bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between shoulder abduction strength and rotator cuff tear in elderly women: a general population study
Authors: Hinsley Hannah , Ganderton Charlotte , Arden Nigel K , Carr Andrew J 
Published: July 2023

ObjectivesTo investigate the effect of age-related rotator cuff tears on shoulder strength in a general population cohort.DesignCross sectional observational study.SettingThis study was set in an outpatient clinic setting in Chingford, North East London, and was a component of the 20 year visit of the Chingford 1000 women cohort.ParticipantsIndividuals were part of the Chingford 1000 women cohort, a 20-year-old longitudinal population study. This cohort has been extensively characterised as representative of the population of the UK. At the 20 year visit, 446 attended for shoulder assessment and were aged between 64 and 87.Primary and secondary outcome measuresIsometric shoulder abduction strength measured using a Nottingham Mecmesin Myometer and the presence of rotator cuff pathology, determined via ultrasound examination (GE voluson i portable ultrasound machine with a 10-16MHz linear probe). Shoulders were classified into normal, abnormal tendon/partial tear, full-thickness tears (>0 and ≤2.5 cm) and full-thickness tears (>2.5 cm). Symptoms were defined using the Oxford Shoulder Score, where an abnormal score was defined as symptomatic.Results446 women (891 shoulders) aged 71 (range 65–84) were included in the study. Age, the presence of pain and the non-dominant arm were demonstrated to reduce strength. Rotator cuff tears and pathology had no isolated effect on shoulder strength in those aged under 70. However, in the over 70s full-thickness tears>0 and ≤2.5 cm, and >2.5 cm had mean reductions of 6.3 and 12.7 N, respectively (p<0.001).ConclusionRotator cuff tears of all sizes in those aged under 70 were not associated with a loss of shoulder strength. In those aged over 70, strength was reduced by 30% with small and 40% with large full thickness tears. Loss in strength was associated a loss of ability to perform activities of daily living but only for large tears.
Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours
Authors: Suc Gaspard , Cachier Agnès , Hentic Olivia , Bazire Baptiste , Sannier Aurélie , Delhomme Clémence , Nataf Patrick , Laschet Jamila , Deschamps Lydia , Garbarz Eric , Ou Phalla , Caligiuri Giuseppina , Iung Bernard , Ruszniewski Philippe , de Mestier Louis , Arangalage Dimitri 
Published: July 2023

ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short-term outcomes of CHD.MethodsFrom January 2003 to June 2022, consecutive patients with liver metastases of midgut NETs and severe CHD (severe valve disease with symptoms and/or right ventricular enlargement) were included at Beaujon and Bichat hospitals. All patients underwent clinical evaluation and echocardiography.ResultsOut of 43 (16%) consecutive patients with severe CHD and liver metastases of midgut NETs, 79% presented with right-sided heart failure. Tricuspid valve replacement was performed in 26 (53%) patients including 19 (73%) cases of combined pulmonary valve replacement. The 30-day postoperative mortality rate was high (19%), and preoperative heart failure was associated with worse survival (p=0.02). Epicardial pacemakers were systematically implanted in operated patients and 25% were permanently paced. A postoperative positive right ventricular remodelling was observed (p<0.001). A greater myofibroblastic infiltration was observed in pulmonary versus tricuspid valves (p<0.001), suggesting that they may have been explanted at an earlier stage of the disease than the tricuspid valve, with therefore potential for evolution.ConclusionsWe observed a high postoperative mortality rate and baseline right-sided heart failure was associated with worse outcome. In surviving patients, a positive right ventricular remodelling was observed. Prospective, multicentre studies are warranted to better define the management strategy and to identify biomarkers associated with outcome in CHD.
Differential expression of IFN-α, IL-12 and BAFF on renal immune cells and its relevance to disease activity and treatment responsiveness in patients with proliferative lupus nephritis
Authors: Nawata Aya , Nakayamada Shingo , Hisano Satoshi , Miyazaki Yusuke , Miyamoto Tetsu , Shiba Eisuke , Hisaoka Masanori , Tanaka Yoshiya 
Published: July 2023

ObjectiveSince molecularly targeted therapies are emerging for treating lupus nephritis (LN), this study aimed to assess the immunohistochemical findings of the cytokines in renal tissue and their pathological and clinical relevance in LN.MethodsFifty patients with proliferative LN formed the case group; 5 with LN class II, IgA nephropathy and 10 with idiopathic haematuria were enrolled as controls. Immunohistochemical analysis for CD3, CD20, interferon (IFN)-α, interleukin (IL)-12/p40 and B-cell activating factor (BAFF) was performed by scoring the number of positive cells/area of the cortex. All immunohistochemical investigations were performed on formalin-fixed paraffin-embedded renal tissue. Proliferative LN cases were grouped by the dominant expression of IFN-α, IL-12/p40 and BAFF, and subsequently, clinicopathological features were compared.ResultsClinical data of patients with proliferative LN included urine protein creatinine ratio, 2.2 g/gCre; anti-double-stranded DNA antibody, 200.9 IU/mL; total complement activity (CH50), 21.9 U/mL and SLE Disease Activity Index, 19.8 points. Proliferative LN cases, including class III (n=18) and IV (n=32), were classified into three subgroups according to the immunohistochemical score based on the dominancy of IFN-α (n=17), IL-12 (n=16) and BAFF group (n=17) proteins. Hypocomplementaemia and glomerular endocapillary hypercellularity were significantly increased in the IFN-α group, whereas chronic lesions were significantly higher in the IL-12 group (p<0.05). The IFN-α group had a poorer renal prognosis in treatment response after 52 weeks.ConclusionsThe immunohistochemistry (IHC) of IFN-α, IL-12 and BAFF for proliferative LN enabled grouping. Especially, the IFN-α and IL-12 groups showed different clinicopathological features and renal prognoses. The results indicated the possibility of stratifying cases according to the IHC of target molecules, which might lead to precision medicine.
Association between exercise load, resting heart rate, and maximum heart rate and risk of future ST-segment elevation myocardial infarction (STEMI)
Authors: Helleryd Edvin , Rawshani Araz , Rawshani Aidin , Hjärtstam Nellie , Myredal Anna , Skoglund Kristofer 
Published: July 2023

ObjectiveThis study aimed to examine the association between exercise workload, resting heart rate (RHR), maximum heart rate and the risk of developing ST-segment elevation myocardial infarction (STEMI).MethodsThe study included all participants from the UK Biobank who had undergone submaximal exercise stress testing. Patients with a history of STEMI were excluded. The allowed exercise load for each participant was calculated based on clinical characteristics and risk categories. We studied the participants who exercised to reach 50% or 35% of their expected maximum exercise tolerance. STEMI was adjudicated by the UK Biobank. We used Cox regression analysis to study how exercise tolerance and RHR were related to the risk of STEMI.ResultsA total of 66 949 participants were studied, of whom 274 developed STEMI during a median follow-up of 7.7 years. After adjusting for age, sex, blood pressure, smoking, forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow and diabetes, we noted a significant association between RHR and the risk of STEMI (p=0.015). The HR for STEMI in the highest RHR quartile (>90 beats/min) compared with that in the lowest quartile was 2.92 (95% CI 1.26 to 6.77). Neither the maximum achieved exercise load nor the ratio of the maximum heart rate to the maximum load was significantly associated with the risk of STEMI. However, a non-significant but stepwise inverse association was noted between the maximum load and the risk of STEMI.ConclusionRHR is an independent predictor of future STEMI. An RHR of >90 beats/min is associated with an almost threefold increase in the risk of STEMI.
Cardiovascular and renal multimorbidity increase risk of atrial fibrillation in the PREVEND cohort
Authors: Van Deutekom Colinda , Geelhoed Bastiaan , Van Munster Barbara C , Bakker Stephan J L , Gansevoort Ron T , Van Gelder Isabelle C , Rienstra Michiel 
Published: July 2023

ObjectiveAtrial fibrillation (AF) is a condition that occurs in the presence of comorbidities. With the accumulation of comorbidities (multimorbidity), some combinations may more often occur together than others. Information on the impact of clustering of these on incident AF is sparse. We aimed to investigate clustering of cardiovascular and renal comorbidities and study the association between comorbidity clusters and incident AF.MethodsWe used the community-based Prevention of Renal and Vascular ENd-stage Disease (PREVEND) cohort in which 8592 individuals participated. Latent class analysis was performed to assess clustering of 10 cardiovascular and renal comorbidities.ResultsWe excluded individuals with prior AF or missing ECG data, leaving 8265 individuals for analysis (mean age 48.9±12.6 years, 50.2% women). During 9.2±2.1 years of follow-up, 251 individuals (3.0%) developed AF. A model with three clusters was the optimal model, with one cluster being young (44.5±10.8 years) and healthy, carrying a low (1.0%) risk of incident AF; one cluster being older (63.0±8.4 years) and multimorbid, carrying a high (16.2%) risk of incident AF and a third middle-aged (57.0±11.3 years), obese and hypertensive cluster carrying an intermediate risk (5.9%) of incident AF. While the prevalence of the comorbidities differed between classes, no clear combination(s) of comorbidities was observed within the classes.ConclusionsWe identified three clusters of comorbidities in individuals in the community-based PREVEND cohort. The three clusters contained different amount of comorbidities carrying different risks of incident AF. However, there were no differences between the clusters regarding specific combination(s) of comorbidities.
Systematic review of the incidence and clinical risk predictors of atrial fibrillation and permanent pacemaker implantation for bradycardia in Fabry disease
Authors: Vijapurapu Ravi , Roy Ashwin , Demetriades Polyvios , Warfield Adrian , Hughes Derralynn A , Moon James , Woolfson Peter , de Bono Joseph , Geberhiwot Tarekegn , Kotecha Dipak , Steeds Richard Paul 
Published: July 2023

IntroductionFabry disease (FD) is an X-linked lysosomal storage disorder caused by enzyme deficiency, leading to glycosphingolipid accumulation. Cardiac accumulation triggers local tissue injury, electrical instability and arrhythmia. Bradyarrhythmia and atrial fibrillation (AF) incidence are reported in up to 16% and 13%, respectively.ObjectiveWe conducted a systematic review evaluating AF burden and bradycardia requiring permanent pacemaker (PPM) implantation and report any predictive risk factors identified.MethodsWe conducted a literature search on studies in adults with FD published from inception to July 2019. Study outcomes included AF or bradycardia requiring therapy. Databases included Embase, Medline, PubMed, Web of Science, CINAHL and Cochrane. The Risk of Bias Agreement tool for Non-Randomised Studies (RoBANS) was utilised to assess bias across key areas.Results11 studies were included, eight providing data on AF incidence or PPM implantation. Weighted estimate of event rates for AF were 12.2% and 10% for PPM. Age was associated with AF (OR 1.05–1.20 per 1-year increase in age) and a risk factor for PPM implantation (composite OR 1.03). Left ventricular hypertrophy (LVH) was associated with AF and PPM implantation.ConclusionEvidence supporting AF and bradycardia requiring pacemaker implantation is limited to single-centre studies. Incidence is variable and choice of diagnostic modality plays a role in detection rate. Predictors for AF (age, LVH and atrial dilatation) and PPM (age, LVH and PR/QRS interval) were identified but strength of association was low. Incidence of AF and PPM implantation in FD are variably reported with arrhythmia burden likely much higher than previously thought.PROSPERO databaseCRD42019132045.
A regular  interior solution of Einstein field equations
Authors: Estevez-Delgado Gabino , Estevez-Delgado Joaquin , Duran Modesto Pineda , Cleary-Balderas Arthur 
Published: July 2023

Starting from the solution of the Einstein field equations in a static and spherically symmetric space–time that contains an isotropic fluid, we construct a model to represent the interior of compact objects with compactness rate [Formula: see text]. The solution is obtained by imposing the isotropy condition for the radial and tangential pressures; this generates an ordinary differential equation of second order for the temporal gtt and radial grr metric potentials, which can be solved for a specific function of gtt. The graphic analysis of the solution shows that it is physically acceptable, which is to say that the density, pressure, and speed of sound are positive, regular and monotonically decreasing functions; also, the solution is stable due to meeting the criteria of the adiabatic index. When taking the data of mass [Formula: see text] and radius [Formula: see text] that corresponds to the estimations of the star PSR J0030+045, we obtain values of central density ρc = 7.5125 × 1017 kg/m3 for the maximum compactness u = 0.19628 and of ρc = 2.8411 × 1017 kg/m3 for the minimum compactness u = 0.13460, which are consistent with those expected for this type of star.
Requests for Verification across Varieties of Spanish
Authors: Satti Ignacio 
Published: July 2023

Abstract
This article examines requests for verification across varieties of Spanish. It focuses on the role of gaze behaviour in the design of the request and shows how gaze is interrelated with other resources, such as facial expressions, epistemic markers, prosody and tag questions. By comparing speakers from Argentina, Bolivia, Colombia and Ecuador, the article finds similarities but also differences between the groups of speakers. The speakers from Bolivia and Ecuador rarely establish mutual gaze or use facial expressions during the verification sequence. Instead, more frequently, they deploy other resources for obtaining verifications, such as tag questions, hand gestures and rising intonation. The article considers differences in gaze behaviour within the larger machinery of response mobilisation and shows how gaze is intertwined with other aspects of conversational organisation. Results are based on qualitative and quantitative analysis. The data stems from face-to-face conversations recorded in similar side-by-side settings.
Looking Cool, Doing Tricks, Managing Stress, and Nicotine Addiction: Youth Perspectives on Nicotine Vaping and Implications for Prevention
Authors: Crane Lori A. , Asdigian Nancy L. , Fitzgerald Monica D. 
Published: July 2023

Purpose To understand the contextual and psychosocial factors associated with youth vaping in Colorado, the state with the highest youth vaping rates in 2019, and to propose strategies for prevention interventions. Design Focus groups. Setting In-person. Participants 24 youth aged 11-17, including youth who had vaped (n = 11) and who had never vaped (n = 13). Method Qualitative responses using a semi-structured focus group guide were analyzed using a matrix approach with a mixed deductive/inductive content analysis. Results Analysis revealed the highly social nature of vaping initiation and use; the use of vaping to control negative emotions; and the acquisition of vaping products through retail outlets, friends, family, and other youth who sell a variety of substances and devices to youth. Youth provided insight into how vaping is concealed from parents and teachers, and their attitudes about the health risks and benefits of vaping. Conclusion When considered with other studies, our findings suggest a universality in the youth vaping experience that is highly social. Interventions should include peer-to-peer messaging with an emphasis on changing social norms and highlighting undesirable outcomes of vaping such as negative reactions by friends and close adults, adverse effects on athletic success and future aspirations, expense, addiction, and punishment. Parent education is also recommended. Rigorous research is needed to test interventions to reverse the growing trend of youth vaping.
Seroconversion rate of SARS-CoV-2 IgG antibodies and dating behaviour in HIV-PrEP users in a German metropolis during the COVID-19 pandemic
Authors: Weidlich Simon , Schneider Jochen , Lee Marcel , Mijočević Hrvoje , Graf Natalia , Protzer Ulrike , Spinner Christoph , Noe Sebastian 
Published: July 2023

Background At the beginning of the COVID-19 pandemic, when mortality was high, social distance was the only option to prevent transmission of SARS-CoV-2 and prohibit uncontrolled spreading. As the impact of social distancing on sexual behavior was unclear, we aimed to assess the influence of sexual risk behavior on SARS-CoV-2 seroconversion in HIV pre-exposition prophylaxis (PrEP) users after declaration of the pandemic. Methods Prospective study on SARS-CoV-2 IgG-antibody seroconversion rate over time in men having sex with men (MSM) using PrEP at a single tertiary university hospital in Munich, Germany, during quarterly (Q) routine HIV-PrEP visits over 1 year per participant (May 2020 - September 2021). Seroconversion was defined as at least one positive anti-nucleocapsid (anti-N) SARS-CoV-2 IgG antibody test as surrogate for past infection. In addition, sexually transmitted infections (STIs), personal estimated risk behavior and sexual contacts were assessed. Results Seroconversion rate during the full observation period was 7.3% (9/124 subjects) by September 2021. Percentage of subjects with symptomatic STIs ( T. pallidum, N. gonorrhoeae, C. trachomatis and M. genitalium) was 18.7% in Q3-20, 8.1% in Q4-20, 11.1% in Q1-21, 11.6% in Q2-21 and 9.5% in Q3-21. Perception of subjective threat of SARS-CoV-2 infection and adequacy of preventive measures decreased during the observation period. However, self-reported sex behavior remained stable during the observation period. Conclusions Our cohort showed low proportion of PrEP-users with anti-N IgG by September 2021, comparable to the local incidence. Sexual behavior in this cohort did not change, despite local recommendations for social distancing.
Can we predict failure of non-operative management of blunt splenic injuries on arrival? A comparison of predictors of immediate splenectomy versus splenectomy secondary to non-operative management failure
Authors: Naveed Asad , Adams-McGavin Robert Christopher , Beckett Andrew , Colak Errol , Rezende-Neto Joao , Ahmed Najma , Gomez David 
Published: July 2023

Aims and Background The spleen is the most frequently injured solid organ after blunt trauma and a trial non-operative management (NOM) has become the standard of care in hemodynamically stable patients. It remains uncertain which patients are at increased risk of non-operative management failure (NOMF) at initial presentation. We explored whether clinical variables including the contemporary rotational thromboelastography (ROTEM) parameters are predictive of NOMF. Materials and Methods Data for all adult patients with a blunt splenic injury was collected retrospectively at St. Michael’s Hospital in Toronto, Canada between 2005 and 2021. Those who underwent a splenectomy within 4 hours of presentation were classified as direct operative management (OM), while those who had a splenectomy after 4 hours of observation were classified as NOM failure. Vital signs on arrival and injury characteristics were collected. Logistic regression was used to identify predictors of OM and predictors of NOM failure. Results Seven hundred and seventeen patients were identified with splenic injury during our study period. The median Injury Severity Score (ISS) was 27 (IQR 17–36), and 19% ( n = 134) had a shock index of 1 or more. One hundred and eleven (15.5%) underwent direct operative management. A shock index above 1 and increasing spleen injury severity were strong predictors of patients undergoing direct OM. The remaining 606 patients underwent NOM of which 59% ( n = 357) of these were admitted to the ICU. NOM failure occurred in 7.4% ( n = 45) with a median time to NOM failure of 23 (IQR 8–72) hours. The American Association for the Surgery of Trauma (AAST) spleen injury severity was the major factor significantly associated with NOM failure. Conclusions The only major predictor of NOMF available on arrival is increased spleen injury grade. Other clinical variables such as age, vital signs on arrival, and bloodwork were not significantly able to predict NOM failure. Additional investigation is required to identify novel predictors of NOM failure.
Effects of walking with a portable oxygen concentrator on muscle oxygenation while performing normal or pursed-lip breathing in patients with interstitial lung disease: a randomized crossover trial
Authors: Hun Kim Sang , Beom Shin Yong , Shin Myung-Jun , Hui Hong Cho , Huh Sungchul , Yoo Wanho , Lee Kwangha 
Published: July 2023

Background: In patients with interstitial lung disease (ILD), decreased oxygen saturation (SpO2) reduces physical performance and causes exertional dyspnea. Portable oxygen concentrator (POC) and pursed-lip breathing (PLB) have the potential to improve these parameters in ILD patients. Objective: To evaluate the effects of PLB while using a POC during walking in ILD patients Design: Prospective, randomized crossover trial. Methods: We compared two breathing techniques. Participants not trained in PLB received a familiarization session before the first 6-min walking test (6MWT). During the first visit, patients performed the 6MWT under natural breathing (NB1) without oxygen (O2); during the second visit, they performed the 6MWT twice, once each with PLB (PLB1) and natural breathing (NB2) under O2 supplementation, to compare the effectiveness of NB and PLB. Results: Twenty participants were recruited; half had exercise-induced desaturation (EID) and half normal SpO2. In the normoxemia group (NG), the difference in the 6-min walking distance (6MWD) between NB1 and PLB1 was 28.8 ± 24.0 m, indicating reduced exercise capacity in PLB1. There were no significant differences in the quadriceps tissue saturation index (TSI), SpO2, and 6MWD between the PLB1 and NB2 in any patient or subgroup. All participants showed a significant increase in the SpO2 at rest, nadir SpO2, and mean SpO2 during the 6MWT with PLB and NB2 using a POC than with NB1. TSI showed a significant improvement at the beginning of 6MWT in ILD patients with EID in the PLB and NB2 condition. Conclusion: Acute exposure to PLB did not improve symptoms, muscle oxygenation, or SpO2; however, it decreased the walking distance in the normoxemia group. POC improved leg muscle oxygenation in ILD patients with EID. The use of PLB and POC should be prescribed according to disease characteristics and severity.