bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foot and Ankle Kinematics During Descent From Varying Step Heights
Authors: Gerstle Emily E. , O’Connor Kristian , Keenan Kevin G. , Cobb Stephen C. 
Published: July 2017

In the general population, one-third of incidences during step negotiation occur during the transition to level walking. Furthermore, falls during curb negotiation are a common cause of injury in older adults. Distal foot kinematics may be an important factor in determining injury risk associated with transition step negotiation. The purpose of this study was to identify foot and ankle kinematics of uninjured individuals during descent from varying step heights. A 7-segment foot model was used to quantify kinematics as participants walked on a level walkway, stepped down a single step (heights: 5 cm, 15 cm, 25 cm), and continued walking. As step height increased, landing strategy transitioned from the rearfoot to the forefoot, and the rearfoot, lateral and medial midfoot, and medial forefoot became more plantar flexed. During weight acceptance, sagittal plane range of motion of the rearfoot, lateral midfoot, and medial and lateral forefoot increased as step height increased. The changes in landing strategy and distal foot function suggest a less stable ankle position at initial contact and increased demand on the distal foot at initial contact and through the weight acceptance phase of transition step negotiation as step height increases.
Effects of a Prophylactic Knee Sleeve on Anterior Cruciate Ligament Loading During Sport-Specific Movements
Authors: Sinclair Jonathan , Taylor Paul J. 
Published: July 2017

Context: Prophylactic knee bracing is extensively utilized in athletic populations to reduce the high risk from knee injuries, but its role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. Objective: The aim of this investigation was to explore the effects of a prophylactic knee sleeve on ACL loading parameters linked to the etiology of injury in recreational athletes. Setting: Laboratory. Design: Repeated measures. Participants: Thirteen healthy male recreational athletes. Intervention: Participants performed run, cut, and single-leg hop movements under 2 conditions; prophylactic knee sleeve and no sleeve. Main Outcome Measures: Biomechanical data were captured using an 8-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate, and instantaneous ACL load rate were quantified using a musculoskeletal modeling approach. Results: The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/1286.39 N/kg/s and no sleeve = 743.91/1471.42 N/kg/s) and cut (sleeve = 222.55/1058.02 N/kg/s and no sleeve = 377.38/1183.01 N/kg/s) movements. Conclusions: Given the biomechanical association between ACL loading and the etiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.
Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions
Authors: Moffatt Suzanne , Steer Mel , Lawson Sarah , Penn Linda , O’Brien Nicola 
Published: July 2017

ObjectivesTo describe the experiences of patients with long-term conditions who are referred to and engage with a Link Worker social prescribing programme and identify the impact of the Link Worker programme on health and well-being.DesignQualitative study using semistructured interviews with thematic analysis of the data.InterventionLink Worker social prescribing programme comprising personalised support to identify meaningful health and wellness goals, ongoing support to achieve agreed objectives and linkage into appropriate community services.SettingInner-city area in West Newcastle upon Tyne, UK (population n=132 000) ranked 40th most socioeconomically deprived in England, served by 17 general practices.ParticipantsThirty adults with long-term conditions, 14 female, 16 male aged 40–74 years, mean age 62 years, 24 white British, 1 white Irish, 5 from black and minority ethnic communities.ResultsMost participants experienced multimorbidity combined with mental health problems, low self-confidence and social isolation. All were adversely affected physically, emotionally and socially by their health problems. The intervention engendered feelings of control and self-confidence, reduced social isolation and had a positive impact on health-related behaviours including weight loss, healthier eating and increased physical activity. Management of long-term conditions and mental health in the face of multimorbidity improved and participants reported greater resilience and more effective problem-solving strategies.ConclusionsFindings suggest that tackling complex and long-term health problems requires an extensive holistic approach not possible in routine primary care. This model of social prescribing, which takes into account physical and mental health, and social and economic issues, was successful for patients who engaged with the service. Future research on a larger scale is required to assess when and for whom social prescribing is clinically effective and cost-effective.
Effectiveness of behavioural change techniques in physiotherapy interventions to promote physical activity adherence in patients with hip and knee osteoarthritis: a systematic review protocol
Authors: Willett Matthew , Duda Joan , Gautrey Charlotte , Fenton Sally , Greig Carolyn , Rushton Alison 
Published: July 2017

IntroductionOsteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements. This systematic review aims to evaluate the effectiveness of behavioural change techniques (BCTs) used in physiotherapy interventions to improve PA adherence.Methods and analysisMedline, Cochrane and PEDro registers of Controlled Trials, EMBASE, CINAHL and PsycInfo databases, and key grey literature sources will be rigorously searched for randomised controlled trials that compared a physiotherapy intervention incorporating BCTs with other therapies, placebo interventions, usual care or no-treatment. Two independent researchers will conduct literature searches, assess trial eligibility, extract data, conduct risk of bias assessment (using Cochrane risk of bias tool), classify BCTs and evaluate the quality of the body of literature following Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Narrative synthesis of key outcomes will be presented and meta-analysis will be performed if included trials are clinically homogenous, based on their intervention and comparator groups and outcome measures. This review will be reported in line with the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines.Ethics and disseminationResearch ethics approval is not required. This review will help inform clinicians and researchers on the most effective behavioural change techniques used in physiotherapy interventions to enhance adherence to PA prescription for patients with lower limb OA. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations.Trial registration numberPROSPERO CRD42016039932.
PATHway I: design and rationale for the investigation of the feasibility, clinical effectiveness and cost-effectiveness of a technology-enabled cardiac rehabilitation platform
Authors: Claes Jomme , Buys Roselien , Woods Catherine , Briggs Andrew , Geue Claudia , Aitken Moira , Moyna Niall , Moran Kieran , McCaffrey Noel , Chouvarda Ioanna , Walsh Deirdre , Budts Werner , Filos Dimitris , Triantafyllidis Andreas , Maglaveras Nicos , Cornelissen Véronique A 
Published: July 2017

IntroductionExercise-based cardiac rehabilitation (CR) independently alters the clinical course of cardiovascular diseases resulting in a significant reduction in all-cause and cardiac mortality. However, only 15%–30% of all eligible patients participate in a phase 2 ambulatory programme. The uptake rate of community-based programmes following phase 2 CR and adherence to long-term exercise is extremely poor. Newer care models, involving telerehabilitation programmes that are delivered remotely, show considerable promise for increasing adherence. In this view, the PATHway (Physical Activity Towards Health) platform was developed and now needs to be evaluated in terms of its feasibility and clinical efficacy.Methods and analysisIn a multicentre randomised controlled pilot trial, 120 participants (m/f, age 40–80 years) completing a phase 2 ambulatory CR programme will be randomised on a 1:1 basis to PATHway or usual care. PATHway involves a comprehensive, internet-enabled, sensor-based home CR platform and provides individualised heart rate monitored exercise programmes (exerclasses and exergames) as the basis on which to provide a personalised lifestyle intervention programme. The control group will receive usual care. Study outcomes will be assessed at baseline, 3 months and 6 months after completion of phase 2 of the CR programme. The primary outcome is the change in active energy expenditure. Secondary outcomes include cardiopulmonary endurance capacity, muscle strength, body composition, cardiovascular risk factors, peripheral endothelial vascular function, patient satisfaction, health-related quality of life (HRQoL), well-being, mediators of behaviour change and safety. HRQoL and healthcare costs will be taken into account in cost-effectiveness evaluation.Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki. This protocol has been approved by the director and clinical director of the PATHway study and by the ethical committee of each participating site. Results will be disseminated via peer-reviewed scientific journals and presentations at congresses and events.Trial registration numberNCT02717806. This trial is currently in the pre-results stage.
Downscaling Extreme Precipitation from CMIP5 Simulations Using Historical Analogs
Authors: Castellano Christopher M. , DeGaetano Arthur T. 
Published: July 2017

AbstractAn approach for downscaling daily precipitation extremes using historical analogs is applied to simulations from phase 5 of the Coupled Model Intercomparison Project (CMIP5). The method employs a multistep procedure in which the occurrence of extreme precipitation on a given target day is determined on the basis of the probability of extreme precipitation on that day’s closest historical analogs. If extreme precipitation is expected, daily precipitation observations associated with the historical analogs are used to approximate precipitation amounts on the target day. By applying the analog method to historical simulations, the ability of the CMIP5 models to simulate synoptic weather patterns associated with extreme precipitation is assessed. Differences between downscaled and observed precipitation extremes are investigated by comparing the precipitation frequency distributions for a subset of rarely selected extreme analog days with those for all observed days with extreme precipitation. A supplemental composite analysis of the synoptic weather patterns on these rarely selected analog days is utilized to elucidate the meteorological factors that contribute to such discrepancies. Overall, the analog method as applied to CMIP5 simulations yields realistic estimates of historical precipitation extremes, with return-period precipitation biases that are comparable in magnitude to those obtained from dynamically downscaled simulations. The analysis of rarely selected analog days reveals that precipitation amounts on these days are generally larger than precipitation amounts on all days with extreme precipitation, leading to an underestimation of return-period precipitation amounts at many stations. Furthermore, the synoptic composite analysis reveals that tropical cyclones are a common feature on these rarely selected analog days.
Empirical Relations between Size Parameters of Ice Hydrometeor Populations and Radar Reflectivity
Authors: Matrosov Sergey Y. , Heymsfield Andrew J. 
Published: July 2017

AbstractEmpirical power-law relations between the equivalent radar reflectivity factor Ze and the slope parameter of the gamma function Λ (i.e., Λ = c; used to describe ice hydrometeor size distributions) are derived. The Λ parameter can also be considered as a size parameter since it is proportional to the inverse of the hydrometeor characteristic size, which is an important geophysical parameter describing the entire distribution. Two datasets from two-dimensional microphysical probes, collected during aircraft flights in subtropical and midlatitude regions, were used to obtain Λ by fitting measured size distributions. Reflectivity for different radar frequencies was calculated from microphysical probe data by using nonspherical-particle models. The derived relations have exponent d values that are approximately from −0.35 to −0.40, and the prefactors c are approximately between 30 and 55 (Λ: cm−1; Ze: mm6 m−3). There is a tendency for d and c to decrease when radar frequency increases from Ku band (~14 GHz) to W band (~94 GHz). Correlation coefficients between Ze and Λ can be very high (~0.8), especially for lower frequencies. Such correlations are similar to those for empirical relations between reflectivity and ice water content (IWC), which are used in many modeling and remote sensing applications. Close correspondences of reflectivity to both Λ and IWC are due to a relatively high correlation between these two microphysical parameters. Expected uncertainties in estimating Λ from reflectivity could be as high as a factor of 2, although estimates at lower radar frequencies are more robust. Stratifying retrievals by temperature could result in relatively modest improvement of Λ estimates.
A Simulation-Free Exact Conditional Goodness-of-Fit Test for The Binomial Distribution
Authors: Hazra Arnab 
Published: July 2017

ABSTRACT: Several exact testing methods for continuous distributions, asymptotic as well as simulation based exact methods for both- discrete and continuous cases have been developed for analyzing goodness-of-fit, a priori. An exact Kolmogorov-Smirnov type goodness-of-fit test is developed for checking whether the data comes from a binomial distribution or not. This is a conditional test; p-value is calculated as the conditional probability given the sample total and hence the success probability need not be specified under the null hypothesis. Instead of using simulation, p-value is calculated using a sequential procedure and hence the inference procedure is simulationfree. Properties of the test, some examples, power comparisons with other existing techniques are also provided.
Parametric Analysis of Lifetime Data With Multiple Causes of Failure Using Cause Specific Reversed Hazard Rates
Authors: Anjana S. , Sankaran P. G. 
Published: July 2017

ABSTRACT: Lifetime data with multiple causes of failure is a common phe-nomenon in survival studies. The present paper focuses on the parametric regression analysis of lifetime data with multiple causes of failure. We define the cause specific reversed hazards model in the presence of covariates with inverse Weibull as baseline distribution. This parametric regression approach facilitates analysis of lifetime data with multiple causes of failure under left-censoring. We discuss the estimation of the parameters of the model. Simulation studies are carried out to examine the finite sample behaviour of the estimators. We illustrate the applicability of the proposed model using a real-life data set.
Naming Sequentially Presented Letters and Words
Authors: Kolers Paul A. , Katzman Martin T. 
Published: July 2017

Subjects were presented with sequences of letters six units long. The sequences were presented serially so that each letter of a sequence fell upon the same part of a viewing screen as every other one. The task was to name the letters or to name the words they formed. The principal variables were the kinds of words, the duration of a blank interval between the third and fourth letters of a sequence, and the duration of the individual letters. Correct responses were found to increase toward 100% as the duration of the letters approached about 1/3 sec. The magnitude of the interval between the third and fourth letters had little effect upon recognition. Contextual factors were found to exert influences that enabled the words to be grouped over relatively long temporal separations. A distinction can be made experimentally between naming letters and naming the word they spell. In addition, it was found that the subject could sometimes name all the letters in a sequence but got their order wrong. This is taken to indicate differences in the mechanisms associated with identifying events and identifying their temporal order.
Hypothermia in Elderly Patients Presenting to Accident & Emergency During the Onset of Winter
Authors: Pedley D.K. , Paterson B. , Morrison W. 
Published: July 2017

It is well established that the elderly population is vulnerable to hypothermia, leading to increased morbidity. A prospective observational study took place between 1 October 1999 and 31 December 1999 in a large teaching hospital Accident and Emergency department. Core temperature was assessed at presentation using a tympanic probe on patients over 65 years of age. A total of 1543 eligible patients attended during the study period. Complete data was available on 958 patients. Forty-eight patients (5%) were found to be hypothermic (core temperature <350Celcius). There were two peaks in hypothermic presentations; these corresponded to periods of cold weather. The incidence of hypothermia was higher in non-ambulant patients and those with co-morbidity; the majority of patients lived in relatively deprived areas by a postcode derived deprivation index. Mortality was 34% in patients hypothermic at presentation. Hypothermia contributes to mortality and morbidity in elderly patients; its incidence may be higher than previously reported.
Fetal sex-determination in Delhi: A population-based investigation
Authors: Chaturvedi S , Chhabra P , Bharadwaj S , Smanla S , Kannan A T ,   Students Study Group
Published: July 2017

A population-based cross-sectional inquiry was carried out in Delhi to assess the practice of fetal sex determination, sex-selective abortions and awareness about the related law. Atotal of 1514 respondents, selected through multistage cluster sampling from all across Delhi, were interviewed using a pretested, semistructured questionnaire. Legal awareness (73.6%) was significantly better among the male and urban respondents. Only 39 (2.6%) of the respondents had ever gone for fetal sex determination. In 17 (43.6%) of them, it was done in spite of being aware of its unlawfulness, and in 33 (84.6%), the couple had one or more living male children. Frequency of fetal sex determination was comparable for slum and urban areas. Fifty-six additional cases of fetal sex determination, occurring in the neighbourhood of the respondents, were also reported. A total of 28 cases of female feticide were reported. Awareness about the illegality of fetal sex determination has improved, compared with the 1997-1998 data collected from East Delhi (55.3-73.6%). However, this comparison also shows a marginal increase in the practice of fetal sex determination (2.1-2.6%). In all cases of feticide, a qualified doctor was involved. A number of couples abandoned the abortion plan midway, even after detecting that the fetus was female, and there were occasional cases where the doctor refused to abort the female fetus.
Domiciliary visits to the old and the mentally ill: How valuable?
Authors: Crome Peter , Malham Alison , Baker Dereth , Smith Allison E , Bloor Roger 
Published: July 2017

Summary In the early days of the British National Health Service, domiciliary visits were a continuation of the tradition whereby general practitioners (GPs) met consultants in the patient's home. The nature of domiciliary visits, which still attract a special fee, has since changed. We analysed the effectiveness of all domiciliary visits undertaken in a NHS trust providing primary care, mental health and elderly care services to a population of 470 000. Data were obtained from domiciliary visit claim forms and from questionnaires completed by the consultant, the referring GP and consultant peer reviewers. The largest number of visits (total 234) was in geriatric medicine 48.9%, followed by old-age psychiatry 44.9%. Geriatric medicine was more likely than psychiatry to admit patients to hospital (19%) after a visit. All domiciliary visits in old-age psychiatry were done during the day (9 am to 5 pm). Only 2% of GPs stated that they attended any of the domiciliary visits; almost all thought that the outcome of domiciliary visits was of value. Old-age-psychiatry peer reviewers believed that all visits in that specialty were appropriate; in geriatric medicine this figure was 77% and in other psychiatric specialties 65%. The findings indicate that domiciliary visits were not being used routinely as a pathway to hospital admission, though they were often used to expedite admission or gain a quick consultant opinion; the visits were valued by GPs. The practice of domiciliary visits differs greatly from the definition in NHS terms and conditions of service. One or other should be altered.
Consultation skills of medical students before and after changes in curriculum
Authors: Utting M R , Campbell F , Rayner C , Whitehouse C R , Dornan T L 
Published: July 2017

Summary The University of Manchester Medical School has adopted problem-based learning as its main educational method, with a change of emphasis from a biomedical to a biopsychosocial approach. The training of junior medical students in clinical interviewing is intended to reinforce and develop their interpersonal skills. We measured the impact of this new curriculum by assessing two intakes of students covering the period before and after its introduction; a third intake was later added to examine the effect of further curriculum adjustments. 86 students, randomly selected, were videorecorded conducting diagnostic interviews with standardized patients 10 weeks after they had started to learn clinical interviewing. Two instruments were developed—a 23-item communication skills scale and a 13-item information-gathering scale and both showed acceptable inter-rater and test-retest reliability. Communication skills did not differ between years. The total score for information-gathering fell by 13% (95% confidence interval –20 to –6%, P 0.001) in the first year after introduction of the new educational approach but returned to baseline the following year after further modification of the course. Although the new approach yielded no measurable improvement in the process of communication, assessment 10 weeks after the start of interview training may be too early to permit definitive conclusions. We conclude that it is possible to change to a more patient-centred emphasis in teaching medical interviewing. Some initial loss of information content was rectified by adjustment of the course. Our unfavourable early experience highlights the need to evaluate educational change.