bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Acute Physical Fatigue and Cognitive Function During Orthostatic Challenge in Men and Women: A Neuroergonomics Investigation
Authors: Mehta Ranjana K. , Nuamah Joseph 
Published: July 2020

Background Postflight orthostatic challenge (OC), resulting from blood pooling in lower extremities, is a major health concern among astronauts that fly long-duration missions. Additionally, astronauts undergo physical demanding tasks resulting in acute fatigue, which can affect performance. However, the effects of concurrent OC and acute physical fatigue on performance have not been adequately investigated. Objective The purpose of this study was to determine the relationship between acute physical fatigue and cognitive function during OC. Methods Sixteen healthy participants performed the mental arithmetic task and psychomotor tracking tasks in the absence and presence of a prior 1-hour physically fatiguing exercise, on separate days under OC (induced via lower body negative pressure). We recorded task performances on the cognitive tests and prefrontal cortex oxygenation using functional near-infrared spectroscopy, along with physiological and subjective responses. Results The introduction of the cognitive tasks during OC increased cerebral oxygenation; however, oxygenation decreased significantly with the cognitive tasks under the acute fatigue conditions, particularly during the tracking task and in males. These differences were accompanied by comparable task performances. Discussion The findings suggest that mental arithmetic is a more effective countermeasure than psychomotor tracking under acute physical fatigue during OC. Whereas females did not show a significant difference in cerebral oxygenation due to task, males did, suggesting that it may be important to consider gender differences when developing countermeasures against OC.
Diaphragmatic hernia: a rare complication of hepatic ablation
Authors: Macmillan Mark T , Lim Shueh Hao , Ireland Hamish M 
Published: July 2020

Introduction Ablation has become an effective treatment for small hepatocellular carcinomas (HCC). Whilst ablation is a safe and effective technique, diaphragmatic injury is a rarely associated but significant complication. Case presentation: We present a case of a 67 year old patient who developed a diaphragmatic defect following microwave ablation (MWA) for HCC. The diaphragmatic defect progressed to herniation which was complicated by perforation of intrahernial large bowel. The patient was treated by emergency laparotomy and an extended right hemi-colectomy was performed. Conclusion Our report adds to the current available knowledge on diaphragmatic injury following hepatic ablation and demonstrates the potential for life threatening consequences associated with this complication.
Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease
Authors: Çevik Nazan , Akalın Yavuz , Avci Özgür , Çınar Ali , Öztürk Alpaslan , Özkan Yüksel 
Published: July 2020

Background: No consensus has been reached in the treatment of Frieberg disease. Our aim was to evaluate medium- to long-term results of patients with advanced Freiberg disease managed with extensor digitorum brevis tendon interpositional arthroplasty. Methods: There were 24 patients (19 females, 5 males) managed with interpositional arthroplasty for advanced Freiberg disease between 2003 and 2015. The mean follow-up was 133.8 (range, 60-198) months. According to Smillie classification, there were 4 grade 3, 13 grade 4, and 7 grade 5 patients. Patients were evaluated preoperatively and at the final follow-up with the American Orthopaedic Foot & Ankle Society (AOFAS) score and metatarsophalangeal joint range of motion and postoperatively with visual analog scale (VAS) and subjective satisfaction evaluation. Joint space was evaluated on x-rays. Results: Mean AOFAS score increased (53.9 to 80.3, P = .001). Eight patients had excellent, 14 had good, and 2 had fair scores. A significant increase was found in dorsiflexion (38.1° [24°-52°] vs 55.3° [34°-65°]; P = .001) and plantarflexion (19.0° [10°-28°] vs 28.6° [19°-39°]; P = .001). Narrowing of the joint space was not seen in any patient, but expansion was determined in all patients (0.39 [0.35-0.47] vs 0.44 [0.41-0.47] cm; P = .002). Of the patients, 9 were very satisfied, 12 were satisfied, 2 were moderately satisfied, and 1 was dissatisfied. The mean postoperative VAS pain score was 1.7 ± 0.9 (0-4). Conclusion: After a minimum 5-year follow-up, most patients with Freiberg disease managed with interpositional arthroplasty using the extensor digitorum brevis tendon had excellent to good functional results with a widening of the joint space. Level of Evidence: Level IV, retrospective case series.
The Gut Microbiome as a Component of the Gut–Brain Axis in Cognitive Health
Authors: Gao Wen , Baumgartel Kelley L. , Alexander Sheila A. 
Published: July 2020

Introduction: The human microbiome, the microorganisms living in and on the body, plays a vital role in brain physiology and pathophysiology. The gut microbiome (GMB) has been identified as a link in the gut–brain axis moderating cognitive development and health. Objectives: The objectives of this scoping review are to discuss mechanisms of the microbiome–gut–brain axis in cognition, review the existing literature on the GMB and cognition, and discuss implications for nursing research. Methods: We searched Pubmed using the terms “gut microbiome,” “brain,” and “cognition” and the terms “gut brain axis,” “microbiome,” and “cognition”; removed duplicates, studies not published in English, and unrelated publications; and added additional articles identified through references. We retained the 85 most relevant publications for this review. Results: Common themes in the current literature include GMB components; interactions on cognitive development; effects of GMB–gut–brain interactions on cognition, mild cognitive impairment and Alzheimer’s disease; effects of GMB interactions with physiologic stress on cognition in critical care; and GMB modification for improved cognition. Review of the literature on each of these topics reveals multiple theoretical mechanisms of action for GMB–gut–brain interaction that modify cognitive development and function across the lifespan. Discussion: GMB components and dysbiosis have been implicated in many cognitive states, and specific microbiota constituents contribute to cognitive development, stability, and impairment. The study of these interactions is relevant to nursing research as it addresses the holistic human experience and microbiome constituents are modifiable, facilitating translation into the clinical setting.
Optical coherence tomography angiography in myopic peripapillary intrachoroidal cavitation complicated by choroidal neovascularization
Authors: Comune Chiara , Montorio Daniela , Cennamo Gilda 
Published: July 2020

Purpose: To detect the vessel density (VD) of the radial peripapillary capillary (RPC) in eyes affected by pathological myopia with or without a peripapillary intrachoroidal cavitation (PICC) and in eyes with PICC complicated by choroidal neovascularization (CNV), using optical coherence tomography angiography (OCTA). Methods: We prospectively enrolled highly myopic patients from January 2016 to December 2019 at the Eye Clinic of the University of Naples “Federico II.” We divided included patients into three groups: group 1 including patients with PICC complicated by CNV; group 2 including patients with PICC without complications; group 3 including patients with high myopia without PICC and CNV. One-way analysis of variance (ANOVA) followed by Bonferroni post hoc analysis was used to evaluate differences in VD of radial peripapillary capillary (RPC) in papillary whole, peripapillary regions and its sectors among the three groups. Results: We enrolled 12 highly myopic eyes with PICC complicated by CNV, 21 highly myopic eyes with PICC without CNV and 23 highly myopic eyes without PICC. The myopic eyes with PICC revealed a statistically significant reduction in VD of the RPC comparing to the other groups ( p < 0.001), especially in eyes affected by myopic PICC complicated by CNV ( p < 0.001). These results were similar analyzing the VD in different sectors of the peripapillary region among the three groups ( p < 0.001). Conclusion: OCTA detects the changes in peripapillary vascular density of highly myopic eyes. We demonstrated that the RPC vasculature is significantly influenced by the presence of PICC, especially in myopic eyes developing a CNV.
A systematic review of intrapersonal coach development programs: Examining the development and evaluation of programs to elicit coach reflection
Authors: Silva Eduardo Jorge Da , Evans M Blair , Lefebvre Jordan S , Allan Veronica , Côté Jean , Palmeira António 
Published: July 2020

Background The current approaches used to develop coaches within many sport organisations extend beyond merely the professional knowledge related to sport-specific aspects. Effective coaching notably entails intrapersonal skills related to learning through experience and developing one’s own approach, and these skills are often targeted in coach development. Recognising that researchers have delivered Coach Development Programs (CDPs) that use strategies like reflective practice to foster coaches’ strategies and attitudes toward reflection, reviewing research in this domain could inform the development of our field. We conducted the current review to examine nonformal intrapersonal CDPs within the academic literature with goals of summarising existing CDPs, while also identifying factors related to their implementation. Method: The PRISMA guidelines informed our search strategy, including a database search along with supplemental strategies to identify studies. In addition to describing the CDPs generally, each study was also coded for: (a) potential to be implemented and maintained in sport contexts, (b) behaviour change techniques (BCTs), and (c) risk of bias. Results: After screening the full-texts of studies, we identified 10 unique intrapersonal CDPs. Most CDPs entailed pilot investigations of small samples, involving both qualitative and quantitative methods focused on coaches’ experiences when using reflective strategies. The majority of CDPs were conducted in-person and in one-on-one contexts. The most frequently used BCT was self-monitoring of behaviour, and low-to-moderate information was reported regarding internal and external validity. Conclusions: Whereas reflective practice may enable coach development, researchers must seek opportunities to design higher-quality intervention studies that are designed to enhance both internal and external validity.
Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review
Authors: D’Amico Ferdinando , Wexner Steven D , Vaizey Carolynne J , Gouynou Célia , Danese Silvio , Peyrin‐Biroulet Laurent 
Published: July 2020

BackgroundFecal incontinence is a disabling condition affecting up to 20% of women.ObjectiveWe investigated fecal incontinence assessment in both inflammatory bowel disease and non‐inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials.MethodsWe searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non‐inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019.ResultsIn total, 328 studies were included; 306 studies enrolled non‐inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non‐inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies.ConclusionBased on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.
Efficacy and safety of galcanezumab for prevention of migraine headache in Japanese patients with episodic migraine: A phase 2 randomized controlled clinical trial
Authors: Sakai Fumihiko , Ozeki Akichika , Skljarevski Vladimir 
Published: July 2020

Objective: This study was designed to assess the efficacy and safety of galcanezumab in comparison with placebo for the prevention of migraine in Japanese patients with episodic migraine. Methods: In this double-blind, placebo-controlled study, which was conducted over 6 months, randomized adult patients received subcutaneous injections of galcanezumab (120 mg n = 115, 240 mg n = 114) or placebo ( n = 230) once monthly. The primary endpoint was the overall mean change from baseline in the number of monthly migraine headache days. The key secondary outcome measures were response rates (≥50%, ≥75%, and 100%); the Migraine-Specific Quality-of-Life Questionnaire Role Function-Restrictive score; monthly migraine headache days requiring acute treatment; and Patient Global Impression of Severity (PGI-S). Results: The mean change from baseline in monthly migraine headache days over months 1–6 was significantly ( p < 0.001) greater for the 120-mg galcanezumab dose (−3.60 days) and the 240-mg galcanezumab dose (−3.36 days) compared with placebo (−0.59 days). Both the 120-mg and 240-mg doses of galcanezumab were superior compared with placebo for each of the key secondary endpoints except for PGI-S (only the 240-mg dose was superior). The most commonly reported treatment-emergent adverse events were local injection-site reactions; erythema, swelling, pruritus, and pain were more commonly reported by patients who were treated with galcanezumab than those treated with placebo. Conclusion: The number of monthly migraine headache days was reduced with both doses of galcanezumab, and both doses were safe and well tolerated in Japanese patients with episodic migraine.
A randomised crossover comparison of two endotracheal tube introducers: the FROVA and the Flexible Tip Bougie for GlideScope intubation of a difficult airway manikin by infrequent intubators
Authors: Cormack John , Langley Bridget , Bhanabhai Louisa-Rose , Kluger Roman 
Published: July 2020

AbstractBackgroundThis unblinded randomised crossover study compares two endotracheal tube introducers (ETIs): the FROVA and the “Flexible Tip Bougie” (FTB), in an airway manikin mimicking difficult intubation with a percentage of glottic opening view of 30%. Participants were Emergency Medicine and Anaesthesia trainees with recent experience of less than twenty patient intubations. The primary outcome was time to intubation, further divided into time taken to pass the ETI and time to railroad the endotracheal tube (ETT) over the ETI. The secondary outcome was the difficulty of intubation.ResultsThe median total time to ETT placement was significantly shorter with the FTB (37.5 s) compared with the FROVA ETI (63.0 s),P= 0.0006. The median difficulty reported (scores 0–10 with 0 being no difficulty) with the FTB was 2 compared with 5 for the FROVA,P< 0.0001.ConclusionsThe FTB enabled significantly faster and easier placement of the endotracheal tube compared with the FROVA in inexperienced hands intubating a difficult intubation manikin.
Safety evaluation of root extract of Pueraria lobata and Scutellaria baicalensis in rats
Authors: Song Jungbin , Kim Young-Sik , Lee Donghun , Kim Hocheol 
Published: July 2020

Abstract
Background
The roots of Pueraria lobata and Scutellaria baicalensis, herbal medicines with a long history of widespread use, have been traditionally prescribed in combination to treat stroke, diabetes, and acute infectious diarrhea in East Asia. Nevertheless, toxicological data on these herbs and their combination are limited. This study investigated the acute and 13-week subchronic toxicity of root extract of P. lobata and S. baicalensis (HT047) for stroke treatment in male and female Sprague-Dawley rats.

Methods
In the acute toxicity study, HT047 was administered orally at a single dose of 5000 mg/kg. In the subchronic toxicity study, HT047 was administered orally at repeated daily doses of 800, 2000, and 5000 mg/kg/day for 13 weeks, followed by a 4-week recovery period.

Results
In the acute toxicity study, there were no deaths or toxicologically significant changes in clinical signs, body weight, and necropsy findings. In the subchronic toxicity study, HT047 at all doses caused no death and no treatment-related adverse effects on food consumption; organ weight; ophthalmologic, urinalysis, and hematological parameters; and necropsy findings of both rat sexes. There were some treatment-related alterations in clinical signs, body weight, and serum biochemistry and histopathological parameters; however, these changes were not considered toxicologically significant because they were resolved during the recovery period or resulted from the pharmacological effects of P. lobata and S. baicalensis.

Conclusions
The oral approximate lethal dose (the lowest dose that causes mortality) of HT047 was greater than 5000 mg/kg in male and female rats. The oral no-observed-adverse-effect level of HT047 was greater than 5000 mg/kg/day in rats of both sexes, and no target organs were identified. The present findings support the safety of an herbal extract of P. lobata and S. baicalensis as a therapeutic agent for stroke and further confirm the safety of the combined use of P. lobata and S. baicalensis in clinical practice.
The SPLUNC1-βENaC complex prevents Burkholderia cenocepacia invasion in normal airway epithelia
Authors: Ahmad Saira , Kim Christine Seul Ki , Tarran Robert 
Published: July 2020

AbstractCystic fibrosis (CF) patients are extremely vulnerable to Burkholderia cepacia complex (Bcc) infections. However, the underlying etiology is poorly understood. We tested the hypothesis that short palate lung and nasal epithelial clone 1 (SPLUNC1)–epithelial sodium channel (ENaC) interactions at the plasma membrane are required to reduce Bcc burden in normal airways. To determine if SPLUNC1 was needed to reduce Bcc burden in the airways, SPLUNC1 knockout mice and their wild-type littermates were infected with B. cenocepacia strain J2315. SPLUNC1 knockout mice had increased bacterial burden in the lungs compared to wild-type littermate mice. SPLUNC1-knockdown primary human bronchial epithelia (HBECs) were incubated with J2315, which resulted in increased bacterial burden compared to non-transduced HBECs. We next determined the interaction of the SPLUNC1-ENaC complex during J2315 infection. SPLUNC1 remained at the apical plasma membrane of normal HBECs but less was present at the apical plasma membrane of CF HBECs. Additionally, SPLUNC1-βENaC complexes reduced intracellular J2315 burden. Our data indicate that (i) secreted SPLUNC1 is required to reduce J2315 burden in the airways and (ii) its interaction with ENaC prevents cellular invasion of J2315.
Self-reported health status and disease-specific quality of life one year after treatment for peripheral arterial disease in clinical practice
Authors: Larsen Anne Sofie F. , Reiersen Anne Therese , Nådland Inger Helene , Wesche Jarlis 
Published: July 2020

AbstractBackgroundVascuQoL-6 (VQ-6) is a disease-specific quality of life (QoL) instrument validated for use in clinical practice and vascular registries before and after treatment for peripheral arterial disease (PAD). To improve future interpretation of self-reported outcome, an unselected cohort was followed through one year to provide observational data after both conservative and invasive treatment.MethodsConsecutive patients with intermittent claudication (IC) or critical limb ischemia (CLI) were included. All patients completed VQ-6 and Short Form-36 (SF-36), and were evaluated with ankle-brachial index (ABI) measurement pre- and post-exercise, a constant load treadmill test and clinical consultation at baseline and after one year. Change statistics and correlation analysis were used to describe self-reported outcome after conservative and invasive treatment for PAD.ResultsOne hundred seventy-one patients with peripheral arterial disease (PAD) were included, 70 (41%) female. 147 (86%) of the patients suffered from IC. 136 (80%) patients had one-year follow up, death, amputation and withdrawal were the major causes of loss to follow-up. Forty-eight patients (35%) evaluated their health to be unchanged compared to one year ago. There was a strong correlation between self-reported general health status based on SF-36 item 2 and VQ-6 summary score (Spearmans rho = − 0.536). Patients admitted to invasive intervention (endovascular or surgery) improved in all domains of SF-36, and in the physical component summary score (SF-36 PCS). Patients admitted to best medical treatment, smoking cessation and walking exercise (conservative group) improved only in the physical domains. There was significant improvement in VQ-6 summary score for both groups, mean 2.20 (95%CI 1.14–3.27) in the conservative group, 4.68 (95%CI 3.67–5.70) in the invasive group. VQ-6 sum score improved more than four points for 56% in the invasive group, 36% in the conservative group.ConclusionsTreatment for symptomatic PAD, both invasive and conservative, improves self-reported health status and disease specific QoL after one year. Interpretation of patient-reported outcome measured with VQ-6 after surgery or endovascular treatment must be seen in light of the improvement from conservative treatment alone.Trial registrationISRCTN14846962(retrospectively registered).