bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sports-Related Concussion in Adolescent Gaelic Games Players
Authors: O’Connor Siobhán , Moran Kieran , Burke Cian , Whyte Enda 
Published: October 2019

Background: Gaelic games are some of the most popular sports played by Irish adolescents, and the Gaelic Athletic Association has undertaken educational initiatives to improve awareness of a sports-related concussion (SRC). However, SRC underreporting is common among adolescent athletes internationally, potentially due to poor knowledge or attitudes toward SRC. This study aimed to examine previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future education in adolescent Gaelic games players and their parents. Hypotheses: The hypotheses were as follows: (1) A significant number of adolescent Gaelic games players will have experienced an SRC, (2) nondisclosure of SRCs will be common, and (3) adolescents will display poorer attitudes toward reporting than parents. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Adolescent male and female Gaelic games players (n = 113) and parents (n = 151) completed an anonymous questionnaire examining previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future SRC education initiatives. Results: Overall, 57.5% of adolescent Gaelic games players suspected they had suffered an SRC previously, and a greater number of suspected SRCs were reported than were medically diagnosed. Adolescent players (mean score, 11.4/14) and their parents (mean score, 11.8) displayed good knowledge of SRC signs and symptoms. However, adolescents were less likely to report an SRC during an important game or if an important game was coming up. Both adolescents and their parents would like more SRC education, particularly in the format of online videos or medical professional–led workshops. Conclusion: Underreporting of SRC occurs in adolescent players, despite good knowledge of SRC signs and symptoms. Education is required to highlight the importance of completing a return-to-play program after an SRC regardless of match importance. Clinical Relevance: A multifaceted educational strategy that targets the wider Gaelic games community in the preferred formats identified by key stakeholders is required.
Implementation strategies, and barriers and facilitators for implementation of physical activity at work: a scoping review
Authors: Garne-Dalgaard Anne , Mann Stephanie , Bredahl Thomas Viskum Gjelstrup , Stochkendahl Mette Jensen 
Published: October 2019

AbstractBackgroundInactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplace-based physical activity (PA) initiatives. Previous studies on workplace-based PA have only shown moderate and short-term effects. This has been attributed to the lack of clear implementation strategies and understanding of factors that may hinder or enable uptake of PA. To ensure long-term, sustainable outcomes, there is a need for a better understanding of implementation strategies, and barriers and facilitators to workplace-based PA.MethodA scoping review of studies investigating implementation approaches and factors affecting uptake of workplace-based PA was conducted. Qualitative and quantitative articles published in MEDLINE, Embase, Scopus, or PsycINFO between 2008 and 2018 evaluating the implementation of PA were included. Data on study characteristics, evaluation, and implementation methods applied were systematically extracted. Two reviewers extracted, coded, and organised factors affecting uptake using the Theoretical Domains Framework (TDF).ResultsAfter dual, blinded screening of titles and abstracts, 16 articles reporting on eight studies were included in the review. Several different methods of implementation were applied, including information meeting, kick-off events, and “change agents” as the most common. A total of 109 factors influencing implementation were identified, consisting of 57 barriers and 52 facilitators. Barriers most often related to the TDF domainsEnvironmental Context and Resources(n = 34, 36.2%),Social influences(n = 13, 13.8%), andSocial/Professional Role and Identity(n = 8, 8.5%). Likewise, facilitators most often related to the TDF domainsSocial influences(n = 17, 19.5%),Environmental Context and Resources(n = 16, 18.4%), andSocial/Professional Role and Identity(n = 9, 10.3%).ConclusionOur review has highlighted the multilevel factors affecting the uptake of workplace-based PA and underpins the complexities in implementation of such initiatives. The published literature predominantly provides details from the employees’ perspectives on factors that need to be addressed and a lack of attention to these factors will cause them to hamper uptake of PA. The analysis of barriers and facilitators provides a theoretical foundation to guide future intervention design. However, further research is needed to fully understand the success or failure of implementation processes.
Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial
Authors: Pontet Julio , Yic Christian , Díaz-Gómez José L. , Rodriguez Pablo , Sviridenko Igor , Méndez Diego , Noveri Sylvia , Soca Ana , Cancela Mario 
Published: October 2019

Abstract
Background
Point-of-care ultrasound (POCUS) is a tool in increasing use, but there is still a lack of basics for its routine use and evidence of its impact in intensive care.

Objective
To measure the impact of POCUS on resource utilization, diagnostic accuracy, and clinical management in medical-surgical intensive care units (ICUs).

Methods
Prospective, controlled study, in two polyvalent ICUs. The patients were randomly assigned to POCUS or control group.

Interventions
POCUS patients received systematic ultrasound examination of optic nerve, lung/pleura, heart, abdomen, and venous system, performed at the bedside by trained intensivists. Control patients were treated by critical care specialists who do not perform ultrasound in their clinical practice.

Results
We included 80 patients, 40 per group. There were no significant differences in age, sex, APACHE II score, or admission diagnosis. POCUS group used fewer resources per patient in the first 5 days of hospitalization: chest radiography (2.6 ± 2.0 vs 4.1 ± 3.5, P = 0.01), additional ultrasound evaluations performed by a radiology specialist (0.6 ± 0.7 vs 1.1 ± 0.7, P = 0.002), and computed tomography studies (0.5 ± 0.6 vs 0.9 ± 0.7, P = 0.007). Time to perform any requested ultrasound evaluation after ICU admission was 2.1 ± 1.6 h versus 7.7 ± 6.7 h (P = 0.001). Systematic ultrasound evaluation led to better characterization of ICU admission diagnosis in 14 (35%) patients and change in clinical management in 24 (60%). POCUS group had lower fluid balance at 48 and 96 h after admission (P = 0.01) and spent less time mechanically ventilated (5.1 ± 5.7 days vs 8.8 ± 9.4, P = 0.03).

Conclusions
Systematic application of POCUS may decrease utilization of conventional diagnostic imaging resources and time of mechanical ventilation, and facilitate meticulous intravenous fluid administration in critically ill patients during the first week of stay in the ICU.
Trial registration ClinicalTrials.gov Identifier: NCT03608202.
Land use and urban sustainability assessment: a 3D-GIS application to a case study in Gozo
Authors: Morosini Rosa , Zucaro Floriana 
Published: October 2019

Abstract
Balancing urban growth and natural resource availability has been recognized as the main challenge of the 21st century from the strategic documents adopted by the recent World Summits. Agenda 21 advocates sustainable land use, as soil is a crucial natural resource to reduce urban vulnerability due e.g. to climate change, energy saving, and natural disasters. In this perspective, this paper aims at supporting local decision makers in identifying the portions and the buildings of an urban area most susceptible to transformation, in order to promote a sustainable land use according to physical and functional characteristics. The proposed methodology combines the 3D modeling of urban settlements and the adoption of the performance-based approach by the urban transformation government, in order to guarantee the satisfaction of the supply–demand ratio through a compatible balance between urban growth dynamics and the overall urban efficiency. The test area was Gozo island, where a significant urban transformation will occur as a consequence of the new Malta-Gozo tunnel construction.
Midpalatal suture maturation stage assessment in adolescents and young adults using cone-beam computed tomography
Authors: Jimenez-Valdivia Ludy Marileidy , Malpartida-Carrillo Violeta , Rodríguez-Cárdenas Yalil Augusto , Dias-Da Silveira Heraldo Luis , Arriola-Guillén Luis Ernesto 
Published: October 2019

Abstract

Background
The aim of this study was to evaluate the midpalatal suture maturation stages in adolescents and young adults using cone-beam computed tomography (CBCT).

Methods
The sample comprised 200 CBCT scans of individuals aged 10 to 25 years old (95 males and 105 females) divided into three groups, adolescents (n = 48), post-adolescents (n = 52), and young adults (n = 100). The Planmeca ProMax 3D software was used for the midpalatal suture maturation stage evaluation according to Angieleri’s method, using cross-sectional axial slice. Two previously calibrated examiners analyzed the images and classified according to five different maturation stages. A, B, and C stages were considered with open midpalatal suture, and D and E were considered without open midpalatal suture. Association tests were performed using chi-square test also, and a binary logistic regression was evaluated (P < 0.05).

Results
The possibility to find open midpalatal suture in individuals of 10 to 15 years old was 70.8%, in subject aged 16 to 20 and 21 to 25 years old was 21.2% and 17%, respectively. Furthermore, this possibility in individuals older than 16 years was greater in males than in females.

Conclusions
The possibility to find open midpalatal suture in post-adolescents and young adults is greater than the orthodontists considered years ago. Furthermore, men are more likely to find midpalatal suture opening. These implications might be considered by the orthodontists when maxillary expansion is required. Besides, the ossification of the middle palatal suture is very variable, and therefore, the use of CBCT might be recommended to clarify this possibility.
A qualitative exploration of Bahrain and Kuwait herbal medicine registration systems: policy implementation and readiness to change
Authors: Alostad Azhar H. , Steinke Douglas T. , Schafheutle Ellen I. 
Published: October 2019

AbstractBackgroundThe Kuwaiti drug regulatory authority (DRA) lack a structured classification system for the assessment of imported herbal medicines (HMs), which leads to ambiguity in the registration process. This study aimed to examine the policy development and implementation process in an established HM registration system (Bahrain) and harness lessons to inform recommendations for a suitable HM classification system and explore implementation readiness in Kuwait.MethodsA sequential study design was chosen, with data collected in Bahrain (case 1), recommendations formed and readiness for implementation explored subsequently in Kuwait (case 2). With ethics and DRA approval in place, data sources were documentary review of regulatory policies, direct observations of HMs registration processes, and semi-structured interviews with twenty three key officials involved in the HMs registration processes. Data from all three sources were analysed thematically and findings triangulated.ResultsThe classification policy in Bahrain was found to be based on evidence and extensive stakeholder engagement, resulting in a clear and organised HM registration process. The availability of HMs classification policies in other DRAs, officials’ dedication and teamwork, and support by higher authority, were identified as the main facilitators in policy development and successful implementation. Barriers were the diversity of HM classifications worldwide, a lack of staff and resultant workload, and lack of training. Proposed recommendations for Kuwait were to adopt a clear definition of what constituted HMs, and to introduce a Traditional Herbal Registration based on this definition and the product’s characteristics. Interviews in Kuwait showed that almost all participants were in favour of the proposed recommendations and were in support of timely implementation. Interviewees anticipated that consistency in the HM registration process would be the main benefit, increasing reviewer’s confidence in making regulatory decisions. Interviewees also identified potential challenges which may impede successful implementation, including staff shortages, resistance to change by internal and external stakeholders, and the impact of cultural and traditional ways of working.ConclusionsInsights into the HM policy development and implementation process in Bahrain, and exploration of Kuwait’s readiness to implement resultant recommendations informed an effective implementation process for a well-designed HMs policy for Kuwait and other Arab countries.
Adiponectin and human eating behaviour: a Mendelian randomization study
Authors: Awofala Awoyemi Abayomi , Ogundele Olusegun Emmanuel , Adekoya Khalid Olajide , Osundina Samuel Adesayo 
Published: October 2019

AbstractBackgroundAdiponectin plays key roles in regulating appetite and food intake. Altered circulating adiponectin levels have been observed in human eating disorders such as anorexia nervosa, bulimia nervosa or binge eating. In addition, an association between circulating adiponectin levels and human eating behaviour (EB) has been reported. Interestingly, a disturbance in eating behaviour is the defining characteristic of human eating disorders. However, it is unknown whether adiponectin is causally implicated in human EB. We therefore aimed to investigate the causal effect of adiponectin on EB.ResultsMendelian randomization (MR) analysis estimated the influence of blood adiponectin on EB by combining data on the association of adiponectin gene (ADIPOQ) variants with adiponectin levels and with three EB factors involving disinhibition, restraint and hunger. Using inverse-variance weighted (IVW) regression method and other complementary MR techniques (weighted median regression, MR Egger and weighted modal regression), the MR analysis revealed a broadly consistent evidence that higher blood adiponectin concentration was significantly associated with increased EB factor disinhibition (beta coefficient for IVW regression [βIVW], 3.05; 95% confidence interval [CI] 1.10, 5.00) but non-significantly associated with increased EB factor restraint (βIVW, 0.17; 95% CI − 1.85, 2.18), and increased EB factor hunger (βIVW, 1.63; 95% CI − 0.75, 4.01).ConclusionsOverall, our findings indicate a causal role of adiponectin levels in eating disinhibition but not in eating restraint and hunger.
Composite Tetraheteroarylenes and Related Higher Cyclic Oligomers of Heteroarenes Produced by Palladium-Catalyzed Direct Coupling
Authors: Fukuzumi Keita , Nishii Yuji , Miura Masahiro 
Published: October 2019

Abstract
Substantial research interests have been focused on cyclic π-conjugated molecules owing to their unique chemical and physical properties. By constructing hybrid aromatic arrays within these cyclic systems, new series of composite macrocycles would be provided. Our group has been studying the construction of such hybrids by adopting the palladium-catalyzed direct coupling of heteroaromatics. We herein report the synthesis and characterization of thiophene-thiazole composite macrocycles. X-ray diffraction analyses revealed that some of these coupling products exhibit characteristic helical assemblies in the solid state. Additionally, we synthesized a heteroarene-fused cyclooctatetraene composed of four different heteroaryl fragments.
PET imaging of a 68Ga labeled modified HER2 affibody in breast cancers: from xenografts to patients
Authors: Xu Yuping , Wang Lizhen , Pan Donghui , Yu Chunjing , Mi Baoming , Huang Qianhuan , Sheng Jie , Yan Junjie , Wang Xinyu , Yang Runlin , Yang Min 
Published: October 2019

Objective:
Overexpression of human epidermal growth factor receptor-2 (HER2) in breast cancers provides promising opportunities for imaging and targeted therapy. Developing HER2 targeted positron emission tomography (PET) probes might be benefit for management of the disease. Small high-affinity scaffold proteins, affibodies, are ideal vectors for imaging HER2 overexpressed tumors. Despite of the initial success on development of 18F labeled ZHER2:342 affibody, the tedious synthesis producers, low yields and unfavorable pharmacokinetics may hinder the clinical use. 68Ga is an attractive positron emitter for PET imaging. A simple preparation of 68Ga labeled ZHER2:342 analog, 68Ga-NOTA-MAL-Cys-MZHER2:342, was reported in the study. The in vivo performances of the tracer for assessing HER2 status in breast cancers were also evaluated.

Methods:
NOTA-MAL conjugated Cys-MZHER2:342 was radiolabeled with 68Ga. The probe was evaluated by in vitro tests including stability and cell binding studies in breast cancer cells with different HER2 levels. In vivo evaluation was performed in mice bearing tumors using microPET imaging and biodistribution experiments. A PET/CT imaging study was initially performed in patients with breast cancers.

Results:
The tracer was synthesized in a straightforward chelation method with satisfactory non-decay corrected yield (81±5%) and radiochemical purity (&gt;95%). In vivo micro-PET imaging showed that HER2 high levels expressed BT474 xenografts were more clear visualized than HER2 low levels expressed MCF-7 tumors (16.12 ± 2.69 ID%/g vs 1.32 ± 0.19 ID%/g at 1 h post-injection). The outcome was consistent with the immunohistochemical analysis. No significant radioactivity was accumulated in healthy tissues (less than 2% ID/g) except kidneys. In a preliminary clinical study, 68Ga-NOTA-MAL-Cys-MZHER2:342 PET imaging allowed more high-contrast detection of HER2 positive primary tumors (maximum standardized uptake value = 2.16±0.27) than those in HER2 negative primary focus (maximum standardized uptake value = 0.32±0.05). No detectable side-effects were found.

Conclusion:
In summary, this study indicates the significant efficiency of the 68Ga labeled HER2 affibody. Preclinical and clinical studies support the possibility of monitoring HER2 levels in breast cancers using 68Ga-NOTA-MAL-Cys-MZHER2:342.

Advances in knowledge:
The research investigated the feasibility of a 68Ga labeled HER2 affibody modified with a hydrophilic linker for breast cancer PET imaging. Favorable outcomes showed that the probe might be valuable for determining HER2 status of the disease.
Factors affecting spirometry reference range in growing children
Authors: Sadiq Sara , Rizvi Nadeem Ahmed , Soleja Fahad Khalid , Abbasi Muaz 
Published: October 2019

Objectives: To find out the association of weight, height and age with spirometry variables and to generate a regression equation by taking weight as an independent variable beside age and height among children and adolescents of Karachi.
Methods: A modified form of ISSAC questionnaire was used. The spirometry variables recorded were Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1/FVC, Peak expiratory flow rate (PEF), Forced expiratory flow between 25% and 75% expired volume (FEF25-75). A person’s correlation coefficient among boys and girls were calculated for all spirometry variable considering age, height and weight as independent variables. The linear regression models were calculated.
Results: The results reported a linear correlation of lung function variables with all three independent variables (i.e. p-value = 0.000), in which age and height manifested a strong positive correlation while weight reported a moderately significant correlation. All spirometry variables such as FVC, FEV1, PEF and FEF25-75 reported a significant coefficient of dependency and coefficient of correlation individually with age, height and weight.
Conclusion: It is concluded that beside age, height and weight both also have significant correlation with lung volumes so these should be taken into account when using spirometry as a diagnostic test.
doi: https://doi.org/10.12669/pjms.35.6.1212
How to cite this:Sadiq S, Rizvi NA, Soleja FK, Abbasi M. Factors affecting spirometry reference range in growing children. Pak J Med Sci. 2019;35(6):1587-1591. doi: https://doi.org/10.12669/pjms.35.6.1212
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pathological discrepancy between colposcopic directed cervical biopsy and conisation results: A five years experience of a single center in Turkey
Authors: Aydoğmuş Hüseyin , Sen Serhat , Aydogmus Serpil 
Published: October 2019

Objective: To analyze the clinical outcomes and treatment strategies of patients who underwent conisation in a tertiary hospital clinic
Methods: The study was designed as a retrospective cohort study. Retrospective data’s of 176 patients who underwent conisation due to detection of dysplasia via colposcopic biopsy or cytology-histology discrepancy between 2012 and 2017 were collected. Colposcopy guided biopsies were performed according to HPV positivity and/or abnormal smear results in Izmir Katip Celebi University Ataturk Research and Training Hospital.
Results: Indications for colposcopic biopsies were HPV positivity in 51 patients (29.1%), abnormal smear results in 125 patients (70.9 %). Distribution of abnormal smear results were ASCUS, ASC-H, LSIL, HSIL in 6 (4.8 %), 21 (16.8 %), 24 (19.2%), 74 (59.2%) patients respectively. According to biopsy results, 8 patients (4.4 %) showed no dysplasia where two (1.1%) and 162 (91.5 %) patients were with LSIL and HSIL respectively. Only two were diagnosed with in situ carcinoma. Among 162 patients with HSIL in colposcopic biopsy, 45 showed no dysplasia where four were diagnosed with invasive carcinoma.
Conclusions: To detect high grade cervical lesions colposcopy guided biopsy is gold standard. Although cone biopsy should be performed related to severity of dysplasia in order to sustain the diagnosis and treatment. Contradictory results between colposcopic and cone biopsies should be considered during decision-making process.
doi: https://doi.org/10.12669/pjms.35.6.408
How to cite this:Aydogmus H, Sen S, Aydogmus S. Pathological discrepancy between colposcopic directed cervical biopsy and conisation results: A five years experience of a single center in Turkey. Pak J Med Sci. 2019;35(6):1627-1630. doi: https://doi.org/10.12669/pjms.35.6.408
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.