bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peak Loads Associated With High-Impact Physical Activities in Children
Authors: Fassett Zach , Jagodinsky Adam E. , Thomas David Q. , Williams Skip M. 
Published: February 2022

Physical activities involving impact loading are important for improving bone strength and mineral density in children. There is little research quantifying impact loads associated with various high-impact activities. Purpose: Examine the magnitude of peak ground reaction forces (pGRF) across different jumping activities in children. Methods: Eight children between 8 and 12 years (9.63 [1.49] y; 1.42 [0.08] m; 33.69 [4.81] kg), performed 5 trials of a broad jump, countermovement jump, jumping jack, leap jump, and drop jump on a force plate. The pGRF were determined during the landing phase of each activity and expressed in units of body weight (BW). A repeated-measures analysis of variance was employed to assess differences in pGRF across activities. Results: Drop jump exhibited the greatest pGRF (3.09 [0.46] BW) in comparison with the vertical jumping jack (2.56 [0.21] BW; P < .001) and countermovement jump (2.45 [0.22] BW; P = .001), as well as the horizontal broad jump (2.25 [0.2] BW; P = .003), and leap jump (2.01 [0.1] BW; P = .002). Conclusion: Peak loads between 2 and 3.1 BW were exhibited across each jump activity, which is moderate compared with magnitudes in most jump interventions seeking to improve bone health. All conditions except drop jump exhibited loading <3 BW, suggesting these activities may not produce sufficient loads to improve bone outcomes.
Sex, military occupation and rank are associated with risk of anterior cruciate ligament injury in tactical-athletes
Authors: Aguero Aubrey D , Irrgang J J , MacGregor A J , Rothenberger S D , Hart J M , Fraser J J 
Published: February 2022

IntroductionAnterior cruciate ligament (ACL) injury is common within the US military and represents a significant loss to readiness. Since recent changes to operational tempo, there has not been an analysis of ACL injury risk. The aim of this retrospective cohort study was to evaluate military occupation, sex, rank and branch of service on ACL injury risk in the US military from 2006 to 2018.MethodsThe Defense Medical Epidemiology Database was queried for the number of US tactical athletes with International Classification of Diseases diagnosis codes 717.83 (old disruption of ACL), 844.2 (sprain of knee cruciate ligament), M23.61 (other spontaneous disruption of ACL) and S83.51 (sprain of ACL of knee) on their initial encounter. Relative risk and χ2statistics were calculated to assess sex and military occupation effects on ACL injury. A multivariable negative binomial regression model evaluated changes in ACL injury incidence with respect to sex, branch of service and rank.ResultsThe study period displayed a significant decrease in the ACL injury rate at 0.18 cases per 1000 person-years or relative decrease of 4.08% each year (p<0.001) after averaging over the main and interactive effects of sex, rank and branch of service. The interaction effect of time with sex indicated a steeper decline in the incidence in men as compared with women. The risk of ACL injury by sex was modified by rank. The incidence among military personnel varied by occupation.ConclusionDespite the decline among tactical athletes over time, rates of ACL injury remain much higher than the general US population. Sex, rank, branch of service and military occupation were found to be risk factors for ACL injury. It is critical for policy makers to understand the salient risk factors for ACL injury to guide proactive measures to prevent injury.
Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study
Authors: Fatusi Adesegun , Riley Taylor , Kayembe Patrick K , Mabika Crispin 
Published: February 2022

ObjectivesTo estimate age-specific abortion incidence and unintended pregnancy in Kinshasa, Democratic Republic of Congo and compare care experiences between adolescents (15–19 years) and older women (20–49 years).DesignWe used the age-specific variant of the Abortion Incidence Complications Method to estimate abortion and unintended pregnancy, with data from three primary sources: Health Facility Survey (n=361) provided postabortion care (PAC) caseloads; Prospective Morbidity Survey (n=1031) provided the age distribution and characteristics of women presenting for PAC and Health Professional Survey (n=115) provided an estimate of the proportion of abortions resulting in facility-based treatment of complications. Bivariate (χ2, t-test) and multivariable (binary logistic regression, Cox proportional hazard) analyses were used to compare abortion care experiences.SettingHealth facilities proving PAC in Kinshasa.ParticipantsWomen who presented to PAC facilities with abortion complications and their care providers.Primary and secondary outcome measuresThe primary measures were abortion incidence and proportion of pregnancies unintended. The secondary measures were the odd of reporting specific abortion care experiences.ResultsAdolescents had an estimated 27 590 induced abortions, constituting 18.8% of abortions in Kinshasa in 2016. Adolescents had the lowest abortion rate among women less than 35 years (55.2/1000 women) but the highest rate among ever sexually active women (138.4/1000) and recently sexually active women (167.2/1000). Also, adolescents had the highest abortion ratio (82.4/100 live births), proportion of pregnancies unintended (80%) and proportion of unintended pregnancies ending in abortion (49%). Compared with older women, adolescents had higher odds of reporting pregnancy unintendedness (adjusted OR, AOR 1.36, 95% CI 1.75 to 2.24), seeking abortion at later than first trimester (AOR 1.34, 95% CI 1.09 to 1.63) and from non-medical professionals (AOR 1.68, 95% CI 1.31 to 2.14), and not using contraceptives before pregnancy (AOR 2.23, 95% CI 2.77 to 3.43) or postabortion (AOR 2.46, 95% CI 1.87 to 3.29).ConclusionsInterventions are needed to reduce unintended pregnancy among adolescents in Kinshasa and improve their abortion care experiences.
Design of the HEM-POWR study: a prospective, observational study of
real-world treatment with damoctocog alfa pegol in patients with haemophilia
A
Authors: Sanabria Martin , Álvarez Román María Teresa , Castaman Giancarlo , Janbain Maissaa , Matsushita Tadashi , Meijer Karina , Oldenburg Johannes , Friedl Sabine , Reding M T 
Published: February 2022

Introduction
Haemophilia A is a rare bleeding disorder caused by defects in
coagulation factor VIII (FVIII). Damoctocog alfa pegol (BAY 94–9027,
Jivi, Bayer, Germany) is a site-specifically PEGylated,
extended-half-life, recombinant FVIII, approved for use in previously
treated patients (PTPs) aged ≥12 years with haemophilia A. However, a
real-world evidence regarding routine clinical use of damoctocog alfa
pegol is limited.

Methods and analysis
HEM-POWR is a multinational, multicentre, non-interventional,
prospective, postmarketing cohort study evaluating the effectiveness and
safety of real-world treatment with damoctocog alfa pegol. Estimated
enrolment is ≥200 PTPs with haemophilia A, receiving damoctocog alfa
pegol (on-demand, prophylaxis or intermittent prophylaxis (as per local
label)), observed for 36 months. Primary outcomes are total bleeding
events and annualised bleeding rate; secondary outcomes include
long-term safety, joint health, pharmacokinetics, patient-reported
outcomes (PROs) from validated questionnaires and perioperative
haemostasis. Where applicable, reasons for switching to damoctocog alfa
pegol, choice of treatment regimen and dose will also be captured.
Exploratory and descriptive statistical analyses will be performed, and
will be stratified by parameters including, but not limited to,
prophylaxis regimen and haemophilia severity. Patients can record bleeds
and consumption in electronic (e) Diaries, ePROs, and can access
non-promotional study information (videos explaining study procedures)
via an online patient portal. Optionally, patients can enrol in the
LIFE-ACTIVE substudy designed to investigate the relationship between
activity (measured by the ActiGraph CP Insight watch) and effectiveness
parameters collected from HEM-POWR.

Ethics and dissemination
Study approval was obtained by local independent ethics committees
and authorities in participating study centres across Europe, the
Americas and Asia. Informed consent from patients or their legal
representative is a requirement for participation. The study results
will be submitted for publication in a peer-reviewed scientific journal
and presented at scientific conferences.

Trial registration numbers
NCT03932201, EUPAS26416.

Protocol version and date
V.1.2, 27 September 2019.
Protection levels of N95-level respirator substitutes proposed during the COVID-19 pandemic: safety concerns and quantitative evaluation procedures
Authors: Ballard David H , Dang Audrey J , Kumfer Benjamin M , Weisensee Patricia B , Meacham J Mark , Scott Alex R , Ruppert-Stroescu Mary , Burke Broc A , Morris Jason , Gan Connie , Hu Jesse , King Bradley , Jammalamadaka Udayabhanu , Sayood Sena , Liang Stephen , Choudhary Shruti , Dhanraj David , Maranhao Bruno , Millar Christine , Bertroche J Tyler , Shomer Nirah , Woodard Pamela K , Biswas Pratim , Axelbaum Richard , Genin Guy , Williams Brent J , Meacham Kathleen 
Published: February 2022

ObjectiveThe COVID-19 pandemic has precipitated widespread shortages of filtering facepiece respirators (FFRs) and the creation and sharing of proposed substitutes (novel designs, repurposed materials) with limited testing against regulatory standards. We aimed to categorically test the efficacy and fit of potential N95 respirator substitutes using protocols that can be replicated in university laboratories.SettingAcademic medical centre with occupational health-supervised fit testing along with laboratory studies.ParticipantsSeven adult volunteers who passed quantitative fit testing for small-sized (n=2) and regular-sized (n=5) commercial N95 respirators.MethodsFive open-source potential N95 respirator substitutes were evaluated and compared with commercial National Institute for Occupational Safety and Health (NIOSH)-approved N95 respirators as controls. Fit testing using the 7-minute standardised Occupational Safety and Health Administration fit test was performed. In addition, protocols that can be performed in university laboratories for materials testing (filtration efficiency, air resistance and fluid resistance) were developed to evaluate alternate filtration materials.ResultsAmong five open-source, improvised substitutes evaluated in this study, only one (which included a commercial elastomeric mask and commercial HEPA filter) passed a standard quantitative fit test. The four alternative materials evaluated for filtration efficiency (67%–89%) failed to meet the 95% threshold at a face velocity (7.6 cm/s) equivalent to that of a NIOSH particle filtration test for the control N95 FFR. In addition, for all but one material, the small surface area of two 3D-printed substitutes resulted in air resistance that was above the maximum in the NIOSH standard.ConclusionsTesting protocols such as those described here are essential to evaluate proposed improvised respiratory protection substitutes, and our testing platform could be replicated by teams with similar cross-disciplinary research capacity. Healthcare professionals should be cautious of claims associated with improvised respirators when suggested as FFR substitutes.
Changes in arterial stiffness indices during a single haemodialysis session in end-stage renal disease population: a systematic review and meta-analysis protocol
Authors: Fortier Catherine , Obeid Hasan , Paré Mathilde , Garneau Charles-Antoine , Sidibé Aboubacar , Boutouyrie Pierre , Agharazii Mohsen 
Published: February 2022

IntroductionPatients with end-stage renal disease are at higher risk of cardiovascular morbidity and mortality, a risk mediated in part by increased aortic stiffness. Arterial stiffness is assessed at different anatomical locations (central elastic or peripheral muscular arteries) using a variety of mechanical biomarkers. However, little is known on the robustness of each of these mechanical biomarkers following a haemodynamic stress caused by a single haemodialysis (HD) session.Methods and analysisA systematic review has been designed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. A targeted search strategy applicable in key databases (PubMed, Embase, the Cochrane Library, Web of Science and grey literature) is constructed to search articles and reviews from inception to 16 October 2020. Only articles of studies conducted with adults under chronic HD for kidney failure, with repeated measures of arterial stiffness metrics (pulse wave velocity, Augmentation Index, arterial distensibility or stiffness) following a before-and-after design surrounding a HD session will be selected. The screening process, data extraction and assessment of risk bias will be done by two independent pairs of reviewers. Meta-analysis will enable adjustments for potential confounders and subgroup analyses will be performed to discriminate changes in arterial stiffness metrics from elastic, muscular or global arterial territories.Ethics and disseminationThis study does not require ethical approval. Findings will be submitted for publication to relevant peer-reviewed journals and will be presented at profession-specific conferences.PROSPERO registration numberCRD42020213946.
Barriers and facilitators to interdisciplinary communication during consultations: a qualitative study
Authors: Liu Pingyang , Lyndon Audrey , Holl Jane L , Johnson Julie , Bilimoria Karl Y , Stey Anne M 
Published: February 2022

ObjectiveCommunication failures between clinicians lead to poor patient outcomes. Critically injured patients have multiple injured organ systems and require complex multidisciplinary care from a wide range of healthcare professionals and communication failures are abundantly common. This study sought to determine barriers and facilitators to interdisciplinary communication between the consulting trauma, intensive care unit (ICU) team and specialty consultants for critically injured patients at an urban, safety-net, level 1 trauma centre.DesignAn observational qualitative study of barriers and facilitators to interdisciplinary communication.SettingWe conducted observations of daily rounds in two trauma surgical ICUs and recorded the most frequently consulted teams.ParticipantsKey informant interviews after presenting clinical vignettes as discussion prompts were conducted with a broad range of clinicians from the ICUs and physicians and nurse practitioners from the consultant teams who were identified during the observations. Interviews were recorded and transcribed verbatim. Data of these 10 interviews were combined with primary transcript data from prior study (25 interviews) and analysed together because of the same setting with same themes. Independent coding of the transcripts, with iterative reconciliation, was performed by two coders.Outcomes measuresFacilitators and barriers of interdisciplinary communication were identified.ResultsA total of 35 interview transcripts were analysed. Cardiology and interventional radiology were the most frequently consulted teams. Consulting and consultant clinicians reported that perceived accessibility from the team seeking a consultation and the consultant team impacted interdisciplinary communication. Accessibility had a physical dimension as well as a psychological dimension. Accessibility was demonstrated by responsiveness between clinicians of different disciplines and in turn facilitated interdisciplinary communication. Social norms, cognitive biases, hierarchy and relationships were reported as both facilitators and barriers to accessibility, and therefore, interdisciplinary communication.ConclusionAccessibility impacted interdisciplinary communication between the consulting and the consultant team.Article summaryElucidates barriers and facilitators to interdisciplinary communication between consulting and consultant teams.
Prelacteal feeding practice and its determinant factors among mothers
having children less than 6 months of age in Bure district, Northwest
Ethiopia: a community-based cross-sectional study
Authors: Mose Ayenew , Abebe Haimanot 
Published: February 2022

Objective
The main aim of this study was to assess prelacteal feeding practice
and its determinant factors among mothers having children less than 6
months of age in Bure district, Northwest Ethiopia.

Design
Community-based cross-sectional study design.

Setting
Northern Ethiopia.

Participants
The present study was conducted among 621 mothers who had children
less than 6 months of age in Bure district, Northwest Ethiopia, from 1
March 2019 to 30 March 2019.

Primary outcome
Mothers prelacteal feeding practice, modelled using multivariable
logistic regression.

Secondary outcome
Determinant factors of prelacteal feeding practice.

Results
This study found that the prevalence of prelacteal feeding practice
was 11.6% ((95% CI 9.0% to 14.2%)). Delayed initiation of breast feeding
(adjusted OR, AOR=5.4, 95% CI 2.2 to 13.5), mothers who did not get
counselling of breast feeding (AOR=2.9, 95% CI 1.2 to 7.2), home
delivery (AOR=6.9, 95% CI 2.2 to 21.5), primiparous mothers (AOR=4.1,
95% CI 1.4 to 12.2), a newborn with history of neonatal illness
(AOR=3.3, 95% CI 1.3 to 8.5) and lack of postnatal care visits (AOR=3.9,
95% CI 1.3 to 11.8) were determinant factors of prelacteal feeding
practice.

Conclusions
Delayed initiation of breast feeding, mothers who did not get
counselling of breast feeding, home delivery, primiparous mothers,
newborns with a history of neonatal illness and lack of postnatal care
visits were determinant factors of prelacteal feeding practice.
Therefore, healthcare workers should provide a home to home health
education for mothers on the merits of early initiation of breast
feeding, promote institutional delivery, enhance maternal health-seeking
behaviour and encourage mothers to have postnatal care visits is
recommended.
Systematic review on the use of patient-held health records in low-income and middle-income countries
Authors: Joseph Linju , Lavis Anna , Greenfield Sheila , Boban Dona , Humphries Claire , Jose Prinu , Jeemon Panniyammakal , Manaseki-Holland Semira 
Published: February 2022

ObjectiveTo review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs).MethodsThe literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar.ResultsSix observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients’ experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition.ConclusionLimited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions.PROSPERO registration numberCRD42019139365.
Effectiveness of low-dose amitriptyline and mirtazapine for insomnia disorder: study protocol of a randomised, double-blind, placebo-controlled trial in general practice (the DREAMING study)
Authors: Bakker Mette H , Hugtenburg Jacqueline G , van Straten Annemieke , van der Horst Henriëtte E , Slottje Pauline 
Published: February 2022

IntroductionFor over more than a decade, low-dose amitriptyline and mirtazapine are prescribed off-label for insomnia. However, placebo-controlled evidence on these antidepressants for insomnia is still lacking. Therefore, the present trial aims to assess the effectiveness of low-dose amitriptyline (10–20 mg/day) and mirtazapine (7.5–15 mg/day) in patients with insomnia disorder with difficulty maintaining sleep or early-morning awakening problems in general practice.Methods and analysisThe Drug REdiscovery: low-dose Amitriptyline and Mirtazapine for INsomnia disorder in General practice (DREAMING) study is a randomised, double-blind, placebo-controlled trial in about 50 general practices. Adults (18–85 years) with insomnia disorder (Diagnostic and Statistical Manual of Mental Disorders-5) who ask their general practitioner (GP) for sleep medication when non-pharmacological treatment is deemed not effective, are eligible. Exclusion criteria: isolated sleep initiation problem, contraindications for or drug–drug interactions with either amitriptyline or mirtazapine. Participants (n=156) will be randomly assigned to three parallel treatment groups of 16-week treatment with either amitriptyline (one or two tablets of 10 mg/day) or mirtazapine (one or two tablets of 7.5 mg/day) or placebo (one or two tablets) alongside usual GP care. All participants start and end with single dose, but dose can be doubled following GP consultation in week 3. Questionnaire assessments will be conducted at baseline, week 6, 12, 20 and 52. The primary study outcome is self-reported insomnia severity at 6 weeks, measured with the Insomnia Severity Index (ISI) in an intention to treat analysis. Secondary outcomes include subjective sleep quality quantified by sleep indices, daytime functioning and symptoms, safety and treatment evaluation and other sleep care consumption.Ethics and disseminationThe Medical Ethics Committee of the VU Medical Centre Amsterdam approved this trial. The results of this trial will be published in peer-reviewed scientific journals and presented at relevant academic conferences and to key stakeholders.Trial registration numberNTR7449.