bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the utility of high‐resolution manometry for the diagnosis of defecatory disorders in women with chronic constipation
Authors: Sharma Mayank , Muthyala Anjani , Feuerhak Kelly , Puthanmadhom Narayanan Susrutha , Bailey Kent R. , Bharucha Adil E. 
Published: July 2020

AbstractBackgroundWe compared the utility of existing and modified versions of high‐resolution manometry for diagnosing defecatory disorders (DD).MethodsIn 64 healthy and 136 constipated women, we compared left lateral (LL) and seated manometry, and analyzed with existing (ManoView™) and new methods, for discriminating between constipated patients with normal and prolonged rectal balloon expulsion time (BET). In both positions, the rectoanal gradient (RAG) and, for the new analysis, the pressure topography pattern during evacuation were used to discriminate between constipated patients without and with DD.Key ResultsThe BET was prolonged, suggestive of a DD, in 52 patients (38%). During evacuation, rectoanal pressures and the RAG were greater in the seated than the LL position (P≤.001). The new analysis identified 4 rectoanal pressure patterns. In the seated position, the BET was associated with the pattern (P=.0001), being prolonged in, respectively, 45%, 15%, 53%, and 0% of patients with minimal change, anal relaxation, paradoxical contraction, and transmission. Within each pattern, the RAG was greater (ie, less negative, P<.0001) in patients with a normal than a prolonged BET. Compared to the ManoView™ RAG in the LL position, the integrated analysis (ie, pattern and new RAG) in the LL position (P<.01) and the seated ManoView™ gradient (P=.02) were more effective for discriminating between constipated patients without and with DD.Conclusions & InferencesAnorectal HRM ideally should be performed in the more physiological seated position and analyzed by a two‐tier approach, which incorporates the overall pattern followed by the rectoanal gradient. These findings reinforce the utility of manometry for diagnosing DD.
A Prospective, Multi‐Center, Clinical Trial of a 10‐kHz Spinal Cord Stimulation System in the Treatment of Chronic Pelvic Pain
Authors: Tate Jordan L. , Stauss Thomas , Li Sean , Rotte Anand , Subbaroyan Jeyakumar 
Published: July 2020

AbstractBackgroundChronic pelvic pain (CPP) is a debilitating condition that often leads to disability and does not respond to conventional treatments. This study was conducted to evaluate the effects of paresthesia‐independent 10‐kHz spinal cord stimulation (SCS) in subjects with CPP.MethodsThis prospective, single‐arm pilot study enrolled subjects with clinical diagnoses of CPP and mean pain scores of ≥ 5.0 cm on a 10‐cm VAS. Subjects underwent trial stimulations with 10‐kHz SCS, and those who had successful trial stimulations (≥40% pain relief) received permanently implanted devices and were followed for 12 months.ResultsOf the 21 subjects who underwent the 10‐kHz SCS trial, 17 were successful and 14 subjects received permanent implants. No neurological deficits were observed in any subjects and all adverse events (AEs) were resolved without sequelae during the study period. Over 12 months, mean VAS scores decreased by 72% from baseline, and 10 of 13 subjects (77%) were responders (≥50% pain relief). Pain remission (VAS score ≤ 3.0 cm) was reported by 8 of 13 subjects (62%), and mean pain scores on the short‐form McGill Pain Questionnaire 2 decreased as well. Pain Disability Index scores declined by 29 points, and 85% of the subjects reported satisfaction.ConclusionsParesthesia‐independent stimulation with 10‐kHz SCS reduced pelvic pain in subjects with CPP and was not associated with any unexpected AEs. While larger, controlled studies are needed, results of this study suggest that this therapeutic modality could potentially treat patients with CPP while improving their quality of life.
Perioperative changes in platelet count in patients with atrial septal defect
Authors: Akashi Akiko , Kamada Masahiro , Nakagawa Naomi , Ishiguchi Yukiko , Moritou Yuuji , Hara Mayuko , Eguchi Yoshimi 
Published: July 2020

AbstractBackgroundPlatelet count and function change following atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO). However, the clinical significance of these changes remains unclear. We examined changes in platelet count and mean platelet volume (MPV) before and after ASO placement, and the association between platelet count, MPV and various factors. We discussed the mechanism and clinical significance of changes in platelet count and MPV.MethodsWe evaluated 109 patients with ASD who underwent ASO placement, and we performed various analyses of platelet count and MPV.ResultsYounger patients typically had higher platelet counts and lower MPV on admission. They also had large ASDs relative to their body constitution; larger devices were therefore used. Rates of change in platelet count were higher in younger patients. There were no significant associations between platelet count or MPV before placement and mean pulmonary artery pressure, and Qp/Qs, and between the number of thrombocytopenia and presence or absence of headache or residual ASD. Platelet counts decreased on average by 21.3% for the first 3 days after ASO placement. One month after placement, platelet counts were slightly improved but remained lower than before placement. Conversely, MPV increased significantly after ASO placement and remained high a month after placement. The ASO size was the most influential factor in platelet count reduction after ASD closure by ASO.ConclusionsOne month after ASO placement, platelet counts decreased and MPVs continued to increase, suggesting that platelet consumption and new production were still occurring a month after placement.
Lifestyle habits associated with screen time among pupils in Japan
Authors: Kohyama Jun 
Published: July 2020

AbstractBackgroundMedia use is pervasive among pupils. This study aimed to determine lifestyle factors associated with screen time.MethodsThe study used a cross‐sectional design, and 2,722 questionnaires obtained from pupils in grades 5–12 were analyzed. Multiple regression analysis was used to determine significant lifestyle factors associated with screen time. Grade, gender, bedtime and waking time on both school days and non‐school days, academic performance, sleepiness, breakfast, dinner regularity, defecation habits, hours of after‐school activities, physical activity, and body mass index were used as the variables.ResultsSignificant regression formulae were obtained for all school types: adjusted R2/P values were 0.21/<0.001 for elementary school, 0.21/<0.001 for junior high school, and 0.14/<0.001 for high school. Later non‐school‐day bedtime (standardized regression coefficient/P values were 0.14/< 0.001 for elementary school, 0.14/<0.001 for junior high school, and 0.09/<0.05 for high school) was significantly associated with increased screen time for all school types. In both elementary and junior high schools, more sleepiness (0.12/<0.001 for elementary school, 0.13/<0.001 for junior high school), shorter after‐school activity (−0.24/<0.001 for elementary school, −0.19/<0.001 for junior high school), and higher standardized body mass index (0.08/<0.05 for elementary school, 0.08/<0.01 for junior high school) were significantly associated with screen time increase. In both junior and senior high schools, breakfast skipping (0.15/<0.001 for junior school, 0.14/<0.001 for high school) revealed a significant association with screen time increase.ConclusionsMedia use is associated with variable lifestyle habits. Effective approaches to reduce heavy media use remain to be determined.
Cordella et al v Italy and the effectiveness of human rights law remedies in cases of environmental pollution
Authors: Greco Roberta 
Published: July 2020

AbstractThis case note focuses on the ongoing monitoring of the execution of the judgment of the European Court of Human Rights of 24 January 2019 in Cordella et al v Italy, in which the Court found Italy responsible for the violation of the right to private and family life of the applicants due to its failure to adopt the necessary measures for preventing and prohibiting the environmental pollution caused by the ex‐Ilva steelworks. After highlighting the shortcomings of the judgment, in particular the decision not to adopt the pilot judgment procedure, the note shows how these weaknesses have impacted the execution of the Court’s decision, which, after more than a year, is at a standstill.
Pleural effusions and pneumothorax: Beyond simple plumbing
Authors: Thomas Rajesh , Rahman Najib M. , Maskell Nick A. , Lee Y.C. Gary 
Published: July 2020

ABSTRACTPleural diseases affect millions of people worldwide. Pleural infection, malignant pleural diseases and pneumothorax are common clinical challenges. A large number of recent clinical trials have provided an evidence‐based platform to evaluate conventional and novel methods to drain pleural effusions/air which reduce morbidity and unnecessary interventions. These successes have generated significant enthusiasm and raised the profile of pleural medicine as a new subspecialty. The ultimate goal of pleural research is to prevent/stop development of pleural effusions/pneumothorax. Current research studies mainly focus on the technical aspects of pleural drainage. Significant knowledge gaps exist in many aspects such as understanding of the pathobiology of the underlying pleural diseases, pharmacokinetics of pleural drug delivery, etc. Answers to these important questions are needed to move the field forward. This article collates opinions of leading experts in the field in highlighting major knowledge gaps in common pleural diseases to provoke thinking beyond pleural drainage. Recognizing the key barriers will help prioritize future research in the quest to ultimately cure (rather than just drain) these pleural conditions.
Effect of aerobic fitness on the relation between age and whole‐body heat exchange during exercise‐heat stress: a retrospective analysis
Authors: Notley Sean R. , Meade Robert D. , Kenny Glen P. 
Published: July 2020

New Findings

What is the central question of this study?
Does higher aerobic fitness, indexed by peak oxygen uptake (), attenuate the age‐related decline in thermoregulatory function during exercise in the heat?

What is the main finding and its importance?
When assessed in aerobically fit and less fit adults (: ∼30 vs. ∼50 ml kg−1 min−1) aged 18–66 years, a steeper decline in whole‐body total heat loss (evaporative + dry heat exchange) was observed with increasing age in less aerobically fit adults. These outcomes indicate that increased aerobic fitness may attenuate the age‐related decline in thermoregulatory function during exercise‐heat stress.

AbstractAgeing is associated with decrements in cutaneous vasodilatation and sweating that attenuate whole‐body total heat loss (evaporative + dry heat exchange) during exercise‐heat stress. However, it remains uncertain whether increased aerobic fitness, as indexed by peak oxygen uptake (), slows that age‐related decline. To evaluate this possibility, we conducted a retrospective analysis of data from aerobically fit (n = 38; : (mean (SD)) 49 (4) ml kg−1 min−1) and less fit (n = 35; : 32 (3) ml kg−1 min−1) adults spanning a broad age range (18–65 vs. 18–66 years). Participants performed three, 30 min bouts of cycling at metabolic heat productions of 150, 200 and 250 W m−2, each separated by 15 min recovery, in dry heat (40˚C, ∼15% relative humidity). Metabolic heat production and whole‐body total heat loss were measured using indirect and direct calorimetry, respectively. Total heat loss (mean (95% CI)) declined at a rate of 5 (2, 8), 6 (3, 8) and 5 (3, 10) W m−2 per decade during exercise at metabolic heat productions of 150, 200 and 250 W m−2, respectively, in less aerobically fit individuals (all P ≤ 0.002), due primarily to reductions in evaporative heat loss. In contrast, no significant associations between age and total heat loss were observed in aerobically fit individuals (all P ≥ 0.146). As such, the slope of the age‐related reduction in total heat loss was steeper in less fit compared to fit individuals across all three exercise bouts (all P ≤ 0.029). These outcomes indicate that increased aerobic fitness attenuates the age‐related decline in exercise thermoregulation.
Dynamic Modeling for Bi-Modal, Rotary Wing, Rolling-Flying Vehicles
Authors: Atay Stefan , Buckner Gregory , Bryant Matthew 
Published: July 2020

Abstract
This paper presents a rigorous analysis of a promising bi-modal multirotor vehicle that can roll and fly. This class of vehicle provides energetic and locomotive advantages over traditional unimodal vehicles. Despite superficial similarities to traditional multirotor vehicles, the dynamics of the vehicle analyzed herein differ substantially. This paper is the first to offer a complete and rigorous derivation, simulation, and validation of the vehicle's terrestrial rolling dynamics. Variational mechanics is used to develop a six degrees-of-freedom dynamic model of the vehicle subject to kinematic rolling constraints and various nonconservative forces. The resulting dynamic system is determined to be differentially flat and the flat outputs of the vehicle are derived. A functional hardware embodiment of the vehicle is constructed, from which empirical motion data are obtained via odometry and inertial sensing. A numerical simulation of the dynamic model is executed, which accurately predicts complex dynamic phenomena observed in the empirical data, such as gravitational and gyroscopic nonlinearities; the comparison of simulation results to empirical data validates the dynamic model.
Thermal bottlenecks in the life cycle define climate vulnerability of fish
Authors: Dahlke Flemming T. , Wohlrab Sylke , Butzin Martin , Pörtner Hans-Otto 
Published: July 2020

Some cope better than othersIncreasingly, research is revealing how organisms may, or may not, adapt to a changing climate. Understanding the limitations placed by a species's physiology can help to determine whether it has an immediate potential to deal with rapid change. Many studies have looked at physiological tolerance to climate change in fishes, with results indicating a range of responses. Dahlkeet al.conducted a meta-analysis to explore how life stage may influence a species's ability to tolerate temperature change (see the Perspective by Sunday). They found that embryos and breeding adult fishes are much more susceptible to temperature change than those in other life stages and that this factor must therefore be considered in evaluations of susceptibility.Science, this issue p.65; see also p.35
Effect of socioeconomic deprivation on outcomes of diabetes complications in patients with type 2 diabetes mellitus: a nationwide population-based cohort study of South Korea
Authors: Choi Dong-Woo , Lee Sang Ah , Lee Doo Woong , Joo Jae Hong , Han Kyu-Tae , Kim SeungJu , Park Eun-Cheol 
Published: July 2020

IntroductionThis study aimed to examine the effect of socioeconomic deprivation on the outcomes of diabetes complications in patients with type 2 diabetes mellitus (T2DM).Research design and methodsWe conducted a cohort study using claims data and 2005 national census data. We included of 7510 patients newly diagnosed with T2DM from 2004 to 2012 and aged 40 years or above. We excluded participants who had onset of diabetes complications and hospitalization within 1 year after initial onset T2DM, aged less than 40 years and with missing covariates. We used the regional socioeconomic deprivation index and classified study participants into five categories according to the quintile distribution. We calculated the adjusted HR and 95% CI for hospitalization related to diabetes complications and all-cause mortality by applying Cox proportional hazards model and the adjusted subdistribution hazards model.ResultsThe percentages of participants in the first quintile (least deprived) to fifth quintile (most deprived) were 27.0%, 27.9%, 19.5%, 14.8%, and 10.8% for socioeconomic deprivation; 25.4%, 28.8%, 32.4%, 34.6%, and 37.6% for hospitalization due to diabetes complications; 1.3%, 2.1%, 2.5%, 2.9%, and 3.6% for deaths from diabetes complications; and 5.7%, 7.2%, 9.7%, 9.7%, and 13.1% for deaths from all causes, respectively. Participants with higher socioeconomic deprivation had a higher HR for hospitalization and mortality from all-cause and diabetes complications. These associations were the strongest among men and participants in their 40s in hospitalization related to diabetes complications, 50s in diabetes complications-specific mortality and 50s and 60s in all-cause mortality.ConclusionsPatients with T2DM with high socioeconomic deprivation had higher hospital admission and mortality rates for diabetes complications than those with low deprivation. We cannot fully explain the effect of socioeconomic deprivation on diabetes outcomes. Therefore, further studies are needed in order to find underlying mechanisms for these associations.
Association of cerebral blood flow with myelin content in cognitively unimpaired adults
Authors: Bouhrara Mustapha , Alisch Joseph S R , Khattar Nikkita , Kim Richard W , Rejimon Abinand C , Cortina Luis E , Qian Wenshu , Ferrucci Luigi , Resnick Susan M , Spencer Richard G 
Published: July 2020

BackgroundMyelin loss and cerebral blood flow (CBF) decline are central features of several neurodegenerative diseases. Myelin maintenance through oligodendrocyte metabolism is an energy-demanding process, so that myelin homeostasis is particularly sensitive to hypoxia, hypoperfusion or ischaemia. However, in spite of its central importance, little is known about the association between blood supply and myelin integrity.ObjectiveTo assess associations between cortical and subcortical CBF, and subcortical myelin content, in critical brain white matter regions.Materials and methodsMRI was performed on a cohort of 67 cognitively unimpaired adults. Using advanced MRI methodology, we measured whole-brain longitudinal and transverse relaxation rates (R1and R2), sensitive but non-specific markers of myelin content, and myelin water fraction (MWF), a direct surrogate of myelin content, as well as regional CBF, from each of these participants.ResultsAll quantitative relaxometry metrics were positively associated with CBF in all brain regions evaluated. These associations between MWF orR1and CBF, and, to a lesser extent, betweenR2and CBF, were statistically significant in most brain regions examined, indicating that lower regional cortical or subcortical CBF corresponds to a decrease in local subcortical myelin content. Finally, all relaxometry metrics exhibited a quadratic, inverted U-shaped, association with age; this is attributed to the development of myelination from young to middle age, followed by progressive loss of myelin in later years.ConclusionsIn this first study examining the association between local blood supply and myelin integrity, we found that myelin content declines with CBF across a wide age range of cognitively normal subjects.
Prevalence and correlates of physical activity in a sample of UK adults observing social distancing during the COVID-19 pandemic
Authors: Smith Lee , Jacob Louis , Butler Laurie , Schuch Felipe , Barnett Yvonne , Grabovac Igor , Veronese Nicola , Caperchione Cristina , Lopez-Sanchez Guillermo F , Meyer Jacob , Abufaraj Mohammad , Yakkundi Anita , Armstrong Nicola , Tully Mark A 
Published: July 2020

ObjectiveTo investigate the levels and correlates of physical activity during COVID-19 social distancing in a sample of the UK public.MethodsThis paper presents analyses of data from a cross-sectional study. Levels of physical activity during COVID-19 social distancing were self-reported. Participants also reported on sociodemographic and clinical data. The association between several factors and physical activity was studied using regression models.ResultsNine hundred and eleven adults were included (64.0% were women and 50.4% of the participants were aged 35–64 years). 75.0% of the participants met the physical activity guidelines during social distancing. Meeting these guidelines during social distancing was significantly associated with sex (reference: male; female: OR=1.60, 95% CI 1.10 to 2.33), age (reference: 18–34 years; ≥65 years: OR=4.11, 95% CI 2.01 to 8.92), annual household income (reference: <£15 000; £15 000–<£25 000: OR=2.03, 95% CI 1.11 to 3.76; £25 000–<£40 000: OR=3.16, 95% CI 1.68 to 6.04; £40 000–<£60 000: OR=2.27, 95% CI 1.19 to 4.34; ≥£60 000: OR=2.11, 95% CI 1.09 to 4.09), level of physical activity per day when not observing social distancing (OR=1.00 (per 1 min increase), 95% CI 1.00 to 1.01), and any physical symptom experienced during social distancing (reference: no; yes: OR=0.31, 95% CI 0.21 to 0.46).ConclusionDuring COVID-19, social distancing interventions should focus on increasing physical activity levels among younger adults, men and those with low annual household income. It should be noted in the present sample that women and younger adults are over-represented.
Prediction of cardiovascular health by non-exercise estimated cardiorespiratory fitness
Authors: Cabanas-Sánchez Verónica , Artero Enrique G , Lavie Carl J , Higueras-Fresnillo Sara , García-Esquinas Esther , Sadarangani Kabir P , Ortolá Rosario , Rodríguez-Artalejo Fernando , Martínez-Gómez David 
Published: July 2020

ObjectiveTo estimate the incidence of major biological cardiovascular disease (CVD) risk factors in adults using non-exercise estimated cardiorespiratory fitness (eCRF).Methods200 039 healthy people (99 957 women), aged ≥18 years (38.5±12.1 years) from the Taiwan MJ Cohort. eCRF was estimated with validated algorithms. Biological CVD risk factors, including hypertension (HTN), hypercholesterolemia, atherogenic dyslipidaemia, type 2 diabetes mellitus (T2DM) and systemic inflammation, were assessed by standardised physical examinations and laboratory tests.ResultsIn a basic model, baseline eCRF was inversely associated with the incidence of each CVD risk factor in both men and women (HR per 1 metabolic equivalent (MET) increase in eCRF ranged from 0.53 for T2DM in women to 0.96 for hypercholesterolemia in women). In full adjusted models, the associations were attenuated but remained statistically significant, with the exception of hypercholesterolemia in women. In a subcohort of 116 313 individuals with two repeated exposure measurements, an increase in eCRF was associated in both sexes with a subsequent lower incidence of CVD risk factors (HR per 1-MET increase ranged from 0.58 to 0.91 in models adjusted for age, year of examination and baseline eCRF). Comparisons of predictive performance showed that the addition of eCRF to values of traditional CVD risk factors had relevant improvements in risk discrimination (C-index increased from 0.1% to 3.2%), mainly for HTN and T2DM risk prediction.ConclusionseCRF and its changes predict the incidence of biological CVD risk factors, especially HTN and T2DM. Routine assessment of eCRF in clinical settings is technically feasible and might be useful for CVD prevention.