bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate Change, Air Pollution, and Physical Inactivity: Is Active Transportation Part of the Solution?
Authors: ALESSIO HELAINE M. , BASSETT DAVID R. , BOPP MELISSA J. , PARR BRIAN B. , PATCH GRETCHEN S. , RANKIN JANET W. , ROJAS-RUEDA DAVID , ROTI MELISSA W. , WOJCIK JANET R. 
Published: February 2021

ABSTRACT

Active transportation is defined as self-propelled, human-powered transportation modes, such as walking and bicycling. In this article, we review the evidence that reliance on gasoline-powered transportation is contributing to global climate change, air pollution, and physical inactivity and that this is harmful to human health. Global climate change poses a major threat to human health and in the future could offset the health gains achieved over the last 100 yr. Based on hundreds of scientific studies, there is strong evidence that human-caused greenhouse gas emissions are contributing to global climate change. Climate change is associated with increased severity of storms, flooding, rising sea levels, hotter climates, and drought, all leading to increased morbidity and mortality. Along with increases in atmospheric CO2, other pollutants such as nitrogen dioxide, ozone, and particulate matter (e.g., PM2.5) are released by combustion engines and industry, which can lead to pulmonary and cardiovascular diseases. Also, as car ownership and vehicle miles traveled have increased, the shift toward motorized transport has contributed to physical inactivity. Each of these global challenges has resulted in, or is projected to result in, millions of premature deaths each year. One of the ways that nations can mitigate the health consequences of climate change, air pollution, and chronic diseases is through the use of active transportation. Research indicates that populations that rely heavily on active transportation enjoy better health and increased longevity. In summary, active transportation has tremendous potential to simultaneously address three global public health challenges of the 21st century.
Heat Reacclimation Using Exercise or Hot Water Immersion
Authors: GERRETT NICOLA , ALKEMADE PUCK , DAANEN HEIN 
Published: February 2021

ABSTRACT

Introduction
The aim of this study was to compare the effectiveness of exercise versus hot water immersion heat reacclimation (HRA) protocols.

Methods
Twenty-four participants completed a heat stress test (HST; 33°C, 65% RH), which involved cycling at a power output equivalent to 1.5 W·kg−1 for 35 min whereby thermophysiological variables were measured. This was followed by a graded exercise test until exhaustion. HST1 was before a 10-d controlled hyperthermia (CH) heat acclimation (HA) protocol and HST2 immediately after. Participants completed HST3 after a 28-d decay period without heat exposure and were then separated into three groups to complete a 5-d HRA protocol: a control group (CH-CON, n = 8); a hot water immersion group (CH-HWI, n = 8), and a controlled hyperthermia group (CH-CH, n = 8). This was followed by HST4.

Results
Compared with HST1, time to exhaustion and thermal comfort improved; resting rectal temperature (T
re), end of exercise T
re, and mean skin temperature (T
sk) were lower; and whole body sweat rate (WBSR) was greater in HST2 for all groups (P < 0.05). After a 28-d decay, only WBSR, time to exhaustion, and mean T
sk returned to pre-HA values. Of these decayed variables, only WBSR was reinstated after HRA; the improvement was observed in both the CH-CH and the CH-HWI groups (P < 0.05).

Conclusion
The data suggest that HRA protocol may not be necessary for cardiovascular and thermal adaptations within a 28-d decay period, as long as a 10-d CH-HA protocol has successfully induced these physiological adaptations. For sweat adaptations, a 5-d CH or HWI-HRA protocol can reinstate the lost adaptations.
Effect of Leg Eccentric Exercise on Muscle Damage of the Elbow Flexors after Maximal Eccentric Exercise
Authors: CHEN TREVOR C. , CHEN HSIN-LIAN , CHENG LI-FU , CHOU TAI-YING , NOSAKA KAZUNORI 
Published: February 2021

ABSTRACT

Purpose
The magnitude of muscle damage induced by maximal eccentric exercise is attenuated when the same exercise is repeated by homologous muscle of the ipsilateral or contralateral limb. It is not known if the muscle damage–protective effect is also transferred to nonhomologous muscles. The present study investigated the effects of unilateral knee extensor (KE) or flexor (KF) eccentric exercise on muscle damage induced by elbow flexor (EF) eccentric exercise of the ipsilateral or contralateral side.

Methods
Young healthy sedentary men were assigned to four experimental groups (n = 13 per group) that performed five sets of six maximal eccentric contractions (MaxEC) of the KE or KF of the same or opposite side of the arm that performed MaxEC of the EF 1 wk later, and a control group that performed two bouts of MaxEC of the EF using a different arm for each bout separated by 1 wk. Changes in several indirect muscle damage markers were compared among the groups by mixed-design, two-way ANOVA.

Results
Changes in maximal voluntary concentric contraction torque, range of motion, muscle soreness, and plasma creatine kinase activity after KE or KF MaxEC were not different (P > 0.05) between legs, but greater (P < 0.05) after KF than KE MaxEC. The changes in the variables after EF MaxEC in the experimental groups were not different (P > 0.05) from the first bout of the control group but larger (P < 0.05) than the second bout of the control group, and no differences between the ipsilateral and contralateral sides were evident.

Conclusions
These results showed that no protective effect on EF MaxEC was conferred by the leg exercises, suggesting that muscle damage protection was not transferred from KE or KF to EF.
Health Outcomes after Pregnancy in Elite Athletes: A Systematic Review and Meta-analysis
Authors: KIMBER MIRANDA L. , MEYER SARAH , MCHUGH TARA-LEIGH , THORNTON JANE , KHURANA RSHMI , SIVAK ALLISON , DAVENPORT MARGIE H. 
Published: February 2021

ABSTRACT

Purpose
This study aimed to evaluate postpartum maternal health and training outcomes of females who were competing or training as elite athletes before or during pregnancy.

Methods
Online databases were searched up to August 26, 2020. Studies of any design and language were eligible if they contained information on the relevant population (postpartum athletes [any period after pregnancy]), exposure (engaged in the highest level of sport immediately before or during pregnancy), comparators (sedentary/active controls), and outcomes: maternal (breastfeeding initiation and duration, postpartum weight retention or loss, bone mineral density, low back or pelvic girdle pain, incontinence [prevalence or severity of stress, urge or mixed urinary incontinence, fecal incontinence], injury, anemia, diastasis recti, breast pain, depression, anxiety) and training (<6 wk time to resume activity, training volume or intensity, performance level).

Results
Eleven studies (n = 482 females, including 372 elite athletes) were included. We identified “very low” certainty evidence demonstrating a higher rate of return to sport before 6 wk postpartum among elite athletes compared with nonelite athletes (n = 145, odds ratio = 6.93, 95% confidence interval = 2.73–17.63, I
2 = 11). “Very low” certainty evidence from three studies (n = 179) indicated 14 elite athletes obtained injuries postpartum (7 stress fractures, 9 “running injuries”). “Very low” certainty evidence from five studies (n = 262) reported that 101 (40.5%) elite athletes experienced improved performance postpartum.

Conclusion
Compared with controls, “very low” quality evidence suggests that elite athletes return to physical activity early in the postpartum period and may have an increased risk of injury. Additional high-quality evidence is needed to safely guide return to sport of elite athletes in the postpartum period.
Effects of 150- and 450-mL Acute Blood Losses on Maximal Oxygen Uptake and Exercise Capacity
Authors: SKATTEBO ØYVIND , JOHANSEN ESPEN SPRO , CAPELLI CARLO , HALLÉN JOSTEIN 
Published: February 2021

ABSTRACT

Purpose
This study investigated whether maximal oxygen uptake (V˙O2max) and exercise capacity are affected by small acute blood loss (150 mL) and elucidated compensatory mechanisms.

Methods
Thirteen male subjects (V˙O2max, 63 ± 9 mL·kg−1·min−1; mean ± SD) performed incremental exercise to exhaustion on a cycle ergometer in three experimental conditions: in euvolemia (control; blood volume [BV], 6.0 ± 0.7 L) and immediately after acute BV reductions of 150 mL (BVR150mL) and 450 mL (BVR450mL). Changes in plasma volume (PV) and BV during exercise were calculated from hematocrit, hemoglobin concentration, and hemoglobin mass (carbon monoxide rebreathing).

Results
The reduction in V˙O2max per milliliter of BVR was 2.5-fold larger after BVR450mL compared with BVR150mL (−0.7 ± 0.3 vs −0.3 ± 0.6 mL·min−1·mL−1, P = 0.029). V˙O2max was not significantly changed after BVR150mL (−1% ± 2%, P = 0.124) but reduced by 7% ± 3% after BVR450mL (P < 0.001) compared with control. Peak power output only decreased after BVR450mL (P < 0.001). At maximal exercise, BV was restored after BVR150mL compared with control (−50 ± 185 mL, P = 0.375) attributed to PV restoration, which was, however, insufficient in restoring BV after BVR450mL (−281 ± 184 mL, P < 0.001). The peak heart rate tended to increase (3 ± 5 bpm, P = 0.062), whereas the O2 pulse (−2 ± 1 mL per beat, P < 0.001) and vastus lateralis tissue oxygenation index (−4% ± 8% points, P = 0.080) were reduced after BVR450mL, suggesting decreased stroke volume and increased leg O2 extraction.

Conclusion
The deteriorations of V˙O2max and of maximal exercise capacity accelerate with the magnitude of acute blood loss, likely because of a rapid PV restoration sufficient to establish euvolemia after a small but not after a moderate blood loss.
Randomized Trial Examining the Effect of a 12-wk Exercise Program on Hedonic Eating
Authors: UNICK JESSICA L. , DUNSIGER SHIRA I. , LEBLOND TIFFANY , HAHN KORINA , THOMAS J. GRAHAM , ABRANTES ANA M. , STROUD LAURA R. , WING RENA R. 
Published: February 2021

ABSTRACT
Nonhomeostatic (or hedonic) eating can be detrimental to weight control efforts, yet the effect of exercise on hedonic eating is unclear.

Purpose
This efficacy trial tests the hypothesis that exercise training favorably affects hedonic eating (i.e., overeating, stress-induced overeating, disinhibited eating, eating when tempted), in a sample of women who are overweight or obese.

Methods
Participants were inactive at baseline, self-identified as “stress eaters,” and were randomized to 12 wk of moderate-intensity exercise training (EX; combination of supervised and objectively confirmed unsupervised sessions) or to a no-exercise control condition (CON). EX participants were given an exercise goal of 200 min·wk−1. No dietary instructions or weight control strategies were provided. Assessments occurred at baseline and 12 wk. Overeating episodes, stress-induced overeating, and dietary temptations were measured over 14 d at each assessment using ecological momentary assessment. Disinhibition and dietary restraint were assessed via a questionnaire.

Results
Forty-nine participants (age, 40.4 ± 10.8 yr; body mass index, 32.4 ± 4.1 kg·m−2) enrolled, and 39 completed this study. Adherence to the exercise intervention was high (99.4% of all prescribed exercise). At week 12, the proportion of eating episodes that were characterized as overeating episodes was lower in EX versus CON (21.98% in EX vs 26.62% in control; P = 0.001). Disinhibition decreased in EX but not in CON (P = 0.02) and was driven by internal factors. There was a trend such that CON was more likely to give into dietary temptations (P = 0.08). Stress-induced overeating was low and did not differ between conditions (P = 0.61).

Conclusions
Exercise training reduced the likelihood of overeating and eating in response to internal cues in women who self-identified as stress eaters. This may be one pathway by which exercise affects body weight.
Physical Activity Engagement Worsens Health Outcomes and Limits Exercise Capacity in Growth-restricted Mice
Authors: FERGUSON DAVID P. , LESZCZYNSKI ERIC C. , MCPEEK ASHLEY C. , PENDERGRAST LOGAN A. , VISKER JOSEPH R. , TRIPLETT ASHLEY N. 
Published: February 2021

ABSTRACT

Introduction
A total of 161 million children a year are growth restricted, leading to a 47% increased risk of chronic disease in adulthood. Physical activity (PA) reduces the risk of mortality from chronic disease. The purpose of the present investigation was to determine the effect of a PA intervention (wheel running) on cardiac and skeletal muscle capacities in gestational (GUN) and postnatal (PUN) growth-restricted mice as compared with nonrestricted controls (CON).

Methods
A low-protein cross-fostering FVB mouse model was used to induce growth restriction during gestation and the first 21 d of postnatal life. Mouse pups were recovered on a healthy diet until mature and provided wheel access for 3 wk. At completion of the PA intervention, mice underwent maximal exercise testing on a treadmill, echocardiography, and skeletal muscle histology.

Results
After the PA intervention, CON mice had a 45% improvement in maximal exercise capacity (P = 0.0390) because of cardiac and skeletal muscle adaptations, but GUN and PUN mice did not. Alarmingly, PUN female mice exposed to wheels had 11.45% lower left ventricular volume (P = 0.0540) and 18% lower left ventricle area (P = 0.0585), with blood flow velocities indicative of cardiac fibrosis (GUN had elevated isovolumetric contraction time P = 0.0374; GUN females and PUN males had longer isovolumetric relaxation time P = 0.0703). PUN male mice had mixed skeletal muscle responses with an oxidative shift in the diaphragm (P = 0.0162) but a glycolytic shift in the extensor digitorum longus (P = 0.0647). PUN female mice had a glycolytic shift in the soleus after wheel running.

Conclusions
Unexpectedly, growth-restricted mice were nonresponders to a PA intervention and displayed negative cardiac outcomes.
Mobile Health Augmented Cardiac Rehabilitation (MCard) in Post-Acute Coronary Syndrome Patients: A randomised controlled trial protocol
Authors: Hisam Aliya , Haq Zia Ul , Khan Zohaib , Doherty Patrick , Pell Jill 
Published: February 2021

Objectives: To determine the effectiveness of mobile health augmented cardiac rehabilitation (MCard) on health-related quality of life (HRQoL), clinical and behavioural outcomes in post-ACS.
Methods: A single-centre, single-blinded, two-arm randomised controlled trial is planned at Armed Forces Institute of Cardiology (AFIC), Pakistan. The duration was two years, that is from January 2019 till December 2020. A total of 160 participants were recruited and randomly allocated to the control group or the intervention group. Intervention is a mobile health augmented cardiac rehabilitation (MCard), a medically supervised cardiac rehabilitation program for 23-24 weeks. The phase one includes individual counselling during the hospital stay and in phase two includes communication of standardised messages related to healthy lifestyle modification through a specifically designed software.
Results: This clinical trial results will give insight into the impact of MCard in improving the health outcomes (HRQoL, clinical and behavioural) of participants. If proven to be effective, this technology can be scaled up and implemented in other cardiac centres in the country. It utilises fewer human resources and can be delivered at a lower cost.
Conclusion: The study protocol will be giving evidence either MCard can contribute to improving the HRQoL, clinical and behavioural outcomes of post-ACS patients following hospital discharge. Considering the COVID-9 situation, this is the perfect time to implement and evaluate the effectiveness of MCard on health outcomes among post-ACS patients.
doi: https://doi.org/10.12669/pjms.37.3.3664
How to cite this:Hisam A, Zia-Ul-Haq, Khan Z, Doherty P, Pell J. Mobile Health Augmented Cardiac Rehabilitation (MCard) In Post-Acute Coronary Syndrome Patients: A randomised controlled trial protocol. Pak J Med Sci. 2021;37(3):890-896. doi: https://doi.org/10.12669/pjms.37.3.3664
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage
Authors: Parveen Rashida , Khakwani Mehnaz , Tabassum Sobia , Masood Sajjad 
Published: February 2021

Objectives: This study was planned with an aim to find out the effectiveness of oral versus vaginal micronized progesterone for the treatment of threatened miscarriage.
Methods: This randomized controlled trial was conducted at The Department of Obstetrics and Gynaecology, Nishtar Hospital Multan, from August 2019 to January 2020. A total of 136 pregnant women, aged 18 to 45 years having vaginal bleeding were included and divided into two groups (68 women in each group). Participants in the Group-A were given oral micronized progesterone as 200mg twice a day while Group-B participants were given vaginal progesterone suppository 400mg once a day. All women were followed up until 20th week of their pregnancy. Outcome was labeled as prevention of miscarriage if woman had no bleeding per vagina and pregnancy went beyond 20th weeks of gestation.
Results: In a total of 136 women enrolled, mean age was noted to be 30.85+3.34 years. Overall, mean gestational age was noted to be 9.3+2.7 weeks. A total of 98 women (49 in each group) completed the follow up and were included in the final analysis regarding outcome. Among Groups-A, 45 (91.8) had prevention of miscarriage while 4 (9.2%) had miscarriage in comparison to 36 (73.5%) in Group-B had prevention of miscarriage whereas 13 (26.5%) had miscarriage and this difference was statistically significant in between the both study groups as women in Group-A had significantly better outcome in terms of prevention of miscarriage. (P value = 0.0164).
Conclusion: The use of oral micronized progesterone was found to be significantly more effective than vaginal progesterone in women with threatened miscarriage.
doi: https://doi.org/10.12669/pjms.37.3.3700
How to cite this:Parveen R, Khakwani M, Tabassum S, Masood S. Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage. Pak J Med Sci. 2021;37(3):628-632. doi: https://doi.org/10.12669/pjms.37.3.3700
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Aftermath of traumatic tympanic membrane perforation: Our findings at a tertiary care hospital in Pakistan
Authors: Wahid Fazali , Saleem Muhammad , Muhammad Raza , Khan Muhammad Riaz 
Published: February 2021

Objectives: To determine the outcome of traumatic tympanic membrane perforation in a teaching hospital at Peshawar, Pakistan.
Methods: This prospective observational study was performed in the Department of ENT and Head and Neck Surgery, MTI/LRH, Peshawar, Pakistan from January 2016 to December 2019 after approved from Institutional Research and Ethical Board. All consented patients fulfilling inclusion criteria were enrolled. Sample size was calculated 114 using online sample size calculator (OpenEpi). Every patient was evaluated properly, subsequently otoscopy and PTA was performed. Required information was recorded and analyzed using SPSS (version 25).
Results: Out of 114 patients 81 (71.1%) were males and 33(28.9%) were female with male: female ratio of 2.5:1. Patient’s age ranged from 6- 55 years with mean ± SD age of 26.41 ± 9.7 years. Majority of Patients, 46.5%( 53) were in 2nd decade. Amongst the causes slap outnumbered (80, 70.2%), and left ear was involved predominately (67, 58.7%) affecting mainly anterio-inferior quadrant (50, 43.9%). Small size perforation was most common finding (64, 56.1%). Majority of patients (72, 63.2%) presented in a week time and single perforation was the commonest (107, 93.%). Most of traumatic TM perforation got healed spontaneously (97, 85.1%).
Conclusion: It is concluded that spontaneous healing of traumatic membrane perforation occurs in more than 90% cases provided the ear is kept dry and not accompanied by unfavorable conditions.
doi: https://doi.org/10.12669/pjms.37.3.3923
How to cite this:Wahid FI, Saleem M, Muhammad R, Khan MR. Aftermath of traumatic tympanic membrane perforation: Our findings at a tertiary care hospital in Pakistan. Pak J Med Sci. 2021;37(3):874-878. doi: https://doi.org/10.12669/pjms.37.3.3923
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Prevention of Bortezomib-Induced Polyneuropathy in Multiple Myeloma Patients
Authors: Garrido David , Riva Eloisa 
Published: February 2021

Bortezomib (Velcade®) is a proteasome pathway inhibitor that has improved multiple myeloma (MM) overall survival. Bortezomib-induced peripheral neuropathy (BIPN) is a frequent adverse event, requiring delay, dose reduction or cessation of therapy. Although most of the symptoms resolve after discontinuation or dose-reduction, almost 25% develop chronic symptoms, affecting quality of life and limiting the therapeutic choices.
There is limited evidence regarding the strategies to prevent bortezomib-induced polyneuropathy (BIPN). We conducted a review of the published data to summarize the available information regarding BIPN prevention strategies.
Our search included literature published in the Cochrane Library databases, Medline/PubMed, SciELO, Google Scholar, and Trip Database in the last ten years, including observational analytic studies, experimental studies, systematic reviews, and metanalysis, which reported the efficacy of interventions to prevent BIPN.
Eight studies have been included. The subcutaneous administration of bortezomib has shown a protective effect of all grades of BIPN (OR=0.40, 95% CI 0.27 to 0.59, p<0.001) and grade 3 to 4 (OR = 0.45, 95% CI 0.25 to 0.82, P<0.05), as evidenced in a metanalysis. Cumulative dose of bortezomib > 30 mg/m2 is significantly associated with a higher risk of BIPN.
Other therapies as Acetyl-l-carnitine (ALC), dexamethasone in partnered dosing (day of/after bortezomib), high-dose intravenous mecobalamin (HDIME), and the combination of docosahexaenoic acid, α-lipoic acid, vitamin C 60 mg, and vitamin E have been assessed but their efficacy for BIPN prevention has not been confirmed.
We conclude that the subcutaneous route of administration of bortezomib effectively prevents BIPN while other strategies lack robust evidence to be recommended.