bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cooling During Exercise May Induce Benefits Linked to Improved Brain Perfusion
Authors: Douzi Wafa , Dugué Benoit , Theurot Dimitri , Vinches Ludwig , Hallé Stéphane , Dupuy Olivier 
Published: September 2020

AbstractThe aim of this study was to evaluate the impact of using a cooling vest during physical exercise (per-cooling) in humid and temperate conditions (≈22°C, ≈80% relative humidity) on perceptual and physiological responses (tissue oxygenation and heart rate). 20 physically active men performed twice a 30-min cycling exercise at 70% of their theoretical maximum heart rate while using an activated (experimental condition) and a deactivated (control condition) cooling system in a randomized crossover study. Heart rate and tissue (cerebral and muscular) oxygenation were continuously measured during exercise and recovery, and skin temperature was measured every 10 min. Perception of temperature, humidity and comfort were assessed at the end of the recovery period. Results showed a decrease in trunk skin temperature (p<0.05), a faster heart rate recovery and an increase in the concentration of total hemoglobin at the brain level (p<0.05) compared with control condition. Moreover, an improved subjective rating of thermal sensations, wetness and comfort compared to control values (p<0.05) was noted. In conclusion, wearing a cooling vest during submaximal exercise improves perceptual and physiological responses in humid temperate conditions, which may be due to a better blood perfusion at the brain level and a better parasympathetic reactivation.
New Machine Learning Approach for Detection of Injury Risk Factors in Young Team Sport Athletes
Authors: Jauhiainen Susanne , Kauppi Jukka-Pekka , Leppänen Mari , Pasanen Kati , Parkkari Jari , Vasankari Tommi , Kannus Pekka , Äyrämö Sami 
Published: September 2020

AbstractThe purpose of this article is to present how predictive machine learning methods can be utilized for detecting sport injury risk factors in a data-driven manner. The approach can be used for finding new hypotheses for risk factors and confirming the predictive power of previously recognized ones. We used three-dimensional motion analysis and physical data from 314 young basketball and floorball players (48.4% males, 15.72±1.79 yr, 173.34±9.14 cm, 64.65±10.4 kg). Both linear (L1-regularized logistic regression) and non-linear methods (random forest) were used to predict moderate and severe knee and ankle injuries (N=57) during three-year follow-up. Results were confirmed with permutation tests and predictive risk factors detected with Wilcoxon signed-rank-test (p<0.01). Random forest suggested twelve consistent injury predictors and logistic regression twenty. Ten of these were suggested in both models; sex, body mass index, hamstring flexibility, knee joint laxity, medial knee displacement, height, ankle plantar flexion at initial contact, leg press one-repetition max, and knee valgus at initial contact. Cross-validated areas under receiver operating characteristic curve were 0.65 (logistic regression) and 0.63 (random forest). The results highlight the difficulty of predicting future injuries, but also show that even with models having relatively low predictive power, certain predictive injury risk factors can be consistently detected.
Neuromuscular Control of Ankle-stabilizing Muscles-specific Effects of Sex and Menstrual Cycle
Authors: Khowailed Iman Akef , Lee Haneul 
Published: September 2020

AbstractThe purpose of this study was to examine the differences in neuromuscular control and mechanical properties of the ankle-stabilizing muscles between men and women, and during different phases of menstrual cycle in women. Fifteen women with regular menstrual cycles and 17 male counterparts were included in this study. Electromyographic signals were recorded from the peroneus longus (PL) and tibialis anterior (TA) muscles while performing three balance tasks. Muscle tone, stiffness, and elasticity of muscles were measured using a MyotonPRO in the resting position. Outcomes were measured twice (ovulation and early follicular phases) for women, while measurements were acquired only once for men. Significantly higher tibialis anterior-peroneus longus co-contraction (TA/PL ratio) was observed in all balance tasks in women than in men (p< 0.05); however, significant differences between phases of the menstrual cycle were noted only in the 2 most difficult tasks (p< 0.05). A similar pattern was observed in the postural sway. These results highlight the importance of sex-specific hormonal effects on neuromuscular control and mechanical properties, and as well as the differences during phases of the menstrual cycle. These insights assume significance in the context of developing neuromuscular strategies for the purpose of preventing lower extremity injuries during sports activities.
Follow-up of Acute Respiratory Disorders in Cyclists Competing in the
100th Giro d’Italia
Authors: Pollastri Luca , Macaluso Claudio , Vinetti Giovanni , Tredici Giovanni , Lanfranconi Francesca 
Published: September 2020

AbstractAcute respiratory disorder is a common sub-clinical condition affecting elite
cyclists. Monitoring the perturbations of the immunological cells in the
respiratory tract, indicative of a likely proinflammatory state, during an
International Cycling Union world tour is a challenging task. The aim of this
study was to follow up on the sign and symptoms of upper way respiratory
infections with or without asthma, using non-invasive methods, during a 21-day
race (100° Giro d’Italia, 2017). Nine male elite cyclists of the
Bahrain Merida Team were evaluated before the training season and daily during
the race. Clinical history, skin prick and spirometric test, acute respiratory
symptoms were measured using validated questionnaires, and values of fraction of
exhaled nitric oxide were collected longitudinally. Four of the 9 athletes had
allergies with/or consistent abnormal spirometric curves before the
race. During the race, 5 athletes had a fraction of exhaled nitric oxide values
>20 ppb which correlated with respiratory symptoms collected
through questionnaires. These were related to the environmental characteristics
of the places travelled through in the race. The athletes with a predisposition
to chronic respiratory inflammation in the pre-competitive season were more
likely to develop acute respiratory symptoms during the race.
The Inverse Association of Muscular Strength with Carotid
Intima-media and Extra-media Thickness in Women
Authors: Karabinus Julie A. , DeBlois Jacob P. , Keller Allison , Glasgow Alaina C. , Barreira Tiago V. , Heffernan Kevin S. 
Published: September 2020

AbstractThe purpose of this study was to determine the relationship between strength and
atherosclerotic cardiovascular disease (CVD) risk in young women. Carotid
intima-media thickness (IMT) and extra-media thickness (EMT) were used as
measures of subclinical atherosclerosis and CVD risk. Muscular strength, IMT,
and EMT were measured in 70 young women (mean age=21±4 years).
Strength was determined using a handgrip dynamometer and expressed relative to
body mass. IMT and EMT were measured using ultrasonography of the left common
carotid artery. Objectively measured moderate-vigorous physical activity (MVPA)
was assessed with accelerometry. Higher relative handgrip strength was
associated with lower IMT (r=−0.23; p<0.05) and lower
EMT (r=−0.27; p<0.05). Associations between relative
handgrip strength and IMT (r=−0.24) as well as EMT
(r=−0.25) remained significant after adjusting for potential
confounders including traditional CVD risk factors and MVPA (p<0.05).
These results show that there is an inverse association between handgrip
strength with carotid IMT and EMT in young women. Muscular strength may reduce
CVD risk in young women via favorable effects on subclinical carotid
atherosclerosis independent of physical activity.
Tissue Factor-Independent Coagulation Correlates with Clinical Phenotype in Factor XI Deficiency and Replacement Therapy
Authors: Bertaggia Calderara Debora , Zermatten Maxime G. , Aliotta Alessandro , Batista Mesquita Sauvage Ana P. , Carle Vanessa , Heinis Christian , Alberio Lorenzo 
Published: September 2020

Abstract
Background In factor XI (FXI) deficiency, bleeding cannot be predicted by routine analyses. Since FXI is involved in tissue factor (TF)-independent propagation loop of coagulation, we hypothesized that investigating the spatiotemporal separated phases of coagulation (TF-dependent and -independent) could improve diagnostics.
Objectives This article investigates the correlation of parameters describing TF-dependent and -independent coagulation with the clinical phenotype of FXI deficiency and their ability to assess hemostasis after FXI replacement.
Methods We analyzed: (1) plasma from healthy controls (n = 53); (2) normal plasma (n = 4) spiked with increasing concentrations of a specific FXI inhibitor (C7P); (3) plasma from FXI-deficient patients (n = 24) with different clinical phenotypes (13 bleeders, 8 non-bleeders, 3 prothrombotics); (4) FXI-deficient plasma spiked with FXI concentrate (n = 6); and (5) plasma from FXI-deficient patients after FXI replacement (n = 7). Thrombin generation was measured with the reference method calibrated automated thrombogram and with Thrombodynamics (TD), a novel global assay differentiating TF-dependent and -independent coagulation.
Results C7P dose-dependently decreased FXI activity, prolonged activated partial thromboplastin time, and hampered TF-independent coagulation. In FXI-deficient bleeders, TD parameters describing TF-independent propagation of coagulation and fibrin clot formation were reduced compared with controls and FXI-deficient nonbleeders and increased in FXI-deficient patients with prothrombotic phenotype. Receiver operating characteristic analysis indicated that TF-independent parameters were useful for discriminating FXI-deficient bleeders from non-bleeders. In FXI-deficient plasma spiked with FXI concentrate and in patients receiving FXI replacement, TD parameters were shifted toward hypercoagulation already at plasma FXI levels around 20%.
Conclusion TF-independent coagulation parameters assessed by TD have the potential to identify the clinical phenotype in FXI-deficient patients and to monitor FXI replacement therapy.
Successful Free Tissue Transfer in the Profoundly Hypercoagulable Glioblastoma Multiforme Patient: Surgical Experience and Anticoagulation Protocol
Authors: Niziol Paul A. , Doval Andres F. , Jalalabadi Faryan , Klebuc Michael 
Published: September 2020

Abstract
Background Glioblastoma multiforme (GBM) produces a hypercoagulable environment and is associated the highest rates of deep venous thrombosis (DVT) and pulmonary emboli (PE) of any malignancy. The use of postoperative radiation in this generally compromised patient group is associated with the development of complex scalp wounds. Free tissue transfer reconstruction will be essential in selected cases despite the presence of an underlying hypercoagulable state.
Methods A 67-year-old female with a history of previous DVT presented with osteoradionecrosis and infected scalp wound following GBM treatment. She underwent reconstruction with a free vastus lateralis flap and skin graft. Initial anticoagulation was provided with intravenous heparin and transitioned to oral apixaban. Wound cultures demonstrated coagulase-negative Staphylococcus, Actinomyces neuii, and Peptoniphilus harei and were treated with a 6-week course of intravenous cefepime and vancomycin.
Results Despite the initial failure of a local scalp rotation flap, successful wound healing was achieved with a free muscle flap and a course of culture specific antibiotics. The patient succumbed to recurrent disease 22 months after surgery, underscoring the importance of limiting hospitalization and maximizing quality of life in this group of patients.
Conclusion Free tissue transfer can be successfully achieved in the hypercoagulable GBM patient. Heparin and apixaban were employed successfully in the prevention of thrombotic events. Antiplatelet therapy should also be considered to counteract platelet aggregation induced by the transmembrane glycoprotein (podoplanin) that is expressed on GBM tumor cells. Enzyme-linked immunosorbent assay testing (ELISA) of blood soluble podoplanin may help determine the degree of hypercoagulability and guide therapy.
Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis
Authors: Rajial Tanuja , Batra Prerna , Harit Deepika , Singh Narendra Pal 
Published: September 2020

Objective Positive CSF culture is the gold standard for the diagnosis of meningitis but it carries poor sensitivity. CSF procalcitonin (PCT) is shown to have some utility for the diagnosis of meningitis though there are limited studies in neonatal age group. We planned this study to compare CSF, serum, and CSF to serum PCT levels in neonates with confirmed, probable, and nonmeningitis groups to determine its optimal cut-off in CSF and serum for diagnosing meningitis.
Study Design Sixty-seven neonates who qualified for lumbar puncture were enrolled in the study. Neonates were categorized into confirmed meningitis, i.e., CSF cytochemistry and culture positive (N = 17), probable meningitis, i.e., CSF cytochemistry positive but culture negative (N = 25) and nonmeningitis, i.e., both cytochemistry and culture negative (N = 25). CSF and serum samples were stored at −80°C for PCT assay.
Results Significant difference was seen in mean of CSF PCT in neonates with confirmed (0.31 ng/mL), probable (0.22 ng/mL), and nonmeningitis (0.11 ng/mL) groups. Similarly, significant difference was observed in serum PCT levels also, though the ratio of serum to CSF PCT was comparable. At cut-off of 0.2 ng/mL, CSF PCT had sensitivity of 95.2% and specificity of 96% in the diagnosis of meningitis.
Conclusion CSF PCT is more specific marker for the diagnosis of neonatal meningitis as compared with serum PCT and CSF to serum PCT ratio.
Key Points
Antithrombin p.Thr147Ala: The First Founder Mutation in People of African Origin Responsible for Inherited Antithrombin Deficiency
Authors: de la Morena-Barrio Belén , Jochmans Kristin , de la Morena-Barrio Maria Eugenia , Orlando Christelle , Pareyn Inge , Vanhoorelbeke Karen , Martínez-Martínez Irene , Vicente Vicente , Corral Javier 
Published: September 2020

AbstractBackground Hereditary antithrombin deficiency is a rare autosomal-dominant disorder predisposing to recurrent venous thromboembolism (VTE). To date, only two founder mutations have been described.Objectives We investigated the antithrombin p.Thr147Ala variant, found in 12 patients of African origin. This variant is known as rs2227606 with minor allele frequency of 0.5% in Africans and absent in Europeans. A possible founder effect was investigated.Methods Phenotypical characterization was established through immunological and functional methods, both under basal and stress conditions. Recombinant antithrombin molecules were constructed by site-directed mutagenesis and expressed in HEK-293T cells. Secreted antithrombin was purified and functionally characterized. Structural modeling was performed to predict the impact of the mutation on protein structure. A novel nanopore sequencing approach was used for haplotype investigation.Results Ten patients experienced VTE, stroke, or obstetric complications. Antithrombin antigen levels and anti-IIa activity were normal or slightly reduced while anti-Xa activity was reduced with only one commercial assay. On crossed immunoelectrophoresis, an increase of antithrombin fractions with reduced heparin affinity was observed under high ionic strength conditions but not under physiological conditions. The recombinant p.Thr147Ala protein displayed a reduced anti-Xa activity. Structural modeling revealed that residue Thr147 forms three hydrogen bonds that are abolished when mutated to alanine. The investigated patients shared a common haplotype involving 13 SERPINC1 intragenic single nucleotide polymorphisms.Conclusion Antithrombin p.Thr147Ala, responsible for antithrombin type II heparin binding site deficiency, is the first founder mutation reported in people of African ancestry. This study further emphasizes the limitations of commercial methods to diagnose this specific subtype.
Pathological Features of Ruptured Coronary Plaque and Thrombus Interfaces: Fibrin and von Willebrand Factor as Platelet Scaffolds on Rupture Sites
Authors: Yamashita Atsushi , Nishihira Kensaku , Gi Toshihiro , Maekawa Kazunari , Hatakeyama Kinta , Horiuchi Saki , Wada Kei , Shibata Yoshisato , Asada Yujiro 
Published: September 2020

AbstractArterial thrombus formation is thought to be initiated by platelet adhesion to the subendothelial matrix, but ruptured atherosclerotic plaques are characterized by substantial reduction of matrix proteins compared with stable plaques. Intraplaque erythrocytes and/or fibrin have been reported in high-risk coronary plaques. The aims of the current study were to identify factors that provide scaffolds for platelets at the sites of ruptured coronary plaques and investigate depositions of iron and bilirubin as hemoglobin catabolites in the ruptured plaques. Histological characteristics of plaque components and the thrombus interface were examined in 73 acute coronary aspirated thrombi. Necrotic debris (95%), macrophages (95%), and cholesterin clefts (81%) were observed frequently at the ruptured plaque and thrombus interface. A fibrous matrix (47%), calcification (32%), and extracellular deoxyribonucleic acid (15%) were identified as small foci. Tissue factor was localized in the necrotic core and macrophages. Fibrin and von Willebrand factor were consistently deposited within the plaques and beneath platelet aggregations. The citrullinated histone H3-immunopositive area accounted for only 0.5% of the plaque area. Bilirubin and iron depositions were detected in approximately 20% of the plaques in addition to biliverdin reductase and ferritin expression in macrophages. Fibrin and von Willebrand factor rather than matrix proteins and neutrophil extracellular traps may be major adhesive molecules at the sites of ruptured plaques. Iron and bilirubin deposits may be markers for rupture-prone plaques.
Edoxaban versus Warfarin in Patients with Atrial Fibrillation at the Extremes of Body Weight: An Analysis from the ENGAGE AF-TIMI 48 Trial
Authors: Boriani Giuseppe , Ruff Christian T. , Kuder Julia F. , Shi Minggao , Lanz Hans J. , Antman Elliott M. , Braunwald Eugene , Giugliano Robert P. 
Published: September 2020

AbstractBackground The effects of anticoagulants at extremes of body weight (BW) are not well described. The aim of this study was to analyze the pharmacokinetics/pharmacodynamics and clinical outcomes in patients randomized to warfarin, higher dose edoxaban (HDER), and lower dose edoxaban (LDER) regimens at extremes of BW in ENGAGE AF-TIMI 48.Methods and Results We analyzed three BW groups: low BW (LBW: <5th percentile, ≤55 kg, N = 1,082), middle BW (MBW: 45th–55th percentile, 79.8–84 kg, N = 2,153), and high BW (HBW: >95th percentile, ≥120 kg, N = 1,093). In the warfarin arm, LBW patients had higher rates of stroke/systemic embolism (SSE: 6.5 vs. 4.7 in MBW vs. 1.6% in HBW, P trend < 0.001), major bleeding (MB: 9.3 vs. 7.7 vs. 6.5%, P trend = 0.08), and worse net clinical outcome of systemic embolic event, MB, or death (31.5 vs. 19.1 vs. 16.0%, P trend < 0.0001). The time-in-therapeutic range with warfarin was lowest in LBW patients (63.0 vs. 69.3 vs. 70.1% patients, P trend < 0.001). The pharmacokinetic/pharmacodynamic profile of edoxaban was consistent across BW groups. The risk of SSE was similar between HDER and warfarin for each of the three weight groups (P int = 0.52, P int-trend = 0.86). MB was reduced by LDER versus warfarin (P int = 0.061, P int-trend = 0.023), especially in LBW patients. Net clinical outcomes were improved by HDER versus warfarin (P int = 0.087, P int-trend = 0.027), especially in LBW patients.Conclusion Patients with LBW in ENGAGE AF-TIMI 48 had in general a more fragile clinical status and poorer international normalized ratio control. The pharmacokinetic/pharmacodynamic profile of edoxaban was consistent across extremes of BW, resulting in similar efficacy compared with warfarin, while major or clinically relevant non-MB and net outcomes were most favorable with edoxaban as compared to warfarin in LBW patients.
Anal Fissure in Children
Authors: Patkova Barbora , Wester Tomas 
Published: September 2020

AbstractAnal fissure is a common clinical problem in children and is defined as a longitudinal tear in the anal canal. The typical presentation is painful defecation and rectal bleeding. The etiology of anal fissure is unknown, but passage of hard stools and increased internal anal sphincter pressure are considered important factors. The treatment is oriented to relieve the spasm of the internal anal sphincter, which prevents healing of the fissure. Conservative management with stool softeners, topical analgesics, and sitz baths is recommended as first-choice therapy. Surgical treatment has been replaced by nonoperative management as definitive therapy, which is associated with a marginally higher success rate than placebo. Most recent studies have focused on nonoperative treatment with glyceryl trinitrate, calcium channel blockers, or botulinum toxin injection treatment. There are a few controlled studies to compare the different nonoperative treatment options in children. Success rates vary between the studies, and there is no clear evidence about which is the optimal nonoperative treatment. A significant recurrence rate has been reported after nonoperative management of anal fissure. It is important to treat constipation to avoid recurrent tears in the anal canal.
Surgical Management of Rectal Prolapse in Infants and Children
Authors: Saadai Payam , Trappey A. Francois , Langer Jacob L. 
Published: September 2020

AbstractThe surgical management of children with rectal prolapse is wide ranging and without consensus within the pediatric surgical community. While the majority of rectal prolapse in infants and children resolves spontaneously or with the medical management of constipation, a small but significant subset of patients may require intervention for persistent symptoms. In this review, we discuss the etiology and pathophysiology of rectal prolapse in both infants and children, options for medical management, described interventions and surgical options and their outcomes, and future avenues for research and investigation.
The multifaceted nature of the antipassive construction
Authors: Janic Katarzyna , Witzlack-Makarevich Alena 
Published: September 2020

Abstract
The present chapter opens the volume by proving an
overview of the antipassive construction from the typological perspective.
After setting the scene by introducing the major theoretical concepts used
in this volume, we consider various aspects of the formal and functional
variation of the antipassive construction. First, we show how the
antipassive construction varies among languages with respect to the
realization of the P argument. We then discuss various aspects of
the antipassive marker, including its dedicatedness and obligatoriness, as
well as its syncretism with other functions. This chapter also zooms in on
various functions performed by the antipassive. In addition to semantic,
discourse-pragmatic and syntactic functions commonly recognized in the
literature, we also address a less typical stylistic function. Another
parameter of variation discussed is the productivity of the antipassive.
Finally, this chapter addresses the question of various constructions which
formally or functionally overlap with antipassive constructions.