bluuebunny/crossref_metadata_2025_split huggingface dataset:
PILOT VALIDATION OF THE CLINICAL USE PHYSICAL ACTIVITY QUESTIONNAIRE FOR PREGNANCY (CPAQPREG)
Authors: Power JJ , Evans GM , Tsintzas K 
Published: October 2013

AimThe Clinical Use Physical Activity Questionnaire for Pregnancy (CPAQpreg) is proposed as a rapid, simple and accurate method to identify pregnant women whose levels of physical activity fail to meet those recommended by the Royal College of Obstetricians and Gynaecologists (RCOG).1MethodsA pilot validation of CPAQpreg was performed at Leeds General Infirmary, UK. Each participant completed CPAQpreg and the Pregnancy Physical Activity Questionnaire (PPAQ). PPAQ has previously been validated for use in pregnancy but is both time consuming and difficult to interpret.2Total amounts of physical activity (MET minutes/week−1) were calculated for each questionnaire and subdivided by intensity; moderate, vigorous and combined (moderate+vigorous). Each participant was classified as active or inactive in accordance with RCOG physical activity guidance.ResultsA total of 191 participants completed the minimum data set (86.8% response rate). The prevalence of inactivity was 29.8%. CPAQpreg showed excellent levels of agreement with PPAQ in the identification of inactive individuals (Cohen's Kappa=0.758, p<0.001) with a high sensitivity (96.5%, 95%CI 86.8–99.4) and high specificity (85.8%, 95% CI 78.5–91.0) Correlation between questionnaires for combined (moderate+vigorous) intensity physical activity was good (Spearman's correlation coefficient =0.072 p<0.01) but wide levels of agreement (−9772 to 5104 MET minutes/week−1) and a negative bias (−2335 MET minutes/week−1) were shown on Bland Altman plots.ConclusionsThe CPAQpreg showed excellent levels of agreement with the PPAQ in the identification of inactive pregnant women. Further studies comparing the CPAQpreg with an objective measure would further enhance its validity and support the recommendation that the CPAQpreg is used at every contact between pregnant women and healthcare providers to identify inactive individuals quickly and accurately.
QT INTERVALS IN ATHLETES
Authors: Milne CJ , Stewart K , Hillis WS 
Published: October 2013

AimTo determine factors affecting the QT interval in athletes and find an improved means of QT correction (QTc)MethodData was gathered from the CAYA (Cardiovascular Assessment in Young Athletes) screening programme for athletes aged 35 and under. This included assessment of personal/family history, clinical examination, ECG and echocardiogram. This study used ECG data of heart rate, measured QT interval and Bazett1corrected QT interval (QTc). Athletes were divided into age groups and sex to provide age and sex related comparisons. Analysis was performed using co-efficients to determine significant factors affecting QTc. This was then added to linear regression models to provide a most accurate correlation of QT interval based on these factors.ResultsComplete data was held for 1545 athletes (1280 males, 265 females) aged 10–35. Overall data showed a mean age of 18.03. Heart rate varied from 34–123 bpm. Bazett QTc interval varied from 308–592 ms. Mean Bazett QTc of the males was 406.6 ms, and 422.5 ms. From the CAYA data, statistical significance was shown for the factors of age, sex and heart rate in determining QT interval. This provided the following conversion for most accurate determination of QT interval based on the statistically significant factors: QT=515.7–(1.984×HR)+(0.601×Age)+(9.33 if female)ConclusionQT interval is dependent on heart rate, sex and age, and all factors should be taken into account when determining QTc. The above formula provides the most accurate means of determining a QT interval based on an athlete's individual details. However, further work is ongoing to determine a new formula for means of QT correction that also accounts for these factors, as Bazett's does not. This will then allow a fairer comparison between individual athletes.
THE IMPACT OF THE TACKLE: SHOULDER INJURIES IN A RUGBY UNION TEAM
Authors: Whitham RDJ 
Published: October 2013

BackgroundRugby Union (rugby) is the third most popular contact sport in the world and has one of the highest reported incidences of injuries amongst all sports. Thoroughly characterising these injuries may help develop preventative methods to reduce absence from rugby at professional and amateur levels. Although the tackle event is most commonly associated with concussion and cervical nerve root injuries, shoulder injuries are responsible for up to 46% of days lost to participation at a professional level.AimsThis study sought to evaluate the circumstances, severity, and type of shoulder injuries over the course of one season at a professional rugby team.MethodAll shoulder injuries from matches and training during the 2010–11 season at a Welsh regional rugby team were identified retrospectively using theSportsCodevideo analysis programme. Data recorded for circumstances included direction and height of a tackle, and player movement and the nature of a tackle (e.g. stopping tackle). Severity was measured by number of days lost from competition and/or training. Type of shoulder injury was classified using the Orchard Sports Injury Classification System (OSICS) version 10.1.ResultsThere were 24 injuries (3 training injuries and 21 match-related) during the 2010–2011 season. The tackle event caused 92% of injuries (n=22) and resulted in 99% (399 of 405 days) of time lost to shoulder injuries. Cumulatively, players who were tackled remained injured for longer than those tackling (266 days vs. 133 days). Of the 19 videos available for analysis of injury circumstance, injuries most frequently occurred when tackles were high (74%), front-on (53%) and when players were moving with speed (68%). The commonest injuries sustained were acromioclavicular joint sprains (n=9), yet per injury the most severe were dislocation injuries (mean severity, 51.5 days).DiscussionThe tackle event causes the majority of shoulder injuries in professional rugby and is the commonest cause of days lost due to shoulder injuries. Therefore, potential methods of “prehabilitation” such as strengthening muscles around the joint to stabilise the shoulder and coaching correct tackle techniques are essential in minimising time lost. A larger study across a greater number of professional rugby teams, using immediate post-injury video analysis, is needed before evidence-based recommendations for shoulder injury prevention can be made.
A RANDOMISED PLACEBO CONTROLLED TRIAL TO COMPARE THE EFFECTS OF TWO DOSAGES OF OMEGA-3 PUFA ON EXERCISE-INDUCED BRONCHOCONSTRICTION (EIB)
Authors: Williams NC , Hunter K , Johnson MA , Sharpe GR 
Published: October 2013

Treatment of EIB often involves drug interventions, but long-term use may cause systemic side effects (Dahl,Respir Med2006;8:1307–1317). Supplementing the diet of EIB sufferers with fish oil rich in omega-3 (ω-3) polyunsaturated fatty acids (PUFA) improved post-exercise lung function and reduced systemic markers of inflammation and the need for bronchodilator use (Mickleboroughet al.Am J Respir Crit Care Med2003;168:1181–1189; Mickleboroughet al. Chest 2006;129:39–49). However, these studies used high dosages of ω-3 PUFA (5–6 g·day−1), so we examined (and report preliminary data for) the effects of two different dosages of ω-3 PUFA on EIB in asthmatics.Six physically active EIB positive (≥ −10%ΔFEV1after eucapnic voluntary hyperventilation, EVH) males and 6 (age and activity matched) non-EIB males (CTRL) volunteered for the randomised, double-blind placebo (PLA) controlled crossover study. Subjects completed (in a counterbalanced fashion) three 21 day experimental conditions: (A) HIGH dose: 6.2 g·day−1ω-3 PUFA (3.7 g EPA, 2.5 g DHA) (B) HALF dose 3.1 g·day−1(1.8 g EPA, 1.3 g DHA) and (C) PLA (medium chain triglyceride). EIB response to EVH was assessed on days 0 and 21, with a 14 day washout period between conditions. For CTRLs, FEV1was not different after EVH within or between conditions. In the EIB group, the %ΔFEV1at 6-min post-EVH was improved equally after HIGH and HALF, both being better than PLA (P<0.05): at day 21 the %ΔFEV16 min post-EVH was −32±20% (PLA), −21±18% (HIGH), and −19±18% (HALF). From day 0 to 21, %ΔFEV1at 6 min post-EVH showed 38±16% and 36±21% improvements for HIGH and HALF respectively and PLA showed no change (−6±19%) (P>0.05). These data suggest that lower dosages (3.1 g·day−1) of ω-3 PUFA are as effective in aiding the treatment of EIB as high (6.2 g·day−1) dosages.
Investigation of alcohol-related social norms among youth aged 14–17 years in Perth, Western Australia: protocol for a respondent-driven sampling study
Authors: Hildebrand Janina , Maycock Bruce , Howat Peter , Burns Sharyn , Allsop Steve , Dhaliwal Satvinder , Lobo Roanna 
Published: October 2013

IntroductionAlcohol use among young people is a major public health concern in Australia and internationally. Research elucidating social norms influencing alcohol use supports the desire to conform to peers. However, there is a lack of evidence on how social norms are transmitted from the community to young people and between family members and peers, as previous studies are limited to mainly school and university environments. This article describes the proposed process to investigate common alcohol-related norms held by 14-year-olds to 17-year-olds in Perth, Western Australia, and to clarify the process and pathways through which proalcohol norms are transmitted to adolescents.Methods and analysisThis cross-sectional quantitative study will use respondent-driven sampling (RDS) to recruit a sample of 672 adolescents from sporting groups, youth programmes and the community in Perth. Data will be collected with a previously developed and validated multidimensional online survey instrument. A variety of strategies will be explored to aid participation including face-to-face recruitment and survey administration, web-based RDS and a ‘mature minor’ consent assessment protocol. Data analysis will include descriptive statistics of demographic characteristics, as well as social network and dyadic analyses, to explore the connections between shared understanding of norms and behaviours among individuals and how these translate into reported practices.Ethics and disseminationThis research is expected to extend our understanding of normative development pathways to inform future interventions, and will be widely disseminated through conference presentations, peer-reviewed papers, media channels and community seminars. A study reference group of key health industry stakeholders will be established to encourage integration of study findings into policy and practice, and results will guide the development of community interventions. The Curtin University Human Research Ethics Committee has granted approval for this research.
Functional TLR5 Genetic Variants Affect Human Colorectal Cancer Survival
Authors: Klimosch Sascha N. , Försti Asta , Eckert Jana , Knežević Jelena , Bevier Melanie , von Schönfels Witigo , Heits Nils , Walter Jessica , Hinz Sebastian , Lascorz Jesus , Hampe Jochen , Hartl Dominik , Frick Julia-Stefanie , Hemminki Kari , Schafmayer Clemens , Weber Alexander N.R. 
Published: October 2013

Abstract
Toll-like receptors (TLR) are overexpressed on many types of cancer cells, including colorectal cancer cells, but little is known about the functional relevance of these immune regulatory molecules in malignant settings. Here, we report frequent single-nucleotide polymorphisms (SNP) in the flagellin receptor TLR5 and the TLR downstream effector molecules MyD88 and TIRAP that are associated with altered survival in a large cohort of Caucasian patients with colorectal cancer (n = 613). MYD88 rs4988453, a SNP that maps to a promoter region shared with the acetyl coenzyme-A acyl-transferase-1 (ACAA1), was associated with decreased survival of patients with colorectal cancer and altered transcriptional activity of the proximal genes. In the TLR5 gene, rs5744174/F616L was associated with increased survival, whereas rs2072493/N592S was associated with decreased survival. Both rs2072493/N592S and rs5744174/F616L modulated TLR5 signaling in response to flagellin or to different commensal and pathogenic intestinal bacteria. Notably, we observed a reduction in flagellin-induced p38 phosphorylation, CD62L shedding, and elevated expression of interleukin (IL)-6 and IL-1β mRNA in human primary immune cells from TLR5 616LL homozygote carriers, as compared with 616FF carriers. This finding suggested that the well-documented effect of cytokines like IL-6 on colorectal cancer progression might be mediated by TLR5 genotype-dependent flagellin sensing. Our results establish an important link between TLR signaling and human colorectal cancer with relevance for biomarker and therapy development. Cancer Res; 73(24); 7232–42. ©2013 AACR.
The Role of Protein Kinase CK2 in Glioblastoma Development
Authors: Ji Haitao , Lu Zhimin 
Published: October 2013

Abstract
Glioblastoma is the most prevalent and malignant primary brain tumor in adults, and its response to current therapies is limited. Protein kinase CK2 is overexpressed in glioblastoma and regulates glioblastoma cell survival, proliferation, and migration and brain tumorigenesis. Targeting CK2 for glioblastoma treatment may benefit patients with glioblastoma. Clin Cancer Res; 19(23); 6335–7. ©2013 AACR.
Increased levels of lysosomal cysteinyl cathepsins in human varicose veins: A histology study
Authors: Xu Na , Zhang Yuan-Yuan , Lin Yan , Bao Bin , Zheng Lei , Shi Guo-Ping , Liu Jian 
Published: October 2013

SummaryVaricose veins are a major chronic venous disease characterised by extensive remodelling of the extracellular matrix architecture in the vascular wall. Although matrix metalloproteinases have been implicated in these pathologic events, little is known about the functional relevance of other protease family members. Here, we studied the distribution of lysosomal cysteine proteases, cathepsins B, L, K, and S, and their endogenous inhibitor, cystatin C, in long saphenous vein specimens from nine normal donors and 18 patients with varicose veins (VVs). Immunohistochemical analysis demonstrated increased levels of cathepsins L, K, B, and S and reduced levels of cystatin C in VVs. This imbalance between cysteinyl cathepsins and cystatin C may favour VV remodelling. To investigate the inflammatory mechanism of their expression, we examined a detailed inflammatory cell profile in VVs, including macrophages, T lymphocytes, and mast cells. Increased numbers of CD3-positive T cells and tryptase-positive mast cells were found in VVs, and enhanced levels of cysteinyl cathepsins were detected from lesion CD3-positive T cells, chymase-positive mast cells, endothelial cells, and smooth-muscle cells. Elevated cathepsins, and their co-localisation to infiltrated inflammatory cells and to vascular cells, suggest that these proteases participate in extracellular matrix degradation in response to inflammation during VV pathogenesis.
Use of proton pump inhibitors and the risk of coronary events in new users of low-dose acetylsalicylic acid in UK primary care
Authors: Johansson Saga , Nagy Péter , Soriano Lucía Cea , Rodríguez Luis A. García 
Published: October 2013

SummaryThis study evaluated the risk of cardiovascular events associated with the use of proton pump inhibitors (PPIs) in new users of acetylsalicylic acid (ASA) for the secondary prevention of cardiovascular events. Two cohorts of patients aged 50–84 years were identified from UK primary care databases: individuals with a first prescription for ASA (75−300 mg/day) for secondary prevention of cardiovascular events (n = 39,513; CVD cohort) or with a record of hospitalisation for an acute coronary event (n = 42,542; ACS cohort) in 2000–2007. Cases of nonfatal myocardial infarction (MI) and coronary death were identified: 1,222 in the CVD cohort and 604 among new users of ASA in the ACS cohort. A nested case–control analysis estimated the relative risk (RR) of non-fatal MI or coronary death associated with use vs non-use of PPI therapy. Current continuous use of PPI therapy was not associated with a significant increase in RR overall: in the CVD cohort (RR = 1.14 [95% confidence interval = 0.91−1.43]); in the ACS cohort (0.88 [0.66−1.18]); or among current continuous users of ASA as antiplatelet monotherapy (CVD cohort: 1.15 [0.80−1.66]; ACS cohort: 0.73 [0.43−1.23]; pooled analysis of both cohorts: 0.96 [0.62−1.48]). In conclusion, among first-time users of ASA for the secondary prevention of cardiovascular events, PPI use was not shown to be associated with an increased risk of non-fatal MI or coronary death.
Benefit-to-harm ratio of thromboprophylaxis for patients undergoing major orthopaedic surgery
Authors: Liang Jane , Bergqvist David , Yusen Roger D. , Hull Russell D. 
Published: October 2013

SummarySurgeons consider the benefit-to-harm ratio when making decisions regarding the use of anticoagulant venous thromboembolism (VTE) prophylaxis. We evaluated the benefit-to-harm ratio of the use of newer anticoagulants as thromboprophylaxis in patients undergoing major orthopaedic surgery using the likelihood of being helped or harmed (LHH), and assessed the effects of variation in the definition of major bleeding on the results. A systematic literature search was performed to identify phase II and phase III studies that compared regulatory authority-approved newer anticoagulants to the low-molecularweight heparin enoxaparin in patients undergoing major orthopaedic surgery. Analysis of outcomes data estimated the clinical benefit (number-needed-to-treat [NNT] to prevent one symptomatic VTE) and clinical harm (number-needed-to-harm [NNH] or the NNT to cause one major bleeding event) of therapies. We estimated each trial’s benefitto-harm ratio from NNT and NNH values, and expressed this as LHH = (1/NNT)/(1/NNH) = NNH/NNT. Based on reporting of efficacy and safety outcomes, most studies favoured enoxaparin over fondaparinux, and rivaroxaban over enoxaparin. However, when using the LHH metric, most trials favoured enoxaparin over both fondaparinux and rivaroxaban when they included surgical-site bleeding that did not require reoperation in the definition of major bleeding. The exclusion of bleeding at surgical site which did not require reoperation shifted the benefit-to-harm ratio in favour of the newer agents. Variations in the definitions of major bleeding may change the benefit-to-harm ratio and subsequently affect its interpretation. Clinical trials should attempt to improve the consistency of major bleeding reporting.
A non-interventional comparison of rivaroxaban with standard of care for thromboprophylaxis after major orthopaedic surgery in 17,701 patients with propensity score adjustment
Authors: Haas Sylvia , Kreutz Reinhold , Mantovani Lorenzo G. , Pattanayak Cassandra W. , Holberg Gerlind , Jamal Waheed , Schmidt André , Eickels Martin van , Lassen Michael R. , Turpie Alexander G. G. 
Published: October 2013

SummaryRivaroxaban demonstrated superior efficacy and a similar safety profile to enoxaparin for the prevention of venous thromboembolism in the phase III RECORD programme in patients undergoing elective hip or knee replacement surgery. The XAMOS study investigated adverse events, including bleeding and thromboembolic events, in patients receiving rivaroxaban for thromboprophylaxis in routine clinical practice. XAMOS was a non-interventional, open-label cohort study in patients undergoing major orthopaedic surgery of the hip or knee (predominantly elective arthroplasty), in which rivaroxaban was compared with other pharmacological thromboprophylaxis. All adverse events were documented, including symptomatic thromboembolic and bleeding events. Crude and adjusted incidences based on propensity score subclasses were calculated and compared between the rivaroxaban and standard-of-care groups. A total of 17,701 patients were enrolled from 252 centres in 37 countries. Crude incidences of symptomatic thromboembolic events three months after surgery in the safety population were 0.89% in the rivaroxaban group (n=8,778) and 1.35% in the standard-of-care group (n=8,635; odds ratio [OR] 0.65; 95% confidence interval [CI] 0.49–0.87), and 0.91% and 1.31% (weighted) in the propensity score-adjusted analysis (OR 0.69; 95% CI 0.56–0.85), respectively. Treatment-emergent major bleeding events (as defined in the RECORD studies) occurred in 0.40% and 0.34% of patients in the rivaroxaban and standard-of-care groups in the safety population (OR 1.19; 95% CI 0.73–1.95), and in 0.44% versus 0.33% (weighted) in the propensity score-adjusted analysis (OR 1.35; 95% CI 0.94–1.93), respectively. This study in unselected patients confirmed the favourable benefit–risk profile of rivaroxaban seen in the RECORD programme.
Impact of Preoperative Moderate/Severe Mitral Regurgitation on 2-Year Outcome After Transcatheter and Surgical Aortic Valve Replacement
Authors: Barbanti Marco , Webb John G. , Hahn Rebecca T. , Feldman Ted , Boone Robert H. , Smith Craig R. , Kodali Susheel , Zajarias Alan , Thompson Christopher R. , Green Philip , Babaliaros Vasilis , Makkar Raj R. , Szeto Wilson Y. , Douglas Pamela S. , McAndrew Tom , Hueter Irene , Miller D. Craig , Leon Martin B. 
Published: October 2013

Background—
The effect of preoperative mitral regurgitation (MR) on clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) is controversial. This study sought to examine the impact of moderate and severe MR on outcomes after TAVR and surgical aortic valve replacement (SAVR).

Methods and Results—

Data were drawn from the randomized Placement of Aortic Transcatheter Valve (PARTNER) Trial cohort A patients with severe, symptomatic aortic stenosis undergoing either TAVR (n=331) or SAVR (n=299). Both TAVR and SAVR patients were dichotomized according to the degree of preoperative MR (moderate/severe versus none/mild). At baseline, moderate or severe MR was reported in 65 TAVR patients (19.6%) and 63 SAVR patients (21.2%). At 30 days, among survivors who had isolated SAVR/TAVR, moderate/severe MR had improved in 25 SAVR patients (69.4%) and 30 TAVR patients (57.7%), was unchanged in 10 SAVR patients (27.8%) and 19 TAVR patients (36.5%), and worsened in 1 SAVR patient (2.8%) and 4 TAVR patients (5.8%; all
P
=NS). Mortality at 2 years was higher in SAVR patients with moderate or severe MR than in those with mild or less MR (49.8% versus 28.1%; adjusted hazard ratio, 1.73; 95% confidence interval, 1.01–2.96;
P
=0.04). In contrast, MR severity at baseline did not affect mortality in TAVR patients (37.0% versus 32.7%, moderate/severe versus none/mild; hazard ratio, 1.14; 95% confidence interval, 0.72–1.78;
P
=0.58;
P
for interaction=0.05).

Conclusions—
Both TAVR and SAVR were associated with a significant early improvement in MR in survivors. However, moderate or severe MR at baseline was associated with increased 2-year mortality after SAVR but not after TAVR. TAVR may be a reasonable option in selected patients with combined aortic and mitral valve disease.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00530894.