bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis
Authors: Toohey Liam A , Drew Michael K , Cook Jill L , Finch Caroline F , Gaida Jamie E 
Published: August 2017

BackgroundPrevious injury is a strong risk factor for recurrent lower limb injury in athletic populations, yet the association between previous injury and a subsequent injury different in nature or location is rarely considered.ObjectiveTo systematically review data on the risk of sustaining a subsequent lower limb injury different in nature or location following a previous injury.MethodsEight medical databases were searched. Studies were eligible if they reported lower limb injury occurrence following any injury of a different anatomical site and/or of a different nature, assessed injury risk, contained athletic human participants and were written in English. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. Meta-analysis was conducted using a random effects model.ResultsTwelve studies satisfied the eligibility criteria. Previous history of an ACL injury was associated with an increased risk of subsequent hamstring injury (three studies, RR=2.25, 95% CI 1.34 to 3.76), but a history of chronic groin injury was not associated with subsequent hamstring injury (three studies, RR=1.14, 95% CI 0.29 to 4.51). Previous lower limb muscular injury was associated with an increased risk of sustaining a lower limb muscular injury at a different site. A history of concussion and a variety of joint injuries were associated with an increased subsequent lower limb injury risk.ConclusionsThe fact that previous injury of any type may increase the risk for a range of lower limb subsequent injuries must be considered in the development of future tertiary prevention programmes.Systematic review registration numberCRD42016039904 (PROSPERO).
Assessing the global reach and value of a provider-facing healthcare app using large-scale analytics
Authors: O'Reilly-Shah Vikas , Easton George , Gillespie Scott 
Published: August 2017

BackgroundThe rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Challenges include ensuring the delivery of high-quality, up-to-date and optimised information. Opportunities include the ability to study global practice patterns, access to medical and surgical care and continuing medical education needs.MethodsWe studied users of a free anaesthesia calculator app used worldwide. We combined traditional app analytics with in-app surveys to collect user demographics and feedback.Results31 173 subjects participated. Users were from 206 countries and represented a spectrum of healthcare provider roles. Low-income country users had greater rates of app use (p<0.001) and ascribed greater importance of the app to their practice (p<0.001). Physicians from low-income countries were more likely to adopt the app (p<0.001). The app was used primarily for paediatric patients. The app was used around the clock, peaking during times typical for first start cases.ConclusionsThis mHealth app is a valuable decision support tool for global healthcare providers, particularly those in more resource-limited settings and with less training. App adoption and use may provide a mechanism for measuring longitudinal changes in access to surgical care and engaging providers in resource-limited settings. In-app surveys and app analytics provide a window into healthcare provider behaviour at a breadth and level of detail previously impossible to achieve. Given the potentially immense value of crowdsourced information, healthcare providers should be encouraged to participate in these types of studies.
Predictors of attrition from care at 2 years in a prospective cohort of HIV-infected adults in Tigray, Ethiopia
Authors: Bucciardini Raffaella , Fragola Vincenzo , Abegaz Teshome , Lucattini Stefano , Halifom Atakilt , Tadesse Eskedar , Berhe Micheal , Pugliese Katherina , Fucili Luca , Gregorio Massimiliano Di , Mirra Marco , Castro Paola De , Terlizzi Roberta , Tatarelli Paola , Binelli Andrea , Zegeye Teame , Campagnoli Michela , Vella Stefano , Abraham Loko , Godefay Hagos 
Published: August 2017

IntroductionEthiopia has experienced rapid expansion of antiretroviral therapy (ART). However, as long-term retention in ART therapy is key for ART effectiveness, determinants of attrition need to be identified so appropriate interventions can be designed.MethodsWe used data from the ‘Cohort of African people Starting Antiretroviral therapy’ (CASA) project, a prospective study of a cohort of HIV-infected patients who started ART in seven health facilities (HFs). We analysed the data of patients who had started first-line ART between January 2013 and December 2014. The Kaplan–Meier method was used to estimate the probability of retention at different time points. The Cox proportional hazards model was used to identify factors associated with attrition.ResultsA total of 1198 patients were included in the study. Kaplan–Meier estimates of retention in care were 83.9%, 82.1% and 79.8% at 12, 18 and 24 months after starting ART, respectively. Attrition was mainly due to loss to follow-up, transferred-out patients and documented mortality. A multivariate Cox proportional hazard model showed that male sex, CD4 count <200 cells/µL and the type of HF were significantly associated with attrition.ConclusionsThe observed attrition differences according to gender suggest that separate interventions designed for women and men should be explored. Moreover, innovative strategies to increase HIV testing should be supported to avoid CD4 levels falling too low, a factor significantly associated with higher attrition in our study. Finally, specific studies to analyse the reasons for different levels of attrition among HFs are required.
Does the index-to-ring finger length ratio (2D:4D) differ in amyotrophic lateral sclerosis (ALS)? Results from an international online case–control study
Authors: Parkin Kullmann Jane Alana , Pamphlett Roger 
Published: August 2017

ObjectivesThe ratio of the length of the index finger (2D) to the ring finger (4D) (2D:4D) has been reported to be lower (ie, 2D<4D) in people with amyotrophic lateral sclerosis (ALS) than non-ALS controls. This has led to suggestions that exposure to increased prenatal testosterone, which also lowers this ratio, could be a risk factor for ALS. In an attempt to test this hypothesis, we examined 2D:4Ds from large numbers of patients with ALS and controls.SettingAn online multilingual questionnaire enabling respondents to measure their own index and ring finger lengths.ParticipantsOf the initial 949 respondents, 572 remained for analysis after elimination for inability to straighten fingers, not answering the question, statistical outliers and aged <40 years. Respondents remaining for analysis were 202 patients with ALS (125 males, 77 females) and 370 non-ALS controls (112 males, 258 females).ResultsUnpaired t-tests with 95% CIs were used to assess differences in mean 2D:4Ds. Males had significantly lower mean 2D:4Ds than females, in both ALS and control groups, for both left and right hands. No significant differences were found in 2D:4Ds between ALS and control groups, in either males or females, for either left or right hands. Receiver operating characteristic curves showed no power for 2D:4Ds to predict ALS status in either males or females.Conclusions2D:4Ds did not differ between patients with ALS and controls in this study. This was despite the dataset being large enough to confirm the established finding of lower 2D:4Ds in males compared with females. These findings do not support the hypothesis that exposure to increased prenatal testosterone is a risk factor for ALS. A putative lower 2D:4D has been proposed to explain the link between ALS and exercise, but our results indicate that other exercise-related factors are more likely to explain this association.
Effectiveness of a standardised exercise programme for recurrent neck and low back pain: a multicentre, randomised, two-arm, parallel group trial across 34 fitness clubs in Finland
Authors: Suni Jaana H , Rinne Marjo , Tokola Kari , Mänttäri Ari , Vasankari Tommi 
Published: August 2017

BackgroundNeck and low back pain (LBP) are common in office workers. Exercise trials to reduce neck and LBP conducted in sport sector are lacking. We investigated the effectiveness of the standardised Fustra20Neck&Back exercise program for reducing pain and increasing fitness in office workers with recurrent non-specific neck and/or LBP.MethodVolunteers were recruited through newspaper and Facebook. The design is a multi-centre randomised, two-arm, parallel group trial across 34 fitness clubs in Finland. Eligibility was determined by structured telephone interview. Instructors were specially educated professionals. Neuromuscular exercise was individually guided twice weekly for 10 weeks. Webropol survey, and objective measurements of fitness, physical activity, and sedentary behavior were conducted at baseline, and at 3 and 12 months. Mean differences between study groups (Exercise vs Control) were analysed using a general linear mixed model according to the intention-to-treat principle.ResultsAt least moderate intensity pain (≥40 mm) in both the neck and back was detected in 44% of participants at baseline. Exercise compliance was excellent: 92% participated 15−20 times out of 20 possible. Intensity and frequency of neck pain, and strain in neck/shoulders decreased significantly in the Exercise group compared with the Control group. No differences in LBP and strain were detected. Neck/shoulder and trunk flexibility improved, as did quality of life in terms of pain and physical functioning.ConclusionsThe Fustra20Neck&Back exercise program was effective for reducing neck/shoulder pain and strain, but not LBP. Evidence-based exercise programs of sports clubs have potential to prevent persistent, disabling musculoskeletal problems.
Understanding cardiac troponin part 1: avoiding troponinitis
Authors: Body Richard , Carlton Edward 
Published: August 2017

Cardiac troponin (cTn) is a highly specific biomarker of myocardial injury and is central to the diagnosis of acute myocardial infarction (AMI). By itself, however, cTn cannot identify the cause of myocardial injury. ‘Troponinitis’ is the condition that leads clinicians to falsely assign a diagnosis of AMI based only on the fact that a patient has an elevated cTn concentration. There are many causes of myocardial injury other than AMI. Clinicians are required to differentiate myocardial injury caused by AMI from other causes.In part 1 of this series on cTn, we provide a structured overview to help practising clinicians to interpret ‘positive’ cTn results appropriately. There are three core principles. First, when reviewing a cTn result, clinicians must carefully consider the clinical context. Only this can distinguish primary (termed type 1) AMI caused by coronary artery disease from secondary (termed type 2) AMI caused by another condition with an imbalance in the supply and demand of oxygen to the myocardium. Second, clinicians must consider the patient’s baseline condition in order to determine the presence or absence of factors that may predict a chronic cTn elevation. Third, clinicians should routinely use serial sampling to detect a change of cTn that is expected in patients with acute (rather than chronic) myocardial injury. Using these simple principles, clinicians can avoid underdiagnosis and overdiagnosis of AMI.
North-South disparities in English mortality1965–2015: longitudinal population study
Authors: Buchan Iain E , Kontopantelis Evangelos , Sperrin Matthew , Chandola Tarani , Doran Tim 
Published: August 2017

BackgroundSocial, economic and health disparities between northern and southern England have persisted despite Government policies to reduce them. We examine long-term trends in premature mortality in northern and southern England across age groups, and whether mortality patterns changed after the 2008–2009 Great Recession.MethodsPopulation-wide longitudinal (1965–2015) study of mortality in England's five northernmost versus four southernmost Government Office Regions – halves of overall population. Main outcome measure: directly age-sex adjusted mortality rates; northern excess mortality (percentage excess northern vs southern deaths, age-sex adjusted).ResultsFrom 1965 to 2010, premature mortality (deaths per 10 000 aged <75 years) declined from 64 to 28 in southern versus 72 to 35 in northern England. From 2010 to 2015 the rate of decline in premature mortality plateaued in northern and southern England. For most age groups, northern excess mortality remained consistent from 1965 to 2015. For 25–34 and 35–44 age groups, however, northern excess mortality increased sharply between 1995 and 2015: from 2.2% (95% CI –3.2% to 7.6%) to 29.3% (95% CI 21.0% to 37.6%); and 3.3% (95% CI –1.0% to 7.6%) to 49.4% (95% CI 42.8% to 55.9%), respectively. This was due to northern mortality increasing (ages 25–34) or plateauing (ages 35–44) from the mid-1990s while southern mortality mainly declined.ConclusionsEngland's northern excess mortality has been consistent among those aged <25 and 45+ for the past five decades but risen alarmingly among those aged 25–44 since the mid-90s, long before the Great Recession. This profound and worsening structural inequality requires more equitable economic, social and health policies, including potential reactions to the England-wide loss of improvement in premature mortality.
Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non‐compressive nucleus pulposus extrusion
Authors: Mari Lorenzo , Behr Sebastien , Shea Anita , Dominguez Elisabet , Johnson Philippa J , Ekiri Abel , De Risio Luisa 
Published: August 2017

Dogs with fibrocartilaginous embolic myelopathy (FCEM) or acute non‐compressive nucleus pulposus extrusion (ANNPE) are reported to have a fair prognosis; however, persistent motor/autonomic deficits are possible. Specific MRI patterns have been suggested to differentiate these diseases although never been validated with histopathology in large studies. The aim of this retrospective study was to evaluate if these MRI patterns are associated with different clinical outcomes in dogs with peracute non‐progressive T3‐L3 myelopathy. Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board‐certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635–0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs, respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).Distinguishing between MRI patterns of presumptive ANNPE or FCEM in dogs with peracute non‐progressive T3‐L3 myelopathy may help predict the risk of developing faecal incontinence.
Dynamic Loading Assembly for Testing Actuators of Segmented Mirror Telescope
Authors: Deshmukh Prasanna Gajanan , Parihar Padmakar , Balasubramaniam Karthik A. , Mishra Deepta Sundar , Mahesh P. K. 
Published: August 2017

Upcoming large telescopes are based on Segmented Mirror Telescope (SMT) technology which uses small hexagonal mirror segments placed side by side to form the large monolithic surface. The segments alignment needs to be maintained against external disturbances like wind, gravity, temperature and structural vibration. This is achieved by using three position actuators per segment working at few-nanometer scale range along with a local closed loop controller. The actuator along with a controller is required to meet very stringent performance requirements, such as track rates up to 300[Formula: see text]nm/s (90[Formula: see text]mN/s) with tracking errors less than 5[Formula: see text]nm, dynamical forces of up to [Formula: see text][Formula: see text]N, ability to reject disturbances introduced by the wind as well as by mechanical vibration generated in the mirror cell, etc. To conduct these performance tests in more realistic manner, we have designed and developed a Dynamic Loading Assembly (DLA) at Indian Institute of Astrophysics (IIA), Bangalore. DLA is a computer controlled force-inducing device, designed in a modular fashion to generate different types of user-defined disturbances in extremely precise and controlled manner. Before realizing the device, using a simple spring-mass-damper-based mathematical model, we ensured that the concept would indeed work. Subsequently, simple concept was converted into a detailed mechanical design and parts were manufactured and assembled. DLA has static and dynamic loading capabilities up to 250[Formula: see text]N and 18[Formula: see text]N respectively, with a bandwidth sufficient to generate wind disturbances. In this paper, we present various performance requirements of SMT actuators as well as our effort to develop a dynamic loading device which can be used to test these actuators. Well before using DLA for meaningful testing of the actuator, the DLA itself have gone through various tests and improvements phases. We have successfully demonstrated that DLA can be used to check the extreme performance of two different SMT actuators, which are expected to track the position/force with a few nanometer accuracy.
Comprehensive Genomic Profiling of Metastatic Squamous Cell Carcinoma of the Anal Canal
Authors: Morris Van , Rao Xiayu , Pickering Curtis , Foo Wai Chin , Rashid Asif , Eterovic Karina , Kim Taebeom , Chen Ken , Wang Jing , Shaw Kenna , Eng Cathy 
Published: August 2017

Abstract
Squamous cell carcinoma of the anal canal (SCCA) is a rare gastrointestinal malignancy with an increasing annual incidence globally. The majority of cases are linked to prior infection with the human papillomavirus (HPV). For patients with metastatic SCCA, no consensus standard treatment exists. Identification of relevant targeted agents as novel therapeutic approaches for metastatic SCCA has been limited by a lack of comprehensive molecular profiling. We performed whole-exome sequencing on tumor–normal pairs from 24 patients with metastatic SCCA. Tumor tissue from 17 additional patients was analyzed using a 263-gene panel as a validation cohort. Gene expression profiling was performed on available frozen tissue to assess for differential expression patterns. Based on these findings, patient-derived xenograft (PDX) models of SCCA were generated to test targeted therapies against PI3K and EGFR. Despite a low mutation burden, mutations in PIK3CA, MLL2, and MLL3 were among the most commonly mutated genes. An association between TP53 mutations and HPV-negative SCCA tumors was observed. Gene expression analysis suggested distinct tumor subpopulations harboring PIK3CA mutations and for which HPV had integrated into the host genome. In vivo studies demonstrated improvement with anti-EGFR treatment. Gene mutation frequencies, tumor mutation burden, and gene expression patterns for metastatic SCCA appear similar to other HPV-associated malignancies.
Implications: This first comprehensive genomic characterization for patients with metastatic SCCA provides further rationale for the integration of SCCA into the development of novel targeted therapies across HPV-related cancers. Mol Cancer Res; 15(11); 1542–50. ©2017 AACR.
Scale Characterization and Correction of Diurnal Cycle Errors in MAPLE
Authors: Atencia Aitor , Zawadzki Isztar , Berenguer Marc 
Published: August 2017

AbstractThe most widely used technique for nowcasting of quantitative precipitation in operational and research centers is the Lagrangian extrapolation of the latest radar observations. However, this technique has a limited forecast skill because of the assumption made on its formulation, such as the fact that the motion vectors do not change and, even more important for convective events, neglect any growth or decay in the precipitation field. In this work, the McGill Algorithm for Precipitation Nowcasting by Lagrangian Extrapolation (MAPLE) errors have been computed for 10 yr of radar composite data over the continental United States. The study of these errors shows systematic bias depending on the time of day. This effect is related to the solar cycle, whose heating energy results in an increase in the average rainfall in the afternoon. This external forcing interacts with the atmospheric system, creating local initiation and dissipation of convection depending on orography, land use, cloud coverage, etc. The signal of the diurnal cycle in MAPLE precipitation forecast has been studied in different locations and spatial scales as a function of lead time in order to recognize where, when, and for which spatial scales the signal is significant. This information has been used in the development of a scaling correction scheme where the mean errors due to the diurnal cycle are adjusted. The results show that the developed methodology improves the forecast for the spatial scales and locations where the diurnal cycle signal is significant.
Treatment of knee osteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial
Authors: Lisi Claudio , Perotti Cesare , Scudeller Luigia , Sammarchi Luigi , Dametti Francesca , Musella Valeria , Di Natali Giuseppe 
Published: August 2017

Objective: Aim of this trial was to compare efficacy of activated platelet-rich plasma against hyaluronic acid as intra-articular injections to people with osteoarthritis of the knee. Design: Phase-2 randomized controlled trial, with blind patients and outcome assessors. Setting: Outpatient rehabilitation service; years 2011–2013. Subjects: Patients with knee osteoarthritis grades 2–3 at magnetic resonance imaging (MRI) were included after consent and randomized. Target sample size was 25 patients per group. Interventions: Patients received three activated platelet-rich plasma (intervention group) or hyaluronic acid (controls) intra-articular injections at 4-week intervals. Main measures: Main outcome measure was proportion of patients with >1 grade improvement at six months from last injection, as assessed by a radiologist blind to study group. Patients were evaluated over time clinically and with functional scales (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lysholm, Tegner, American Knee Society Score (AKSS), Lequesne, visual analogue scale (VAS) for pain). Results: Overall, 30 patients were randomized to intervention and 28 to control group. For primary outcome, 28 patients (29 knees) in the intervention and 22 (25 knees) in the control group were available. Patients with at least 1 grade improvement at repeat MRI were 14 (48.3%) in the intervention and 2 (8%) in the control group ( P < 0.003). Improvement in symptoms and functional scales was consistently higher in the intervention group. No side-effects were observed in either group. Conclusion: Activated platelet-rich plasma reduces articular damage as evident at MRI, as soon as six months after treatment; it reduces pain and improves patient’s function and overall quality of life.