bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the relationship between sedimentary transport systems and basin dynamics: A case study from the Levant Basin (Eastern Mediterranean Sea) before, during, and after the Messinian
Authors: Moneron Jimmy , Gvirtzman Zohar , Karcz Zvi , Shitrit Omri , Sagy Yael , Aharonov Einat 
Published: October 2024

Abstract
Submarine channels serve as routes transporting sediments across hundreds of kilometers from continental margins to the deepest parts of a basin’s seafloor. Consequently, owing to the influential role of gravity in determining the flow direction, these channels typically follow the steepest sloping paths, making paleo-drainage systems essential in reconstructing basin dynamics over geological periods. This research aims to document the interrelationships between tectonic tilting, rapid deposition of salt, and delta sediment propagation on basin morphology and consequently on sedimentary transport orientation. Here, we examine how the interplay between these geological processes influenced the orientation of submarine channels in the Levant Basin, our case study, over ~10 m.y. During the late Miocene, sediments originating from the Levant continental margin were transported to the deep parts of the Eastern Mediterranean Sea (i.e., the Herodotus Basin) via a tectonic valley active until the Messinian Salinity Crisis. Later, exceptionally fast burial by salt and subsequent truncation of this evaporitic layer produced a nearly horizontal seafloor that redirected the regional drainage toward the basin’s center, with no connection to the adjacent and much deeper Herodotus Basin. This drainage configuration did not last long since tilting of the basin northward toward the Cyprus subduction zone and northward propagation of the Nile delta have rapidly reshaped basin morphology, resulting in a rotation of major sedimentary routes in the area. From a broad perspective, this research not only exemplifies how rapid salt burial can reset a basin’s drainage system but also has implications for geodynamic and geomorphic processes in evaporite-bearing sedimentary basins within tectonically active areas.
Collapse of an early adolescent girl. Syncope? Simple or sinister?
Authors: Martin Graham , Cavaliere Chiara , Pandya Nikila , Balasubramanian Krishnan 
Published: October 2024

An early adolescent girl presented to the emergency department (ED) of her local hospital following a syncopal episode after a warm bath on a background of increasing breathlessness for 1-year duration. On examination, she was fully alert, no pain or injuries from her syncope, she was warm and well perfused, her respiratory rate at rest was normal and she showed no signs of respiratory distress, there were no signs of seizure activity such as incontinence or tongue biting, she had a raised Jugular Venous Pressure (JVP), a loud pansystolic murmur, there was no cyanosis and no oedema. She was referred for a chest radiograph due to her history of breathlessness and for an ECG based on the examination findings of a murmur. Her ECG showed marked right axis deviation with tall T waves in V1 and P waves in lead II. Therefore, she was referred for an outpatient echocardiogram which demonstrated severely dilated right ventricular (RV) with impaired RV function. She was diagnosed with primary pulmonary hypertension.Her history included red flag symptoms including worsening breathlessness and syncope. Syncopal episodes are common and mostly benign, that is, vasovagal, but attention to a detailed history including constitutional symptoms and examination is crucial to ensure appropriate investigations and management. While causes are commonly benign in paediatrics, it is important to ensure that there are no features of an underlying cause. This includes ruling out commonly seen paediatric presentations that could present as an unwitnessed syncopal episode and this should include seizures, anaemia, arrhythmias, hypotension, hypoglycaemia and pain. If other causes are not ruled out, it can lead to an incorrect diagnosis as found in this patient when she presented a further three times to ED while waiting for her tertiary appointment.
Access to medicines among asylum seekers, refugees and undocumented migrants across the migratory cycle in Europe: a scoping review
Authors: Aljadeeah Saleh , Payedimarri Anil Babu , Kielmann Karina , Michielsen Joris , Wirtz Veronika J , Ravinetto Raffaella 
Published: October 2024

IntroductionAccess to essential medicines is a critical element of health systems and an important measure of their performance. Migrants may face barriers in accessing healthcare, including essential medicines, throughout the migration cycle, which includes the stages of departure from home or residence countries, transit through non-European or European countries, reception and settlement in a country in Europe and deportation. We aim to provide an overview of research and grey literature concerning access to essential medicines for asylum seekers, refugees and undocumented migrants in or heading to Europe (European Union, European Economic Area, Switzerland and the UK).MethodsTo delineate and conceptualise access to medicines, we considered the definition of the Lancet Commission on Essential Medicines and the Pharmaceutical Management framework. These frameworks were combined to guide several critical steps in our review, including defining the search terms, data extraction, data analyses and reporting. Relevant studies and reports were identified through searches in bibliographic and grey literature databases.ResultsOut of 5760 studies and 66 grey literature reports, 108 met the inclusion criteria, with 72 focusing on medicine access. Overall, medicine use and medicine expenditure were found to be lower in migrant populations compared with the host population in many European countries. Although many studies focused on the use of infectious disease and psychotropic medicines, the most frequently used medicines by migrants were analgesics, hypertension and diabetes medicines. Determinants of medicine access were legal restrictions, language and transit times, which all contributed to interruption of and inequities in access to medicines among this population. This scoping review also indicated significant gaps in the literature regarding the evidence on access to medicine at different stages of the migration cycle, specifically in departure, transit and deportation stages.ConclusionOverall, our findings highlighted significant unmet medicine needs among migrants in or on the way to Europe and access disparities attributable to various interconnected barriers. Urgent access is needed to address such inequities, particularly legal barriers, including registration of certain medicines required for treatment. Future research should prioritise investigating medicine access during departure, transit and deportation stages. Policy discussions around migrants’ access to medicines should be centred on framing healthcare as a fundamental right.
Risk of repeat self-harm among individuals presenting to healthcare services: development and validation of a clinical risk assessment model (OxSET)
Authors: Fazel Seena , Vazquez-Montes Maria D L A , Lagerberg Tyra , Molero Yasmina , Walker Jane , Sharpe Michael , Larsson Henrik , Runeson Bo , Lichtenstein Paul , Fanshawe Thomas R 
Published: October 2024

BackgroundA self-harm episode is a major risk factor for repeat self-harm. Existing tools to assess and predict repeat self-harm have major methodological limitations, and few are externally validated.ObjectiveTo develop and validate a risk assessment model of repeat self-harm up to 6 months after an episode of non-fatal self-harm that resulted in an emergency visit to hospital or specialised care.MethodsUsing Swedish national registers, we identified 53 172 people aged≥10 years who self-harmed during 2008–2012. We allocated 37 523 individuals to development (2820 or 7.5% repeat self-harm incidents within 6 months) and 15 649 to geographic validation (1373 repeat episodes) samples, based on region of residence. In a temporal validation of people who self-harmed during 2018–2019, we identified 25 036 individuals (2886 repeat episodes). We fitted a multivariable accelerated failure time model to predict risk of repeat self-harm.FindingsIn the external validations (n=40 685), rates of repeat self-harm were 8.8%–11.5% over 6 months. The final model retained 17 factors. Calibration and discrimination were similar in both validation samples, with observed-to-expected ratio=1.15 (95% CI=1.09 to 1.21) and c-statistic=0.72 (95% CI=0.70 to 0.73) in the geographical validation. At 6 months and a 10% risk cut-off, sensitivity was 51.5% (95% CI=48.8% to 54.2%) and specificity was 80.7% (95% CI=80.1% to 81.4%) in geographic validation; corresponding values were 56.9% (95% CI=55.1% to 58.7%) and 76.0% (95% CI=75.5% to 76.6%) in temporal validation. Discrimination was slightly worse at the 1-month prediction horizon (c-statistics of 0.66–0.68).ConclusionsUsing mostly routinely collected data, simple risk assessment models and tools can provide acceptable levels of accuracy for repeat of self-harm.Clinical implicationsThis risk model (OXford SElf-harm repeat tool) may assist clinical decision-making.
Prevalence and characteristics of headache among medical students in Egypt: a multicentric cross-sectional study
Authors: Mohamed Rashad G , Sarhan Khalid , Kamel Basma , Almetwaly Rahma M , Fouda Eslam E , Meshref Mostafa , Bioumy Sara , Alemam Doaa , Ahmed Hebatalla A 
Published: October 2024

BackgroundHeadaches are one of the most common neurological disorders, ranging in severity from mild discomfort to a severe, debilitating condition. Headaches are particularly prevalent among medical students, which can be attributed to various factors such as psychological stressors, extensive studying, long hours of clinical rotations and high-pressure examination. This study aims to ascertain the prevalence of different types of headaches, along with analysing their associated clinical characteristics among medical students in Egypt.MethodsA multicentric, descriptive questionnaire-based cross-sectional study was conducted across five governmental faculties of medicine in Egypt from November 2022 to March 2023. Using a multistage random sampling method, 600 undergraduate students were selected to participate. Headache was diagnosed based on the International Classification of Headache Disorders.ResultsA total of 493 responses were included in the analysis; the prevalence of headache disorder was 264 (53.5%), with tension-type headaches (TTH) frequent episodic being the highest 89 (33.7%), while TTH chronic and migraine with aura were the least prevalent, accounting for 10 (3.8%) and 31 (11.7%), respectively. Women exhibited a higher overall headache prevalence (69.4%) compared with men (44.4%). A positive family history was found in 120 (45.5%) of students with headache. Lack of sleep and stress were the most frequently reported potential triggers for headaches. Out of 264 medical students, 171 (65%) took analgesics. Only 42 (24.6%) had a medical consultation, while most students 129 (75.4%) took over-the-counter medications.ConclusionNotably, headaches were prevalent in 264 (53.5%) of the respondents. TTH frequent and infrequent emerged as the most common headaches among medical students, followed by migraine without aura then migraine with aura. Participants were statistically different according to sex, faculty, academic year and living conditions. Alarmingly, despite the substantial prevalence, only 42 (24.6%) students sought medical consultation.
Telephone lifestyle intervention to prevent diabetes in women with recent gestational diabetes mellitus attending the national health system: the LINDA-Brasil clinical trial
Authors: Schmidt Maria Inês , Bracco Paula A , Nunes Maria A , Cherubini Kadhija A , Castilhos Cristina D , Spagiari Jainara Z , Galliano Leony M , Ladwig Ruben , Del Vecchio Fabricio B , Del Vecchio Anelita H M , Drehmer Michele , Forti Adriana Costa , Façanha Cristina , Zajdenverg Lenita , de Almeida-Pititto Bianca , Réa Rosângela Roginski , Dualib Patrícia Medici , Duncan Bruce B 
Published: October 2024

Objectives
To evaluate a postpartum telephone-based lifestyle intervention to prevent diabetes in high-risk women with recent gestational diabetes mellitus (GDM).

Design
Multicentre parallel randomised clinical trial.

Setting
Specialised antenatal clinics in the Brazilian National System.

Methods
Lifestyle Intervention for Diabetes Prevention After Pregnancy compared (1:1) postpartum telephone support for lifestyle changes with conventional care in women with recent GDM at substantial risk for diabetes. Randomisation started on 28 March 2015 and ended on 13 March 2020, with the onset of the COVID-19 pandemic. We used Cox regression to estimate HRs for diabetes and analysis of covariance adjusted for follow-up time to assess weight change.

Outcomes
The primary outcome was incident diabetes ascertained with blinded measurements of oral glucose tolerance tests. The secondary outcome was a change in measured weight.

Results
We enrolled 5323 women with GDM, 2735 (51%) being at high risk. After invitations, baseline assessment and exclusions, we assigned 466 women to intervention (231) or control (235) groups. Attendance was satisfactory (≥7/20 phone sessions) in 75%. Over an average follow-up of 29.7 (15.6) months, 142 (30.5%) women progressed to diabetes, 75 (32%) in the control and 67 (29%) in the intervention group. There was no reduction in the incidence of diabetes (HR=0.84; 0.60–1.19) and only a non-significant 0.97 kg less weight gain (p=0.09). Among the 305 women randomised more than 1 year before the COVID-19 pandemic, the intervention did not reduce the incidence of diabetes (HR=0.71; 0.48–1.04) despite a 2.09 kg (p=0.002) lesser weight gain.

Conclusion
The strategy to identify women with GDM at high risk proved valid, as women often gained weight and frequently developed diabetes. Over a 30-month follow-up, telephone support for lifestyle changes at postpartum did not reduce weight gain or diabetes incidence, although only 75% attended the minimum number of telephone sessions. The COVID-19 pandemic negatively impacted trial conduction.

Trial registration number

NCT02327286
.
Single-blinded, randomised, parallel-group, controlled trial comparing the efficacy and cost-effectiveness of therapist- and self-guided internet-delivered behavioural activation versus treatment as usual for adolescents with mild to moderate depression: study protocol
Authors: Andersson Rebecca , Vigerland Sarah , Lenhard Fabian , Ahlen Johan , Bottai Matteo , Mataix-Cols David , Serlachius Eva 
Published: October 2024

IntroductionThe number of adolescents seeking professional help for depression is increasing and, despite advances in treatment, large unmet treatment needs remain. In the current protocol, we describe the design and methodology of a randomised controlled trial (RCT) to evaluate the clinical efficacy of two forms of internet-delivered behavioural activation (I-BA), with and without therapist support, in reducing depressive symptoms, compared with treatment as usual (TAU). Secondary objectives include examining the 12-month maintenance of the treatment effects and conducting a health economic evaluation of the interventions.Methods and analysisIn this single-blinded RCT, we aim to include 215 participants aged 13–17 years with mild to moderate depression who will be randomised (1:1:1 ratio) to 10 weeks of either therapist-guided or self-guided I-BA, or TAU provided by regular mental health clinics. Data will be collected at baseline, weekly for the initial 10 weeks, post-treatment and at 3 and 12-month follow-ups. The primary endpoint is the 3-month follow-up. The primary outcome is blinded clinician-rated severity of depressive symptoms, measured by the Children’s Depression Rating Scale-Revised. Treatment response is defined as a score of ‘Much improved’ or ‘Very much improved’ on the Clinical Global Impression-Improvement Scale, administered at the primary endpoint. Outcome assessors will be blinded to treatment conditions at all assessment points. A health economic evaluation of I-BA will be performed, both in the short term (primary endpoint) and the long term (12-month follow-up).Ethics and disseminationEthical approval was obtained from the Swedish Ethical Review Authority in June 2021. The final participant was enrolled on 3 May 2024 and expected to reach the primary endpoint by November 2024. The results of this study will be disseminated through publication in peer-reviewed journals, presented at conferences and communicated to healthcare providers and the public.Trial registration numberNCT04977856.Rebecca Andersson1, Sarah Vigerland1, Fabian Lenhard1, Johan Ahlen2, 3, Matteo Bottai4, David Mataix-Cols1,6, Eva Serlachius5, 6
Risk of infections among persons treated with opioids for chronic pain: a systematic review and meta-analysis protocol
Authors: Kudrina Irina , Page M Gaberielle , Choinière Manon , Shir Yoram , Eisenberg Mark J , Ben-Sasson Maayan , Lebouché Bertrand , Puzhko Svetlana 
Published: October 2024

IntroductionMillions of persons with chronic pain across North America and Europe use opioids. While the immunosuppressive properties of opioids are associated with risks of infections, these outcomes could be mitigated through careful patient selection and monitoring practices when appropriate. It is important to recognise that some patients do benefit from a carefully tailored opioid therapy. Enough primary studies have been published to date regarding the role of opioids in potential immunosuppression presenting as an increased rate of infection acquisition, infectious complications and mortality. There is thus a critical need for a consensus in this area.Methods and analysisThe methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, the MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies and the Cochrane Handbook for Systematic Reviews of Interventions. We plan to systematically search Ovid MEDLINE, CINAHL, PsycINFO, EMB Review, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and Google Scholar databases from their inception date to December 2023. Full-text primary studies that report measurable outcomes in adults with chronic pain, all routes of opioid use, all types of infections and all settings will be included. We will identify a scope of reported infections and the evidence on the association of opioid use (including specific opioid, dosage, formulation and duration of use) with the risk of negative infectious outcomes. Opioid use-associated outcomes, comparing opioid use with another opioid or a non-opioid medication, will be reported. The meta-analysis will incorporate individual risk factors. If data are insufficient, the results will be synthesised narratively. Publication bias and confounding evaluation will be performed. The Grading of Recommendations Assessment, Development and Evaluation framework will be used.Ethics and disseminationApproval for the use of published data is not required. The results will be published, presented at conferences and discussed in deliberative dialogue groups.PROSPERO registration numberCRD42023402812.
Post-rehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: a mixed methods cluster-feasibility controlled trial
Authors: Pedlow Katy , Kennedy Niamh C , Klempel Natalie , Eng Janice J , Adamson Gary , Hylands Jenny , Hughes Noelene , Campbell Zoe , McDonough Suzanne 
Published: October 2024

BackgroundLess than 50% of stroke survivors regain their pre-stroke level of upper limb function, compounded with a lack of long-term rehabilitation options available. The Graded Repetitive Arm Supplementary Programme (GRASP) is an evidence-based upper limb programme delivered as a standalone programme to stroke survivors. To improve access to such a programme, there is the potential to combine it with a high-utility community-based exercise programme, such as the post-rehabilitation enablement programme (PREP). We aimed to establish if this was feasible to deliver alongside the experience of stroke survivors and therapists, identify any refinements the intervention and the acceptability of the intervention and trial procedures.MethodsA cluster feasibility-controlled trial was conducted using both quantitative and qualitative outcome measures with stroke survivors who were discharged from NHS care. Participants completed PREP for 6 weeks (control), with the intervention group also completing GRASP. The GRASP intervention was refined in between five iterative testing cycles. Focus groups with participants explored the acceptability and feasibility. Individual interviews with intervention therapists explored how feasible it was to embed the intervention into practice, and determine the feasibility of a future larger, mixed methods, randomised controlled trial. Clinical endpoints for upper limb and overall function were explored through the Rating of Everyday Arm use in the Community and Home, 10-metre walk test (10MWT) and quality of life via the Shortened Edinburgh Warwick questionnaire. No further suggestions for intervention design were noted after cycle 4.ResultsRecruitment (n=72) and retention levels (84.7%) were high with 61 participants (mean age of 66 years and 49 weeks post-stroke) completing the study. Participants and therapists reported positive acceptability of the intervention with goal setting and family support noted as beneficial. The home exercise programme was noted as challenging. Participants within both groups demonstrated improvements in clinical measures, with the intervention group demonstrating a greater improvement within the Rating of Everyday Arm-use in the Community and Home and the 10MWT.ConclusionThis study successfully recruited and retained stroke survivors into an upper limb community-based programme. It poses a feasible delivery mechanism to combine evidence-based upper limb approaches with established physical activity programmes in a future large scale and fully powered study.Trial registration numberNCT05090163.
Effect of Holmich protocol exercise therapy on long-standing adductor-related groin pain in athletes: an objective evaluation
Authors: Yousefzadeh Abbas , Shadmehr Azadeh , Olyaei Gholam Reza , Naseri Nasrin , Khazaeipour Zahra 
Published: October 2024

Aim
To objectively evaluate the effect of Holmich protocol-based exercise therapy on long-standing adductor-related groin pain (LSAGP).

Methods
We reproduced the Holmich protocol of exercise therapy and objectively evaluated its effect on 17 male athletes (mean age, 25.07±4.96 years) suffering from LSAGP, of whom 14 participants completed the 10 weeks treatment period. The study was designed as a single-blinded, before-and-after clinical trial. Main outcome measures included pain, functional ability, hip range of motion (ROM), hip abductor and adductor muscle strength, and successful return to sports activity.

Results
Eleven athletes (78.57%) returned to their sports activities in a mean time of 14.2 weeks (range, 10-20 weeks). Visual analogue scale pain score, hip abductor and adductor muscles strength, and function scores improved significantly. Although hip abduction ROM did not show any significant changes (p = 0.609), the extent of progress in the hip internal rotation ROM was significant (p = 0.001). The ratio of hip adduction to abduction strength did not change significantly (p = 0.309 for the isometric and p = 0.957 for the eccentric ratio).

Conclusions
Exercise therapy according to the Holmich programme may be an effective treatment for LSAGP. However, more emphasis should be paid to the hip adductor muscles’ eccentric strength.

Trial registration number

NCT2016080829269N1
.