bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial
Authors: Wang Xue-Qiang , Gu Wei , Chen Bing-Lin , Wang Xin , Hu Hao-Yu , Zheng Yi-Li , Zhang Juan , Zhang Han-Yu , Chen Pei-Jie 
Published: May 2019

Objective: To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group ( n = 45) or the control group ( n = 44). Intervention: The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. Main outcomes: The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). Results: A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = –1.22 to −0.78; P < 0.001), 3.81 point (95% CI, −4.98, −2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense ( P < 0.05), quality of life ( P < 0.05), and Global Perceived Effect ( P = 0.012). Conclusion: The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.
Acute Fingolimod Effects on Baroreflex and Cardiovascular Autonomic Control in Multiple Sclerosis
Authors: Racca Vittorio , Rovaris Marco , Cavarretta Rosella , Vaini Emanuele , Toccafondi Anastasia , Di Rienzo Marco 
Published: May 2019

Background: Fingolimod, an oral drug used in multiple sclerosis (MS) treatment, exerts its action through S1P-receptor engagement. These receptors are also expressed in heart and endothelial cells. The engagement of receptors on the atrial heart myocytes may cause a slowing effect on heart rate (HR). We aimed to explore the acute effect of fingolimod on the cardiac autonomic control, a side-effect of the drug that still needs to be clarified. Methods: In 10 MS patients, we investigated the influence of the first administration of fingolimod (0.5 mg) on sympathetic and parasympathetic indexes via the analysis of the HR variability, and on the baroreflex sensitivity via sequence and alpha coefficient techniques. Results: Fingolimod produced an average HR maximal drop of 12.7 (7.8) beats/min and the minimal HR occurred after 2.73 (0.38) hours from the dose administration. The pulse interval (PI) mean value and the pNN50 and RMSSD indexes of parasympathetic drive to the heart significantly increased. Interestingly, in 6 out of 10 patients also the power in the low-frequency band (LF) increased. The baroreflex sensitivity was not modified by the first dose of the drug. Conclusions: Our findings indicate that although the first dose of fingolimod invariably activates the parasympathetic system, in several subjects, it may induce also a surge in the sympathetic cardiac drive. This suggests that not only the vagal, as usually assumed, but also the sympathetic autonomic branch should be considered in the risk profile assessment of MS patients starting treatment with fingolimod.
Effects of a web-based expert support self-management program (WEST) for women with breast cancer: A randomized controlled trial
Authors: Kim Hye-Jin , Kim Hee-Seung 
Published: May 2019

Introduction This study was a randomized controlled trial that examined the effects of a web-based expert support self-management program (WEST) on metabolic syndrome risk factors and self-efficacy among Korean women with breast cancer. Methods Participants were 60 women with breast cancer (30 participants each in both the experimental and control groups) who also had metabolic risk factors. WEST is based on the self-efficacy theory and is a self-health management program consisting of a web-based program, DIETEX (which entails keeping a health diary, identifying a lifestyle type, inputting personal health information), and expert support. WEST was provided to the experimental group once a week for 24 weeks. Metabolic syndrome risk factors and self-efficacy of the experimental and control groups were examined pre-intervention and at 12 and 24 weeks after intervention. Results The decreases in body fat, body fat percentage, and waist circumference were greater in the experimental group than in the control group at 24 weeks ( p = 0.019, p = 0.025, and p = 0.038, respectively). Discussion The present study can provide basic data for the development and application of interventions for women with breast cancer in the future. Additionally, we propose that WEST be included in the treatment process to complement the intervention of medical personnel for improving metabolic risk factors in women with breast cancer.
Electronic inhaler monitoring and healthcare utilization in chronic obstructive pulmonary disease
Authors: Alshabani Khaled , Attaway Amy A , Smith Michael J , Majumdar Uddalak , Rice Richard , Han Xiaozhen , Wang Xiaofeng , Hatipoğlu Umur 
Published: May 2019

Introduction The effect of electronic inhaler monitoring (EIM) on healthcare utilization in chronic obstructive pulmonary disease (COPD) has not been studied. We hypothesized that the use of EIM in conjunction with a disease management program reduces healthcare utilization in patients with COPD. Methods This is a retrospective pre- and post-analysis of a quality improvement project. Patients with COPD and high healthcare utilization (≥one hospitalization or emergency room visit during the year prior to enrolment) were provided with electronic monitoring devices for monitoring controller and rescue inhaler utilization for one year. Patients were contacted when alerts were triggered, indicating suboptimal adherence to controller inhaler or increased use of rescue inhalers, potentially signalling an impending exacerbation. Healthcare utilization was assessed pre- and post-monitoring, with each subject serving as his/her own control. Results Patients with COPD and high healthcare utilization ( n = 39) were recruited. Mean EIM duration was 280.5 (±120.6) days. The mean age was 68.6 (±9.9) years, FEV1 (mean forced expiratory volume in one second) was 1.1 (±0.4) L, and mean Charlson Comorbidity index was 5.6 (±2.7). Average adherence was 44.4% (28.4%). Compared with the year prior to enrolment, EIM was associated with a reduction in COPD-related healthcare utilization per year (2.2 (±2.3) versus 3.4 (±3.2), p = 0.01). Although there was a reduction in all-cause healthcare utilization, this was not statistically significant (3.4 (±2.6) versus 4.7 (±4.1), p = 0.06). Discussion EIM in conjunction with a disease management program may play a role in reducing healthcare utilization in COPD patients with a history of high healthcare utilization.
Quantification of low abundance Yersinia pestis markers in dried blood spots by immuno-capture and quantitative high-resolution targeted mass spectrometry
Authors: Rifflet Aline , Filali Sofia , Chenau Jérôme , Simon Stéphanie , Fenaille François , Junot Christophe , Carniel Elisabeth , Becher François 
Published: May 2019

Plague, caused by the bacterium Yersinia pestis, is still present in several countries worldwide. Besides, Y. pestis has been designated as Tier 1 agent, the highest rank of bioterrorism agents. In this context, reliable diagnostic methods are of great importance. Here, we have developed an original workflow based upon dried blood spot for simplified sampling of clinical specimens, and specific immuno-mass spectrometry monitoring of Y. pestis biomarkers. Targeted proteins were selectively enriched from dried blood spot extracts by multiplex immunocapture using antibody-coated magnetic beads. After accelerated on-beads digestion, proteotypic peptides were monitored by multiplex LC-MS/MS through the parallel reaction monitoring mode. The DBS-IC-MS assay was designed to quantify both F1 and LcrV antigens, although 10-fold lower sensitivity was observed with LcrV. The assay was successfully validated for F1 with a lower limit of quantification at 5 ng·mL−1 in spiked blood, corresponding to only 0.1 ng on spots. In vivo quantification of F1 in blood and organ samples was demonstrated in the mouse model of pneumonic plague. The new assay could help to simplify the laboratory confirmation of positive point of care F1 dipstick.
Composition of the mucosa‐associated microbiota along the entire gastrointestinal tract of human individuals
Authors: Vuik FER , Dicksved J , Lam SY , Fuhler GM , van der Laan LJW , van de Winkel A , Konstantinov SR , Spaander MCW , Peppelenbosch MP , Engstrand L , Kuipers EJ 
Published: May 2019

BackgroundHomeostasis of the gastrointestinal tract depends on a healthy bacterial microbiota, with alterations in microbiota composition suggested to contribute to diseases. To unravel bacterial contribution to disease pathology, a thorough understanding of the microbiota of the complete gastrointestinal tract is essential. To date, most microbial analyses have either focused on faecal samples, or on the microbial constitution of one gastrointestinal location instead of different locations within one individual.ObjectiveWe aimed to analyse the mucosal microbiome along the entire gastrointestinal tract within the same individuals.MethodsMucosal biopsies were taken from nine different sites in 14 individuals undergoing antegrade and subsequent retrograde double‐balloon enteroscopy. The bacterial composition was characterised using 16 S rRNA sequencing with Illumina Miseq.ResultsAt double‐balloon enteroscopy, one individual had a caecal adenocarcinoma and one individual had Peutz‐Jeghers polyps. The composition of the microbiota distinctively changed along the gastrointestinal tract with larger bacterial load, diversity and abundance of Firmicutes and Bacteroidetes in the lower gastrointestinal tract than the upper gastrointestinal tract, which was predominated by Proteobacteria and Firmicutes.ConclusionsWe show that gastrointestinal location is a larger determinant of mucosal microbial diversity than inter‐person differences. These data provide a baseline for further studies investigating gastrointestinal microbiota‐related disease.
Characterizing Bone Mineral Density Using Lumbar Spine Computed Tomography Attenuation in Patients With Distal Radius Fractures
Authors: Ward Christina M. , Arnold Mark A. , Emohare Osa 
Published: May 2019

Introduction: This study examines how many patients with distal radius fracture (DRF) eligible for bone health evaluation could potentially be screened using bone mineral density (BMD) estimation by L1 vertebra computed tomography (CT) attenuation obtained for other purposes. Materials and Methods: For all adult patients with DRF who presented over a 5-year period, we recorded the age, sex, dual-energy X-ray absorptiometry (DXA) results up to 3 years prior to injury or 1 year post-injury, and L1 CT attenuation on any CT including L1 that had been performed within 6 months of their fracture. 1 We compared the availability of L1 CT attenuation measurement to the rate of DXA scan use. We calculated the percentage of patients with osteoporosis and compared attenuation results to DXA results in those patients where both tests were available. Results: Of 1853 patients with DRF, an L1 CT had been obtained in 195 patients. Of the 685 patients who met criteria for osteoporosis screening, 253 (37%) patients had undergone only DXA screening, 68 (10%) patients had an L1 CT only, and 18 (2%) patients had both tests. Of the 86 patients who met criteria for osteoporosis screening and had an adequate CT, 67 (78%) demonstrated L1 attenuation <135 HU, and 79 (92%) had CT attenuation <160 HU. Discussion: Our study found that 10% of patients with a distal radius fracture who met the criteria for osteoporosis screening had a CT scan that could be used to estimate bone density and that the majority of those patients met criteria for osteoporosis based on CT attenuation. Conclusions: Utilization of opportunistic BMD screening with L1 CT attenuation offers the potential to increase osteoporosis screening from 40% to 50% of eligible patients and make the diagnosis of osteoporosis in an additional 8% of patients with DRF at no additional cost.
Endoscopic side-by-side uncovered self-expandable metal stent placement for malignant hilar biliary obstruction
Authors: Kitamura Katsuya , Yamamiya Akira , Ishii Yu , Mitsui Yuta , Yoshida Hitoshi 
Published: May 2019

Aim: To investigate outcomes of endoscopic bilateral side-by-side placement across the papilla using 10-mm-diameter uncovered self-expandable metal stents for unresectable malignant hilar biliary obstruction. Methods: We retrospectively analyzed 23 patients who underwent endoscopic biliary uncovered self-expandable metal stent placement for unresectable malignant hilar biliary obstruction between January 2015 and September 2016 at our institution. We performed endoscopic side-by-side placement across the papilla using 10-mm-diameter longer-model uncovered self-expandable metal stents. Outcomes included the technical and functional success rates, recurrent biliary obstruction rate, time to recurrent biliary obstruction, reintervention rate, and incidence of adverse events other than recurrent biliary obstruction. Results: Of the 23 patients, 10 with malignant hilar biliary obstruction underwent endoscopic side-by-side uncovered self-expandable metal stent placement across the papilla (median age, 83 years; 6 men). The locations of malignant hilar biliary obstruction were Bismuth types II ( n = 3), III ( n = 3), and IV ( n = 4). The median common bile duct diameter was 8 mm. The technical and functional success rates were 100% and 80%, respectively. Seven patients (70%) developed recurrent biliary obstruction because of stent occlusions, including early hemobilia in two patients and late tumor ingrowth in five patients. The median time to recurrent biliary obstruction was 66 (95% confidence interval: 29–483) days. Six patients (60%) required reintervention, and 1 (10%) underwent transcatheter arterial embolization for right hepatic arterial pseudoaneurysm. Early adverse events other than recurrent biliary obstruction occurred in four patients and late adverse event in one patient. Conclusion: Endoscopic side-by-side placement across the papilla using 10-mm-diameter uncovered self-expandable metal stents was technically feasible for unresectable malignant hilar biliary obstruction; however, it might be better to avoid this method for patients with malignant hilar biliary obstruction because of high recurrent biliary obstruction rate and shorter time to recurrent biliary obstruction.
GH Knockout Mice Have Increased Subcutaneous Adipose Tissue With Decreased Fibrosis and Enhanced Insulin Sensitivity
Authors: List Edward O , Berryman Darlene E , Buchman Mathew , Jensen Elizabeth A , Funk Kevin , Duran-Ortiz Silvana , Qian Yanrong , Young Jonathan A , Slyby Julie , McKenna Savannah , Kopchick John J 
Published: May 2019

Abstract
In 1997, our laboratory used targeted gene disruption of the GH receptor (GHR) to generate GHR knockout (GHR−/−) mice, which have been used in >127 published studies to help elucidate GH’s numerous activities. However, because GH replacement studies cannot be performed using this line, a GH knockout mouse line via targeted disruption of the GH gene is needed. Therefore, we created and characterized GH gene–disrupted (GH−/−) mice. GH−/− mice have severely decreased IGF-1 levels, small body size, and altered body composition with increased adiposity. GH−/− mice are extremely insulin sensitive but glucose intolerant, with a dramatic reduction in pancreatic islet size. Importantly, disruption of the GH gene had profound and depot-specific effects on white adipose tissue (WAT). Subcutaneous WAT from male and female GH−/− mice have significantly larger adipocytes and reduced fibrosis, neither of which occurred in perigonadal WAT, suggesting that GH has a more pronounced effect on subcutaneous WAT. Comparisons of GH−/− mice to previously published data on GHR−/− mice show a remarkably similar phenotype. Finally, we demonstrate that GH−/− mice are responsive to GH treatment, as shown by changes to serum IGF-1 levels; body length, weight, and composition; and insulin sensitivity. This study not only provides characterization of the first mouse line with targeted mutation of the GH gene but also indicates that GH gene disruption dramatically influences fibrosis of subcutaneous WAT.
Myocardial Adaptations to Competitive Swim Training
Authors: WASFY MEAGAN M. , WEINER RORY B. , WANG FRANCIS , BERKSTRESSER BRANT , DELUCA JAMES , HUTTER ADOLPH M. , PICARD MICHAEL H. , BAGGISH AARON L. 
Published: May 2019

ABSTRACT

Purpose
Swim training is performed in the prone or supine position and obligates water immersion, factors that may augment cardiac volume loading more than other endurance sports. At present, prospective data defining the cardiac responses to swim training are lacking. We therefore studied myocardial adaptations among competitive swimmers to establish a causal relationship between swim training and left ventricular (LV) remodeling.

Methods
Collegiate swimmers were studied before and after a 90-d period of training intensification. Transthoracic echocardiography was used to examine LV structural and functional adaptations under resting conditions and during an acute LV afterload challenge generated by isometric handgrip testing (IHGT). A sedentary control population was identically studied with IHGT.

Results
In response to a discrete period of swim training intensification, athletes (n = 17, 47% female, 19 ± 0.4 yr old) experienced eccentric LV remodeling, characterized by proportionally more chamber dilation than wall thickening, with attendant enhancements of resting LV systolic (LV twist) and diastolic (early and late phase tissue velocities) function. Compared with baseline and controls, athletes posttraining demonstrated greater systolic twist impairment during IHGT. However, training-induced LV dilation coupled with gains in diastolic function offsets this acquired systolic susceptibility to acute afterload, resulting in the relative preservation of stroke volume during IHGT.

Conclusion
Swim training, a sport characterized by unique cardiac loading conditions, stimulates eccentric LV remodeling with the concomitant augmentation of systolic twist and diastolic relaxation. This volume-mediated cardiac remodeling appears to result in greater systolic susceptibility to acute afterload challenge. Further work is required to establish how training-induced changes in function translate to human performance and whether these are accompanied by physiologic trade-offs with relevance to common forms of heart disease.
The Effect of Growth Restriction on Voluntary Physical Activity Engagement in Mice
Authors: LESZCZYNSKI ERIC C. , VISKER JOSEPH R. , FERGUSON DAVID P. 
Published: May 2019

ABSTRACT

Introduction
The purpose of this study was to determine the effect of growth restriction on the biological regulation of physical activity.

Methods
Using a cross-fostering, protein-restricted nutritive model, mice were growth-restricted during either gestation (GUN; N = 3 litters) or postnatal life (PUN; N = 3 litters). At 21 d of age, all mice pups were weaned and fed a nonrestrictive healthy diet for the remainder of the study. At 45 d of age, mice were individually housed in cages with free moving running wheels to assess physical activity engagement. At day 70, mice were euthanized, and the nucleus accumbens was analyzed for dopamine receptor 1 expression. Skeletal muscle fiber type and cross-sectional area of the soleus, extensor digitorom longus, and diaphragm were analyzed by immunohistochemistry. The soleus from the other hindleg was evaluated for calsequestrin 1 and annexin A6 expression.

Results
The PUN female mice (15,365 ± 8844 revolutions per day) had a reduction (P = 0.0221) in wheel revolutions per day as compared with the GUN (38,667 ± 8648 revolutions per day) and CON females (36,421.0 ± 6700 revolutions per day). The PUN female mice also expressed significantly higher dopamine receptor 1 compared (P = 0.0247) to the other groups. The PUN female soleus had a higher expression of calsequestrin 1, along with more type IIb fibers (P = 0.0398).

Conclusions
Growth restriction during lactation reduced physical activity in female mice by reducing the central drive to be active and displayed a more fatigable skeletal muscle phenotype.
Healthcare needs of the Muslim patient community in the undergraduate medical curriculum – Are we there?
Authors: Haq Hameed ul , Khan Rehan Ahmed , Yasmin Raheela 
Published: May 2019

Objective: Muslim patients have a unique set of healthcare needs that are related to their faith. These are generally not formally addressed in the medical curricula. The study aimed to recommend additional content that would better tailor the undergraduate curriculum to cater to the needs of this large cohort – Muslim patients. This is with the expectation that patients would have their faith-related health queries resolved by healthcare providers.
Methods: A quantitative descriptive survey design was adopted. A 46-item questionnaire formulated through a literature review was put forth to experts using the Delphi Technique. Experts were selected based on having an academic rank of associate professor and above or medical education credentials. Three iterative rounds were conducted for exploring consensus over a period of five months. Panel agreement of >70% was the criteria for inclusion.
Results: Items were categorized under 7 subject themes: Medicine, Psychiatry, Surgery, Gynecology, Obstetrics, Medical Ethics, and Islamic Studies. Consensus was eventually reached for 41 out of 46 items. These topics included but were not limited to “The Muslim patient in Ramadan: to fast or not to fast?” and “Muslim women and decision-making on pregnancy termination”.
Conclusion: The study suggested that the topics proposed herein were in fact legitimate faith-related healthcare needs of Muslim patients. Their inclusion would add value to the undergraduate medical curriculum and would train practitioners to improve patient outcomes more holistically.
doi: https://doi.org/10.12669/pjms.35.3.861
How to cite this:Haq H, Khan RA, Yasmin R. Healthcare needs of the Muslim patient community in the undergraduate medical curriculum – Are we there?. Pak J Med Sci. 2019;35(3):836-841. doi: https://doi.org/10.12669/pjms.35.3.861
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.