bluuebunny/crossref_metadata_2025_split huggingface dataset:
A quantified description of the interactions between the native cardiovascular system and femoro‐femoral versus femoro‐axillary extracorporeal life support using descending thoracic aorta velocity time integral
Authors: Andrei Stefan , Tran‐Dinh Alexy , Provenchere Sophie , Lortat‐Jacob Brice , Ghodbane Walid , Montravers Philippe , Longrois Dan 
Published: December 2018

AbstractExtracorporeal life support (ECLS) is an important tool in managing severe cardio‐circulatory and respiratory failures. The axillary and the femoral sites are the most frequently used for arterial cannulation. There is no current evidence favoring one site over the other. We tested the hypothesis that the axillary and femoral arterial cannulation site may have different effects on left ventricular (LV) outflow. Seven patients with femoro‐axillary ECLS and 4 patients with femoro‐femoral ECLS were prospectively studied using the Pulse‐wave Doppler (PWD) velocity time integral (VTI) in the descending thoracic aorta (DTA VTI) at different short‐time variations of ECLS flow rates during the ECLS weaning process. The measurements were safe and feasible in all patients. We found a directly proportional correlation between DTA VTI and ECLS flow rate for femoro‐axillary cannulation (P < 0.05) and an inversely proportional correlation in the case of femoro‐femoral cannulation (P < 0.05). This is the first reported utilization of DTA VTI during ECLS that could improve our understanding of the LV‐aorta interactions in patients with ECLS. DTA VTI could be used as a tool, guiding weaning from ECLS.
Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes
Authors: Dela Flemming , Ingersen Arthur , Andersen Nynne B. , Nielsen Maria B. , Petersen Helga H. H. , Hansen Christina N. , Larsen Steen , Wojtaszewski Jørgen , Helge Jørn Wulff 
Published: December 2018

AbstractAimTo examine the effect of high‐intensity interval training (HIIT) on glucose clearance rates in skeletal muscle and explore the mechanism within the muscle.MethodsTen males with type 2 diabetes mellitus (T2DM) and ten matched healthy subjects performed 2 weeks of one‐legged HIIT (total of eight sessions, each comprised of 10 × 1 minute ergometer bicycle exercise at >80% of maximal heart rate, interspersed with one min of rest). Insulin sensitivity was assessed by an isoglycaemic, hyperinsulinaemic clamp combined with arteriovenous leg balance technique of the trained (T) and the untrained (UT) leg and muscle biopsies of both legs.ResultsInsulin‐stimulated glucose clearance in T legs was ~30% higher compared with UT legs in both groups due to increased blood flow in T vs UT legs and maintained glucose extraction. With each training session, muscle glycogen content decreased only in the training leg, and after the training, glycogen synthase and citrate synthase activities were higher in T vs UT legs. No major changes occurred in the expression of proteins in the insulin signalling cascade. Mitochondrial respiratory capacity was similar in T2DM and healthy subjects, and unchanged by HIIT.ConclusionHIIT improves skeletal muscle insulin sensitivity. With HIIT, the skeletal muscle of patients with T2DM becomes just as insulin sensitive as untrained muscle in healthy subjects. The mechanism includes oscillations in muscle glycogen stores and a maintained ability to extract glucose from the blood in the face of increased blood flow in the trained leg.
Randomised clinical trial: Bifidobacterium lactis NCC2818 probiotic vs placebo, and impact on gut transit time, symptoms, and gut microbiology in chronic constipation
Authors: Dimidi Eirini , Zdanaviciene Ausra , Christodoulides Stephanos , Taheri Shiva , Louis Petra , Duncan Peter I. , Emami Nashmil , Crabbé Rafael , De Castro C. Antonio , McLean Peter , Bergonzelli Gabriela E. , Whelan Kevin , Mark Scott S. 
Published: December 2018

SummaryBackgroundConstipation is a prevalent gastrointestinal disorder. Patient dissatisfaction with prescribed medications is common, and there is need for alternative management strategies. Evidence shows that Bifidobacterium species may be beneficial in constipation.AimTo investigate changes in physiological and clinical measures of gut function in patients with chronic constipation following the consumption of Bifidobacterium lactis NCC2818, compared to placebo.MethodsParticipants were randomised to a 4‐week supplementation with B. lactis NCC2818 (1.5 x 1010 CFU/d) or placebo. Gut transit time was measured using a radio‐opaque marker, while symptoms and quality of life were assessed using validated questionnaires. Gut microbiota composition was assessed using quantitative polymerase chain reaction. Analysis of covariance was used for normally distributed variables, and Mann‐Whitney test for non‐normally distributed variables.ResultsSeventy‐five participants were randomised. There was no significant difference between the probiotic and placebo groups in gut transit time change from baseline to week 2 (−11.7 hours, SD 33.0 hours vs −12.9 hours, SD 33.6 hours; P = 0.863) or to week 4 (−20.4 hours, SD 32.5 h vs −8.7 hours, SD 33.8 hours; P = 0.103). There were also no improvements in stool output, symptoms, or quality of life. No differences were found in Bifidobacterium concentrations between the probiotic and placebo groups at week 4 (9.5 log10/g dry faeces, SD 0.3 vs 9.4 log10/g, SD 1.0; P = 0.509).ConclusionsBifidobacterium lactis NCC2818 was not effective in the management of mild chronic constipation. This study highlights the importance of further studies and their publication to better understand the strain‐specific effects of probiotics.
Quality of life measures predict mortality in patients with cirrhosis and severe ascites
Authors: Macdonald Stewart , Jepsen Peter , Alrubaiy Laith , Watson Hugh , Vilstrup Hendrik , Jalan Rajiv 
Published: December 2018

SummaryBackgroundSevere ascites is associated with both a poor health‐related quality of life (HRQL) and a mortality in excess of that captured by current prognostic clinical scores.AimTo determine the association between HRQL and mortality in patients with severe ascites.MethodsThe HRQL data from previously published randomised controlled trials examining the efficacy of satavaptan in ascites were retrospectively evaluated.ResultsOf the 496 patients randomised who completed the SF‐36, 405 patients had complete datasets and were included in the analysis (difficult‐to‐treat ascites, n = 164 or refractory ascites, n = 241). Overall, patients reported poor HRQL, in particular the physical component score (PCS) of SF‐36. The physical component score (PCS) correlated with the mental component score (MCS) of SF‐36 (Spearman rank correlation = 0.68) but not with markers of severity of liver disease. The PCS, but not the MCS, was significantly lower in patients who died (P = 0.01 and P = 0.84, respectively). After confounder‐adjustment, the hazard ratio for a 10‐point increase in the physical component score was 0.83 (95% CI; 0.72‐0.97) for all‐cause mortality and 0.84 (95% CI; 0.71‐0.99) for cirrhosis‐related deaths only, indicating that patients with better physical HRQL live longer on average.ConclusionsPoor physical component score (PCS) of SF‐36 is an independent predictor of 12‐month mortality in patients with severe ascites independent of current prognostic clinical scores. It holds promise not only in prognostic modelling but also as an endpoint in the evaluation of therapies targeting ascites.
Systematic review with meta‐analysis: the prevalence of bile acid malabsorption and response to colestyramine in patients with chronic watery diarrhoea and previous cholecystectomy
Authors: Ruiz‐Campos Laura , Gisbert Javier P. , Ysamat Montserrat , Arau Beatriz , Loras Carme , Esteve Maria , Fernández‐Bañares Fernando 
Published: December 2018

SummaryBackgroundA limited number of small‐sized studies suggest that bile acid diarrhoea is frequent in patients with chronic watery diarrhoea and previous cholecystectomy.AimTo perform a systematic review and meta‐analysis to assess the prevalence of bile acid diarrhoea in patients with chronic watery diarrhoea and previous cholecystectomy, and their response to colestyramine, including a new consecutive series of patients.MethodsMEDLINE and EMBASE were searched up to January 2018. Selected studies included patients with previous cholecystectomy and chronic watery diarrhoea assessed by the 23‐seleno‐25‐homotaurocholic acid (SeHCAT) test. We calculated the pooled rate of bile acid diarrhoea using the inverse double arcsine square root method. Additionally, the medical records of 291 consecutive patients with chronic watery diarrhoea in whom a SeHCAT test was performed were retrospectively reviewed and 74 with previous cholecystectomy were included in the meta‐analysis.ResultsThe search strategy identified eight relevant studies, which, together with the data of the present series, comprise 361 individuals. The pooled bile acid diarrhoea rate was 70% (95% CI 56%‐82%), and was similar when using cut‐offs of 10% or 15%. There was substantial heterogeneity (I2 = 84%). Five studies comprising 166 patients evaluated the effect of colestyramine in patients with bile acid diarrhoea. The pooled colestyramine response rate was 79% (95% CI 63%‐91%) with substantial heterogeneity (I2 = 73%).ConclusionsTwo‐thirds of patients with chronic watery diarrhoea and previous cholecystectomy have bile acid diarrhoea. Response to colestyramine in these patients is good.
Estimation of the economic value of herd‐life length based on simulated changes in survival rate
Authors: Sasaki Osamu , Takeda Hisato , Nishiura Akiko 
Published: December 2018

AbstractFunctional traits are an important aspect of long‐term breeding strategies for dairy cattle. In this regard, it is necessary to develop simple methods for estimating the economic value of herd life. In this study, the economic daily value of herd life was estimated when survival rate varied between −0.05 and 0.05 from the basal survival rate. The extension days per survival rate were 26.5 days in Hokkaido and 20.3 days in other regions. The increases in values of annual income per day of herd life were 95.18 yen in Hokkaido and 101.80 yen in other regions. The relative economic weights of milk yield to herd life per genetic standard deviation were 0.668 in Hokkaido and 1.03 in other regions. Estimated increments in yearly profits based on young sire selection for herd life were 963 yen in Hokkaido and 1,030 yen in other regions. The estimated increments in annual profits based on young sire selection for milk yield were 1,268 yen in Hokkaido and 2,097 yen in other regions. Given that economic value was linearly correlated with herd‐life length, the linear regression coefficients between these factors could be used to estimate the economic value of herd‐life length.
Using an observation tool (Parent–Infant Interaction Observation Scale) to assess parent–infant interaction in the first 2 weeks of life: A feasibility study
Authors: Naughton Aideen , Perkins Lucinda , McMinn Bethan , Kemp Alison 
Published: December 2018

AbstractBackgroundEmotional maltreatment (EM) has profound effects on the developing brain but is hardest to identify in infancy. Early observations of parent–infant interactions may provide opportunities to identify babies at risk of neglect and EM. This prospective study tests, in the first fortnight of life, the feasibility of using an observation tool previously validated for use at 2 to 7 months of age.MethodsWomen awaiting induction of labour were recruited in South Wales in July 2016. Women consented to being contacted postnatally and video recordings of mother‐infant interaction at two home visits between 7 and 10 days (T1) and 8–12 weeks old (T2). Demographic details, information on the pregnancy, delivery, and infant condition were obtained at T1. A questionnaire was completed at T2 to capture any significant events affecting the parent–infant relationship. The Parent‐Infant Interaction Observation Scale (PIIOS) was used to score the videos. Exclusion criteria included admission to neonatal unit.ResultsRecruitment of suitable participants and full research data completion were feasible. Of 60 women who consented to be contacted post‐delivery, 30 women (31 infants) participated at T1 and T2. Three babies were excluded. Women accepted being observed in their homes with their babies, with no attrition between T1 and T2. Using the PIIOS 10 of the 13 items could be scored with an awake infant under 2 weeks.ConclusionThese encouraging findings can inform exploration of an observation tool to identify high‐risk dyads for targeted support. A trial and test of a modified scoring system (based on the PIIOS) should be developed for a future study using a larger sample size. Further research should assess if this approach reliably produces a consistent valid screening tool to assess parental sensitive responsiveness and resilience promoting behaviours at this early stage of life.
Sleep disturbances in women with and without polycystic ovary syndrome in an Australian National Cohort
Authors: Mo Lin , Mansfield Darren R. , Joham Anju , Cain Sean W. , Bennett Christie , Blumfield Michelle , Teede Helena , Moran Lisa J. 
Published: December 2018

SummaryBackgroundPolycystic ovary syndrome (PCOS) is a common condition in reproductive‐aged women. Sleep disturbances may be more prevalent in PCOS. It is not known if this relationship is independent of other factors.AimTo examine the prevalence of sleep disturbances in a large community‐based cohort study in women with and without PCOS and its relationship to clinical, demographic and comorbid factors.MethodsWe examined data from survey 5 (2009) of the Australian Longitudinal Study on Women's Health (n = 6578, n = 484 PCOS and n = 6094 non‐PCOS). Sleep duration and disturbances were self‐reported. Three classes of sleep pattern were derived during latent class analysis (normal sleep duration with average sleep, normal sleep duration with sleep symptoms and short sleep duration with sleep symptoms) and compared between women with and without PCOS using multivariate regression, adjusting for body mass index (BMI), depressive symptoms, demographic and comorbid factors.ResultsWomen with PCOS had similar sleep duration but were more likely to experience difficulty sleeping often (RRR 1.67, 1.20‐2.33, P = 0.003) and sometimes (RRR 1.39, 1.07‐1.80, P = 0.015), with restless sleep reported occasionally (RRR, 1.35 1.00‐1.83, P = 0.049). They reported severe tiredness often (RRR 1.48, 95% CI 1.08‐2.04, P = 0.016) and described more sleep difficulties within the last 12 months (OR 1.29, 1.04‐1.60, P = 0.018) on adjusted analyses. Compared to the class of average sleep duration with no sleep disturbances, PCOS was associated with increased relative risk of having average sleep duration with sleep symptoms (RRR 1.40, 95%CI 1.11‐1.77, P = 0.004) and short sleep duration with sleep symptoms (RRR 1.46, 95%CI 1.07‐1.99, P = 0.016) on adjusted analyses.ConclusionSleep disturbances are more prevalent amongst women with PCOS after adjusting for BMI, depressive symptoms, demographic and comorbid factors. Targeted screening and management of sleep disturbances is warranted in PCOS.
A simulation study assessing the accuracy and reliability of orchidometer estimation of testicular volume
Authors: Elder Charlotte J. , Langley Joe , Stanton Andrew , De Silva Shamani , Akbarian‐Tefaghi Ladan , Wales Jerry K. H. , Wright Neil P. 
Published: December 2018

AbstractContextMeasuring testicular volume (TV) by orchidometer is the standard method of male pubertal staging. A paucity of evidence exists as to its inter‐ and intra‐observer reliability and the impact of clinicians’ gender, training and experience on accuracy.ObjectiveProsthetic testicular models were engineered to investigate accuracy and reliability of TV estimation.DesignSimulation study.SettingConducted over three‐day 2015 British Society for Paediatric Endocrinology and Diabetes (BSPED) meeting.ParticipantsTwo hundred fifteen meeting delegates (161F, 54M): 50% consultants, 30% trainees, 9% clinical nurse specialists, 11% other professionals.InterventionThree child‐sized mannequins displayed latex scrotum containing prosthetic testicles of 3, 4, 5, 10 and 20 mL. Demographic data, paediatric endocrinology experience, TV examination training, examination technique and TV estimations were collected. Delegates were asked to repeat their measurements later during the meeting. Scrotum order was changed daily.Main outcome measuresAccuracy by variance from the simulated TV. Inter‐ and intra‐observer variability.ResultsOne thousand two hundred eighty four individual estimations were obtained. Eighty‐five participants repeated measurements. Delegates measured TV accurately on 33.4% (±2.6) of occasions: overestimations 37% (±2.3), underestimations 28% (±1.8) (Fleiss’ Kappa score 0.04). The accuracy of assessing a 4 mL testis was 36%‐39%. Observers underestimated the volume when paired with a 3 mL testis and overestimated when paired with a 5 mL testis demonstrating a tendency impose biological symmetry. Intra‐observer reliability was lacking; individuals giving different estimations for the same size testicle on 61% (±4.2) of occasions, 20% (±3.5) of estimations were more than 1 size outside the previous measurement. On only 39% (±4.2) of occasions did individuals agree with their previous estimation (irrespective of whether or not it was initially accurate). Training did not impact on results but experience did improve accuracy.ConclusionsOverall TV estimation accuracy was poor. Considerable variation exists between and within subjects. Seniority slightly improved measurement estimation.
The impact of confidence on clinical dental practice
Authors: Fine Peter , Leung Albert , Bentall Clare , Louca Chris 
Published: December 2018

AbstractIntroductionIncreasing confidence through learning has the potential to change General Dental Practitioners’ (GDPs) perceptions of clinical practice. By examining how changes in confidence influence the clinical practice of two cohorts of GDPs, during and following an extended period of postgraduate training, we show the importance of confidence to GDPs and that a lack of confidence is a primary reason why GDPs attend postgraduate training courses.MethodsA mixed‐method approach was adopted for this study. Quantitative data were collected via a series of linked questionnaires; qualitative data were collected using focus group discussions, interviews and contemporaneous field notes. Analysis was undertaken using SPSS software and a phenomenological approach, respectively.FindingsParticipants indicated an increase in confidence in their ability to undertake dental procedures, which led to an increase in confidence in communication skills, and their ability to undertake complex restorative procedures. This led to greater treatment acceptance by patients resulting in better “job satisfaction.”DiscussionA sense of confidence is central to personal development and ongoing study, leading to first, an improved capability to perform tasks (competence); second, confidence is a product of the relationship and trust of those people associated with the individual/professional and third, the correct level of challenge is important to confidence.ConclusionsThe issue of confidence has not been looked at in postgraduate dentistry, but it is well recognised in medical education fields.
Polymorphisms in dopaminergic genes predict proactive processes of response inhibition
Authors: Beu Nathan D. , Burns Nicholas R. , Baetu Irina 
Published: December 2018

AbstractThe ability to inhibit a prepared emotional or motor action is difficult but critical to everyday functioning. It is well‐established that response inhibition relies on the dopaminergic system in the basal ganglia. However, response inhibition is often measured imprecisely due to a process which slows our responses and increases subsequent inhibition success known as proactive inhibition. As the role of the dopamine system in proactive inhibition is unclear, we investigated the contribution of dopaminergic genes to proactive inhibition. We operationalised proactive inhibition as slower responses after failures to inhibit a response in a Go/No‐Go paradigm and investigated its relationship to rs686/A at DRD1 (associated with increased gene expression) and rs1800497/T at DRD2 (associated with reduced D2 receptor availability). Even though our sample (N = 264) was relatively young (18–40 years), we found that proactive inhibition improves the ability to withhold erroneous responses in older participants (p = 0.002) and those with lower fluid intelligence scores (p < 0.001), indicating that proactive inhibition is likely a naturally occurring compensatory mechanism. Critically, we found that a polygenic risk score consisting of the number of rs686 A and rs1800497 T alleles predicts higher engagement of proactive inhibition (p = 0.040), even after controlling for age (p = 0.011). Furthermore, age seemed to magnify these genetic effects (p < 0.001). This suggests that the extent to which proactive inhibition is engaged depends on increased dopamine D1 and decreased D2 neurotransmission. These results provide important considerations for future work investigating disorders of the dopaminergic system.
Early‐morning OFF and levodopa dose failures in patients with Parkinson's disease attending a routine clinical appointment using Time‐to‐ON Questionnaire
Authors: Stocchi F. , Coletti C. , Bonassi S. , Radicati F. G. , Vacca L. 
Published: December 2018

Background and purposeIn patients with Parkinson's disease (PD) with motor fluctuations, total daily OFF time is comprised of both end‐of‐dose time and the time taken to turn ON with medication. However, little is known about the impact of delays in ON time.MethodsThis was a single‐visit pilot study of fluctuating patients with PD attending a routine appointment. During a single visit, adult patients with idiopathic PD who were treated with levodopa for at least 1 year completed a questionnaire evaluating the time waiting for ON and the symptoms experienced while waiting to turn ON. Patients then completed a 5‐day home time‐to‐ON diary, where they documented how long it took to turn ON following their first morning dose of levodopa in 5‐min increments.ResultsA total of 151 consecutive patients completed the study survey, of whom 97 (64.2%) experienced motor fluctuations. Of the patients experiencing motor fluctuations, 54 (56%) reported delays in ON time (latency >30 min) following their first morning dose of levodopa. Half (51%) reported that they had experienced delayed ON at least once in the previous week and 21% reported having delayed ON during all seven mornings of the previous week. In addition, 10% of patients reported having dose failures on four or more mornings during the previous week. The most common symptoms experienced while waiting for ON were slowness (94.8%), fatigue (87.6%), reduced dexterity (82.5%), problems in walking (66.0%) and problems with balance (59.8%).ConclusionEarly‐morning OFF problems such as delays in time to ON and dose failures are common in levodopa‐treated patients with PD.