bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical risk factors for Achilles tendinopathy: a systematic review
Authors: van der Vlist Arco C , Breda Stephan J , Oei Edwin H G , Verhaar Jan A N , de Vos Robert-Jan 
Published: February 2019

BackgroundAchilles tendinopathy is a common problem, but its exact aetiology remains unclear.ObjectiveTo evaluate the association between potential clinical risk factors and Achilles tendinopathy.DesignSystematic review.Data sourcesThe databases Embase, MEDLINE Ovid, Web of Science, Cochrane Library and Google Scholar were searched up to February 2018.Eligibility criteriaTo answer our research question, cohort studies investigating risk factors for Achilles tendinopathy in humans were included. We restricted our search to potential clinical risk factors (imaging studies were excluded).ResultsWe included 10 cohort studies, all with a high risk of bias, from 5111 publications identified. There is limited evidence for nine risk factors: (1) prior lower limb tendinopathy or fracture, (2) use of ofloxacin (quinolone) antibiotics, (3) an increased time between heart transplantation and initiation of quinolone treatment for infectious disease, (4) moderate alcohol use, (5) training during cold weather, (6) decreased isokinetic plantar flexor strength, (7) abnormal gait pattern with decreased forward progression of propulsion, (8) more lateral foot roll-over at the forefoot flat phase and (9) creatinine clearance of <60 mL/min in heart transplant patients. Twenty-six other putative risk factors were not associated with Achilles tendinopathy, including being overweight, static foot posture and physical activity level.ConclusionFrom an ocean of studies with high levels of bias, we extracted nine clinical risk factors that may increase a person’s risk of Achilles tendinopathy. Clinicians may consider ofloxacin use, alcohol consumption and a reduced plantar flexor strength as modifiable risk factors when treating patients with Achilles tendinopathy.Trial registration numberCRD42017053258.
Temporal trends in neonatal mortality and morbidity following spontaneous and clinician-initiated preterm birth in Washington State, USA: a population-based study
Authors: Richter Lindsay L , Ting Joseph , Muraca Giulia M , Synnes Anne , Lim Kenneth I , Lisonkova Sarka 
Published: February 2019

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.
Association between maternal passive smoking and increased risk of delivering small-for-gestational-age infants at full-term using plasma cotinine levels from The Hokkaido Study: a prospective birth cohort
Authors: Kobayashi Sumitaka , Sata Fumihiro , Hanaoka Tomoyuki , Braimoh Titilola Serifat , Ito Kumiko , Tamura Naomi , Araki Atsuko , Itoh Sachiko , Miyashita Chihiro , Kishi Reiko 
Published: February 2019

ObjectivesTo investigate the association between plasma cotinine level measured at the 8th gestational month and the delivery of small-for-gestational-age (SGA) infants, using a highly sensitive ELISA method.DesignProspective birth cohort study from The Hokkaido Study on Environment and Children’s Health.SettingHokkaido, Japan.ParticipantsOur sample included 15 198 mother-infant pairs enrolled in 2003–2012.Main outcome measuresSGA, defined as a gestational age-specific weight Z-score below −2.ResultsThe number of SGA infants was 192 (1.3%). The cotinine cut-off level that differentiated SGA infants from other infants was 3.03 ng/mL for both the total population and the full-term births subgroup (sensitivity 0.307; positive predictive value 2.3%). Compared with infants of mothers with a plasma cotinine level of <3.03 ng/mL, infants of mothers with a plasma cotinine level of ≥3.03 ng/mL showed an increased OR for SGA in the total population and the full-term infant group (2.02(95% CI 1.45 to 2.83) and 2.44(95% CI 1.73 to 3.44), respectively).ConclusionA plasma cotinine level of ≥3.03 ng/mL, which included both passive and active smokers, was associated with an increased risk of SGA. This finding is of important relevance when educating pregnant women about avoiding prenatal passive and active smoking due to the adverse effects on their infants, even those born at full-term.
Impact of the great recession on self-perceived health in Spain: a longitudinal study with individual data
Authors: Saez Marc , Vidiella-Martin Joaquim , Casasnovas Guillem López 
Published: February 2019

ObjectivesOur objective in this study is to evaluate the impact the Great Recession (2008–2014) had on self-perceived health in Spain.DesignWe use a longitudinal database (four waves of the Bank of Spain’s Survey of Household Finances (2005, 2008, 2011 and 2014)) with repeated observations of the same individuals before and after the Great Recession.InterventionsWe consider the Great Recession in a natural experiment and we introduce it as an explanatory variable in a mixed logistic regression model in which we explain the probability of a subject declaring poor health (fair, bad and very bad). In the model we control for both observed and unobserved confounders at both individual and family level.ResultsWe find an average downward trend in self-perceived health during the most severe period of the Great Recession (2009–2011). However, the fact that the adjusted measures are less volatile than the crude ones shows that variation in health status can be captured by either demographic or socioeconomic controls. In fact, there are significant differences in the impact the economic crisis had on health in terms of gender and age group. In particular, the (adjusted) risk of declaring poor health increases after the crisis began but only in those families in which the reference person is a woman younger than 45 years of age or a man aged 75 years or older.ConclusionsGiven our results, we discuss the link between financial wealth and self-rated health and how policy-makers could address the health inequalities that arise from adverse economic and financial shocks.
‘I did not check if the teacher gave feedback’: a qualitative analysis of Taiwanese postgraduate year 1 trainees’ talk around e-portfolio feedback-seeking behaviours
Authors: Fu Ren-Huei , Cho Yu-Hsueh , Quattri Francesca , Monrouxe Lynn V 
Published: February 2019

ObjectivesDespite feedback being an extensively researched and essential component of teaching and learning, there is a paucity of research examining feedback within a medical education e-portfolio setting including feedback-seeking behaviours (FSBs). FSBs can be understood within a cost–value perspective. The objective of this research is to explore the factors that influence postgraduate year 1 (PGY1) trainee doctors’ FSBs via e-portfolios.SettingPostgraduate education provision in the largest teaching hospital in Taiwan.ParticipantsSeventy-one PGY1s (66% male).MethodsA qualitative semistructured one-to-one interview method was adopted. Interviews were audio recorded, transcribed verbatim, anonymised and checked for completeness. Data were analysed inductively via thematic framework analysis and deductively informed using FSB theory. The process comprised data familiarisation, identification of the themes, charting and data interpretation.ResultsTwo main themes of FSB related and e-portfolio related were identified. We present the theme focussing on FSB here to which n=32 (22 males, 10 females) of the n=71 participants contributed meaningfully. Subthemes include factors variously affecting PGY1s’ positive and negative FSBs via e-portfolios at the individual, process and technological levels. These factors include learner-related (internal values vs social influence, forced reflection); teacher-related (committed educators vs superficial feedback); technology-related (face-saving vs lagging systems; inadequate user-interface) and process-related (delayed feedback, too frequent feedback) factors.ConclusionsOur findings reveal the complexity of PGY1s’ FSBs in an e-portfolio context and the interaction of numerous facilitating and inhibiting factors. Further research is required to understand the range of facilitating and inhibiting factors involved in healthcare learners’ FSBs across different learning, social, institutional and national cultural settings.
Evaluating a custom-designed aid to improve communication of genetic results in families with hypertrophic cardiomyopathy: study protocol for a randomised controlled trial
Authors: Burns Charlotte , Yeates Laura , Semsarian Christopher , Ingles Jodie 
Published: February 2019

IntroductionGenetic testing for hypertrophic cardiomyopathy (HCM) in the era of genomics brings unique challenges for genetic counselling. The number of genes routinely included in an HCM gene panel has increased markedly, many with minimal if any robust evidence of gene–disease association. Subsequently, there is a greater chance of uncertain genetic findings. The responsibility of communicating this information with at-risk relatives lies with the index case (proband). We have developed a communication aid to assist with the delivery of genetic results to the proband. We have previously shown the aid is feasible and acceptable and have now developed a study protocol for a randomised controlled trial of a genetic counsellor-led intervention incorporating the communication aid.Methods and analysisThis is a prospective randomised controlled trial. We will investigate the impact of a genetic counsellor-led intervention to return proband genetic results using a custom-designed communication aid. We aim to improve knowledge and empowerment. The primary outcome of this trial is the ability and confidence of the proband to communicate genetic results to at-risk relatives. Secondary outcomes will assess genetic knowledge, satisfaction with services, outcomes from genetic counselling and psychological adaptation to genetic information.Ethics and disseminationThis study has been approved by and is in strict accordance with the Sydney Local Health District Ethics Review Committee (X16-0030; 22/01/2016; version 1). Results from this trial will be prepared as a manuscript and submitted to peer-reviewed journals for publication as well as submission for presentation at national and international meetings.Trial registration numberACTRN12617000706370.
Unravelling the interaction between theDRD2andDRD4genes, personality traits and concussion risk
Authors: Abrahams Shameemah , McFie Sarah , Lacerda Miguel , Patricios Jon , Suter Jason , September Alison V , Posthumus Michael 
Published: February 2019

BackgroundConcussion occurs when biomechanical forces transmitted to the head result in neurological deficits. Personality may affect the balance between safe and dangerous play potentially influencing concussion risk. Dopamine receptor D2 (DRD2) and dopamine receptor D4 (DRD4) genetic polymorphisms were previously associated with personality traits.ObjectivesThis case–control genetic association study investigated the associations of (1)DRD2andDRD4genotypes with concussion susceptibility and personality, (2) personality with concussion susceptibility and (3) the statistical model of genotype, personality and concussion susceptibility.MethodsIn total, 138 non-concussed controls and 163 previously concussed cases were recruited from high school (n=135, junior), club and professional rugby teams (n=166, senior). Participants were genotyped forDRD2rs12364283 (A>G),DRD2rs1076560 (C>A) andDRD4rs1800955 (T>C) genetic variants. Statistical analyses including structural equation modelling were performed using the R environment and STATA.ResultsThe rs1800955 CC genotype (p=0.014) and inferredDRD2(rs12364283–rs1076560)–DRD4(rs1800955) A–C–C allele combination (p=0.019) were associated with decreased concussion susceptibility in juniors. The rs1800955 TT and CT genotypes were associated with low reward dependence in juniors (p<0.001) and seniors (p=0.010), respectively. High harm avoidance was associated with decreased concussion susceptibility in juniors (p=0.009) and increased susceptibility in seniors (p=0.001). The model showed that a genetic variant was associated with personality while personality was associated with concussion susceptibility.ConclusionThese findings highlight the linear relationship between genetics, personality and concussion susceptibility. Identifying a genetic profile of ‘high risk’ behaviour, together with the development of personalised behavioural training, can potentially reduce concussion risk.
Impact of therapeutic drug level monitoring on outcomes of patients with Crohn’s disease treated with Infliximab: real world data from a retrospective single centre cohort study
Authors: Kamperidis Nikolaos , Middleton Paul , Tyrrell Tracey , Stasinos Ioannis , Arebi Naila 
Published: February 2019

BackgroundTherapeutic drug monitoring (TDM) by measuring infliximab (IFX) trough levels and antibodies to infliximab (ATI) is used to optimise treatment in inflammatory bowel disease. We aimed to explore the clinical outcomes of TDM for patients with Crohn’s disease on IFX in real life setting.MethodsThis is a retrospective observational study. Primary outcomes were the clinicians’ response to each TDM result and the rate of IFX discontinuation due to secondary loss of response or serious adverse event. Secondary outcomes included the intestinal surgery rate after IFX initiation and remission 6 months after TDM. Multivariate logistic regression was performed to identify factors associated with IFX discontinuation and abdominal surgery.Results291 patients were included. 238 (81.8%) patients were tested for TDM at least once during their follow-up with 672 TDM results. 95/238 patients (39.9%) had undetectable levels and 76 (31.9%) had positive ATI at least once. The median infliximab trough level was 3.4 µg/mL. IFX was discontinued in 109 patients (37.5%). 526/672 (78.3%) TDMs results were not followed by altered patient management. Treatment was discontinued in 40 (75.5%) patients never tested for TDM compared with 69 (29.0%) of those tested (p<0.01). Fewer TDM tested patients (29; 12.2%) required intestinal surgery post IFX initiation compared with TDM not-tested (15; 28.3%). Not being TDM tested was independently associated with IFX discontinuation and abdominal surgery.ConclusionsIFX discontinuation and intestinal surgery were significantly less frequent with TDM. TDM requested to investigate loss of response resulted in change in patient management.
Long-term outcomes after intervention for pulmonary atresia with intact ventricular septum
Authors: Wright Lydia K , Knight Jessica H , Thomas Amanda S , Oster Matthew E , St Louis James D , Kochilas Lazaros K 
Published: February 2019

ObjectivePulmonary atresia with intact ventricular septum (PA/IVS) can be treated by various operative and catheter-based interventions. We aim to understand the long-term transplant-free survival of patients with PA/IVS by treatment strategy.MethodsCohort study from the Pediatric Cardiac Care Consortium, a multi-institutional registry with prospectively acquired outcome data after linkage with the National Death Index and the Organ Procurement and Transplantation Network.ResultsEligible patients underwent neonatal surgery or catheter-based intervention for PA/IVS between 1982 and 2003 (median follow-up of 16.7 years, IQR: 12.6–22.7). Over the study period, 616 patients with PA/IVS underwent one of three initial interventions: aortopulmonary shunt, right ventricular decompression or both. Risk factors for death at initial intervention included earlier birth era (1982–1992), chromosomal abnormality and atresia of one or both coronary ostia. Among survivors of neonatal hospitalisation (n=491), there were 99 deaths (4 post-transplant) and 10 transplants (median age of death or transplant 0.7 years, IQR: 0.3–1.8 years). Definite repair or last-stage palliation was achieved in the form of completed two-ventricle repair (n=201), one-and-a-half ventricle (n=39) or Fontan (n=96). Overall 20-year survival was 66%, but for patients discharged alive after definitive repair, it reached 97.6% for single-ventricle patients, 90.9% for those with one-and-a-half ventricle and 98.0% for those with complete two-ventricle repair (log-rank p=0.052).ConclusionsTransplant-free survival in PA/IVS is poor due to significant infantile and interstage mortality. Survival into early adulthood is excellent for patients reaching completion of their intended path independent of type of repair.
Outcome of participants with nephrotic syndrome in combined clinical trials of lupus nephritis
Authors: Gomez Mendez Liliana Michelle , Cascino Matthew D , Katsumoto Tamiko R , Brakeman Paul , Brunetta Paul , Jayne David , Dall’Era Maria , Rovin Brad , Garg Jay 
Published: February 2019

ObjectiveThe outcome of participants with nephrotic syndrome in clinical trials of lupus nephritis has not been studied in detail.MethodsCollated data from two randomised controlled trials in lupus nephritis, Lupus Nephritis Assessment of Rituximab (LUNAR) and A Study to Evaluate Ocrelizumab in Patients With Nephritis due to Systemic Lupus Erythematosus (BELONG) were analysed. Nephrotic syndrome was defined as albumin <3 g/dL and urine protein/creatinine ratio ≥3.5 g/g at start of trial. Renal response was defined as a first morning urine protein/creatinine ratio ≤0.5 g/g in addition to ≤25% increase in creatinine from trial entry assessed at week 48. Logistic regression was used to evaluate the association of nephrotic syndrome with renal response while adjusting for treatment received and ACE inhibitor or angiotensin receptor blocker use.Results28 (26%) participants with nephrotic syndrome achieved renal response as compared with 130 (52.5%) of those without (p<0.001). Having nephrotic syndrome at baseline significantly lowered the likelihood of achieving renal response (OR 0.32, 95 % CI 0.19 to 0.54, p<0.001). 125 (80%) participants achieved resolution of their nephrotic syndrome in a median time of 16 weeks.ConclusionsNephrotic syndrome at baseline decreases the likelihood of renal response at 1 year. Longer clinical trials or better short-term predictors of long-term outcomes may better assess the effect of novel therapeutic approaches on subjects with nephrotic syndrome.
Differences in hemodynamic characteristics under high packing density between the porous media model and finite element analysis in computational fluid dynamics of intracranial aneurysm virtual treatment
Authors: Jiang Yeqing , Ge Liang , Di Ruoyu , Lu Gang , Huang Lei , Li Gaohui , Leng Xiaochang , Zhang Sufang , Wan Hailin , Geng Daoying , Xiang Jianping , Zhang Xiaolong 
Published: February 2019

ObjectiveThis study aimed to compare the hemodynamic differences among no sac (NOS), porous media (POM) and finite element analysis (FEA) models to investigate the recurrence-related risks for coiled intracranial aneurysms (IAs).MethodsThe study enrolled 10 patients with 11 IAs who received simple coiling treatment and hemodynamic simulations were performed for all IAs using the above three models. Velocity, wall shear stress (WSS) and residual flow volume (RFV) were calculated and compared in order to assess the model differences for both aneurysm sac and parent vessel regions.ResultsFor parent artery regions, all three models produced similar flow patterns and quantification analysis did not indicate differences in velocity and WSS (p>0.05). For aneurysm sac regions, the FEA model resulted in higher sac-maximized (0.18 m/s vs 0.06 m/s) and sac-averaged velocity (0.013 m/s vs 0.007 m/s), and higher sac-averaged (0.55 Pa vs 0.36 Pa, p=0.006) and sac-maximized WSS (12.1 Pa vs 6.6 Pa) than the POM model. The differences in RFV between the POM and FEA models under 11 different isovelocity thresholds (0.0001 m/s, 0.001 m/s, 0.002 m/s, 0.005 m/s, 0.01 m/s, 0.02 m/s, 0.05 m/s, 0.1 m/s, 0.2 m/s, 0.5 m/s, and 1 m/s) showed that the POM RFV was generally larger than those of the FEA model.ConclusionsCompared with the FEA model, the POM model provides a lower velocity and WSS and higher RFV for the aneurysm sac, which could lead to incorrect estimates of the recurrent risk of coiled IAs under high packing density.
Standard operating procedure reduces interoperator variation and improves accuracy when measuring packed cell volume
Authors: Breheny Craig R , Perez‐Accino Salgado Jorge , Bommer Nicholas X , Handel Ian , Gow Adam G 
Published: February 2019

ObjectiveTo evaluate whether a standard operating procedure (SOP) for canine packed cell volume (PCV) measurement reduces operator‐dependent variation and improves accuracy within a veterinary teaching hospital environment.Materials and methodsClinical staff and final‐year undergraduate veterinary students were recruited to perform PCV measurements in blinded duplicate samples. Participants were randomly allocated to perform this with or without an SOP. Participants’ results were compared against a reference, generated by the authors following the World Health Organization guidelines.ResultsThe study population comprised 18 clinical staff and 39 students. Three clinical staff and seven students displayed errors consistent with inaccurate reading, only one of whom had access to the SOP. Five students and two clinical staff had errors attributable to incorrect preparation, with only one having access to the SOP. Interoperator variation was significantly less using the SOP. Using the SOP, 95 per cent of the results were within 0.0125 l/l of the reference value, in comparison with within 0.09 l/l without SOP. Interoperator variation was significantly less in the SOP group (P=0.0025).Clinical significanceUsing the SOP resulted in less variation and more accurate results. This confirms that PCV measurement with an SOP can truly be a ‘waived’ test.