bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of exercise-induced stress by automated measurement of salivary cortisol concentrations within the circadian rhythm in Japanese female long-distance runners
Authors: Ushiki Kazumi , Tsunekawa Katsuhiko , Shoho Yoshifumi , Martha Larasati , Ishigaki Hirotaka , Matsumoto Ryutaro , Yanagawa Yoshimaro , Nakazawa Asuka , Yoshida Akihiro , Nakajima Kiyomi , Araki Osamu , Kimura Takao , Murakami Masami 
Published: August 2020

AbstractBackgroundOvertraining syndrome, caused by prolonged excessive stress, results in reduced performance and cortisol responsiveness in athletes. It is necessary to collect saliva samples sequentially within circadian rhythm for assessing exercise stress by measuring cortisol concentrations, and automated cortisol measurements using electrochemiluminescence immunoassay (ECLIA) may be useful for measuring a large number of saliva samples. In this study, we evaluated the appropriate use of cortisol-based exercise stress assessment within the circadian rhythm, which may diagnose and prevent overtraining syndrome in athletes.MethodsWe collected saliva and sera from 54 healthy participants and analyzed the correlation between salivary cortisol concentrations measured by ECLIA and enzyme-linked immunosorbent assay (ELISA) or serum cortisol analysis. We also collected saliva continuously from 12 female long-distance runners on 2 consecutive days involving different intensities and types of exercise early in the morning and in the afternoon and measured salivary cortisol concentrations using ECLIA. Each exercise intensity of runners was measured by running velocities, Borg Scale score, and rate of change in the pulse rate by exercise.ResultsECLIA-based salivary cortisol concentrations correlated positively with those detected by ELISA (ρ= 0.924,p< 0.001) and serum cortisol (ρ= 0.591,p= 0.001). In long-distance runners, circadian rhythm of salivary cortisol, including the peak after waking and the decrease promptly thereafter, were detected on both days by continuous saliva sampling. The rates of change in salivary cortisol concentrations were significantly lower after an early morning exercise than after an afternoon exercise on both days (day 1,p= 0.002, and day 2,p= 0.003). In the early morning exercise, the rate of change in salivary cortisol concentration was significantly higher on day 1 than on day 2 (p= 0.034), similar to a significant difference in running velocities (p= 0.001).ConclusionsOur results suggest that automated ECLIA-based salivary cortisol measurements are able to detect the athletes’ circadian rhythm and compare the exercise stress intensities at the same times on different days, even in the early morning, possibly leading to the prevention of overtraining syndrome.
Development and feasibility of a tailored habit-based dietary intervention coupled with natural tooth replacement on the nutritional status of older patients
Authors: McCrum Leigh-Ann , Watson Sinead , McGowan Laura , McGuinness Bernadette , Cardwell Christopher , Clarke Mike , Woodside Jayne V. , McKenna Gerry 
Published: August 2020

AbstractBackgroundOlder adults suffering partial tooth loss may need additional intervention strategies other than natural tooth replacement alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with natural tooth replacement, amongst partially dentate older adults.MethodsThe design and development of the dietary intervention (phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). The dietary intervention consisted of forming three healthy dietary habits around fruits and vegetables, wholegrains and healthy proteins. Feasibility of the intervention was then tested amongst older adults who had recently completed dental treatment for natural tooth replacement in a small non-randomised single arm study (phase 2). The principal feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Supporting outcomes consisted of feasibility of screening procedures, recruitment strategies and retention/attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets.ResultsTwenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (phase 1). Twelve themes related to barriers (e.g. oral health, appetite) and facilitators (e.g. nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (phase 2) where eight themes were identified from feedback interview discussions. The principal outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a supporting outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g. incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention.ConclusionPhase 1 and phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness.Trial registrationISRCTN66118345
Community acquired paediatric pneumonia; experience from a pneumococcal vaccine- naive population
Authors: Kudagammana Sanath Thushara , Karunaratne Ruchira Ruwanthika , Munasinghe Thilini Surenika , Kudagammana Haputhanthirige Donna Wasana Samank 
Published: August 2020

Abstract
Background
Childhood pneumonia continues to be a disease that causes severe morbidity and mortality among children mainly in South-East Asia and Africa though it is not so in the developed world. Pneumonia accounts for 16% of all deaths of children under 5 years old in the world, killing nearly one million children in 2015. In Sri Lanka, there were 21,000 reported cases of pneumonia in 2006, 40% were in the age group of less than 4 years.

Methods
This was a retrospective study done on the children aged 1 month to 14 years who were admitted to the Professorial Paediatric unit of Teaching Hospital, Peradeniya between 1st of March 2016 and 30th of July 2017 fulfilling diagnostic criteria for community-acquired pneumonia. Data including diagnosis, clinical details, management details and other relevant data were collected from patient records by using a data collection sheet.

Results
In this study, 48% of 127 patients admitted with community-acquired pneumonia had bronchopneumonia. About 2/3 of the patients neededa secondline of intravenous antibiotics while 51/ 127 needed care in the high dependency unit with supplemental oxygen. No mortality was observed in the group.

Conclusions
Community- acquired paediatric pneumonia has a significant associated morbidity but not mortality in the studied population. The need for the second-line treatment with intravenous antibiotics in a significant proportion of patients may indicate a high degree of antibiotic resistance. Introduction of national antibiotic policy will help the cause.
Serum 20S proteasome levels are associated with disease activity in MPO-ANCA-associated microscopic polyangiitis
Authors: Maruyama Hiroshi , Hirayama Kouichi , Yamashita Marina , Ohgi Kentaro , Tsujimoto Ryuji , Takayasu Mamiko , Shimohata Homare , Kobayashi Masaki 
Published: August 2020

Abstract
Background
Proteasomes are found in both the cell nucleus and cytoplasm and play a major role in the ubiquitin-dependent and -independent non-lysosomal pathways of intracellular protein degradation. Proteasomes are also involved in the turnover of various regulatory proteins, antigen processing, cell differentiation, and apoptosis. To determine the diagnostic value of serum proteasome in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), we investigated patients with AAV at various stages of the disease.

Methods
Serum 20S-proteasome was measured by ELISA in 44 patients with MPO-ANCA-associated microscopic polyangiitis (MPA) and renal involvement. Thirty of the patients provided serum samples before the initial treatment, and 30 provided samples during remission; 16 provided samples at both time points.

Results
The mean serum 20S-proteasome level was significantly higher in the active-vasculitis patients (3414.6 ± 2738.9 ng/mL; n = 30) compared to the inactive-vasculitis patients (366.4 ± 128.4 ng/mL; n = 30; p <  0.0001) and 40 controls (234.9 ± 90.1 ng/mL; p <  0.0001). There were significant positive correlations between the serum 20S-proteasome level and the Birmingham Vasculitis Activity Score (BVAS) (r = 0.581, p <  0.0001), the ANCA titer (r = 0.384, p <  0.0001), the white blood cell (WBC) count (r = 0.284, p = 0.0042), the platelet count (r = 0.369, p = 0.0002), and the serum C-reactive protein (CRP) level (r = 0.550, p < 0.0001). There were significant negative correlations between the serum 20S-proteasome level and both the hemoglobin concentration (r = − 0.351, p = 0.0003) and the serum albumin level (r = − 0.460, p < 0.0001). In a multiple regression analysis, there was a significant positive correlation between the serum 20S-proteasome level and only the BVAS results (β = 0.851, p = 0.0009). In a receiver operating curve analysis, the area under the curve for the serum 20S-proteasome level was 0.996, which is higher than those of the WBC count (0.738) and the serum CRP level (0.963).

Conclusion
The serum level of 20S-proteasome may be a useful marker for disease activity in AAV.
Mobility and sales activity during the Corona crisis: daily indicators for Switzerland
Authors: Eckert Florian , Mikosch Heiner 
Published: August 2020

AbstractThis paper documents daily compound indicators on physical mobility and sales activity in Switzerland during the Corona crisis. We report several insights from these indicators: The Swiss population substantially reduced its activities already before the shops closed and before the authorities introduced containment policies in mid-March 2020. Activity started to gradually recover from the beginning of April onwards, again substantially before the first phase of the shutdown easing started at the end of April. Low physical mobility during the second half of March and during April likely contributed to the quick fall in new COVID-19 infections since mid-March. The sharp drop in economic activity in consumer-related services during March and April and the gradual recovery in these sectors since May correlate strongly with the reduction and subsequent gradual resurgence of mobility. In addition, while activity within Switzerland was back to normal levels by late June, activity of Swiss residents outside of Switzerland was still below normal.
Occurrence of metastatic eccrine porocarcinoma in an immunosuppressed patient
Authors: Modi Mitul B. , Moshiri Ata S. , Shoji Toru , Mihm Martin C. , Xu Xiaowei , Elder David E. 
Published: August 2020

Abstract
Background
Eccrine porocarcinoma is a rare malignancy accounting for 0.005 to 0.01% of all cutaneous tumors. However, its etiology is not well established. Herein we are reporting the occurrence of metastatic porocarcinoma of the back in a patient with a history of multiple cutaneous malignancies and chronic immunosuppression.

Case presentation
A 79-year-old male with a history of long-term immunosuppressive therapy for left lung transplantation and multiple cutaneous malignancies including melanoma, presented with an enlargening plaque on the right upper back. Biopsy demonstrated an infiltrative epithelial tumor with aggressive histology and ductal formation. Immunohistochemical stains for p63, CK-5/6, and CEA were diffusely positive, while CK-7 and CK-20 were negative. A diagnosis of eccrine porocarcinoma was made. He underwent complete wide excision with negative margins of the right upper back in January 2018. In November 2018, he was found to have a right posterior shoulder mass, positive right axillary lymph nodes, superficial right upper back soft tissue masses and lymphangitic carcinomatosis involving the left lung. He was transitioned to comfort care and subsequently passed from metastatic disease in December 2018.

Conclusion
The occurrence of eccrine porocarcinoma in a patient on long term immunosuppressive therapy for lung transplantation suggests a possible role for chronic immunosuppression in the induction of a subset of eccrine porocarcinomas, as in other cutaneous malignancies.
Hope in a time of civicide: regenerative development and IPAT
Authors: Newman Peter 
Published: August 2020

AbstractThis paper is written as the world faces economic recovery after the Covid pandemic collapse. It also responds to the article inSustainable Earthby Peter Hancock ‘In Praise of Civicide’ by creating a more hopeful vision of the future. Peter suggests the only hope is in psychological mind-sets that can change behaviour as nothing else will stop the path to destruction from present growth in population, the economy and technology. Rather than seeing inevitable civicidal elements, as devised in the IPAT model used by Peter and many others to explain global environmental destruction, the paper reassesses the fundamentals of this model developed by Paul and Anne Ehrlich in the 1960's. As the global economy has collapsed and environmental impacts improved everywhere, the Hancock argument based on IPAT would seem to have support. The paper shows how it is possible to grow again in the three IPAT factors if the world moves beyond sustainable development which just minimises impact to regenerative development which reclaims environmental impacts. If all three elements combine to create uncontrolled growth as was happening in the 60’s to 80’s then civicide is inevitable, but not if they change to regenerative development. The three stages of exploitive, sustainable and regenerative development turn IPAT from being negative to positive about civilization. These choices are very stark in the 2020’s. The technological possibilities of a regenerative future are outlined and the fundamentals needed for a sustainable earth are sketched, providing some evidence of hope for using the present pandemic and economic collapse as the basis for regenerating civilization not praising civicide.
Hand strenght and dexterity in interphalangeal hand osteoarthritis and effects of osteophyte formations
Authors: Güven Nurhan , Dinçer Fitnat , Çetin Alp , Güven Serdar Can 
Published: August 2020

Abstract
Background
Hand osteoarthritis (HOA) is a complex disorder with various subtypes characterized with predominance of different features. It is challenging to estimate the severity of hand disability in HOA, since contribution of different disease components to clinical burden is yet to be clarified. The aim of the study is to investigate hand functions in nonerosive interphalangeal hand osteoarthritis (HOA) without inflammatory features, and search for effects of osteophyte formations detected by radiography and ultrasound on functionality.

Methods
Thirty one HOA patients and 20 healthy subjects with similar age, gender, body mass index were included. Hand functions were evaluated by self-reported questionnaires and objective strength and dexterity measurements. A total of 459 interphalangeal joints were evaluated and scored by radiography and ultrasound for ostephyte formations.

Results
Strength and dexterity measurements were similar between groups. Self-reported functionality was hampered in HOA group but not statistically significant. Osteophyte scores obtained by ultrasound and radiography were significantly higher in HOA group. Osteophyte scores obtained by ultrasound were higher than the scores obtained by radiography. Ultrasound scores showed no correlation with any of the parameters while osteophytes scores obtained by radiography partially showed a significant negative correlation with assembly part of dexterity testing.

Conclusions
No significant difference observed in hand strength and dexterity in nonerosive interphalangeal HOA patients withouth signs of inflammation when compared to healthy subjects. Osteophyte formations prominent enough to be deteceted by radiography may have a negative effect on hand dexterity.
New freshwater plesiosaurian materials from the Middle Jurassic Xintiangou Formation of the Sichuan Basin, southwestern China
Authors: Zhang Feng , Yu Hai-Dong , Xiong Can , Wei Zhao-Ying , Peng Guang-Zhao , Wei Xue-Fang 
Published: August 2020

AbstractSichuan Basin is very famous for the Mesozoic reptiles, especially the Jurassic dinosaurs. Here, we report some isolated plesiosaurian teeth and vertebrae newly excavated from the Middle Jurassic Xintiangou Formation in Yunyang county, Chongqing City, the northeastern region of the Sichuan Basin, southwestern China. The specimens are referred to Pliosauroidea based on the combination of the following features: the circular cross-section of the tooth crown, apicobasal ridges fully covering the enamel surface and reaching to the apex, the short and amphicoelous centrum, the centrum shorter than wide or tall, and the absence of a keel on the lateral surface of the cervical centrum. With the fragmentary nature, it is undetermined whether the Yunyang specimens belong to a known taxon or represent a new species of Plesiosauria. These plesiosaurian specimens further demonstrate that the freshwater plesiosaurians are common in the Jurassic deposits of the Sichuan Basin. For a comprehensive knowledge of the plesiosaurians of the basin in origin, distribution and diversity, to discover new and more complete specimens is necessarily the first priority.
Predicting response to neo-adjuvant chemotherapy and assessment of residual disease in breast cancer using contrast-enhanced spectral mammography: a combined qualitative and quantitative approach
Authors: Kamal Rasha Mohammed , Saad Sherihan Mahmoud , Moustafa Amr Farouk Ibrahim , Gomaa Mohammed Mohammed , Mokhtar Omniya , Gouda Iman , Hassan Ahmed , Hilal Amany , ElZayat Ashraf 
Published: August 2020

Abstract
Background
Magnetic resonance imaging (MRI) is the gold standard imaging modality for evaluation of response for neo-adjuvant chemotherapy (NAC) in breast cancer as it has the advantage of providing both; morphology assessment together with providing functional information which can be obtained by contrast injection. Until the recent emergence of contrast-enhanced mammography as a promising breast imaging modality, these features were considered unique for MRI. The aim of the study is to evaluate the competence of contrast-enhanced spectral mammography (CESM) in the prediction of response to NAC and the assessment of residual disease extent, as well as the assessment of a new combined (quantitative and qualitative) evaluation approach that is proposed by the authors. The study included 81 patients with pathologically proved breast cancer scheduled for receiving NAC. They underwent 2 CESM examinations; pre- and post-NAC (maximum 10 days before surgery). All patients were assessed using the RECIST 1.1 criteria and a combined approach (RECIST+ qualitative subjective assessment). Results were in correlation to postoperative pathology using the Miller-Payne grading. For statistical evaluation, patients were classified into responders and non-responders.

Results
Postoperative histopathology showed that 60/81 lesions were responders (Miller-Payne grades 3, 4, and 5) while the combined response evaluation approach and RECIST 1.1 alone showed 57/60 (95%) patients and 46/60 patients (76.7%) as responders respectively. The combined response evaluation approach showed higher sensitivity and positive and negative predictive values compared to the evaluation based on RECIST alone (95%, 87.6%, and 81.2% compared to 76.6%, 86.7%, and 50% respectively).

Conclusion
CESM can be readily used to assess tumor response to NAC and allows the assessment of functional changes in residual tumor cells in addition to size discrepancy. Using CESM, we could accurately assess residual tumor extent and thus enable better surgical planning.
Large subcapsular hematoma of the liver due to faja corset: a rare case report
Authors: Minhas Sheharyar , Minhas Ahmed , Malik Maira , Sumanam Phaniram 
Published: August 2020

Abstract
Background
Subcapsular hematoma of the liver is a potentially life-threatening but extremely rare condition. It is often caused by a blunt trauma or other predisposing conditions such as a liver tumor, intra-tumor hemorrhage, surgery, preeclampsia, liver biopsy, and hemodialysis. Predisposing causes of liver hematoma include its large size and proximity to fixed structures. To date, there have been no reported cases of subcapsular liver hematoma caused by tight clothing such as corsets. Our case report is about an extremely rare case of subcapsular hematoma of the liver caused by wearing a tight faja corset in a young healthy female.

Case presentation
A forty-five-year-old Spanish female without any underlying health problems presented with sudden onset epigastric and right upper quadrant abdominal pain after wearing a faja corset the night prior to the hospital presentation. CT abdomen was noted for subcapsular hematoma of the liver. Her symptoms persisted and repeat CT abdomen showing worsening of the liver hematoma. Patient had interventional radiology (IR) guided drainage and was subsequently discharged home.

Conclusions
Subscapular liver hematomas need to be considered in patients presenting with acute onset abdominal pain after wearing certain tight clothing. The necessity of an early and accurate diagnosis is vital for management as hemodynamically stable patients can be managed conservatively. Our patient was managed with IR-guided aspiration drainage of the hematoma. Surgery can be considered a last resort in case of life-threatening hemodynamic instability, peritoneal signs, free abdominal fluid, and failure of arterial embolization. Our case highlights the importance of early recognition of traumatic subcapsular hematomas to prevent life-threatening complications.