bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function
Authors: Moolhuijsen Loes M E , Visser Jenny A 
Published: August 2020

Abstract

Context
Anti-müllerian hormone (AMH) is produced by granulosa cells of small, growing follicles in the ovary. Serum AMH levels strongly correlate with the number of growing follicles, and therefore AMH has received increasing attention as a marker for ovarian reserve. This review summarizes recent findings and limitations in the application of serum AMH in ovarian reserve assessment.

Evidence Acquisition
A PubMed search was conducted to find recent literature on the measurements and use of serum AMH as a marker for ovarian reserve.

Evidence Synthesis
Serum AMH levels are measured to assess the “functional ovarian reserve,” a term that is preferred over “ovarian reserve,” since AMH levels reflect the pool of growing follicles that potentially can ovulate. Serum AMH levels are used in individualized follicle-stimulating hormone dosing protocols and may predict the risk of poor response or ovarian hyperstimulation syndrome but has limited value in predicting ongoing pregnancy. Serum AMH levels are studied to predict natural or disease-related age of menopause. Studies show that the age-dependent decline rates of AMH vary among women. The generalized implementation of serum AMH measurement has also led to an increase in diagnostic assays, including automated assays. However, direct comparison of results remains problematic.

Conclusion
Serum AMH remains the preferred ovarian reserve marker. However, the lack of an international standard for AMH limits comparison between AMH assays. Furthermore, little is known about endogenous and exogenous factors that influence serum AMH levels, which limits proper interpretation of AMH values in a clinical setting.
Intraoperative Data Enhance the Detection of High-Risk Acute Kidney Injury Patients When Added to a Baseline Prediction Model
Authors: Kim Minjae , Li Gen , Mohan Sumit , Turnbull Zachary A. , Kiran Ravi P. , Li Guohua 
Published: August 2020

BACKGROUND:
Aspects of intraoperative management (eg, hypotension) are associated with acute kidney injury (AKI) in noncardiac surgery patients. However, it is unclear if and how the addition of intraoperative data affects a baseline risk prediction model for postoperative AKI.

METHODS:
With institutional review board (IRB) approval, an institutional cohort (2005–2015) of inpatient intra-abdominal surgery patients without preoperative AKI was identified. Data from the American College of Surgeons National Surgical Quality Improvement Program (preoperative and procedure data), Anesthesia Information Management System (intraoperative data), and electronic health record (postoperative laboratory data) were linked. The sample was split into derivation/validation (70%/30%) cohorts. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL within 48 hours or >50% within 7 days of surgery. Forward logistic regression fit a baseline model incorporating preoperative variables and surgical procedure. Forward logistic regression fit a second model incorporating the previously selected baseline variables, as well as additional intraoperative variables. Intraoperative variables reflected the following aspects of intraoperative management: anesthetics, beta-blockers, blood pressure, diuretics, fluids, operative time, opioids, and vasopressors. The baseline and intraoperative models were evaluated based on statistical significance and discriminative ability (c-statistic). The risk threshold equalizing sensitivity and specificity in the intraoperative model was identified.

RESULTS:
Of 2691 patients in the derivation cohort, 234 (8.7%) developed AKI. The baseline model had c-statistic 0.77 (95% confidence interval [CI], 0.74–0.80). The additional variables added to the intraoperative model were significantly associated with AKI (P < .0001) and the intraoperative model had c-statistic 0.81 (95% CI, 0.78–0.83). Sensitivity and specificity were equalized at a risk threshold of 9.0% in the intraoperative model. At this threshold, the baseline model had sensitivity and specificity of 71% (95% CI, 65–76) and 69% (95% CI, 67–70), respectively, and the intraoperative model had sensitivity and specificity of 74% (95% CI, 69–80) and 74% (95% CI, 73–76), respectively. The high-risk group had an AKI risk of 18% (95% CI, 15–20) in the baseline model and 22% (95% CI, 19–25) in the intraoperative model.

CONCLUSIONS:
Intraoperative data, when added to a baseline risk prediction model for postoperative AKI in intra-abdominal surgery patients, improves the performance of the model.
A Methyltransferase Inhibitor (Decitabine) Alleviates Intergenerational Effects of Paternal Neonatal Exposure to Anesthesia With Sevoflurane
Authors: Xu Ning , Lei Lei , Lin Yunan , Ju Ling-Sha , Morey Timothy E. , Gravenstein Nikolaus , Yang Jianjun , Martynyuk Anatoly E. 
Published: August 2020

BACKGROUND:
Neonatal exposure to sevoflurane induces neurobehavioral and neuroendocrine abnormalities in exposed male rats (generation F0) and neurobehavioral, but not neuroendocrine, abnormalities in their male, but not female, offspring (generation F1). These effects of sevoflurane are accompanied by a hypermethylated neuron-specific K+-2Cl− (Kcc2) Cl− exporter gene in the F0 spermatozoa and the F1 male hypothalamus, while the gene’s expression is reduced in the F0 and F1 hypothalamus. We investigated whether inhibition of deoxyribonucleic acid methyltransferases (DNMTs) before paternal sevoflurane exposure could alleviate the anesthetic’s F0 and F1 effects.

METHODS:
Sprague-Dawley male rats were anesthetized with 2.1% sevoflurane for 5 hours on postnatal day (P) 5 and mated with control females on P90 to generate offspring. The nonselective DNMT inhibitor decitabine (0.5 mg/kg, intraperitoneally) was administered 30 minutes before sevoflurane exposure. The F0 and F1 male rats were evaluated in in vivo and in vitro tests in adulthood.

RESULTS:
Paternal exposure to sevoflurane induced impaired prepulse inhibition of the acoustic startle response and exacerbated corticosterone responses to stress in F0 males and impaired prepulse inhibition of the startle responses in F1 males. These effects were accompanied in both generations by reduced and increased expressions of hypothalamic Kcc2 and Dnmt3a/b, respectively. Decitabine deterred the effects of paternal exposure to sevoflurane in F0 and F1 males.

CONCLUSIONS:
These results suggest that similar decitabine-sensitive mechanisms regulating expression of multiple genes are involved in the mediation of neurobehavioral abnormalities in sires neonatally exposed to sevoflurane and in their future unexposed male offspring.
A 30-Min Rest Protocol Does Not Affect W′, Critical Power, and Systemic Response
Authors: TRISKA CHRISTOPH , HOPKER JAMES , WESSNER BARBARA , REIF ASTRID , TSCHAN HARALD , KARSTEN BETTINA 
Published: August 2020

ABSTRACT

Purpose
This study aimed to assess and compare the systemic response of oxygen uptake kinetics and muscle deoxygenation between a 30-min rest protocol and a multivisit protocol on the parameters of the power–duration relationship (i.e., critical power [CP] and W′).

Methods
Nine endurance-trained triathletes reported to the laboratory on five occasions: a preliminary graded exercise test and a familiarization, a 30-min single-visit protocol (time trials of 10, 5, and 2 min in that order interspersed with 30 min rest), and a multivisit protocol (time trials of 10, 5, and 2 min in randomized order interspersed by >24 h rest). Heart rate (HR) was recorded continuously, respiratory gases were measured breath by breath, and deoxygenation was recorded at 10 Hz using near-infrared spectroscopy (NIRS) during all tests. Blood lactate (BLa−) concentration was measured before all time trials. Maximal HR (HRmax), oxygen uptake (V˙O2) during the first 2 min (V˙O2onset), mean response time, end-exercise V˙O2 (V˙O2peak), V˙O2 amplitude (amplV˙O2), O2 deficit, NIRS τ, amplitude (amplNIRS), and time delay were assessed. To compare the two protocols and to assess the differences in W′ and CP, a paired sample t-test was used as well as a two-way ANOVA to assess the differences between trials and/or protocols, including trial–protocol interactions.

Results
No significant differences, and trivial effect sizes, were found for W′ and CP between protocols (P = 0.106–0.114, d < 0.01–0.08). Furthermore, no significant differences between protocols were found for all parameters, except for [BLa−]. Significant differences between trials were found for V˙O2ampl, V˙O2onset, NIRS τ, amplNIRS, [BLa−], and HRmax.

Conclusion
Results suggest that W′ and CP can be determined using the 30-min rest protocol without confounding effects of previous severe exercise compared with the multivisit protocol.
Mortality Effects of Hypothetical Interventions on Physical Activity and TV Viewing
Authors: YANG YI , HODGE ALLISON M. , DUGUÉ PIERRE-ANTOINE , WILLIAMSON ELIZABETH J. , GARDINER PAUL A. , BARR ELIZABETH L. M. , OWEN NEVILLE , DUNSTAN DAVID W. , LYNCH BRIGID M. , ENGLISH DALLAS R. 
Published: August 2020

ABSTRACT

Introduction
Long-term effects of physical activity and television (TV) viewing on mortality have been inferred from observational studies. The associations observed do not allow for inferences about the effects of population interventions and could be subject to bias due to time-varying confounding.

Methods
Using data from the Australian Diabetes, Obesity and Lifestyle Study, collected in 1999–2000 (T0), 2004–2005 (T1), and 2011–2012 (T2), we applied the parametric g-formula to estimate cumulative risks of death under hypothetical interventions on physical activity and/or TV viewing determined from self-report while adjusting for time-varying confounding.

Results
In the 6377 participants followed up for 13 yr from 2004 to 2005 to death or censoring in 2017, 781 participants died. The observed cumulative risk of death was 12.2%. The most effective hypothetical intervention was to increase weekly physical activity to >300 min (risk ratio (RR), 0.66 (0.46–0.86) compared with a “worst-case” scenario; RR, 0.83 (0.73–0.94) compared with no intervention). Reducing daily TV viewing to <2 h in addition to physical activity interventions did not show added survival benefits. Reducing TV viewing alone was least effective in reducing mortality (RR, 0.85 (0.60–1.10) compared with the worst-case scenario; RR, 1.06 (0.93–1.20) compared with no intervention).

Conclusions
Our findings suggested that sustained interventions to increase physical activity could lower all-cause mortality over a 13-yr period, and there might be limited gain from intervening to reduce TV viewing time in a relatively healthy population.
Cockpit Temperature as an Indicator of Thermal Strain in Sports Car Competition
Authors: BARTHEL SAMUEL C. , FERGUSON DAVID P. 
Published: August 2020

ABSTRACT
Under current Federation Internationale de l’Automobile (FIA) rules, the maximum cockpit temperature allowed in endurance sports car racing is dictated by the external ambient temperature (FIA Technical Regulation: 901-1). In the event that cockpit temperature exceeds ambient temperature, the race car driver is required to stop until the temperature has reduced. However, it is not known if cockpit temperature is an accurate measure of thermal strain on the driver.

Purpose
This study aimed to evaluate the relationship between race car cockpit temperature and thermal strain indicators among race car drivers.

Methods
Four male racing drivers’ heart rate (HR), skin temperature (T
skin), and core temperature (T
core) were measured continuously using the Equivital Life Monitor bio harness, and physiological strain index (PSI) was calculated during a hot (ambient temperature of 34.1°C ± 2.8°C) 6-h endurance race. Only data collected during green flag racing laps were analyzed.

Results
Cross-sectional analyses showed that cockpit temperature did not have a significant relationship with percent of HRmax, T
skin, T
core, or PSI (P > 0.05) during the race. Cockpit temperature decreased during driving time, whereas percent of HRmax, T
skin, T
core, and PSI increased (P < 0.05).

Conclusion
Cockpit temperature does not correlate with measures of race car driver thermal strain. Therefore, metrics to determine driver thermal strain should include direct monitoring of the race car driver.
Healthcare Resource Utilization and Costs in Celiac Disease: A US Claims Analysis
Authors: Cappell Katherine , Taylor Aliki , Johnson Barbara H. , Gelwicks Steve , Wang Song , Gerber Michele , Leffler Daniel A. 
Published: August 2020

INTRODUCTION:
Celiac disease (CeD) is a lifelong immune-mediated enteropathy in which dietary gluten triggers an inflammatory reaction in the small intestine. This retrospective cohort study examines healthcare resource utilization (HRU) and costs between patients with CeD and matched controls.

METHODS:
Patients with CeD (cases) with an endoscopic biopsy and ≥2 medical encounters with a CeD diagnosis between January 1, 2010, and October 1, 2015, were identified in the MarketScan databases. The date of the first claim with a CeD diagnosis on or after the endoscopic biopsy was the index date. Cases were matched 1:1 to patients without CeD (controls) on demographic characteristics and Deyo-Charlson Comorbidity Index score. Clinical characteristics, all-cause, and CeD-related HRU and costs (adjusted to 2017 US dollars) were compared between cases and controls during the 12 months before (baseline) and 24 months after (follow-up) the index date.

RESULTS:
A total of 11,008 cases (mean age 40.6 years, 71.3% women) were matched to 11,008 controls. During the follow-up, a higher proportion of cases had all-cause and CeD-related HRU including inpatient admissions, emergency department visits, gastroenterologist visits, dietician visits, endoscopic biopsies, and gastroenterology imaging (all P ≤ 0.002). Incremental all-cause and CeD-related costs were in the first ($7,921 and $2,894) and second ($3,777 and $935) year of follow-up, driven by outpatient services costs.

DISCUSSION:
In this US national claims database analysis, there was evidence of an increase in both all-cause and CeD-related HRU and related costs in patients with CeD compared with matched patients without CeD, suggesting a significant economic burden associated with CeD.
Social Determinants of Outcomes in Inflammatory Bowel Disease
Authors: Bernstein Charles N. , Walld Randy , Marrie Ruth Ann 
Published: August 2020

INTRODUCTION:
In a population-based inflammatory bowel disease (IBD) cohort, we aimed to determine whether having lower socioeconomic status (LSS) impacted on outcomes.

METHODS:
We identified all 9,298 Manitoba residents with IBD from April 1, 1995, to March 31, 2018 by applying a validated case definition to the Manitoba Health administrative database. We could identify all outpatient physician visits, hospitalizations, surgeries, intensive care unit admissions, and prescription medications. Their data were linked with 2 Manitoba databases, one identifying all persons who received Employment and Income Assistance and another identifying all persons with Child and Family Services contact. Area-level socioeconomic status was defined by a factor score incorporating average household income, single parent households, unemployment rate, and high school education rate. LSS was identified by any of ever being registered for Employment and Income Assistance or with Child and Family Services or being in the lowest area-level socioeconomic status quintile.

RESULTS:
Comparing persons with LSS vs those without any markers of LSS, there were increased rates of annual outpatient physician visits (relative risk [RR] = 1.10, 95% confidence interval [CI] = 1.06–1.13), hospitalizations (RR = 1.38, 95% CI = 1.31–1.44), intensive care unit admission (RR = 1.94, 95% CI = 1.65–2.27), use of corticosteroids >2,000 mg/yr (RR = 1.12, 95% CI = 1.03–1.21), and death (hazard ratio 1.53, 95% CI = 1.36–1.73). Narcotics (RR = 2.17, 95% CI = 2.01–2.34) and psychotropic medication use (RR = 1.98, 95% CI = 1.84–2.13) were increased. The impact of LSS was greater for those with Crohn's disease than for those with ulcerative colitis.

DISCUSSION:
LSS was associated with worse outcomes in persons with IBD. Social determinants of health at time of diagnosis should be highly considered and addressed.
Smoking and Colorectal Cancer Risk, Overall and by Molecular Subtypes: A Meta-Analysis
Authors: Botteri Edoardo , Borroni Elisa , Sloan Erica K. , Bagnardi Vincenzo , Bosetti Cristina , Peveri Giulia , Santucci Claudia , Specchia Claudia , van den Brandt Piet , Gallus Silvano , Lugo Alessandra 
Published: August 2020

INTRODUCTION:The aim of this study was to provide the most comprehensive and up-to-date evidence on the association between cigarette smoking and colorectal cancer (CRC) risk.METHODS:We conducted a systematic review and meta-analysis of epidemiological studies on the association between cigarette smoking and CRC risk published up to September 2018. We calculated relative risk (RR) of CRC according to smoking status, intensity, duration, pack-years, and time since quitting, with a focus on molecular subtypes of CRC.RESULTS:The meta-analysis summarizes the evidence from 188 original studies. Compared with never smokers, the pooled RR for CRC was 1.14 (95% confidence interval [CI] 1.10–1.18) for current smokers and 1.17 (95% CI 1.15–1.20) for former smokers. CRC risk increased linearly with smoking intensity and duration. Former smokers who had quit smoking for more than 25 years had significantly decreased risk of CRC compared with current smokers. Smoking was strongly associated with the risk of CRC, characterized by high CpG island methylator phenotype (RR 1.42; 95% CI 1.20–1.67; number of studies [n] = 4),BRAFmutation (RR 1.63; 95% CI 1.23–2.16; n = 4), or high microsatellite instability (RR 1.56; 95% CI 1.32–1.85; n = 8), but not characterized byKRAS(RR 1.04; 95% CI 0.90–1.20; n = 5) orTP53(RR 1.13; 95% CI 0.99–1.29; n = 5) mutations.DISCUSSION:Cigarette smoking increases the risk of CRC in a dose-dependent manner with intensity and duration, and quitting smoking reduces CRC risk. Smoking greatly increases the risk of CRC that develops through the microsatellite instability pathway, characterized by microsatellite instability-high, CpG island methylator phenotype positive, andBRAFmutation.
Synthesis and Characterization of Benzodithiophene (BDT) Quinoid Compounds as a Potential Compound for n-Type Organic Thin-Film Transistors (OTFT)
Authors: Ariefin Mokhamat , Ayudha Vety Sri Harlinda 
Published: August 2020

Two potential compounds as an n-Type organic thin-film transistor (OTFT) from benzodithiophene (BDT) derivatives have been synthesized and characterized. BDT was chosen as the core because it has π-conjugated bonds, rigid structures, and planar. Quinoid structure with end-cap (terminal group) in the form of dicyanomethylene is used because it can lower the LUMO value of the compound, and side chains are selected in the form of alkoxy so that two BDT derivatives are obtained namely BDTQ-6 (hexyloxy) and BDTQ-10 (decyloxy). Based on the results of TGA, BDTQ-6 and BDTQ-10 have decomposition points of 183°C and 203°C, which indicate the compound has excellent thermal stability. From the UV-Vis measurement, the λmax value of the two compounds is 599 nm with optical gap energy (Eg°pt) of 1.7 eV. From the DPV measurement, the LUMO value for the two compounds is -4.3 eV, with an energy gap (Eg) of 1.69 eV (BDTQ-6) and 1.70 eV (BDTQ-10). Based on observations of the crystal structure through x-ray diffraction, it was found that the BDTQ-10 crystal has a "brick type" layer arrangement with a distance between layers of 3.55 Å. With excellent thermal stability and suitable LUMO values and energy gaps, it is expected that BDTQ-6 and BDTQ-10 compounds have the potential to be n-Type OTFT materials.
Sections of the Brief-Balance Evaluation Systems Test Relevant for Discriminating Fast Versus Slow Walking Speeds in Community-Dwelling Older Women
Authors: Shinohara Tomoyuki , Saida Kosuke , Miyata Kazuhiro , Usuda Shigeru 
Published: August 2020

Background and Purpose:
Walking speed can be used to identify characteristics of frailty in older adults. It has a strong positive correlation with balance abilities. The Brief-Balance Evaluation Systems Test (Brief-BESTest) was developed to assess functions of the 6 balance control systems in a short time. However, for community-dwelling older adults, the relationship between walking speed and the Brief-BESTest needs to be clarified. Even the cutoff scores for each Brief-BESTest section should be indicated for physical therapists to effectively evaluate balance deficits. Our objective was to establish cutoff scores for individual Brief-BESTest sections, determine fast or slow walkers in community-dwelling older adults, and investigate the relationship between balance control systems and walking speed.

Methods:
In a cross-sectional study involving 55 participants 77 years and older, the Brief-BESTest was evaluated after grouping the participants based on their walking speeds in public community centers. We compared the age, history of falls, handgrip strength, quadriceps strength, appendicular skeletal muscle mass index, comfortable walking speeds, and the Brief-BESTest scores between the fast- and slow-walking groups by using the independent t test, Fisher exact test, or Mann-Whitney U test. We also determined the receiver operating characteristic curves, and calculated the cutoff, area under the curve (AUC), sensitivity, and specificity of each section.

Results:
All sections of the Brief-BESTest, except Section 1 (Biomechanical Constraints) were able to differentiate between fast and slow walkers in community-dwelling older women. Section VI (Stability in Gait) showed the highest AUC (0.83) and the cutoff score for the fast- and slow-walker groups was 3.0 points (sensitivity = 0.85, specificity = 0.81). Sections III, IV, and V (Anticipatory, Reactive, and Sensory Orientation, respectively) had moderate AUC (0.71-0.72). Sections I and II (Stability Limits) showed weak correlations with the walking speed.

Conclusions:
Three sections (III, anticipatory postural adjustments; IV, reactive postural responses; and VI, stability in gait) could differentiate between fast and slow walkers. Section VI was a particularly important balance function measurement that differentiated the walking speed with the highest accuracy. Therefore, it should be a primary focus when physical therapists treat community-dwelling older adults.