bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of dextrose dose on hypoglycemia development following treatment of hyperkalemia
Authors: Farina Nicholas , Anderson Christopher 
Published: April 2018

Background: Hyperkalemia is an electrolyte abnormality that may cause ventricular dysrhythmias and cardiac arrest. The presence of hyperkalemia may necessitate prompt treatment via intravenous insulin and dextrose. One notable complication of this therapy is the development of hypoglycemia. Previous trials have examined the impact of altering the insulin dose administered on hypoglycemia development; no trials to date however, have examined the impact of altering the dextrose dose. Methods: This was a multicenter, retrospective, matched cohort study of patients who received intravenous insulin and dextrose for reversal of hyperkalemia. Patients received either 25 g or 50 g of dextrose in addition to 10 units of insulin. Study populations were matched based on preexisting rates of acute kidney injury, end-stage renal disease, and diabetes mellitus. Blood glucose levels were measured at 60 and 240 min following treatment. Results: A total of 240 patients were included in the analysis. At 60 min following treatment, 15.8% of patients who received 25 g of dextrose developed hypoglycemia, as opposed to 8.3% of patients who received 50 g of dextrose ( p = 0.11). Hyperglycemia was more common in patients who received 50 g of dextrose at 60 min posttreatment; however, this difference did not persist at 240 min. Potassium reduction at 60 min did not differ between groups. In patients with a pretreatment blood glucose <110 mg/dl or without diabetes, rates of hypoglycemia were significantly lower when 50 g of dextrose was administered. Conclusion: In the overall patient population, use of 50 g of dextrose instead of 25 g does not reduce hypoglycemia incidence. However, it may be beneficial is select patient populations, such as patients without type 2 diabetes or patients with a baseline blood glucose <110 mg/dl. Administration of 50 g of dextrose did not appear to place patients at significant risk for hyperglycemia however and could be considered during treatment of hyperkalemia.
Stochastically modulated inter-pulse intervals to increase the efficiency of functional electrical stimulation cycling
Authors: Aksöz EA , Luder MA , Laubacher M , Riener R , Binder-Macleod SA , Hunt KJ 
Published: April 2018

Introduction Functional electrical stimulation cycling has various health benefits, but the mechanical power output and efficiency are very low compared to volitional muscle activation. Stimulation with variable frequency showed significantly higher power output values in experiments with a knee dynamometer. The aim of the present work was to compare stochastic modulation of inter-pulse interval to constant inter-pulse interval stimulation during functional electrical stimulation cycling. Methods Seventeen able-bodied subjects participated ( n = 17). Quadriceps and hamstring muscle groups were stimulated with two activation patterns: P1-constant frequency, P2-stochastic inter-pulse interval. Power output was measured on functional electrical stimulation ergometer. Results Overall, mean power output with the stochastically modulated pattern P2 was lower than with P1 (12.57 ± 3.74 W vs. 11.44 ± 3.81 W, P1 vs. P2, p = 0.022), but no significant differences during the first 30 s and the last 30 s were observed. Conclusions This study showed that stimulation strategies that use randomized modulation of inter-pulse intervals can negatively affect power output generation during functional electrical stimulation cycling. To minimise voluntary contractions, power measurement and assessment should be focused on the periods where only the quadriceps are stimulated.
Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players
Authors: Rothermich Marcus A. , Conte Stan A. , Aune Kyle T. , Fleisig Glenn S. , Cain E. Lyle , Dugas Jeffrey R. 
Published: April 2018

Background: Recent reports have highlighted the progressive increase in the incidence of ulnar collateral ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge of the incidence and other epidemiological factors regarding UCL injuries, specifically in college baseball players, is currently lacking. Purpose: To evaluate, over a period of 1 year, the incidence of UCL injuries requiring surgery in National Collegiate Athletic Association (NCAA) Division I baseball programs. Study Design: Descriptive epidemiology study. Methods: A total of 155 Division I collegiate baseball programs agreed to participate in the study. Demographics (position, year, background [location of high school]) for all players on these rosters were obtained from public websites. At the conclusion of the 2017 collegiate baseball season, the athletic trainer for each program entered anonymous, detailed information on injured players through an electronic survey into a secured database. Results: All 155 teams enrolled in the study completed the electronic survey. Of the 5295 collegiate baseball players on these rosters, 134 underwent surgery for an injured UCL (2.5% of all eligible athletes), resulting in a team surgery rate of 0.86 per program for 1 year. These 134 players came from 88 teams, thus 56.8% of the study teams underwent at least 1 surgery during the year. The surgery rate was 2.5 per 100 player-seasons for all players and was significantly higher among pitchers (4.4/100 player-seasons) than nonpitchers (0.7/100 player-seasons). The surgery rate was also significantly higher in underclassmen (3.1/100 player-seasons among freshmen and sophomores) than upperclassmen (1.9/100 player-seasons among juniors and seniors) (incidence rate ratio, 1.7; 95% CI, 1.1-2.4). Players from traditionally warm-weather states did not undergo UCL surgery at a significantly different rate from players from traditionally cold-weather states (2.7/100 player-seasons vs 2.1/100 player-seasons, respectively). Nearly half of surgeries (48.5%) were performed during the baseball season. Conclusion: The incidence of UCL surgeries in NCAA Division I collegiate baseball players represents substantial morbidity to this young athletic population. Risk factors for injuries requiring surgery include being a pitcher and an underclassman. Awareness of these factors should be considered in injury prevention programs. Furthermore, this initial study can serve as a foundation for tracking these surgical injuries in future years and then identifying trends over time.
Osteopathic Manipulative Treatment in Surgical Care
Authors: Sposato Niklas S. , Bjerså Kristofer 
Published: April 2018

Background. A growing trend in surgical care is the investigation and incorporation of multimodal interventions into standardized programs. Additionally, manual therapies such as osteopathic manipulative treatment (OMT) are being used with patients in surgical care. Yet the scientific dialogue and the use of OMT in surgical care are currently insubstantial. Objective. The aim of this study was to present an overview of published research articles within the subject field of OMT in surgical care. Method. Summative review of peer-reviewed research articles published in osteopathic journals during the period 1990 to 2017. In total, 10 articles were identified. Result. Previous research has been conducted within the areas of abdominal, thoracic, gynecological, and/or orthopedic surgery with measured outcomes such as pain, analgesia consumption, length of hospital stay, and range of motion. Heterogeneity was identified in usage of osteopathic techniques, treatment duration, and occurrence, as well as in the treating osteopath’s experience. Conclusion. Despite the small number of research articles within this field, both positive measured effects as well as the absence of such effects were identified. Overall, there was a heterogeneity concerning surgical contexts, diagnoses, signs and symptoms, as well as surgical phases in current interprofessional osteopathic publications. In this era of multimodal surgical care, we argue that there is an urgent need to evaluate OMT in this context of care and with a proper research approach.
A next-generation sequencing–based assay for minimal residual disease assessment in AML patients with FLT3-ITD mutations
Authors: Levis Mark J. , Perl Alexander E. , Altman Jessica K. , Gocke Christopher D. , Bahceci Erkut , Hill Jason , Liu Chaofeng , Xie Zhiyi , Carson Andrew R. , McClain Valerie , Stenzel Timothy T. , Miller Jeffrey E. 
Published: April 2018

Key PointsA sensitive and specific assay was developed for detection of MRD in patients with AML who harbor FLT3-ITD mutations. This standardized assay is readily available and may be used to guide therapy decisions in patients with AML.
Gastric Emptying Impacts the Timing of Meal Glucose Peak in Subjects With Uncomplicated Type 1 Diabetes
Authors: Lupoli Roberta , Creanza Annalisa , Griffo Ettore , Nardone Gerardo , Rocco Alba , Bozzetto Lutgarda , Annuzzi Giovanni , Riccardi Gabriele , Capaldo Brunella 
Published: April 2018

Abstract

Context
Diabetes mellitus is associated with gastrointestinal (GI) motility dysfunction, ranging from delayed to accelerated gastric emptying (GE).

Objective
To evaluate GE in patients with type 1 diabetes mellitus (T1DM) without chronic complications and to investigate its relation with postprandial glucose and GI hormone responses.

Design
Cross-sectional study.

Setting/Participants
Forty-two patients with T1DM free of chronic complications referred to Federico II University and 31 healthy controls similar for age, sex, and body mass index.

Interventions/Main Outcome Measures
GE was assessed by using the 13C-octanoate breath test with a standardized solid meal. During the meal, plasma glucose, ghrelin, and glucagon-like peptide 1 (GLP-1) responses were assessed, and GI symptoms were evaluated by a specific questionnaire.

Results
Patients with T1DM showed a significantly slower GE half-emptying time (GE t1/2) (113 ± 34 minutes) than did controls (89 ± 17 minutes; P &lt; 0.001). Thirty-six percent of T1DM showed a delayed GE (t1/2 &gt; 120 minutes), whereas all controls showed a normal GE. When patients with T1DM were stratified according to GE t1/2, postmeal glucose response was significantly different between those with delayed and those with normal GE (P = 0.013). In particular, patients with T1DM and delayed GE showed a significantly longer mean time to peak glucose than did patients with normal GE (P = 0.004). In addition, GE t1/2 was an independent predictor of the time to peak glucose (β = 0.329; P = 0.025). GLP-1 and ghrelin responses to the test meal, as well as the prevalence of GI symptoms, were similar between patients with T1DM and controls and between patients with T1DM with normal GE and those with delayed GE.

Conclusions
Delayed GE time is associated with a longer time to peak glucose. GE evaluation could be useful for individualizing the timing of preprandial insulin bolus in patients with T1DM.
Paradoxes of Visibility
Authors: Wundram Pimentel Alejandra , Leonardo Segura Mónica 
Published: April 2018

Abstract
Identification documents are essential for the recognition of individuals within the nation-state. By denying trans people the right to change the M or the F on these documents, governments perpetuate perceptions of trans people as frauds and of trans bodies as fake. Examining both legal examples and ethnographic data, the article calls attention to the current attempts to formulate a national gender identity law in Guatemala. Doing so, we discuss trans visibility as contentious. Because of the need for social inclusion, including access to services, trans activist organizations work to make trans people visible within the nation-state. At the same time, changing the sex marker on their identification documents could make trans populations more vulnerable to surveillance. Therefore, trans activists seek to ensure that trans individuals' status and history as transgender is rendered invisible in these legal name and sex changes. The article argues that the apparent tension between visibility and invisibility, made evident in the process of drafting the gender identity law, can be understood only in the context of local trans discourses that aim to claim inclusion in normative gender categories through renegotiating the meaning of men and women.
Patterns of mitochondrial membrane remodeling parallel functional adaptations to thermal stress
Authors: Chung Dillon J. , Sparagna Genevieve C. , Chicco Adam J. , Schulte Patricia M. 
Published: April 2018

ABSTRACT
The effect of temperature on mitochondrial performance is thought to be partly due to its effect on mitochondrial membranes. Numerous studies have shown that thermal acclimation and adaptation can alter the amount of inner-mitochondrial membrane (IMM), but little is known about the capacity of organisms to modulate mitochondrial membrane composition. Using northern and southern subspecies of Atlantic killifish (Fundulus heteroclitus) that are locally adapted to different environmental temperatures, we assessed whether thermal acclimation altered liver mitochondrial respiratory capacity or the composition and amount of IMM. We measured changes in phospholipid headgroups and headgroup-specific fatty acid (FA) remodeling, and used respirometry to assess mitochondrial respiratory capacity. Acclimation to 5°C and 33°C altered mitochondrial respiratory capacity in both subspecies. Northern F. heteroclitus exhibited greater mitochondrial respiratory capacity across acclimation temperatures, consistent with previously observed subspecies differences in whole-organism aerobic metabolism. Mitochondrial phospholipids were altered following thermal acclimation, and the direction of these changes was largely consistent between subspecies. These effects were primarily driven by remodeling of specific phospholipid classes and were associated with shifts in metabolic phenotypes. There were also differences in membrane composition between subspecies that were driven largely by differences in phospholipid classes. Changes in respiratory capacity between subspecies and with acclimation were largely but not completely accounted for by alterations in the amount of IMM. Taken together, these results support a role for changes in liver mitochondrial function in the ectothermic response to thermal stress during both acclimation and adaptation, and implicate lipid remodeling as a mechanism contributing to these changes.
Comparison of hs-CRP level between low calorie high protein to standard protein diet in obese individuals with weight cycling - a randomised trial
Authors: Paranoan Adventia Natali , Jutamulia Joan , Prasetya Septian Ika , Mudjihartini Ninik , Witjaksono Fiastuti 
Published: April 2018

Background: Obesity is associated with various health problems. Low-grade inflammation is a condition found in obese people and contributes to the development of various diseases. The objective of this study was to compare the effects of calorie restriction diet with high-protein (HP) or standard protein (SP) to inflammation marker (hs-CRP) in obese individuals with weight cycling. Methods: 61 healthy obese men and women (25 – 49 years old) with a history of weight cycling were recruited and were randomly assigned to one of the intervention groups, HP or SP groups. Both groups were suggested to reduce their daily caloric intake by 1000 kcal with regular physical activity for 56 days. Subjects in HP group were given a daily protein intake of 22-30% from total daily caloric intake, while SP group were prescribed 12-20%. Dietary consultation was conducted through daily reminder by phone and weekly counseling. The measurement of hs-CRP level was performed prior to and at the end of the intervention. Results: 54 subjects completed the program, yet due to several reasons only 32 of them were measured for hsCRP before and after completing the program, 15 from HP group and 17 from SP group. After completing the 56-day diet program, SP group experienced reduction of hs-CRP by -0.446 + 4.239, while HP underwent increase by 0.135 + 2.389. The mean difference of change in hs-CRP level between the two groups were not statistically significant (P=0.094). Conclusion: Low calorie diet with either HP or SP for 8 weeks significantly reduced body weight (P<0.001) and BMI (P<0.001) in healthy obese subjects but the difference of change in the hs-CRP level between them were not significant. The protein composition of a low calorie diet may not affect the inflammatory state of obese individuals with weight cycling. Trial registration number: NCT03374150
Internal transcribed spacer for identification of yeast species isolated from cancer patients at the Isotope and Radiation Center, Khartoum, Sudan: A cross-sectional, case-control study
Authors: Nagla Mohamed M.A. , El Fadil Omer E. , Muzamil Abdel Hamid M. , Hisham Altayeb N. , Bahaeldeen Mohamed B. , El-Nour El-Amin 
Published: April 2018

Background:Cancer patients have a high risk of fungal infections, especially by Candida species.Non-C. albicans Candidainfections and less common yeast infections have been increasing in recent years. Identification by conventional methods can be difficult and sometimes inconclusive. This study aimed to detect the prevalence of oral yeast species isolated from cancer patients, from oral swab, sputum and urine, using Internal Transcribed Spacer (ITS) sequence analysis, since little is known about this problem in Sudan.Methods:The study involved 333 cancer patients (168 patients under treatment [study group] and 165 patients before treatment [control group]). Oral swabs were collected from all patients. Urine or sputum specimens were collected from patients under treatment showing clinical features of UTI or lower respiratory tract infection, respectively. ITS1 and ITS2 region of isolated yeast were amplified by PCR and sequenced. The obtained sequences were compared to reference sequence available in the GenBank database using BLAST.Results:Culture results showed oral yeastspecies were isolated from 69/168 (41.1%) and 74/165 (44.8%) of patients among study and control groups, respectively (P value > 0.05). 2/9 (22.2%) patients were urine growth positive and 8/14 (57.1%) patients were sputum culture positive. Sequence analysis showed,C. albicanswas the most prevalent organism (93; 52.5%) followed byC. tropicalis(29; 16.4%), andC. glabrata(24; 13.6%). Non-C. albicans Candidaand uncommon rare yeast were found to be associated with oral infections and colonization among the study and control groups, whereasC.albicans was the most common species (66.7%) associated with oral candidiasis among the treated patients. Conclusion:Cancer patients were highly colonized with different oral yeast species, which indicates that ITS sequence analysis is an accurate method for identification. This will aid effective management to prevent dissemination of disease especially among those who are under chemo and/or radiotherapy treatment.
A novel ultrasound technique to detect early chronic kidney disease
Authors: Hewadikaram Dulitha K. , Bandara Mudhitha , Pattivedana Amal N. , Jayaweera Hiran H. E. , Jayananda Kithsiri M. , Madhavi W. A. Monica , Pallewatte Aruna , Jayasumana Channa , Siribaddana Sisira , Wansapura Janaka P. 
Published: April 2018

Chronic kidney disease (CKD) of unknown etiology is recognized as a major public health challenge and a leading cause of morbidity and mortality in the dry zone in Sri Lanka. CKD is asymptomatic and are diagnosed only in late stages. Evidence points to strong correlation between progression of CKD and kidney fibrosis. Several biochemical markers of renal fibrosis have been associated with progression of CKD. However, no marker is able to predict CKD consistently and accurately before being detected with traditional clinical tests (serum creatinine, and cystatin C, urine albumin or protein, and ultrasound scanning). In this paper, we hypothesize that fibrosis in the kidney, and therefore the severity of the disease, is reflected in the frequency spectrum of the scattered ultrasound from the kidney. We present a design of a simple ultrasound system, and a set of clinical and laboratory studies to identify spectral characteristics of the scattered ultrasound wave from the kidney that correlates with CKD. We believe that spectral parameters identified in these studies can be used to detect and stratify CKD at an earlier stage than what is possible with current markers of CKD.
Participants’ perspectives and preferences on clinical trial result dissemination: The TRUST Thyroid Trial experience
Authors: Racine Emmy , Hurley Caroline , Cheung Aoife , Sinnott Carol , Matvienko-Sikar Karen , Baumgartner Christine , Rodondi Nicolas , Smithson William H. , Kearney Patricia M. 
Published: April 2018

Background: While there is an increasing consensus that clinical trial results should be shared with trial participants, there is a lack of evidence on the most appropriate methods. The aim of this study is to use a patient and public involvement (PPI) approach to identify, develop and evaluate a patient-preferred method of receiving results of the Thyroid Hormone Replacement for Subclinical Hypo-Thyroidism Trial (TRUST). Methods: This is a mixed methods study with three consecutive phases. Phase 1 iteratively developed a patient-preferred result method using semi-structured focus groups and a consensus-orientated-decision model, a PPI group to refine the method and adult literacy review for plain English assessment. Phase 2 was a single-blind parallel group trial. Irish TRUST participants were randomised to the intervention (patient-preferred method) and control group (standard method developed by lead study site). Phase 3 used a patient understanding questionnaire to compare patient understanding of results between the two methods. Results: Patients want to receive results of clinical trials, with qualitative findings indicating three key themes including ‘acknowledgement of individual contribution’, ‘contributing for a collective benefit’ and ‘receiving accessible and easy to understand results’. Building on these findings, a patient-preferred method of receiving results was developed as described above. TRUST participants (n=101) were randomised to the intervention. The questionnaire response rate was 74% for the intervention group and 62% for the control group. There were no differences in patient understanding between the two methods. Conclusions: We have demonstrated that it is feasible to conduct PPI with regard to the dissemination of results. The study identified and developed a patient-preferred method of receiving clinical trial results for older adults over 65 years. Although, in this study PPI did not influence patients’ final understanding of results, it provides a record of the process of conducting PPI within the clinical trial setting.
Negative refraction and tiling billiards
Authors: Davis Diana , DiPietro Kelsey , Rustad Jenny , St Laurent Alexander 
Published: April 2018

Abstract
We introduce a new dynamical system that we call tiling billiards, where trajectories refract through planar tilings. This system is motivated by a recent discovery of physical substances with negative indices of refraction. We investigate several special cases where the planar tiling is created by dividing the plane by lines, and we describe the results of computer experiments.