (5) inconvenience. These demonstrate key knowledge gaps challenging current community health education. Important barriers, including fear of treatment cost and the time needed for screening, were also raised.ConclusionOur study details important barriers to cervical cancer screening relating to knowledge gaps, attitudes of fear or embarrassment and the role of contacts and service models. These provide data for policy and planning to improve the screening that will decrease the incidence and mortality rates of cervical cancer in China.
Jesus and the Wings of Yhwh
Authors: Rowlands Jonathan 
Published: March 2019

AbstractIn this article the author analyses the lament over Jerusalem (Matt 23:37–39; Luke 13:34–35) and its use of bird imagery. He argues the picture of Jesus as a mother hen builds on an established metaphor that uses the imagery of a protective bird to refer to Yhwh’s divine protection over Israel. The author therefore asserts this pericope most likely portrays Jesus as the person of Yhwh.
The Effect of Walking on Auditory Localization, Visual Discrimination, and Aurally Aided Visual Search
Authors: Brungart Douglas S. , Kruger Sarah E. , Kwiatkowski Tricia , Heil Thomas , Cohen Julie 
Published: March 2019

Objective: The present study was designed to examine the impact that walking has on performance in auditory localization, visual discrimination, and aurally aided visual search tasks. Background: Auditory localization and visual search are critical skills that are frequently conducted by moving observers, but most laboratory studies of these tasks have been conducted on stationary listeners who were either seated or standing during stimulus presentation. Method: Thirty participants completed three different tasks while either standing still or while walking at a comfortable self-selected pace on a treadmill: (1) an auditory localization task, where they identified the perceived location of a target sound; (2) a visual discrimination task, where they identified a visual target presented at a known location directly in front of the listener; and (3) an aurally aided visual search task, where they identified a visual target that was presented in the presence of multiple visual distracters either in isolation or in conjunction with a spatially colocated auditory cue. Results: Participants who were walking performed auditory localization and aurally aided visual search tasks significantly faster than those who were standing, with no loss in accuracy. Conclusion: The improved aurally aided visual search performance found in this experiment may be related to enhanced overall activation caused by walking. It is also possible that the slight head movements required may have provided auditory cues that enhanced localization accuracy. Application: The results have potential applications in virtual and augmented reality displays where audio cues might be presented to listeners while walking.
Evaluation of attention, perception, and stress levels of clinical cardiovascular perfusionists during cardiac operations: a pilot study
Authors: Merkle Frank , Kurtovic Dino , Starck Christoph , Pawelke Cynthia , Gierig Sina , Falk Volkmar 
Published: March 2019

Background: Performing cardiopulmonary bypass is a complex task which involves evaluating visual input from patient monitors and technical parameters displayed at the heart-lung machine console as well as reacting to other sensory input. Only few studies are available concerning the competency requirements for clinical cardiovascular perfusionists, including attention, perception, and coping with mental stress. This study aims at evaluating attention, perception, and stress levels of clinical cardiovascular perfusionists during cardiopulmonary bypass. Methods: Nine clinical cardiovascular perfusionists voluntarily offered to participate in the study. Participants were asked to wear Tobii 2 eye-tracking glasses throughout the procedures. Specific time points were analyzed (cardiopulmonary bypass on, initial cardioplegia delivery, steady state, cross-clamp off, and weaning from cardiopulmonary bypass). Data acquisition was supplemented by participants’ self-evaluation regarding their stress levels and by National Aeronautics and Space Administration Task Load Index (NASA TLX) questionnaires. Results: Seven datasets were sufficient to be evaluated. The clinical cardiovascular perfusionists’ professional experience ranged from 0.5 to 24 years. Evaluation of eye-tracking data revealed large variations in areas of interest hits, fixation, and dwell times. Across all phases, the venous reservoir, mean arterial pressure, arterial pump display, cardioplegia control, and data management system received the highest levels of attention. Pupil diameter measurements increased at start of cardiopulmonary bypass, cardioplegia delivery, and weaning off, but returned to base level during steady state. Clinical cardiovascular perfusionists’ self-evaluation showed that subjective stress level was highest at the start and the end of the procedure. NASA TLX questionnaires revealed medium-to-high mental and temporal workloads, but low physical workloads. Performance, effort, and frustration indices showed medium workloads. Conclusion: During cardiopulmonary bypass, perfusionists are subjected to stress. Peak stress levels were highest during start and end of cardiopulmonary bypass. Furthermore, visual attention and perception varied between the operative phases. Further studies are indicated to evaluate the design of heart-lung machines and stress-coping strategies during cardiopulmonary bypass.
Partial Capitate Shortening Osteotomy and Its Impact on Lunate Revascularization: Mid-Term Results
Authors: Tahta Mesut , Zengin Eyup C. , Ozturk Tahir , Mete B. Dirim , Gunal İzge , Sener Muhittin 
Published: March 2019

Background: Treatment of Kienböck disease is still a clinical challenge. The treatment used in each instance is decided according to stage of the disease at presentation. Good clinical and radiological results could be obtained with partial capitate shortening osteotomy. However, mid-term results of this technique and its effect on lunate revascularization are not well known. Objectives: The aim of this study was to report our results of partial capitate shortening osteotomy in the treatment of stage II and IIIA Kienböck disease. Methods: Ten patients were enrolled in the study with a mean age of 37.7 years old (standard deviation [SD] = 9.6). Patients were evaluated clinically in terms of range of motion, DASH and VAS scores, satisfaction with the outcome, and grip/tip/palmar/key pinch strength compared to the contralateral side. Radiological evaluation consisted of Lichtman staging on plain radiographs and lunate revascularization on magnetic resonance imaging (MRI) at both preoperative and postoperative evaluations. Results: The mean duration of follow-up was 55.2 (SD = 24) months. The mean DASH and VAS scores were 14.3 (SD = 6.7) and 1.5 (SD = 1.3), respectively. For patient satisfaction, the mean score was 3.6 (SD = 0.6). The Lichtman stage of 7 patients remained unchanged. Lunate revascularization was detected with MRI in 6 patients. Conclusions: Although the number of patients in the study prevents more strict conclusions, our results are promising, and the technique presented offers minimally but observable lunate revascularization and high success rates in preventing the progression of the disease.
Examining the role of funders in ensuring value and reducing waste in research: An organizational case-study of the Patient-Centered Outcomes Research Institute
Authors: Whitlock Evelyn P. , Selby Joe V. , Dunham Kelly M. , Fernandez Alicia , Forsythe Laura P. , Norquist Grayson 
Published: March 2019

International experts have recommended actions that funders can take to improve the value of research investments. They state that self-assessment and public sharing are the basis for accountability and improvement. We examined our policies and practice to determine the extent to which the Patient-Centered Outcomes Research Institute’s (PCORI) policies and practices as a research funder align with international best practice recommendations. A self-audit of current policies and practice against 17 recommendations and 35 sub-recommendations representing five major stages of research production, based on adapted methods used for self-assessment by another funder, was performed. Fit of existing PCORI policies and practices with 35 sub-recommendations, qualitative assessment of adequacy (area of strength; area of partial strength; area of growth; not applicable) for 17 recommendations for five stages of research production was assessed. Of the 17 recommendations, 15 were applicable to PCORI’s research mission and focus. PCORI has policies and practices in place for all elements of six recommendations (“area of strength”) and policies that address each element but with some still in active development for three (“area of partial strength”). PCORI is partially addressing six of the 15 relevant recommendations (“area of growth”). Areas for growth include making study protocols publicly available, improving policies on data sharing, and enhancing collaboration with other funders to reduce redundant funding. A voluntary consortium of international funders is underway to encourage further progress, including additional self-assessment and public sharing for accountability. These findings indicate PCORI has undertaken efforts to align its funding practices with international recommendations to ensure the value of public dollars invested in research. Further efforts will likely require additional coordination and collaboration between funders and stakeholders.
Aerosol delivery of dry powder synthetic lung surfactant to surfactant-deficient rabbits and preterm lambs on non-invasive respiratory support
Authors: Walther Frans J. , Gupta Monik , Lipp Michael M. , Chan Holly , Krzewick John , Gordon Larry M. , Waring Alan J. 
Published: March 2019

Background: The development of synthetic lung surfactant for preterm infants has focused on peptide analogues of native surfactant proteins B and C (SP-B and SP-C). Non-invasive respiratory support with nasal continuous positive airway pressure (nCPAP) may benefit from synthetic surfactant for aerosol delivery. Methods: A total of three dry powder (DP) surfactants, consisting of phospholipids and the SP-B analogue Super Mini-B (SMB), and one negative control DP surfactant without SMB, were produced with the Acorda Therapeutics ARCUS® Pulmonary Dry Powder Technology. Structure of the DP surfactants was compared with FTIR spectroscopy, in vitro surface activity with captive bubble surfactometry, and in vivo activity in surfactant-deficient adult rabbits and preterm lambs. In the animal experiments, intratracheal (IT) aerosol delivery was compared with surfactant aerosolization during nCPAP support. Surfactant dosage was 100 mg/kg of lipids and aerosolization was performed using a low flow inhaler. Results: FTIR spectra of the three DP surfactants each showed secondary structures compatible with peptide folding as an α-helix hairpin, similar to that previously noted for surface-active SMB in other lipids. The DP surfactants with SMB demonstrated in vitro surface activity <1 mN/m. Oxygenation and lung function increased quickly after IT aerosolization of DP surfactant in both surfactant-deficient rabbits and preterm lambs, similar to improvements seen with clinical surfactant. The response to nCPAP aerosol delivery of DP surfactant was about 50% of IT aerosol delivery, but could be boosted with a second dose in the preterm lambs. Conclusions: Aerosol delivery of DP synthetic surfactant during non-invasive respiratory support with nCPAP significantly improved oxygenation and lung function in surfactant-deficient animals and this response could be enhanced by giving a second dose. Aerosol delivery of DP synthetic lung surfactant has potential for clinical applications.