bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of exercise training and sex on dynamic responses of O2 uptake in type 2 diabetes
Authors: Green Simon , Kiely Catherine , O’Connor Eamonn , Gildea Norita , O’Shea Donal , Egaña Mikel 
Published: March 2020

Effects of training and sex on oxygen uptake dynamics during exercise in type 2 diabetes mellitus (T2DM) are not well established. We tested the hypotheses that exercise training improves the time constant of the primary phase of oxygen uptake (τp oxygen uptake) and with greater effect in males than females. Forty-one subjects with T2DM were assigned to 2 training groups (Tmale, Tfemale) and 2 control groups (Cmale, Cfemale), and were assessed before and after a 12-week intervention period. Twelve weeks of aerobic/resistance training was performed 3 times per week, 60–90 min per session. Assessments included ventilatory threshold (VT), peak oxygen uptake, τp oxygen uptake (80%VT), and dynamic responses of cardiac output, mean arterial pressure and systemic vascular conductance (80%VT). Training significantly decreased τp oxygen uptake in males by a mean of 20% (Tmale = 42.7 ± 6.2 to 34.3 ± 7.2 s) and females by a mean of 16% (Tfemale = 42.2 ± 9.3 to 35.4 ± 8.6 s); whereas τp oxygen uptake was not affected in controls (Cmale = 41.6 ± 9.8 to 42.9 ± 7.6 s; Cfemale = 40.4 ± 12.2 to 40.6 ± 13.4 s). Training increased peak oxygen uptake in both sexes (12%–13%) but did not alter systemic cardiovascular dynamics in either sex. Training improved oxygen uptake dynamics to a similar extent in males and females in the absence of changes in systemic cardiovascular dynamics. Novelty Similar training improvements in oxygen uptake dynamics were observed in males and females with T2DM. In both sexes these improvements occurred without changes in systemic cardiovascular dynamics.
Menstruation and the Ṭawāf al-Ifāḍa
Authors: Nurgat Yahya 
Published: March 2020

Abstract
This article examines Ibn Taymiyya’s (d. 728/1328) unprecedented fatwas allowing menstruating female pilgrims to perform the ṭawāf al-ifāḍa, an essential rite of the hajj. In normative jurisprudential law, menstruating women are obliged to stay in Mecca and fulfil this rite only after returning to ritual purity. However, women in Ibn Taymiyya’s time found the prospect of staying in Mecca a difficult one, predominantly due to the risk of returning home without the protection of the hajj caravan. For modern pilgrims, bureaucratic and financial obstacles also make extending one’s stay in Mecca a difficult task. This paper examines how Ibn Taymiyya’s application of ḍarūra enabled him to provide legal recourse for the numerous female pilgrims affected by the consequences of menstruating while on the hajj. It also explores the extent to which contemporary scholars have engaged with his landmark ruling in order to assist Muslim women today.
Genealogy of Knowledge and Delegitimization of Universities: The Pseudo-Paracelsian Aurora Philosophorum
Authors: Bulang Tobias 
Published: March 2020

Abstract
This article introduces the pseudo-Paracelsian treatise Aurora Philosophorum (last third of the sixteenth century) and focusses on the contexts of a specific genealogy of knowledge presented in this text. It reaches from a divine origin of human knowledge to the universities of the author’s times. Here, the transfer of science throughout history is described as a process of continuous decline. The concept of knowledge negotiated by this text is conceptualized not as theory alone: knowledge has a genuine in­strumental and practical aspect. The article also presents the principles of the forthcoming edition and commentary of the handwritten and printed copies of the Aurora Philosophorum.
Coming to Terms in Namibia
Authors: Melber Henning 
Published: March 2020

Abstract
The South West African People’s Organisation (SWAPO of Namibia) had a unique status among anti-colonial movements. Fighting South Africa’s illegal occupation of South West Africa/Namibia, dubbed by the United Nations as a “trust betrayed,” it resorted to armed struggle in the 1960s. SWAPO was subsequently recognized as “the sole and authentic representative of the Namibian people” by a United Nations General Assembly resolution since the mid-1970s. The political culture in post-colonial Namibia is much characterized by the dominance of SWAPO as a former liberation movement and its official history. This paper summarizes the relevance of the armed struggle for the heroic narrative. It contrasts the glorification with some of the ‘hidden histories’ and trajectories related to some less documented realities of the armed struggle and its consequences which do not have much visibility in the official historiography. It thereby finally seeks to present a more nuanced picture by giving voice to some protagonists of a post-colonial political culture not considered as mainstream.
Skull Base Osteomyelitis Complicated by Petrous Internal Carotid Artery Blowout
Authors: Weitzman Rachel E. , Parikh Anuraag S. , Gadkaree Shekhar K. , Corrales C. Eduardo 
Published: March 2020

Skull base osteomyelitis (SBO) is an invasive infection of the external auditory canal, with involvement of the skull base, typically in the elderly diabetic population. Diagnosis may be challenging, as it requires a combination of clinical, laboratory, and radiographical findings. The mainstay of treatment is long-term antibiotic therapy, but surgical debridement of the temporal bone may be necessary in refractory cases. Commonly reported complications include cranial neuropathies, meningitis, temporal lobe abscess, and dural venous sinus thrombosis. A rare and life-threatening complication of SBO is petrous internal carotid artery (ICA) blowout, which has been described as presenting with bleeding from the ear. Here, we describe the case of a 77-year-old woman with SBO complicated by a petrous ICA blowout, which presented with fulminant epistaxis. To our knowledge, this is the second reported case of a massive hemorrhage from a petrous ICA blowout secondary to SBO and the first presentation with massive epistaxis. We present this case to raise awareness of this potential impending complication in patients with SBO and recommend consideration of this etiology when assessing patients with massive epistaxis in the appropriate clinical setting. Level of evidence: III
A Cross-Sectoral Comparison of Prevalence and Predictors of Symptoms of Depression Over Time Among Older Adults in Ontario, Canada
Authors: Neufeld Eva , Freeman Shannon , Spirgiene Lina , Horwath Urszula 
Published: March 2020

Objectives: Late-life depression, a common mental health issue, poses a significant burden of illness globally. We investigated factors associated with symptoms of depression among older adults across 3 health sectors in Ontario, Canada. Method: Electronic health assessment data on older adults aged 60 years+ in home care (HC; N = 359 217), long-term care (LTC; N = 125 496), and palliative care (PC; N = 29 934) were examined. Change in symptoms of depression, measured using the interRAI Depression Rating Scale (DRS), over time was examined, including predictors of the development of depression. Results: At baseline, symptoms of depression were observed in 19.1% (HC), 24.2% (LTC), and 11.9% (PC). This increased to 20.6% (HC), 33.8% (LTC), and 13.2% (PC) at follow-up. For most older adults, DRS scores remained the same across sectors over time. Three independent variables emerged consistently across sectors as the main risk and protective factors for symptoms of depression. Conclusion: Although variations in the risk and protective factors for late-life depression were demonstrated across each sector, some commonalities emerged including unmanaged pain, symptoms of depression at baseline, social connectedness, and activity.
Effect of Lateral Gutter Osteophyte Resection on Correction of Varus Deformity in Arthroscopic Ankle Arthrodesis
Authors: Saiga Kenta , Yokoo Suguru , Ohashi Hideki , Horita Masahiro , Furumatsu Takayuki , Ozaki Toshifumi 
Published: March 2020

Background: Recently, arthroscopic ankle arthrodesis has been performed for moderate-to-severe varus-deformed ankle osteoarthritis. However, the effect of osteophyte resection in the lateral gutter in arthroscopic ankle arthrodesis has not been clarified. We hypothesized that a varus-deviated ankle with lateral gutter osteophytes can be corrected by osteophyte resection. Methods: Thirty-nine ankles of 38 patients were included. The mean age of patients was 70.0 (45-83) years. The patients were divided into the following groups: group with an osteophyte in the lateral gutter (osteophyte) and group with no osteophytes (nonosteophyte). Preoperative and postoperative tibiotalar angle, tibial plafond angle, and tibiotalar angle under valgus stress, as well as the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, were recorded. Twelve ankles underwent lateral gutter osteophyte resection, whereas the other 27 ankles did not require osteophyte resection. Results: Preoperative tibiotalar angle was higher in the osteophyte group than in the nonosteophyte group (21.8 vs 11.2 degrees, P = .01). The tibiotalar angle in the preoperative valgus stress imaging was higher in the osteophyte group (12.9 vs 5.7, P < .01). However, the postoperative tibiotalar angle was similar between the 2 groups (7.1 vs 5.4, P = .183). JSSF ankle/hindfoot scale improved in both groups. Conclusion: Lateral gutter osteophyte resection enabled correction of the varus malalignment in arthroscopic ankle arthrodesis. Level of Evidence: Level III, retrospective comparative series.
Development and implementation of an electrolyte replacement protocol in the outpatient oncology infusion centers of a large academic healthcare system
Authors: Ajewole Veronica B , Solomon Jenna M , Schneider Amy M , Heyne Kirk E 
Published: March 2020

Background Patients receiving chemotherapy frequently experience electrolyte imbalances. Electrolyte replacement is, therefore, a necessity as patients may experience life-threatening symptoms. Study objective: The objective of this study was to evaluate the occurrence of low serum potassium and magnesium, and identify the rate of replacement for patients with low serum potassium and magnesium levels. Based on our findings, we developed and implemented a nursing-driven electrolyte replacement protocol. Methods Preimplementation phase – A retrospective review for serum potassium and magnesium values obtained during infusion clinic visit between 1 August and 31 October 2016 was conducted. Implementation phase – A nursing-driven electrolyte replacement protocol with medication order “smart-set” and order selection intelligence within EPIC Beacon was developed and implemented in May 2017. Postimplementation phase – The postimplementation phase data were collected from 1 August to 30 November 2017 using a similar approach as the preimplementation phase. Results Preimplementation phase – During the preimplementation phase of the study, a total of 1495 serum potassium levels and 1193 serum magnesium levels were obtained. Among the 152 patients who needed potassium replacement, 34% ( n = 52) were replaced and among the 118 serum magnesium levels that needed replacement, 30% ( n = 35) were replaced. Postimplementation phase – 3979 serum potassium and 2707 magnesium levels were obtained. Among the 170 patients who needed potassium replacement, 75% ( n = 127) were replaced. Among the 142 patients who needed magnesium replacement, 73% ( n = 104) were replaced. Conclusion A 121% increase in potassium replacement and a 143% increase in magnesium replacement were identified after implementing this protocol.
Acute traumatic quadriplegia: Predictors of in-hospital and six-month mortality
Authors: Alimohammadi Ehsan , Ahadi Paniz , Rezaee Cyrous , Safari-Faramani Roya , Bagheri Seyed Reza , Janatolmakan Maryam 
Published: March 2020

Background Traumatic spinal cord injury is one of the most disastrous and devastating health burdens all over the world with a high mortality rate. The present study aimed to evaluate the predictors of in-hospital and six-month mortality in these patients. Methods The electronic medical records of 87 consecutive patients with acute complete traumatic quadriplegia were reviewed to extract clinical, radiological, and laboratory data. Simple and multiple logistic regression models were used to estimate crude and adjusted odds with 95% confidence interval (CI) ratios for the predictors of in-hospital mortality and six-month mortality. Results There were 48 males and the mean age was 38.67 ± 12.81; in-hospital and six-month mortality were 21.84% and 11.76%, respectively. Traffic road accidents (67.8%) and falls (12.6%) were the most common causes of injury. The univariate analysis demonstrated advanced age, level of injury, late surgery or no surgical intervention, the lack of methylprednisolone therapy, a higher Charlson comorbidity index, the Injury Severity Score, and the presence of respiratory failure or bradycardia on admission were predictors of in-hospital mortality ( p < 0.05). In the final multiple logistic regression model, the level of injury (OR = 0.02 (0.001,0.35), p = 0.008) and the presence of respiratory failure (OR = 2.37 (0.03,13.88), p = 0.024) were the only predictors of in-hospital mortality. The univariate model showed that the level of injury, respiratory failure on admission, and the Injury Severity Score were the predictors of six-month mortality; however, the level of injury was the only predictor of the six-month mortality (OR = 1.12 (0.99, 1.27), p = 0.028) according to the multiple logistic regression model. Conclusions Several factors could affect in-hospital and six-month mortality in patients with traumatic spinal cord injury. Our findings demonstrated the level of injury and respiratory failure on admission as independent predictors of in-hospital mortality in these patients. Furthermore, the level of injury was the only independent predictor of six-month mortality in the present study.
Environmental Needs, Barriers, and Facilitators for Optimal Healing in the Postoperative Process: A Qualitative Study of Patients’ Lived Experiences and Perceptions
Authors: Hesselink Gijs , Smits Merlijn , Doedens Mariël , Nijenhuis Sharon M. T. , van Bavel Denise , van Goor Harry , van de Belt Tom H. 
Published: March 2020

Objectives: Gaining an understanding of postoperative patients’ environmental needs, barriers, and facilitators for optimal healing. Background: An optimal hospital environment (the “healing environment”) can enhance patients’ postoperative recovery and shorten length of stay. However, insights lack into patients’ lived environmental needs for optimal healing after surgery and how these needs are being met. Method: A qualitative study was conducted between August 2016 and August 2017 with 21 patients who underwent elective major abdominal surgery in a Dutch university hospital. Data were collected through context-mapping exercises and interviews to capture patients’ lived experiences and explore the meaning of these experiences. Data were systematically analyzed according to the principles of thematic content analysis. Results: Three themes were identified. First, participants want a sense of control over their treatment, ambient features, privacy, nutrition, and help requests. Participants described the need for positive distractions: personalizing the room, connecting with the external environment, and the ability to undertake activities. Finally, participants expressed the importance of functional, practical, and emotional support from professionals, peers, and relatives. According to participants, the hospital environment often does not meet their healing needs while being hospitalized. Conclusion: The hospital environment often does not meet patients’ needs. Needs fulfillment can be improved by practical adjustments to the physical and interpersonal environment and considering patient’s individual preferences and changing needs during recovery. Patient narratives, pictures, and drawings are valuable sources for hospital managers in their efforts to design evidence-based environments that anticipate to patient-specific needs for achieving early recovery.
Identification of Risk Factors Prospectively Associated With Musculoskeletal Injury in a Warrior Athlete Population
Authors: Teyhen Deydre S. , Shaffer Scott W. , Goffar Stephen L. , Kiesel Kyle , Butler Robert J. , Rhon Daniel I. , Plisky Phillip J. 
Published: March 2020

Background: Musculoskeletal injuries are a primary source of disability. Understanding how risk factors predict injury is necessary to individualize and enhance injury reduction programs. Hypothesis: Because of the multifactorial nature of musculoskeletal injuries, multiple risk factors will provide a useful method of categorizing warrior athletes based on injury risk. Study Design: Prospective observational cohort study. Level of Evidence: Level 2. Methods: Baseline data were collected on 922 US Army soldiers/warrior athletes (mean age, 24.7 ± 5.2 years; mean body mass index, 26.8 ± 3.4 kg/m2) using surveys and physical measures. Injury occurrence and health care utilization were collected for 1 year. Variables were compared in healthy versus injured participants using independent t tests or chi-square analysis. Significantly different factors between each group were entered into a logistic regression equation. Receiver operating characteristic curve and accuracy statistics were calculated for regression variables. Results: Of the 922 warrior athletes, 38.8% suffered a time-loss injury (TLI). Overall, 35 variables had a significant relationship with TLIs. The logistic regression equation, consisting of 11 variables of interest, was significant (adjusted R2 = 0.21; odds ratio, 5.7 [95% CI, 4.1-7.9]; relative risk, 2.5 [95% CI, 2.1-2.9]; area under the curve, 0.73). Individuals with 2 variables had a sensitivity of 0.89, those with 7 or more variables had a specificity of 0.94. Conclusion: The sum of individual risk factors (prior injury, prior work restrictions, lower perceived recovery from injury, asymmetrical ankle dorsiflexion, decreased or asymmetrical performance on the Lower and Upper Quarter Y-Balance test, pain with movement, slower 2-mile run times, age, and sex) produced a highly sensitive and specific multivariate model for TLI in military servicemembers. Clinical Relevance: A better understanding of characteristics associated with future injury risk can provide a foundation for prevention programs designed to reduce medical costs and time lost.
The “Hip Fracture” Bundle—Experiences, Challenges, and Opportunities
Authors: Malik Azeem Tariq , Khan Safdar N. , Ly Thuan V. , Phieffer Laura , Quatman Carmen E. 
Published: March 2020

Introduction: With growing popularity and success of alternative-payment models (APMs) in elective total joint arthroplasties, there has been recent discussion on the probability of implementing APMs for geriatric hip fractures as well. Significance: Despite the growing interest, little is known about the drawbacks and challenges that will be faced in a stipulated “hip fracture” bundle. Results: Given the varying intricacies and complexities of hip fractures, a “one-size-fits-all” bundled payment may not be an amenable way of ensuring equitable reimbursement for participating physicians and hospitals. Conclusions: Health-policy makers need to advocate for better risk-adjustment methods to prevent the creation of financial disincentives for hospitals taking care of complex, sicker patients. Hospitals participating in bundled care also need to voice concerns regarding the grouping of hip fractures undergoing total hip arthroplasty to ensure that trauma centers are not unfairly penalized due to higher readmission rates associated with hip fractures skewing quality metrics. Physicians also need to consider the launch of better risk-stratification protocols and promote geriatric comanagement of these patients to prevent occurrences of costly adverse events.
Critical Thinking in Health Sciences and How It Pertains to Sonography Education: A Review of the Literature
Authors: Weidman Brandy , Salisbury Helen 
Published: March 2020

Objective: Critical thinking is an important skill that sonographers must develop beginning in educational programs and into professional practice. Critical thinking requires students to reflect on information, use judgment skills, and engage in higher levels of thinking, including analysis, interpretation, inference, evaluation, and explanation, to formulate reliable decisions. Methods: Current research related to critical thinking has focused on medicine, nursing, physical therapy, pharmacy, and dental programs, but there has been no description of assessing sonography students. The Dreyfus model has been used as a framework to describe acquired skills that reflects students’ progress from novice to expert clinicians. This model illustrates specific cognitive abilities that students develop as they advance in education. Results: This review of the literature describes critical thinking skills coupled with a framework to understand different levels of cognitive thinking, as well as how it can be assessed. Conclusion: To understand differences between undergraduate sonography students and experts, the Dreyfus model is an excellent model to recognize progression. It can be used with the Health Sciences Reasoning Test, which is a nationally recognized critical thinking examination that can ascertain different levels of health sciences students’ critical thinking skills.
Detecting circular RNA from high-throughput sequence data with de Bruijn graph
Authors: Li Xin , Wu Yufeng 
Published: March 2020

Abstract
Background
Circular RNA is a type of non-coding RNA, which has a circular structure. Many circular RNAs are stable and contain exons, but are not translated into proteins. Circular RNA has important functions in gene regulation and plays an important role in some human diseases. Several biological methods, such as RNase R treatment, have been developed to identify circular RNA. Multiple bioinformatics tools have also been developed for circular RNA detection with high-throughput sequence data.

Results
In this paper, we present circDBG, a new method for circular RNA detection with de Bruijn graph. We conduct various experiments to evaluate the performance of CircDBG based on both simulated and real data. Our results show that CircDBG finds more reliable circRNA with low bias, has more efficiency in running time, and performs better in balancing accuracy and sensitivity than existing methods. As a byproduct, we also introduce a new method to classify circular RNAs based on reads alignment. Finally, we report a potential chimeric circular RNA that is found by CircDBG based on real sequence data. CircDBG can be downloaded from https://github.com/lxwgcool/CircDBG.

Conclusions
We develop a new method called CircDBG for circular RNA detection, which is based on de Bruijn graph. We conduct extensive experiments and demonstrate CircDBG outperforms existing tools, especially in saving running time, reducing bias and improving capability of balancing accuracy and sensitivity. We also introduce a new method to classify circular RNAs and report a potential case of chimeric circular RNA.