bluuebunny/crossref_metadata_2025_split huggingface dataset:
Its not all about sprinting: mechanisms of acute hamstring strain injuries in professional male rugby union—a systematic visual video analysis
Authors: Kerin Fearghal , Farrell Garreth , Tierney Peter , McCarthy Persson Ulrik , De Vito Giuseppe , Delahunt Eamonn 
Published: January 2022

ObjectivesThe mechanisms of hamstring strain injuries (HSIs) in professional Rugby Union are not well understood. The aim of this study was to describe the mechanisms of HSIs in male professional Rugby Union players using video analysis.MethodsAll time-loss acute HSIs identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2015/2016 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three chartered physiotherapists (analysts) independently assessed all videos with a consensus meeting convened to describe the injury mechanisms. The determination of the injury mechanisms was based on an inductive process informed by a critical review of HSI mechanism literature (including kinematics, kinetics and muscle activity). One of the analysts also developed a qualitative description of each injury mechanism.ResultsSeventeen acute HSIs were included in this study. Twelve per cent of the injuries were sustained during training with the remainder sustained during match-play. One HSI occurred due to direct contact to the injured muscle. The remainder were classified as indirect contact (ie, contact to another body region) or non-contact. These HSIs were sustained during five distinct actions—‘running’ (47%), ‘decelerating’ (18%), ‘kicking’ (6%), during a ‘tackle’ (6%) and ‘rucking’ (18%). The most common biomechanical presentation of the injured limb was characterised by trunk flexion with concomitant active knee extension (76%). Fifty per cent of cases also involved ipsilateral trunk rotation.ConclusionHSIs in this study of Rugby Union were sustained during a number of playing situations and not just during sprinting. We identified a number of injury mechanisms including: ‘running’, ‘decelerating’, ‘kicking’, ‘tackle’, ‘rucking’ and ‘direct trauma’. Hamstring muscle lengthening, characterised by trunk flexion and relative knee extension, appears to be a fundamental characteristic of the mechanisms of acute HSIs in Rugby Union.
DNA methylation analysis of cord blood samples in neonates born to gestational diabetes mothers diagnosed before 24 gestational weeks
Authors: Kasuga Yoshifumi , Kawai Tomoko , Miyakoshi Kei , Hori Asuka , Tamagawa Masumi , Hasegawa Keita , Ikenoue Satoru , Ochiai Daigo , Saisho Yoshifumi , Hida Mariko , Tanaka Mamoru , Hata Kenichiro 
Published: January 2022

IntroductionGenome-wide methylation analyses of gestational diabetes mellitus (GDM) diagnosed after 24 gestational weeks (late GDM (L-GDM)) using cord blood have been reported. However, epigenetic changes in neonates born to mothers with GDM diagnosed before 24 gestational weeks (early GDM (E-GDM)) have not been reported. We investigated DNA methylation in neonates born to mothers with E-GDM using cord blood samples.Research design and methodsGenome-wide DNA methylation analysis was performed using an Illumina EPIC array to compare methylation rates of 754 255 autosomal sites in cord blood samples from term neonates born to 162 mothers with GDM (E-GDM: n=84, L-GDM: n=78) and 60 normal glucose tolerance (normal OGTT) pregnancies. GDM was diagnosed based on Japan Society of Obstetrics and Gynecology criteria modified with International Association of Diabetes in Pregnancy Study Group criteria. In this study, all GDM mothers underwent dietary management, while self-monitoring of blood glucose and insulin administration was initiated when dietary modification did not achieve glycemic control.ResultsThere were no significant differences in genome-wide DNA methylation of cord blood samples between the GDM (E-GDM and L-GDM) groups and normal OGTT group or between the E-GDM and normal OGTT groups, L-GDM and normal OGTT groups, and E-GDM and L-GDM groups.ConclusionsThis is the first report to determine the DNA methylation patterns in neonates born to mothers with E-GDM. Neonates born to mothers with GDM, who were diagnosed based on Japan Society of Obstetrics and Gynecology criteria, may not differ in DNA methylation compared with those born to normal OGTT mothers.
Prediction of diabetic kidney disease with machine learning algorithms, upon the initial diagnosis of type 2 diabetes mellitus
Authors: Allen Angier , Iqbal Zohora , Green-Saxena Abigail , Hurtado Myrna , Hoffman Jana , Mao Qingqing , Das Ritankar 
Published: January 2022

IntroductionDiabetic kidney disease (DKD) accounts for the majority of increased risk of mortality for patients with diabetes, and eventually manifests in approximately half of those patients diagnosed with type 2 diabetes mellitus (T2DM). Although increased screening frequency can avoid delayed diagnoses, this is not uniformly implemented. The purpose of this study was to develop and retrospectively validate a machine learning algorithm (MLA) that predicts stages of DKD within 5 years upon diagnosis of T2DM.Research design and methodsTwo MLAs were trained to predict stages of DKD severity, and compared with the Centers for Disease Control and Prevention (CDC) risk score to evaluate performance. The models were validated on a hold-out test set as well as an external dataset sourced from separate facilities.ResultsThe MLAs outperformed the CDC risk score in both the hold-out test and external datasets. Our algorithms achieved an area under the receiver operating characteristic curve (AUROC) of 0.75 on the hold-out set for prediction of any-stage DKD and an AUROC of over 0.82 for more severe endpoints, compared with the CDC risk score with an AUROC <0.70 on all test sets and endpoints.ConclusionThis retrospective study shows that an MLA can provide timely predictions of DKD among patients with recently diagnosed T2DM.
Diabetic hand: prevalence and incidence of diabetic hand problems using data from 1.1 million inhabitants in southern Sweden
Authors: Rydberg Mattias , Zimmerman Malin , Gottsäter Anders , Svensson Ann-Marie , Eeg-Olofsson Katarina , Dahlin Lars B 
Published: January 2022

Introduction‘The diabetic hand’ has traditionally referred to hand complications due to diabetes mellitus (DM), including trigger finger (TF) and Dupuytren’s disease (DD). Recent publications have also proposed DM as a risk factor for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), and possibly osteoarthritis (OA) of the first carpometacarpal (CMC-1) joint. This study aimed to explore prevalence and incidence of diabetic hand complications among the population in southern Sweden.Research design and methodsApproximately 1.1 million inhabitants in the region of Skåne aged ≥18 years, whereof 50 000 with DM, were included. Data on incident CTS, UNE, TF, DD, and OA of the CMC-1 joint between 2004 and 2019 were collected from the Skåne Healthcare Register and cross-linked with the National Diabetes Register. Prevalences on December 31, 2019 and 10-year incidence ratios were calculated for type 1 diabetes (T1D), type 2 diabetes (T2D), and the population without DM, stratified for sex. Prevalence ratios and incidence rate ratios with 95% CIs were used for group comparisons.ResultsThe prevalences of all five studied diagnoses were higher in both men and women with T1D and T2D (p<0.01) and both T1D and T2D had more concomitant prevalent diagnoses (p<0.0001). The 10-year incidence rates of all diagnoses were higher among T1D and T2D (p<0.0001), except OA of the CMC-1 joint in men with T1D (p=0.055).ConclusionsCTS, UNE, and possibly also OA of the CMC-1 joint should be included together with TF and DD when referring to ‘the diabetic hand’. The incidence of hand disorders was up to eight times higher among T1D, and both T1D and T2D had more concomitant prevalent diagnoses compared with the population without DM. Future studies should elucidate the pathophysiology behind diabetic hand complications to enable development of effective preventive measures in patients with diabetes.
Mapping registered nurse anaesthetists’ intraoperative work: tasks, multitasking, interruptions and their causes, and interactions: a prospective observational study
Authors: Olin Karolina , Göras Camilla , Nilsson Ulrica , Unbeck Maria , Ehrenberg Anna , Pukk-Härenstam Karin , Ekstedt Mirjam 
Published: January 2022

IntroductionSafe anaesthesia care is a fundamental part of healthcare. In a previous study, registered nurse anaesthetists (RNAs) had the highest task frequency, with the largest amount of multitasking and interruptions among all professionals working in a surgical team. There is a lack of knowledge on how these factors are distributed during the intraoperative anaesthesia care process, and what implications they might have on safety and quality of care.ObjectiveTo map the RNAs’ work as done in practice, including tasks, multitasking, interruptions and their causes, and interactions, during all phases of the intraoperative anaesthesia work process.MethodsStructured observations of RNAs (n=8) conducted during 30 procedures lasting a total of 73 hours in an operating department at a county hospital in Sweden, using the Work Observation Method By Activity Timing tool.ResultsHigh task intensity and multitasking were revealed during preparation for anaesthesia induction (79 tasks/hour, 61.9% of task time spent multitasking), anaesthesia induction (98 tasks/hour, 50.7%) and preparation for anaesthesia maintenance (86 tasks/hour, 80.2%). Frequent interruptions took place during preoperative preparation (4.7 /hour), anaesthesia induction (6.2 /hour) and preparation for anaesthesia maintenance (4.3 /hour). The interruptions were most often related to medication care (n=54, 19.8%), equipment issues (n=40, 14.7%) or the procedure itself (n=39, 14.3%). RNAs’ work was conducted mostly independently (58.4%), but RNAs interacted with multiple professionals in and outside the operating room during anaesthesia.ConclusionThe tasks, multitasking, interruptions and their causes, and interactions during different phases illustrated the RNAs’ work as done, as part of a complex adaptive system. Management of safety in the most intense phases—preparing for anaesthesia induction, induction and preparing for anaesthesia maintenance—should be investigated further. The complexity and adaptivity of the nature of RNAs’ work should be taken into consideration in future management, development, research and education.
Association between health literacy and multimorbidity: a nationwide, cross-sectional study of a Japanese population
Authors: Tomita Shiori , Aoki Takuya , Ohde Sachiko , Takahashi Osamu , Kimura Takeshi , Matsushima Masato 
Published: January 2022

ObjectivesTo examine the relationship between health literacy and multimorbidity.DesignNationwide cross-sectional study.SettingCommunity settings across Japan.ParticipantsCommunity-dwelling participants aged 20 years or older were selected based on a quota sampling method that adjusted for age, sex and residential area. In total, 3678 participants from the Health Diary Study, with a mean age of 52.3 years (SD, 18.2 years; 1943 (52.8%) female participants), were included.Primary outcome measureMultimorbidity, the primary outcome measure, was defined as the presence of two or more chronic diseases.ResultsOf the 3678 participants, 824 (22.4%) had multimorbidity. The mean functional health literacy (FHL) and communicative and critical health literacy (CCHL) scores were 3.2 (SD, 0.7) and 3.6 (SD, 0.9), respectively. In the univariable analysis, both scores were associated with multimorbidity (p<0.001). However, in the multivariable modified Poisson regression analysis, only the FHL score was significantly associated with multimorbidity (per 1-point increase, 0.91; 95% CI 0.84 to 0.99).ConclusionsAfter adjusting for confounding variables, FHL, not CCHL, was significantly related to the presence of multimorbidity. Further longitudinal studies are required to examine the causal relationship between health literacy and multimorbidity.
Serum 25-hydroxyvitamin D and risk of cancer in a large community population under investigation for cardiovascular disease: a retrospective cohort study
Authors: Yang Jaeun , Dong Yuan , Naugler Christopher T , de Koning Lawrence 
Published: January 2022

ObjectivesIt remains unclear whether vitamin D status is related to cancer risk. We examined this relationship using laboratory, administrative and survey data.DesignRetrospective cohort study.SettingAll care settings within Calgary, Alberta, Canada and surrounding rural communities.ParticipantsPatients tested for serum 25-hydroxyvitamin D from 2009 to 2013 without a past cancer diagnosis but with an ECG and body mass index ±3 months from testing were included. Age, sex, mean hours of daylight during month of testing were linked to census dissemination area-level indicators of socioeconomic status measured in 2011.Primary and secondary outcome measuresHospital discharge diagnoses for any cancer, major cancer (colorectal, breast, lung, prostate, skin) and other cancers >3 months from testing from 2009 to 2016. Cox proportional hazard models were used to examine associations with incident cancer after adjusting for potential confounders. Interactions were tested using multiplicative terms.ResultsAmong 72 171 patients, there were 3439 cancer diagnoses over a median of 5.9 years. After adjustment, increasing quartile of serum 25-OH vitamin D was significantly associated with an increased risk of any cancer and major cancer, however this was completely driven by an increased risk of skin cancer (Q4 vs Q1: HR=2.56, 95% CI 1.70 to 3.86, p for linear trend <0.01). This association was strengthened among individuals residing in communities with higher proportions of non-citizens, recent immigrants, visible (non-white) minorities and those not speaking an official Canadian language (English or French) at home.ConclusionsHigher vitamin D status was associated with a greater risk of skin cancer in a large community population under investigation for cardiovascular disease. This association was likely due to sun exposure and may be modified by community variation in vitamin D supplementation.
Clinical outcome measures and their evidence base in degenerative cervical myelopathy: a systematic review to inform a core measurement set (AO Spine RECODE-DCM)
Authors: Yanez Touzet Alvaro , Bhatti Aniqah , Dohle Esmee , Bhatti Faheem , Lee Keng Siang , Furlan Julio C , Fehlings Michael G , Harrop James S , Zipser Carl Moritz , Rodrigues-Pinto Ricardo , Milligan James , Sarewitz Ellen , Curt Armin , Rahimi-Movaghar Vafa , Aarabi Bizhan , Boerger Timothy F , Tetreault Lindsay , Chen Robert , Guest James D , Kalsi-Ryan Sukhvinder , McNair Angus GK , Kotter Mark , Davies Benjamin 
Published: January 2022

ObjectivesTo evaluate the measurement properties of outcome measures currently used in the assessment of degenerative cervical myelopathy (DCM) for clinical research.DesignSystematic reviewData sourcesMEDLINE and EMBASE were searched through 4 August 2020.Eligibility criteriaPrimary clinical research published in English and whose primary purpose was to evaluate the measurement properties or clinically important differences of instruments used in DCM.Data extraction and synthesisPsychometric properties and clinically important differences were both extracted from each study, assessed for risk of bias and presented in accordance with the Consensus-based Standards for the selection of health Measurement Instruments criteria.ResultsTwenty-nine outcome instruments were identified from 52 studies published between 1999 and 2020. They measured neuromuscular function (16 instruments), life impact (five instruments), pain (five instruments) and radiological scoring (five instruments). No instrument had evaluations for all 10 measurement properties and <50% had assessments for all three domains (ie, reliability, validity and responsiveness). There was a paucity of high-quality evidence. Notably, there were no studies that reported on structural validity and no high-quality evidence that discussed content validity. In this context, we identified nine instruments that are interpretable by clinicians: the arm and neck pain scores; the 12-item and 36-item short form health surveys; the Japanese Orthopaedic Association (JOA) score, modified JOA and JOA Cervical Myelopathy Evaluation Questionnaire; the neck disability index; and the visual analogue scale for pain. These include six scores with barriers to application and one score with insufficient criterion and construct validity.ConclusionsThis review aggregates studies evaluating outcome measures used to assess patients with DCM. Overall, there is a need for a set of agreed tools to measure outcomes in DCM. These findings will be used to inform the development of a core measurement set as part of AO Spine RECODE-DCM.
Well-being treatments in cancer care: patient benefits
Authors: Buiret Guillaume , Lantheaume Sophie 
Published: January 2022

ObjectivesWell-being care is widely offered and delivered in patients with cancer. However, very few studies have rigorously evaluated its benefits. The objective of this study was to evaluate the impact of four well-being treatments (foot reflexology, socio-aesthetics, sophrology and singing) provided in a healthcare facility.MethodsThree hundred and seventy-four patients with cancer were offered a well-being treatment and agreed to evaluate the type of treatment received, the benefits felt as a result, and numerical evaluation scales for pain and well-being before and after the session.ResultsThe distribution of well-being treatments provided was as follows: foot reflexology: 19.0%, socio-aesthetics: 63.9%, sophrology: 6.7%, singing: 10.4%. The average gain in pain relief was 1.01 on a scale of 0–10 (p<10−5) and on well-being 6.97 on a scale of −10 to +10 (p<10−5). One patient (0.3%) experienced pain induced by a foot reflexology session and one patient (0.3%) experienced a deterioration in well-being following a singing session.ConclusionThe well-being treatments studied provided significant pain relief and increased well-being in patients with cancer after their completion.
Better opioid prescribing in an inpatient oncology unit: quality improvement project
Authors: Weil Anna , Vijeratnam Shan Shan , Potter Valerie , Teli Jaymi , Feuer David 
Published: January 2022

ObjectivesUnsafe opioid prescribing can lead to significant patient harm and improving standards is a national priority. This report summarises a three-stage process relating to opioid prescribing, which has led to a sustained improvement.MethodsOpioid prescriptions were reviewed retrospectively over a 4-year period in a tertiary cancer centre. The first audit cycle took place in 2017. When repeated in February 2020 following an opioid education programme implementation, prescribing remained poor. In September 2020, a quality improvement project (QIP) was developed with several interventions including opioid prescribing guidelines.ResultsThe first audit demonstrated that 76% met safe prescribing and 68% best practice. The second audit showed a deterioration in prescribing, 61% met safe prescribing and 39% best practice despite the implementation of an education programme. The QIP has led to an improvement in prescribing, at 4 months, 87% met safe prescribing and 56% best practice.ConclusionsDespite implementation of a medical education initiative, a marked deterioration in safe opioid prescribing occurred. A shift towards QI methodology led to a successful pilot of focused interventions and resulted in improved standards of safe prescribing.
Host transcriptome signatures in human faecal-washes predict histological remission in patients with IBD
Authors: Ungar Bella , Yavzori Miri , Fudim Ella , Picard Orit , Kopylov Uri , Eliakim Rami , Shouval Dror , Levin Yishai , Savidor Alon , Ben-Moshe Shani , Manco Rita , Dan Stav , Egozi Adi , Bahar Halpern Keren , Mayer Chen , Barshack Iris , Ben-Horin Shomron , Itzkovitz Shalev 
Published: January 2022

BackgroundColonoscopy is the gold standard for evaluation of inflammation in inflammatory bowel diseases (IBDs), yet entails cumbersome preparations and risks of injury. Existing non-invasive prognostic tools are limited in their diagnostic power. Moreover, transcriptomics of colonic biopsies have been inconclusive in their association with clinical features.AimsTo assess the utility of host transcriptomics of faecal wash samples of patients with IBD compared with controls.MethodsIn this prospective cohort study, we obtained biopsies and faecal-wash samples from patients with IBD and controls undergoing lower endoscopy. We performed RNAseq of biopsies and matching faecal-washes, and associated them with endoscopic and histological inflammation status. We also performed faecal mass-spectrometry proteomics on a subset of samples. We inferred cell compositions using computational deconvolution and used classification algorithms to identify informative genes.ResultsWe analysed biopsies and faecal washes from 39 patients (20 IBD, 19 controls). Host faecal-transcriptome carried information that was distinct from biopsy RNAseq and faecal proteomics. Transcriptomics of faecal washes, yet not of biopsies, from patients with histological inflammation were significantly correlated to one another (p=5.3×10−12). Faecal-transcriptome had significantly higher statistical power in identifying histological inflammation compared with transctiptome of intestinal biopsies (150 genes with area under the curve >0.9 in faecal samples vs 10 genes in biopsy RNAseq). These results were replicated in a validation cohort of 22 patients (10 IBD, 12 controls). Faecal samples were enriched in inflammatory monocytes, regulatory T cells, natural killer-cells and innate lymphoid cells.ConclusionsFaecal wash host transcriptome is a statistically powerful biomarker reflecting histological inflammation. Furthermore, it opens the way to identifying important correlates and therapeutic targets that may be obscured using biopsy transcriptomics.
Evaluation of biochar products at two inclusion levels on ruminal in vitro methane production and fermentation parameters in a Timothy hay-based diet
Authors: Mengistu G. F. , McAllister T. A. , Tamayao P. J. , Ominski K. H. , Ribeiro G. O. , Okine E. K. , McGeough E. J. 
Published: January 2022

This study evaluated the effects of seven biochar products at two levels of inclusion [2.25% or 4.50% diet dry matter (DM)] on DM disappearance (DMD), cumulative gas and methane (CH4) production, ammonia-nitrogen, and volatile fatty acid (VFA) production from Timothy grass hay over 48 h of incubation. Biochar did not affect gas and CH4 production (P ≥ 0.17) nor the DMD or ruminal fermentation (P ≥ 0.12). In conclusion, the biochar, irrespective of level of inclusion, did not exhibit potential to mitigate CH4 emission in a grass hay diet.