bluuebunny/crossref_metadata_2025_split huggingface dataset:
The magnitude of neuromuscular fatigue is not intensity dependent when cycling above critical power but relates to aerobic and anaerobic capacities
Authors: Schäfer Lisa U. , Hayes Mark , Dekerle Jeanne 
Published: November 2018

New Findings
What is the central question of this study?
Is the magnitude of neuromuscular fatigue dependent upon exercise intensity above critical power (CP) when W′ (the curvature constant of the power–duration relationship) is depleted?
What is the main finding and its importance?
The magnitude of neuromuscular fatigue is the same after two bouts of supra‐CP cycling (3 versus 12 min) when controlling for W′ depletion but is larger for individuals of greater anaerobic capacity after the shorter bout and smaller for individuals of greater aerobic capacity after the longer exercise bout. These findings provide new insight into the mechanisms underpinning exercise above CP.
AbstractThe aim of the present study was to test whether the development of neuromuscular fatigue within the severe‐intensity domain could be linked to the depletion of the curvature constant (W′) of the power–duration relationship. Twelve recreationally active men completed tests to determine peak oxygen consumption, critical power (CP) and W′, followed by two randomly assigned constant‐load supra‐CP trials set to deplete W′ fully in 3 (P‐3) and 12 min (P‐12). Pre‐ to postexercise changes in maximal voluntary contraction, potentiated quadriceps twitch force evoked by single (Qpot) and paired high‐ (PS100) and low‐frequency (PS10) stimulations and voluntary activation were determined. Cycling above CP reduced maximal voluntary contraction (P‐3, −20 ± 10% versus P‐12, −15 ± 7%), measures associated with peripheral fatigue (Qpot, −35 ± 13 versus −31 ± 14%; PS10, −38 ± 13 versus −37 ± 17%; PS100, −18 ± 9 versus −13 ± 8% for P‐3 and P‐12, respectively) and voluntary activation (P‐3, −12 ± 3% versus P‐12, −13 ± 3%; P < 0.05), with no significant difference between trials (P > 0.05). Changes in maximal voluntary contraction and evoked twitch forces were inversely correlated with CP and peak oxygen consumption after P‐12, whereas W′ was significantly correlated with changes in Qpot and PS10 after P‐3 (P < 0.05). Therefore, the magnitude of neuromuscular fatigue does not depend on exercise intensity when W′ is fully exhausted during severe‐intensity exercise; nonetheless, exploration of inter‐individual variations suggests that mechanisms underpinning exercise tolerance within this domain differ between short‐ and long‐duration exercise.
Intensification for redesigned and sustainable agricultural systems
Authors: Pretty Jules 
Published: November 2018

The future of farming
In the mid-20th century, food production from agriculture sharply increased worldwide; however, this was achieved through heavy use of agrochemicals. Extensive collateral damage from excessive use of pesticides, herbicides, and fertilizers has occurred to the wider environment. This has led to biodiversity loss, pesticide resistance and the emergence of new pests, pollution and decline of freshwater supplies, and soil degradation and erosion, as well as direct harm to health. In a Review, Pretty examines the alternative approaches that can achieve sustainable intensification of farming systems by integrating pest management with agroecological systems to minimize costs, maximize yields, restore ecosystem services, and ensure environmental enhancement.

Science
, this issue p.
eaav0294
Sex differences in quality indicator attainment for myocardial infarction: a nationwide cohort study
Authors: Wilkinson Chris , Bebb Owen , Dondo Tatendashe B , Munyombwe Theresa , Casadei Barbara , Clarke Sarah , Schiele François , Timmis Adam , Hall Marlous , Gale Chris P 
Published: November 2018

AimTo investigate sex differences in acute myocardial infarction (AMI) guideline-indicated care as defined by the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) quality indicators.MethodsNationwide cohort study comprising 691 290 AMI hospitalisations in England and Wales (n=233 hospitals) from the Myocardial Ischaemia National Audit Project between 1 January 2003 and 30 June 2013.ResultsThere were 34.5% (n=238 489) women (median age 76.7 (IQR 66.3–84.0) years; 33.9% (n=80 884) ST-elevation myocardial infarction (STEMI)) and 65.5% (n=452 801) men (median age 67.1 (IQR 56.9–77.2) years; 42.5% (n=192 229) STEMI). Women less frequently received 13 of the 16 quality indicators compared with men, including timely reperfusion therapy for STEMI (76.8% vs 78.9%; p<0.001), timely coronary angiography for non-STEMI (24.2% vs 36.7%; p<0.001), dual antiplatelet therapy (75.4% vs 78.7%) and secondary prevention therapies (87.2% vs 89.6% for statins, 82.5% vs 85.6% for ACE inhibitor/angiotensin receptor blockers and 62.6% vs 67.6% for beta-blockers; all p<0.001). Median 30-day Global Registry of Acute Coronary Events risk score adjusted mortality was higher for women than men (median: 5.2% (IQR 1.8%–13.1%) vs 2.3% (IQR 0.8%–7.1%), p<0.001). An estimated 8243 (95% CI 8111 to 8375) deaths among women could have been prevented over the study period if their quality indicator attainment had been equal to that attained by men.ConclusionAccording to the ESC ACCA AMI quality indicators, women in England and Wales less frequently received guideline-indicated care and had significantly higher mortality than men. Greater attention to the delivery of recommended AMI treatments for women has the potential to reduce the sex-AMI mortality gap.
Gravi-weak unification and the black-hole-hedgehog’s solution with magnetic field contribution
Authors: Sidharth B. G. , Das C. R. , Laperashvili L. V. , Nielsen H. B. 
Published: November 2018

In the present paper, we investigated the gravitational black-hole-hedgehog’s solution with magnetic field contribution in the framework of the [Formula: see text]-gravity described by the Gravi-weak unification (GWU) model. Assuming the Multiple Point Principle (MPP), we considered the existence of the two degenerate vacua of the Universe: the first Electroweak (EW)-vacuum with [Formula: see text] GeV (“true vacuum”), and the second Planck scale (“false vacuum”) with [Formula: see text] GeV. In these vacua, we investigated different topological defects. The main aim of this paper is an investigation of the black-hole-hedgehog configurations as defects of the “false vacuum.” We have obtained the solution which corresponds to a global monopole, that has been “swallowed” by the black-hole with core mass [Formula: see text] GeV and radius [Formula: see text] GeV[Formula: see text]. We investigated the metric in the vicinity of the black-hole-hedgehog and estimated its horizon radius: [Formula: see text]. We have considered the phase transition from the “false vacuum” to the “true vacuum” and confirmed the stability of the EW-vacuum.
Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study
Authors: de Bruijn Johan A. , van Zantvoort Aniek P. M. , Hundscheid Henricus Pieter Hubert , Hoogeveen Adwin R. , Teijink Joep A. W. , Scheltinga Marc R. 
Published: November 2018

Background: Up to 8% of patients who underwent a fasciotomy for leg anterior chronic exertional compartment syndrome (ant-CECS) report sensory deficits suggestive of iatrogenic superficial peroneal nerve (SPN) injury. In the current study we aimed to thoroughly assess the risk of SPN injury during a semiblind fasciotomy of the anterior compartment using 2 separate approaches. Methods: A modified semiblind fasciotomy of the anterior compartment was performed via a longitudinal 2-cm skin incision 2 cm lateral of the anterior tibial crest halfway along the line fibular head-lateral malleolus both in cadaver legs and in patients with ant-CECS. In the cadaver legs, the skin was removed after the procedure and possible SPN injuries and spatial relationships between the SPN and the opened fascia were studied. Between January 2013 and December 2016, 64 ant-CECS patients who underwent a fasciotomy of the anterior compartment were prospectively followed. Iatrogenic SPN injuries were assessed using questionnaires and physical examinations. Results: Macroscopic SPN nerve injury was not observed in any of the 9 cadaver legs. In 8 specimens, the SPN was located at least 5 mm posterolateral to the opened fascia. In 1 specimen, an undamaged SPN branch crossed the operative field in a ventral plane. De novo sensory deficits suggestive for iatrogenic SPN injury were not observed in any of the 64 patients (120 legs; 36 females; median age, 22 years) who underwent a fasciotomy of the anterior compartment. Conclusion: The proposed semiblind fasciotomy for treatment of ant-CECS was not associated with SPN injury in either the cadaveric study or our clinical series. Level of Evidence: Level IV, case series.
An Anatomic Study of the Naviculocuneiform Ligament and Its Possible Role Maintaining the Medial Longitudinal Arch
Authors: Swanton Eric , Fisher Lauren , Fisher Andrew , Molloy Andrew , Mason Lyndon 
Published: November 2018

Background: Weight-bearing radiographic analysis of pes planus deformities show, with varying degree of severity, a break in the Meary line. The break in the Meary line occurs not only at the talonavicular joint but also distal to the spring ligament and reported tibialis posterior insertion. Our aim in this study was to investigate the distal plantar ligaments of the medial longitudinal arch, to try to identify other areas where deformity correction could be affected. Methods: We examined 11 cadaveric lower limbs that had been preserved for dissection in a solution of formaldehyde. The lower limbs were carefully dissected to identify the plantar aspect of the medial longitudinal arch. Results: In all specimens, the tibialis posterior tendon inserted into the plantar medial aspect of the navicular with separate slips to the intermediate and lateral cuneiform. The navicular cuneiform ligament extended from the navicular to medial cuneiform. This structure was statically inserted between the navicular and medial cuneiform, which would allow the pull of the tibialis posterior to act on the navicular and medial cuneiform in tandem. The average width of the naviculocuneiform ligament was 15.2 mm (range 12.4-18.0) compared to 9.5 mm (range 7.6-11.4) for the tibialis posterior tendon. Conclusion: The tibialis posterior tendon inserted into the navicular and continued onto the medial cuneiform to provide a static restraint between 2 bony insertions, thus supporting the distal aspect of the medial longitudinal arch. Clinical Relevance: We are confident that it is a structure of importance in maintaining the distal aspect of the medial longitudinal arch and may therefore have significant clinical and surgical implications when treating the pes planus deformity.
Amputation-Free Survival in Patients With Diabetes Mellitus and Peripheral Arterial Disease With Heel Ulcer: Open Versus Endovascular Surgery
Authors: Butt Talha , Lilja Erika , Örneholm Hedvig , Apelqvist Jan , Gottsäter Anders , Eneroth Magnus , Acosta Stefan 
Published: November 2018

Background: Heel ulcers in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD) are hard to heal. The aim of the present study was to evaluate the difference in amputation-free survival (AFS) between open and endovascular revascularization in patients with DM, PAD, and heel ulcers. Methods: Retrospective comparative study of results of open versus endovascular surgery in patients with DM, PAD, and heel ulcer presented at the multidisciplinary diabetes foot clinic between 1983 and 2013. Results: Patients with heel ulcers were treated with endovascular intervention (n = 97) and open vascular surgery (n = 30). Kaplan-Meier analysis showed that the AFS was higher in patients undergoing open vascular surgery compared to the endovascular group ( P = .009). Multivariate analysis showed that open vascular surgery versus endovascular therapy (hazard ratio 2.1, 95% confidence interval 1.1-3.9; P = .025) was an independent factor associated with higher AFS. The proportion of patients undergoing endovascular therapy in the former (1983-2000) time period was 47% compared to 89% in the latter (2001-2013) time period ( P < .001). Conclusion: The AFS was higher after open than endovascular surgery among patients with DM and PAD with heel ulcer. These results suggest that open vascular surgery should be offered more often as opposed to current practice.
Safety and efficacy of non-absorbable mesh in contemporary gynaecological surgery
Authors: Izett Matthew , Kupelian Anthony , Vashisht Arvind 
Published: November 2018

AbstractMesh-augmented pelvic floor surgery evolved to address the limitations of native tissue repair in reconstructive surgery. The development of the synthetic mid-urethral tape signalled a revolution in the treatment of stress urinary incontinence, whilst the use of mesh in abdominal apical prolapse repair may confer benefits over native tissue alternatives. However, these procedures can be associated with mesh-specific complications, underlining the need for shared decision-making between physicians and patients prior to mesh surgery.Transvaginal non-absorbable mesh implants for pelvic organ prolapse are associated with a high risk of serious adverse events, leading to withdrawal or restricted use in many countries. Increased scrutiny has led to growing concerns about complications associated with all types of mesh-augmented reconstructive surgery, attracting widespread media attention.National and international reports have been commissioned examining the safety and efficacy of mesh surgery in gynaecology. They have all highlighted systemic failures in the development, regulation and clinical adoption of medical devices. The widespread application of novel devices prior to the availability of reliable safety and efficacy data, and delayed recognition of adverse events, is of serious concern. Notwithstanding, the available data continue to support a role for mesh augmentation. This review outlines the evolution of gynaecological mesh, the safety and efficacy of pelvic floor surgery using non-absorbable mesh materials, and an overview of specific complications.
Do wearable alcohol-based handrub dispensers increase hand hygiene compliance? - a mixed-methods study
Authors: Keller Jonas , Wolfensberger Aline , Clack Lauren , Kuster Stefan P. , Dunic Mesida , Eis Doris , Flammer Yvonne , Keller Dagmar I. , Sax Hugo 
Published: November 2018

Abstract
Background
Hand Hygiene (HH) compliance was shown to be poor in several studies. Improving the availability of alcohol-based hand rub (ABHR) is a cornerstone for increasing HH compliance.

Methods
In this study, we introduced wearable dispensers for ABHR in an Emergency Department (ED) well equipped with mounted ABHR dispensers and accompanied this single-modal intervention by a quasi-experimental mixed-method study. The study was performed in the ED of the University Hospital Zurich, Switzerland, a 950-bed tertiary teaching hospital. During a five-week baseline period and a seven-week intervention period, we observed HH compliance according to the WHO ‘Five Moments’ concept, measured ABHR consumption, and investigated perceived ABHR availability, self-reported HH compliance and knowledge of HH indications by questionnaire. Multivariable logistic regression was used to identify independent determinants for HH compliance. In addition, semi-structured interviews were conducted and thematically analyzed to assess barriers and facilitators for the use of the newly introduced dispensers.

Results
Across 811 observed HH opportunities, the HH compliance for all moments was 56% (95% confidence interval (CI), 51–62%) during baseline and 64% (CI, 59–68%) during intervention period, respectively. In the multivariable analysis adjusted for sex, profession, and WHO HH moment, there was no difference in HH compliance between baseline and intervention (adjusted Odds ratio: 1.22 (0.89–1.66), p = 0.22), No significant changes were observed in consumption and perceived availability of ABHR. During intervention, 7.5% ABHR was consumed using wearable dispensers. HCP perceived wearable dispensers as unnecessary since mounted dispensers were readily accessible. Poor ergonomic design of the wearable dispenser emerged as a main barrier, especially its lid and fastening mechanism. Interviewees identified two ideal situations for wearable dispensers, HCP who accompany patients from ED to other wards, and HCP approaching a patient from a non-patient areas in the ED such as the central working station or the meeting room.

Conclusion
The introduction of wearable dispensers did not increase observed hand hygiene compliance or ABHR consumption in an ED already well equipped with mounted dispensers. For broader acceptance and use, wearable dispensers might benefit from an optimized ergonomic design.
Understanding, identifying and managing severe dissociative disorders in general psychiatric settings
Authors: Temple Melanie J. 
Published: November 2018

SUMMARYThe severe dissociative disorders of dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS) are complex, not uncommon presentations associated with severe symptoms, high rates of comorbidity, high service use compared with other psychiatric disorders, and high suicidality. They exact high personal and socioeconomic burdens and show poor response to standard treatments, with high levels of treatment attrition and ‘revolving-door’ out-patient and in-patient service use; patients are often misdiagnosed or labelled ‘untreatable’. DID and DDNOS diagnoses remain controversial, but they have been repeatedly validated internationally over the past 20 years and the disorders can be accurately identified using screening tools and structured clinical interviews. Neurobiological understanding of the disorders is increasing; findings are consistent with a trauma origin and have commonality with features seen in other trauma-related disorders. Specialist treatment that addresses the dissociative symptoms alongside their trauma origins shows promise in early evidence. Working knowledge of these disorders among non-specialist psychiatrists and psychologists in the UK remains poor, resulting in long delays before diagnosis and treatment.LEARNING OBJECTIVES•Understand trauma-related DID and DDNOS, in particular that they are ‘real’ and not rare disorders•Know when to suspect their presence in general psychiatric settings and how to assess for them•Understand (and help the patient to access) specialist treatments and be able to apply general approaches in the non-specialist settingDECLARATION OF INTERESTNone.
Subclinical psychosis in adult migrants and ethnic minorities: systematic review and meta-analysis
Authors: Tortelli Andrea , Nakamura Aurélie , Suprani Federico , Schürhoff Franck , Van der Waerden Judith , Szöke Andrei , Tarricone Ilaria , Pignon Baptiste 
Published: November 2018

BackgroundIt is well established that migration and ethnic minority status are risk factors for psychotic disorders. Recent studies have aimed to determine if they are also associated with subclinical psychosis (psychotic-like experiences and schizotypal traits).AimsWe aimed to determine to what extent migrant and ethnic minority groups are associated with higher risk of subclinical psychosis.MethodWe conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and examined findings by ethnicity, migrant status, outcomes of subclinical psychosis and host country. A meta-analysis was carried out with robust variance estimation where possible, to handle statistically dependent effect size estimates.ResultsWe included 28 studies (19 studies on psychotic-like experiences and 9 studies on schizotypal traits) and found that ethnicity, but not migrant status, was associated with current and lifetime psychotic-like experiences. In the narrative analysis, we observed the effect of psychosocial risk factors on this association: Black ethnicity groups showed consistent increased prevalence of current and lifetime psychotic-like experiences compared with the reference population across countries.ConclusionsMore generalisable and standardised cohort studies of psychotic-like experiences and schizotypal traits in relation to migration/ethnicity are necessary to examine the effects of exposures and outcomes in different contexts, and to understand the underlying mechanisms of the association between subclinical psychosis and migrant and ethnic minority status.Declaration of interestNone.
The zinc-finger transcription factor GLI3 is a regulator of precerebellar neuronal migration
Authors: Martinez-Chavez Erick , Scheerer Claudia , Wizenmann Andrea , Blaess Sandra 
Published: November 2018

ABSTRACT
Hindbrain precerebellar neurons arise from progenitor pools at the dorsal edge of the embryonic hindbrain: the caudal rhombic lip. These neurons follow distinct migratory routes to establish nuclei that provide climbing or mossy fiber inputs to the cerebellum. Gli3, a zinc-finger transcription factor in the Sonic hedgehog signaling pathway, is an important regulator of dorsal brain development. We demonstrate that in Gli3-null mutant mice, disrupted neuronal migratory streams lead to a disorganization of precerebellar nuclei. Precerebellar progenitors are properly established in Gli3-null embryos and, using conditional gene inactivation, we provide evidence that Gli3 does not play a cell-autonomous role in migrating precerebellar neurons. Thus, GLI3 likely regulates the development of other hindbrain structures, such as non-precerebellar nuclei or cranial ganglia and their respective projections, which may in turn influence precerebellar migration. Although the organization of non-precerebellar hindbrain nuclei appears to be largely unaffected in absence of Gli3, trigeminal ganglia and their central descending tracts are disrupted. We show that rostrally migrating precerebellar neurons are normally in close contact with these tracts, but are detached in Gli3-null embryos.
Portuguese and Spanish Teletandem: The Role of Mediators
Authors: Ramos Karin Adriane Henschel Pobbe , Carvalho Kelly Cristiane Henschel Pobbe de 
Published: November 2018

Teletandem is a virtual context of learning languages based on principles of autonomy and reciprocity in which two peers collaborate to learn the language of each other. Usually, the interactions occur in institutional groups mediated by a professor or a graduate student. This paper aims to describe the role of a mediator and the process of mediation in Portuguese and Spanish Teletandem. Previous studies have analyzed how the Teletandem practice in the context of very close languages, such as Portuguese and Spanish, presents some inherent specificity related to the natural possibility of certain intercommunication between the interactants (Ramos, Carvalho, & Messias, 2013; Silva-Oyama,2010). In this case, it is necessary to observe the process of mediation more closely and consider the relevance of cultural and linguistic aspects. The theoretical assumptions that guide our description and discussion are based onsociocultural theory for second language learning and assume that the learning process happens through interactions between people and the environment in a cooperative manner (Vygotsky, 1978). The methodological perspective thatanchors this study is grounded theory (Charmaz, 2006), which is based on a systematic collection of data that, after analysis, originate concepts. The reflection corroborates the fact that the development of the process depends on the involvement of the mediator in different roles and suggests that the principles of autonomy and reciprocity are directly related to the mediation process and can contribute to an effective collaborative context of language learning.