bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low serum testosterone levels and the incidence of chronic kidney disease among male adults: A prospective population‐based study
Authors: Amiri Mina , Ramezani Tehrani Fahimeh , Rahmati Maryam , Amanollahi Soudmand Saber , Behboudi‐Gandevani Samira , Sabet Zari , Azizi Fereidoun 
Published: November 2019

AbstractBackgroundDespite existing evidence regarding the role of testosterone as a protective factor for the kidney function in male adults, there are conflicting and inconclusive results on the influence of testosterone deficiency on developing chronic kidney disease (CKD).ObjectiveThis study aimed to investigate the incidence and hazard ratio of CKD among male adults with low testosterone levels compared to controls with normal testosterone levels.Materials and MethodsDuring a 15‐year follow‐up study, a total of 1277 eligible male adults aged 20‐80 year consisting of 605 males with low testosterone levels (< 350 ng/dL) and 672 controls with normal levels participating in the Tehran Lipid and Glucose Study were recruited. Cox's proportional hazards models were applied to estimate hazard ratios of CKD between the groups after adjusting for confounders.ResultsThe total cumulative incidence rate of CKD at the median follow‐up time of approximately 11.2 years was 21/1000 (95% CI: 18/1000, 25/1000) and 18/1000 (95% CI: 16/1000, 22/1000) in the low and normal testosterone groups, respectively (P = .2). The multivariate Cox model adjusted for age, body mass index, dyslipidemia, hypertension, diabetes, and smoking showed that HR of developing CKD in the male adults with low testosterone levels was significantly higher than those with normal levels (HR = 1.38; 95% CI: 1.05, 1.80).Discussion and conclusionThis study shows a higher hazard ratio of CKD progression in male adults with hypogonadism compared to those with normal levels in their later life. Therefore, timely diagnosis and treatment of kidney diseases in hypogonadal men can prevent the morbidity and mortality from CKD.
Climate change and the surgeon: what is the problem? Why is it so hard? What can be done?
Authors: Woodward Alistair 
Published: November 2019

AbstractWe know very well what causes climate change, and in general terms, what the dangers are. This is a new kind of environmental problem, it is not like taking lead out of petrol, and it is important to understand why responding to climate change is so challenging. But that is no reason to give up: in fact there are many opportunities to intervene, including actions that can be taken by surgeons and other health professionals.
“Changing behaviour, changing investment, changing operations”: Using citizen science to inform the management of an urban river
Authors: Cross Iain D. 
Published: November 2019

AbstractSignificant quantities of data are being collected by citizen scientists concerning environmental challenges. Networks of volunteers can collect data on spatial and temporal scales that may be beyond the resource and logistical capacities of the governmental bodies and other organisations that monitor and protect the environment. However, citizen science may be viewed with scepticism by decision makers and excluded from decision‐making because it is perceived as being of poor quality and lacking scientific credibility. This paper explores how citizen science has been used to inform the management of an urban river. It uses the example of the River Crane, a small urban river in London, UK, to demonstrate how data gathered through a volunteer project, Citizen Crane, supported decision‐making about the river. Through analysis of interviews with the project's leadership group, the paper examines how the project leadership team developed a high degree of credibility with stakeholders in the river management. This included drawing on the expertise of stakeholders to design the project and align the monitoring approaches with technical and scientific standards. Other factors of importance included open and professional communication between the Citizen Crane leadership team with regulators and businesses, and the development of shared understandings and expectations about the river's management. The leadership team drew on their professional experience to inform the design and management of the project, and to provide a conduit for data gathered by volunteer scientists to be embedded in decision‐making. The paper unpicks the ways in which citizen science challenges traditional notions of expertise in environmental decision‐making, and contributes to understanding how citizen science can support more legitimate and effective strategies for tackling complex socio‐environmental challenges.
Selected leukocyte subpopulations in peripheral blood and uterine washings in cows before and after intrauterine administration of cefapirin and methisoprinol
Authors: Brodzki Piotr , Lisiecka Urszula , Brodzki Adam , Krakowski Leszek , Szczubiał Marek , Dąbrowski Roman , Junkuszew Andrzej , Bochniarz Mariola 
Published: November 2019

AbstractThe aim of the study was to evaluate the selected lymphocyte subpopulations TCD4, TCD8, BCD21, BCD25, CD18, CD11b, and MHC II in blood and uterine flush of cows with endometritis, before and after intrauterine (i.u.) administration of cefapirin and methisoprinol. The research was carried out on 28 cows with clinical endometritis. Animals were divided into four groups, each composed of seven cows, depending on the i.u. preparation used: Group A, cefapirin; Group B, methisoprinol; Group C, cefapirin and methisoprinol simultaneously; and a control group—without medication. The study was performed using flow cytometry method. Summarizing the results of the research, i.u. infusion of cefapirin caused a weakening of the effector phase of the local uterine immune response; however, it enhanced leukocyte chemotaxis and antigen presentation. After i.u. administration of methisoprinol, the stimulation of specific uterine immunity mechanisms was mainly observed. The use of both mentioned preparations showed the strengthening of specific uterine immunological mechanisms presumably caused by methisoprinol, despite the inhibitory effect of the antibiotic. Intrauterine use of immunostimulatory substances can improve the effectiveness of the endometritis treatment in cows by improving specific local mechanisms of uterine immunity. As a consequence, it may enhance the effector function of immune competent cells and finally eliminate inflammation.
Effect of different pulse numbers of transcranial magnetic stimulation on motor cortex excitability: Single‐blind, randomized cross‐over design
Authors: Tang Zhi‐Ming , Xuan Chun‐Yu , Li Xin , Dou Zu‐Lin , Lan Yu‐Jie , Wen Hong‐Mei 
Published: November 2019

AbstractAimsWe aimed to investigate the effect of different pulse numbers of high‐frequency repetitive transcranial magnetic stimulation (rTMS) over the motor cortex on cortical excitability in healthy participants.MethodsFifteen healthy participants received 600 and 1200 pulses of 5‐Hz rTMS on separate days in a random order. Stimulation (duration, 2 seconds and interval, 1 seconds) was delivered over the left primary motor cortex for the hand, at 90% of resting motor threshold (rMT). The rMT and motor evoked potential (MEP) were measured before stimulation, and at 0 and 30 minutes after rTMS.ResultsNo significant differences were observed between the two conditions for MEP (P = .919) or rMT (P = .266). Compared with baseline, MEP was increased significantly at 0 (P < .001) and 30 minutes (P < .001) after stimulation. After stimulation, rMT was decreased at 0 minute for the 600 and 1200 pulse conditions (P < .001), but had recovered by 30 minutes (P = .073).ConclusionSubthreshold 5‐Hz rTMS increased motor cortex excitability in healthy humans. However, the number of pulses may exhibit a ceiling effect in that beyond a certain point, that is, increasing the number of pulses may exhibit no further increase in cortical excitability.
Routine postoperative intensive care unit admission after colorectal cancer surgery for the elderly patient reduces postoperative morbidity and mortality
Authors: Fahim M. , Visser R. A. , Dijksman L. M. , Biesma D. H. , Noordzij P. G. , Smits A. B. 
Published: November 2019

AbstractAimOlder colorectal cancer (CRC) patients are at increased risk of postoperative morbidity and mortality. Routine postoperative overnight intensive care unit (ICU) admission might reduce this risk. This study aimed to examine the effect of routine overnight ICU admission after CRC surgery on postoperative adverse outcomes and costs in patients aged 80 years or older.MethodsPatients aged 80 years or older who underwent CRC surgery in our centre were included in this observational cohort study. All patients in the period 2014–2017 with routine overnight ICU admission were assigned to the ICU cohort; all patients in the period 2009–2013 were assigned to the non‐ICU cohort. Multivariable logistic regression was performed to compare the primary composite end‐point (30‐day mortality, serious complications and readmission) between the groups. Cost data from the literature were used to perform a cost analysis.ResultsA total of 242 patients were included, 125 in the ICU cohort and 117 in the non‐ICU cohort. Routine overnight ICU admission was associated with a reduced risk of the composite end‐point (OR 0.44, 95% CI 0.22–0.87, P = 0.02) after adjusting for important confounders. In the ICU cohort 28% of patients experienced ICU events requiring intervention; this was not associated with postoperative morbidity or mortality. The 9% reduction in the incidence of serious complications in the ICU cohort is sufficient to offset the additional costs of routine overnight ICU admission.ConclusionRoutine overnight ICU admission after CRC surgery in patients aged 80 years and older is associated with reduced risk of postoperative mortality and morbidity and seems to be cost‐effective.
Suppression of AMP‐activated protein kinase reverses osteoprotegerin‐induced inhibition of osteoclast differentiation by reducing autophagy
Authors: Tong Xishuai , Zhang Chuang , Wang Dong , Song Ruilong , Ma Yonggang , Cao Ying , Zhao Hongyan , Bian Jianchun , Gu Jianhong , Liu Zongping 
Published: November 2019

AbstractObjectivesOsteoclasts (OC) are unique terminally differentiated cells whose primary function is bone resorption. We previously showed that osteoprotegerin (OPG) inhibits OC differentiation in vitro by enhancing autophagy via the adenosine monophosphate‐activated protein kinase (AMPK)/mTOR/p70S6K signalling pathway in vitro. Here, we aimed to elucidate the mechanism of AMPK mediated autophagy to regulate OPG‐mediated inhibition of OC differentiation and identify potential therapeutic targets associated with bone loss.Materials and MethodsWe used the AMPK activator AICAR to determine the relationship between AMPK activation and OC differentiation, and studied the role of AMPK‐mediated autophagy in OPG‐mediated inhibition of OC differentiation by using autophagy inhibitors or AMPK knockdown.ResultsAMP‐activated protein kinase activation caused LC3II accumulation and weakened OC differentiation activity. In contrast, inactivation of autophagy by 3‐methyladenine or Bafilomycin A1 could attenuate OPG‐mediated inhibition of OC differentiation via the AMPK/mTOR/p70S6K signalling pathway. Furthermore, the AMPK inhibitor compound C and knockdown of AMPK impaired OPG‐mediated inhibition of OC differentiation by inducing autophagy.ConclusionsThese results demonstrated that the AMPK signalling pathway functions as a critical regulator in the OPG‐mediated inhibition of OC differentiation, by inducing autophagy. Our results provide a basis for future bone‐related studies on the AMPK signalling pathway.
A randomized, double‐blind, placebo‐controlled, pharmacokinetic and pharmacodynamic study of a fixed‐dose combination of phentermine/topiramate in adolescents with obesity
Authors: Hsia Daniel S. , Gosselin Nathalie H. , Williams Jenna , Farhat Nada , Marier J. F. , Shih Winnie , Peterson Craig , Siegel Robert 
Published: November 2019

AbstractAimsTo assess the pharmacokinetic (PK) and pharmacodynamic characteristics of VI‐0521, a fixed‐dose combination of immediate‐release phentermine (PHEN) and extended‐release topiramate (TPM) in adolescents aged 12 to 17 years with obesity, and to report weight loss and adverse events using this drug combination.Materials and methodsThis was a multicentre, randomized, double‐blind, parallel‐design, placebo‐controlled study in adolescents with obesity. A total of 42 adolescents were randomly assigned in a 1:1:1 ratio to placebo, or to a mid‐dose (PHEN/TPM 7.5 mg/46 mg), or a top‐dose (PHEN/TPM 15 mg/92 mg) of VI‐0521. A total of 26 adolescents were included in the PK analysis (14 from the mid‐dose group and 12 from the top‐dose group).ResultsOn day 56, arithmetic means of terminal elimination half‐life, apparent clearance (CL/F) and apparent central volume of distribution (Vc/F) were consistent across dose levels for both PHEN and TPM. Arithmetic means of CL/F and Vc/F for PHEN and TPM administered as a combination in adolescents with obesity were within 10% to 30% of those previously assessed in adults with obesity enrolled in phase II and III studies. A higher proportion of adolescents in both the mid‐ and top‐dose groups (13.3% and 50.0%, respectively) compared with placebo (0.0%) reached ≥5% weight loss at day 56. The least squares (LS) mean change in systolic blood pressure from baseline to day 56 was −5.2 mmHg for the placebo group, −2.5 mmHg for the mid‐dose group, and − 5.5 mmHg for the top‐dose group. The LS mean change in diastolic blood pressure from baseline to day 56 was −2.4 mmHg for the placebo group, +3.8 mmHg for the mid‐dose group, and + 2.0 mmHg for the top‐dose group. Participants in the top‐dose group had increases in heart rate from baseline of 4.1 bpm, while participants in the mid‐dose group experienced a mean decrease in heart rate of 4.5 bpm at day 56. Both PHEN/TPM dose combinations were safe and well tolerated.ConclusionsTreatment of adolescents with obesity using a fixed‐dose combination of PHEN/TPM for 8 weeks resulted in exposure to PHEN and TPM that was comparable to that observed in adults, statistically significant weight loss, and a tolerable safety profile. These data indicate that both mid‐ and top‐dose levels are appropriate for longer‐term safety and efficacy studies in adolescents.
Liraglutide reduces hyperglycaemia and body weight in overweight, dysregulated insulin‐pump‐treated patients with type 1 diabetes: The Lira Pump trial—a randomized, double‐blinded, placebo‐controlled trial
Authors: Dejgaard Thomas F. , Schmidt Signe , Frandsen Christian S. , Vistisen Dorte , Madsbad Sten , Andersen Henrik U. , Nørgaard Kirsten 
Published: November 2019

AbstractAimTo investigate the efficacy of adding the glucagon‐like peptide‐1 receptor agonist liraglutide to continuous subcutaneous insulin infusion (CSII) in overweight or obese persons with type 1 diabetes and non‐optimal glycaemic control.Materials and methodsA 26‐week, randomized, double‐blind, placebo‐controlled trial including 44 overweight or obese adults with type 1 diabetes randomized 1:1 to liraglutide 1.8 mg once daily (QD) or placebo added to CSII treatment. The primary endpoint was change in haemoglobin A1c (HbA1c). Secondary endpoints included change in insulin dose, CSII settings, glycaemic variability, body weight and patient‐reported outcome measures. Finally, adverse effects including hypoglycaemic events were registered.ResultsHbA1c was reduced by 5 mmol/mol (0.5%) from a baseline of 66 mmol/mol (8.2%) in patients treated with liraglutide compared with a non‐significant change of +2.3 mmol/mol (0.2%) from a baseline of 66 mmol/mol (8.1%) in patients treated with placebo (between‐group difference 7 mmol/mol [0.7%], P < 0.001). Liraglutide reduced total insulin dose by 8 units/day or 16% of total insulin dose (P = 0.008). Mean body weight was reduced by 6.3 kg (P < 0.001) compared with placebo. Concomitantly, time spent in glycaemic target range 4–10 mmol/L (71–180 mg/dL) increased while the risk of hypoglycaemia did not differ between groups at the end of treatment.ConclusionLiraglutide treatment reduced HbA1c, total daily insulin dose and body weight without increasing the risk of hypoglycaemia in CSII‐treated patients with type 1 diabetes and insufficient glycaemic control. Liraglutide may be considered a potential add‐on therapy to insulin in this subgroup of patients.
How does dyslexia impact on the educational experiences of healthcare students? A qualitative study
Authors: Ali Kamran , Kisielewska Jolanta , Subhan Mirza Mohammad Feisal , Tredwin Christopher 
Published: November 2019

AbstractAimsTo explore the impact of dyslexia on the educational experiences of undergraduate students in medicine, dentistry, dental therapy and biomedical sciences.MethodsIt was a qualitative study based on semi‐structured interviews. The study was conducted at the Faculty of Medicine and Dentistry at a University in the South West region of the United Kingdom. Purposive sampling was used, and the participants included undergraduate students from the schools of medicine, dentistry and biomedical sciences.ResultsThe sample consisted of fifteen undergraduate students including five from medicine; four from dentistry; three from dental therapy; and three from biomedical sciences. All students had a formal diagnosis of Dyslexia. The students shared their views and experiences regarding disclosure, transition into the university, learning environments, assessments and challenges after graduation.ConclusionsThis is the first study to explore the impact of dyslexia on the educational experiences of healthcare students from multiple programmes in a variety of educational settings. The findings show that the students were confident regarding disclosure of their dyslexia and had a formal diagnosis of dyslexia established during their school years. Although the participants experienced typical academic difficulties associated with dyslexia, problem‐based learning (PBL) was perceived to be enjoyable and less stressful than traditional lectures and no specific challenges were reported in acquisition of clinical, communication and team‐working skills.
Exploring the pedagogical affordances of a collaborative board game in a dual language immersion classroom
Authors: Poole Frederick , Clarke‐Midura Jody , Sun Chongning , Lam Kyle 
Published: November 2019

AbstractIn this study, we present an educational board game designed to promote both mathematics and Chinese language learning. We use text‐mining techniques to analyze dialog by 40 students, in six groups playing a board game in a dual language immersion context. Our findings provide evidence to support past claims and arguments that play and specifically play within board games can provide a learning environment in which students can experiment with concepts and language without fear of failure. In our study, we not only found that learners were willing and excited to use their L2 skills within the context of the game but also that the board game promoted peer learning, which subsequently provided support for both math and language development.
A survey of world language cooperating teachers: Implications for teacher development
Authors: Moser Kelly M. , García Paul A. , Davis‐Wiley Patricia , Hernández Todd A. 
Published: November 2019

AbstractIn an era of long‐standing world language teacher shortages, the preservice mentoring process has become even more critical. Using data from a national survey, this study provides a profile of PreK–12 world language cooperating teachers (CTs) and shares their beliefs about and perspectives on the teacher candidates with whom they work, their interactions with postsecondary stakeholders, their reasons for serving as CTs, and the challenges that inhibit the smooth and meaningful induction of new colleagues into the profession. Implications highlight opportunities for reform in world language teacher development.
Long‐term physiological and growth responses of Himalayan fir to environmental change are mediated by mean climate
Authors: Panthi Shankar , Fan Ze‐Xin , van der Sleen Peter , Zuidema Pieter A. 
Published: November 2019

AbstractHigh‐elevation forests are experiencing high rates of warming, in combination with CO2rise and (sometimes) drying trends. In these montane systems, the effects of environmental changes on tree growth are also modified by elevation itself, thus complicating our ability to predict effects of future climate change. Tree‐ring analysis along an elevation gradient allows quantifying effects of gradual and annual environmental changes. Here, we study long‐term physiological (ratio of internal to ambient CO2, i.e., Ci/Caand intrinsic water‐use efficiency, iWUE) and growth responses (tree‐ring width) of Himalayan fir (Abies spectabilis) trees in response to warming, drying, and CO2rise. Our study was conducted along elevational gradients in a dry and a wet region in the central Himalaya. We combined dendrochronology and stable carbon isotopes (δ13C) to quantify long‐term trends in Ci/Caratio and iWUE (δ13C‐derived), growth (mixed‐effects models), and evaluate climate sensitivity (correlations). We found that iWUE increased over time at all elevations, with stronger increase in the dry region. Climate–growth relations showed growth‐limiting effects of spring moisture (dry region) and summer temperature (wet region), and negative effects of temperature (dry region). We found negative growth trends at lower elevations (dry and wet regions), suggesting that continental‐scale warming and regional drying reduced tree growth. This interpretation is supported by δ13C‐derived long‐term physiological responses, which are consistent with responses to reduced moisture and increased vapor pressure deficit. At high elevations (wet region), we found positive growth trends, suggesting that warming has favored tree growth in regions where temperature most strongly limits growth. At lower elevations (dry and wet regions), the positive effects of CO2rise did not mitigate the negative effects of warming and drying on tree growth. Our results raise concerns on the productivity of Himalayan fir forests at low and middle (<3,300 m) elevations as climate change progresses.
Unifying macroecology and macroevolution to answer fundamental questions about biodiversity
Authors: McGill Brian J. , Chase Jonathan M. , Hortal Joaquín , Overcast Isaac , Rominger Andrew J. , Rosindell James , Borges Paulo A. V. , Emerson Brent C. , Etienne Rampal S. , Hickerson Michael J. , Mahler D. Luke , Massol Francois , McGaughran Angela , Neves Pedro , Parent Christine , Patiño Jairo , Ruffley Megan , Wagner Catherine E. , Gillespie Rosemary 
Published: November 2019

AbstractThe study of biodiversity started as a single unified field that spanned both ecology and evolution and both macro and micro phenomena. But over the 20th century, major trends drove ecology and evolution apart and pushed an emphasis towards the micro perspective in both disciplines. Macroecology and macroevolution re‐emerged as self‐consciously distinct fields in the 1970s and 1980s, but they remain largely separated from each other. Here, we argue that despite the challenges, it is worth working to combine macroecology and macroevolution. We present 25 fundamental questions about biodiversity that are answerable only with a mixture of the views and tools of both macroecology and macroevolution.