bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Dehydration Affect the Adaptations of Plasma Volume, Heart Rate, Internal Body Temperature, and Sweat Rate During the Induction Phase of Heat Acclimation?
Authors: Sekiguchi Yasuki , Filep Erica M. , Benjamin Courteney L. , Casa Douglas J. , DiStefano Lindsay J. 
Published: January 2020

Clinical Scenario: Exercise in the heat can lead to performance decrements and increase the risk of heat illness. Heat acclimation refers to the systematic and gradual increase in exercise in a controlled, laboratory environment. Increased duration and intensity of exercise in the heat positively affects physiological responses, such as higher sweat rate, plasma volume expansion, decreased heart rate, and lower internal body temperature. Many heat acclimation studies have examined the hydration status of the subjects exercising in the heat. Some of the physiological responses that are desired to elicit heat acclimation (ie, higher heart rate and internal body temperature) are exacerbated in a dehydrated state. Thus, euhydration (optimal hydration) and dehydration trials during heat acclimation induction have been conducted to determine if there are additional benefits to dehydrated exercise trials on physiological adaptations. However, there is still much debate over hydration status and its effect on heat acclimation. Clinical Question: Does dehydration affect the adaptations of plasma volume, heart rate, internal body temperature, skin temperature, and sweat rate during the induction phase of heat acclimation? Summary of Findings: There were no observed differences in plasma volume, internal body temperature, and skin temperature following heat acclimation in this critically appraised topic. One study found an increase in sweat rate and another study indicated greater changes in heart rate following heat acclimation with dehydration. Aside from these findings, all 4 trials did not observe statistically significant differences in euhydrated and dehydrated heat acclimation trials. Clinical Bottom Line: There is minimal evidence to suggest that hydration status affects heat acclimation induction. In the studies that met the inclusion criteria, there were no differences in plasma volume concentrations, internal body temperature, and skin temperature. Strength of Recommendation: Based on the Oxford Centre for Evidence-Based Medicine Scale, Level 2 evidence exists.
Macrophage Proresolving Mediators—the When and Where
Authors: Dalli Jesmond , Serhan Charles 
Published: January 2020

ABSTRACTMacrophages and neutrophils orchestrate acute inflammation and host defense as well as the resolution phase and return to homeostasis. In this article, we review the contribution of macrophages to local lipid mediator (LM) levels and the regulation of macrophage LM profiles by polymorphonuclear neutrophils and neutrophil-derived microparticles. We carried out LM metabololipidomics, profiling distinct phagocytes: neutrophils (PMNs), apoptotic PMNs, and macrophages. Efferocytosis increased specialized proresolving mediator (SPM) biosynthesis, including resolvin D1 (RvD1), RvD2, and RvE2, which were further elevated by PMN microparticles. In studies using deuterium-labeled precursors (d8-arachidonic acid,d5-eicosapentaenoic acid, andd5-docosahexaenoic acid), apoptotic PMNs and microparticles contributed to SPM biosynthesis during efferocytosis. Assessment of macrophage LM profiles in M2 macrophages demonstrated higher SPM levels in this macrophage subset, including maresin 1 (MaR1), and lower amounts of leukotriene B4(LTB4) and prostaglandins than in M1. Apoptotic PMN uptake by both macrophage subtypes led to modulation of their LM profiles. LTB4was downregulated in M2, whereas SPMs including lipoxin A4were increased. Conversely, uptake of apoptotic PMNs by M2 macrophages reduced (∼25%) overall LMs. MaR1 displays potent tissue-regenerative and antinociceptive actions in addition to its proresolving and anti-inflammatory actions. In addition, the MaR1 biosynthetic intermediate 13S,14S-epoxy-maresin is also bioactive, inhibiting LTB4biosynthesis and switching macrophage phenotypes from M1 to M2. Together, these results establish LM signature profiles of human phagocytes and related subpopulations. They demonstrate microparticle regulation of macrophage-specific endogenous LMs during defined stages of acute inflammation and their dynamic changes in human primary phagocytes.
A Middle Devonian basin-scale precious metal enrichment event across northern Yukon (Canada)
Authors: Gadd M.G. , Peter J.M. , Hnatyshin D. , Creaser R. , Gouwy S. , Fraser T. 
Published: January 2020

AbstractHyper-enriched black shale (HEBS) Ni-Mo-Zn-Pt-Pd-Au-Re mineralization is geographically widespread across the Richardson trough in northern Yukon (Canada), where it discontinuously outcrops at the regional contact between the Road River Group and overlying Canol Formation. Stratigraphic relationships indicate that the contact is Middle Devonian, but there are no precise age constraints for the HEBS. We apply Re-Os geochronology to HEBS mineralization from two localities that are 130 km apart, the Nick prospect and the Peel River showing, to date directly the age of sulfide mineralization. The Nick prospect yields an isochron age of 390.7 ± 5.1 (2σ) Ma, whereas the Peel River showing yields an isochron age of 387.5 ± 4.4 (2σ) Ma. Within error, these ages are identical and overlap with the biostratigraphically constrained age of the sedimentary host rocks, indicating that mineralization and sedimentation were coeval. Significantly, the ages of the HEBS overlap those of Middle Devonian Kačák, pumilio, and Taghanic global-scale biotic events which are characterized by eustatic sea-level rise and black shale deposition. Linkage of the Yukon HEBS to one (or more) of these bio-events indicates that sea-level rise may have been requisite to formation of basin-scale HEBS mineralization in northwestern Canada during latest Eifelian and Givetian time.
Magnetite magnetofossils record biogeochemical remanent magnetization in hydrogenetic ferromanganese crusts
Authors: Yuan Wei , Zhou Huaiyang , Yang Zhenyu , Hein James R. , Yang Qunhui 
Published: January 2020

AbstractRecords of natural remanent magnetization (NRM) and geomagnetic polarity reversals preserved within ferromanganese (Fe-Mn) crusts, together with the application of fine-resolution magnetostratigraphic analysis, have been successfully demonstrated. However, because Fe-bearing precipitates or minerals are thought to be either oxides and/or hydroxides precipitated from ambient oxic seawater or detrital minerals, the magnetic properties of the ferromagnetic minerals and the genetic mechanisms remain controversial; moreover, the origin of the NRM is unclear. Here, we show that nanometer-scale magnetite crystals found in Fe-Mn crusts from the Pacific Ocean and South China Sea are magnetosome fossils based on their narrow size range, chain arrangement, chemical purity, and crystallographic perfection, as indicated by transmission electron microscopy. Furthermore, our new data from rock magnetic and electron paramagnetic resonance analyses, combined with a previously reported micro-magnetostratigraphic sequence, indicate that magnetotactic bacteria and their post-mortem remains contribute to a biogeochemical remanent magnetization of Fe-Mn crusts. In addition, the results provide evidence for a previously unappreciated pathway for the biogeochemical cycling of iron in the deep ocean.
A significant acceleration of ice volume discharge preceded a major retreat of a West Antarctic paleo–ice stream
Authors: Bart Philip J. , Tulaczyk Slawek 
Published: January 2020

AbstractFor the period between 14.7 and 11.5 cal. (calibrated) kyr B.P, the sediment flux of Bindschadler Ice Stream (BIS; West Antarctica) averaged 1.7 × 108 m3 a−1. This implies that BIS velocity averaged 500 ± 120 m a−1. At a finer resolution, the data suggest two stages of ice stream flow. During the first 2400 ± 400 years of a grounding-zone stillstand, ice stream flow averaged 200 ± 90 m a−1. Following ice-shelf breakup at 12.3 ± 0.2 cal. kyr B.P., flow accelerated to 1350 ± 580 m a−1. The estimated ice volume discharge after breakup exceeds the balance velocity by a factor of two and implies ice mass imbalance of −40 Gt a−1 just before the grounding zone retreated &gt;200 km. We interpret that the paleo-BIS maintained sustainable discharge throughout the grounding-zone stillstand first due to the buttressing effect of its fringing ice shelf and then later (i.e., after ice-shelf breakup) due to the stabilizing effects of grounding-zone wedge aggradation. Major paleo–ice stream retreat, shortly after the ice-shelf breakup that triggered the inferred ice flow acceleration, substantiates the current concerns about rapid, near-future retreat of major glaciers in the Amundsen Sea sector where Pine Island and Thwaites Glaciers are already experiencing ice-shelf instability and grounding-zone retreat that have triggered upstream-propagating thinning and ice acceleration.
Orogen proximal sedimentation in the Permian foreland basin
Authors: Soto-Kerans Graham M. , Stockli Daniel F. , Janson Xavier , Lawton Timothy F. , Covault Jacob A. 
Published: January 2020

AbstractThe sedimentary fill of peripheral foreland basins has the potential to preserve a record of the processes of ocean closure and continental collision, as well as the long-term (i.e., 107–108 yr) sediment-routing evolution associated with these processes; however, the detrital record of these deep-time tectonic processes and the sedimentary response have rarely been documented during the final stages of supercontinent assembly. The stratigraphy within the southern margin of the Delaware Basin and Marathon fold and thrust belt preserves a record of the Carboniferous–Permian Pangean continental assembly, culminating in the formation of the Delaware and Midland foreland basins of North America. Here, we use 1721 new detrital zircon (DZ) U-Pb ages from 13 stratigraphic samples within the Marathon fold and thrust belt and Glass Mountains of West Texas in order to evaluate the provenance and sediment-routing evolution of the southern, orogen-proximal region of this foreland basin system. Among these new DZ data, 85 core-rim age relationships record multi-stage crystallization related to magmatic or metamorphic events in sediment source areas, further constraining source terranes and sediment routing. Within samples, a lack of Neoproterozoic–Cambrian zircon grains in the pre-orogenic Mississippian Tesnus Formation and subsequent appearance of this zircon age group in the syn-orogenic Pennsylvanian Haymond Formation point toward initial basin inversion and the uplift and exhumation of volcanic units related to Rodinian rifting. Moreover, an upsection decrease in Grenvillian (ca. 1300–920 Ma) and an increase in Paleozoic zircons denote a progressive provenance shift from that of dominantly orogenic highland sources to that of sediment sources deeper in the Gondwanan hinterland during tectonic stabilization. Detrital zircon core-rim age relationships of ca. 1770 Ma cores with ca. 600–300 Ma rims indicate Amazonian cores with peri-Gondwanan or Pan-African rims, Grenvillian cores with ca. 580 Ma rims are correlative with Pan-African volcanism or the ca. 780–560 Ma volcanics along the rifted Laurentian margin, and Paleozoic core-rim age relationships are likely indicative of volcanic arc activity within peri-Gondwana, Coahuila, or Oaxaquia. Our results suggest dominant sediment delivery to the Marathon region from the nearby southern orogenic highland; less sediment was delivered from the axial portion of the Ouachita or Appalachian regions suggesting that this area of the basin was not affected by a transcontinental drainage. The provenance evolution of sediment provides insights into how continental collision directs the dispersal and deposition of sediment in the Permian Basin and analogous foreland basins.
Head and neck cancer in the digital age: an evaluation of mobile health applications
Authors: Fleming Jason , Jeannon Jean-Pierre 
Published: January 2020

AimThe technology of online and mobile-based symptom checkers is developing on a background of unprecedented demand for General Practioner (GP) and medical services. This study was performed to assess the performance of popular ‘artificial intelligence’ symptom checkers currently available to the public and evaluate their accuracy as a screening tool for head and neck cancer symptoms.MethodWe selected three of the most popular and previously compared mobile application (app) symptom checkers available including Babylon (London), Your.md (London) and Ada (Ada Health GmbH, Munich). A recent Pan-London Suspected Cancer Referral Guide was obtained and distilled into a list of qualifying symptoms for referral to secondary care on a 2-week wait cancer pathway. A generic patient background was devised and each symptom was passed through the selected symptom checker apps. Differential diagnoses and recommended triage times were compared.ResultsOverall a cancer diagnosis was suggested possible in the differential diagnosis in 33% of symptoms. As a screening tool, Babylon was the most accurate for including a potential cancer diagnosis in the differential diagnosis, with a sensitivity of 45% cases, Ada with 32% and Your.md 23%. Ada attempted the most diagnoses, able to provide a differential diagnosis in 95% scenarios, but was also the most risk averse triage assessor, with 55% outcomes recommending medical advice immediately or within hours.ConclusionThe ability of modern symptom checkers to promote health awareness and self-checks is promising, but we have identified a number of areas of potential improvement. At present the sensitivity of the tested symptom checker apps remains low for head and neck cancer.
Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi
Authors: Zethof Siem , Bakker Wouter , Nansongole Felix , Kilowe Kelvin , van Roosmalen Jos , van den Akker Thomas 
Published: January 2020

ObjectiveSurgical informed consent is essential prior to caesarean section, but potentially compromised by insufficient communication. We assessed the association between a multicomponent intervention and women’s recollection of information pertaining to informed consent for caesarean section in a low-resource setting, thereby contributing to respectful maternity care.DesignPre-post implementation survey, conducted from January to June 2018, surveying women prior to discharge.SettingRural 150-bed mission hospital in Southern Malawi.ParticipantsA total of 160 postoperative women were included: 80 preimplementation and 80 postimplementation.InterventionBased on observed deficiencies and input from local stakeholders, a multicomponent intervention was developed, consisting of a standardised checklist, wall poster with a six-step guide and on-the-job communication training for health workers.Primary and secondary outcome measuresIndividual components of informed consent were: indication, explanation of procedure, common complications, implications for future pregnancies and verbal enquiry of consent, which were compared preintervention and postintervention using χ2test. Generalised linear models were used to analyse incompleteness scores and recollection of the informed consent process.ResultsThe proportion of women who recollected being informed about procedure-related risks increased from 25/80 to 47/80 (OR 3.13 (95% CI 1.64 to 6.00)). Recollection of an explanation of the procedure changed from 44/80 to 55/80 (OR 1.80 (0.94 to 3.44)), implications for future pregnancy from 25/80 to 47/80 (1.69 (0.89 to 3.20)) and of consent enquiry from 67/80 to 73/80 (OR 2.02 (0.73 to 5.37)). After controlling for other variables, incompleteness scores postintervention were 26% lower (Exp(β)=0.74; 95% CI 0.57 to 0.96). Recollection of common complications increased with 0.25 complications (β=0.25; 95% CI 0.01 to 0.49). Recollection of the correct indication did not differ significantly.ConclusionRecollection of informed consent for caesarean section changed significantly in the postintervention group. Obtaining informed consent for caesarean section is one of the essential components of respectful maternity care.
Emergency medicine registrar training in Africa: overview of programmes, faculty and sustainability
Authors: Akomeah Abena Obenewaa , Sawe Hendry Robert , Mfinanga Juma A , Runyon Michael S , Noste Erin Elizabeth 
Published: January 2020

BackgroundThe specialty of emergency medicine (EM) is new in most African countries, where emergency medicine registrar (residency) programmes (EMRPs) are at different stages of evolution and little is known about the programmes. Identifying and describing these EMRPs will facilitate planning for sustainability, collaborative efforts and curriculum development for existing and future programmes. Our objective was to identify and provide an overview of existing EMRPs in Africa and their applicant requirements, faculty characteristics and plans for sustainability.MethodsWe conducted a descriptive cross-sectional survey of Africa’s EMRPs between January and December 2017, identifying programmes through an online search supplemented by discussions with African EM leaders. Leaders of all identified African EMRPs were invited to participate. Data were collected prospectively using a structured survey and are summarised with descriptive statistics.ResultsWe identified 15 programmes in 12 countries and received survey responses from 11 programmes in 10 countries. Eight of the responding EMRPs began in 2010 or later. Only 36% of the EMRPs offer a 3-year programme. Women make up an average of 33% of faculty. Only 40% of EMRPs require faculty to be EM specialists. In smaller samples that reported the relevant data, 67% (4/6) of EMRPs have EM specialists who trained in that EMRP programme making up more than half of their faculty; 57% of Africa’s 288 EMRP graduates to date are men; and an average of 39% of EMRP graduates stay on as faculty for 78% (7/9) of EMRPs.ConclusionEMRPs currently produce most of their own EM faculty. Almost equal proportions of men and women have graduated from a predominantly >3-year training programme. Graduates have a variety of opportunities in academia and private practice. Future assessments may wish to focus on the evolution of these programme’ curricula, faculty composition and graduates’ career options.
Factors influencing the intention of Indonesian nursing students to work in rural areas
Authors: Firdaus Amanatul , Efendi Ferry , Hadisuyatmana Setho , Aurizki Gading Ekapuja , Abdullah Khatijah Lim 
Published: January 2020

ObjectiveThe aim of this study was to analyse the factors associated with the intention of Indonesian nursing students to work in rural areas.DesignThis was a cross-sectional study. The instrument used was a self-developed questionnaire consisting of 13 questions.The data were analysed using the χ2 statistics test and binary logistic regression with a level of significance <0.05.SettingThe study was conducted at a public nursing school located in urban Surabaya, East Java, Indonesia, in December 2017.ParticipantsA total of 714 nursing students from four different programmes were involved.ResultsThis study found that almost 60% of nursing students were reluctant to work in rural areas. Of the three variables which were significant in the χ2 analysis, only two were significant following the logistic regression test, namely the class programmes of undergraduate regulars (OR=2.274; 95% CI 1.326 to 3.900), profession regulars (OR=2.262; 95% CI 1.110 to 4.607) and rural place of origin (OR=1.405; 95% CI 1.036 to 1.906).ConclusionThe education programme and place of origin were associated with the intention of nursing students to work in rural areas. Therefore, the recruitment of prospective nurses should consider these factors by considering the local context.
Decline in renal function and oral anticoagulation dose reduction among patients with atrial fibrillation
Authors: Inohara Taku , Holmes DaJuanicia N , Pieper Karen , Blanco Rosalia G , Allen Larry A , Fonarow Gregg C , Gersh Bernard J , Hylek Elaine M , Ezekowitz Michael D , Kowey Peter R , Reiffel James A , Naccarelli Gerald V , Chan Paul S , Mahaffey Kenneth W , Singer Daniel E , Freeman James V , Steinberg Benjamin A , Peterson Eric D , Piccini Jonathan P 
Published: January 2020

ObjectiveNon-vitamin K oral anticoagulants (NOACs) require dose adjustment for renal function. We sought to investigate change in renal function over time in patients with atrial fibrillation (AF) and whether those on NOACs have appropriate dose adjustments according to its decline.MethodsWe included patients with AF enrolled in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry treated with oral anticoagulation. Worsening renal function (WRF) was defined as a decrease of >20% in creatinine clearance (CrCl) from baseline. The US Food and Drug Administration (FDA)-approved package inserts were used to define the reduction criteria of NOACs dosing.ResultsAmong 6682 patients with AF from 220 sites (median age (25th, 75th): 72.0 years (65.0, 79.0); 57.1% male; median CrCl at baseline: 80.1 mL/min (57.4, 108.5)), 1543 patients (23.1%) experienced WRF with mean decline in CrCl during 2 year follow-up of −6.63 mL/min for NOACs and −6.16 mL/min for warfarin. Among 4120 patients on NOACs, 154 (3.7%) patients had a CrCl decline sufficient to warrant FDA-recommended dose reductions. Of these, NOACs dosing was appropriately reduced in only 31 (20.1%) patients. Compared with patients with appropriately reduced NOACs, those without were more likely to experience bleeding complications (major bleeding: 1.7% vs 0%; bleeding hospitalisation: 2.6% vs 0%) at 1 year.ConclusionsIn the US practice, about one-fourth of patients with AF had >20% decline in CrCl over time during 2 year follow-up. As a result, about 3.7% of those treated with NOACs met guideline criteria for dose reduction, but of these, only 20.1% actually had a reduction.
Relationship between serum uric acid level and all-cause and cardiovascular mortality in population with obesity
Authors: LI Jie , Huang Jia-Yi , Liu Lin , Lo Kenneth , Sun Shuo , Chen Chao-Lei , Zhang Bin , Feng Ying Qing , Huang Yu-Qing 
Published: January 2020

AbstractBackgroundWe aimed to investigate the association between serum uric acid (SUA) and all-cause or cardiovascular mortality among participants with obesity.MethodAll participants were included from the 1999 to 2014 National Health and Nutrition Examination Survey with follow-up mortality assessment through 31 December 2015. Cox proportional hazards models were built to estimate adjusted HRs and 95% CIs for mortality according to baseline uric acid in quartiles. Obesity was defined as body mass index ≥30 (kg/m2). Generalised additive model (GAM) and two-piecewise linear regression models were performed to explore any non-linearity in associations.ResultsThere were 12 637 adults with obesity eligible for analysis. There were 999 (7.91%) all-cause and 147 (1.16%) cardiovascular mortality occurred during the mean follow-up of 98.11 months. Comparing with the lowest quartile of SUA, the highest SUA group did not have significant association with all-cause (HR 1.08, 95% CI 0.76 to 1.52) and cardiovascular mortality (HR 1.63, 95% CI 0.58 to 4.53) after adjusting for various confounding factors. GAM and two-piecewise linear regression model demonstrated a non-linearly relationship between SUA and all-cause mortality, and the corresponding cut-off point was 6.5 mg/dL. However, there is no significant relationship between uric acid and cardiovascular death on both sides of the cut-off value of 6.1 mg/dL.ConclusionsSUA showed a J-shaped relationship with all-cause mortality, but no significant with cardiovascular mortality in adults with obesity.