bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are professional young rugby league players eating enough? Energy intake, expenditure and balance during a pre‐season
Authors: Costello Nessan , Deighton Kevin , Preston Thomas , Matu Jamie , Rowe Joshua , Jones Ben 
Published: October 2018

AbstractDue to the unique energetic demands of professional young collision sport athletes, accurate assessment of energy balance is required. Consequently, this is the first study to simultaneously investigate the energy intake, expenditure and balance of professional young rugby league players across a pre‐season period. The total energy expenditure of six professional young male rugby league players was measured via doubly labelled water over a fourteen‐day assessment period. Resting metabolic rate was measured and physical activity level calculated. Dietary intake was reported via Snap‐N‐Send over a non‐consecutive ten‐day assessment period, alongside changes in fasted body mass and hydration status. Accordingly, energy balance was inferred. The mean (standard deviation) difference between total energy intake (16.73 (1.32) MJ.day−1) and total energy expenditure (18.36 (3.05) MJ.day−1) measured over the non‐consecutive ten‐day period was unclear (−1.63 (1.73) MJ.day−1; ES = 0.91 ± 1.28; p = 0.221). This corresponded in a most likely trivial decrease in body mass (−0.65 (0.78) kg; ES = 0.04 ± 0.03; p = 0.097). Resting metabolic rate and physical activity level across the fourteen‐day pre‐season period was 11.20 (2.16) MJ.day−1 and 1.7 (0.2), respectively. For the first time, this study utilises gold standard assessment techniques to elucidate the distinctly large energy expenditures of professional young rugby league players across a pre‐season period, emphasising a requirement for equally large energy intakes to achieve targeted body mass and composition adaptations. Accordingly, it is imperative that practitioners regularly assess the energy balance of professional young collision‐sport athletes to ensure their unique energetic requirements are achieved.
Fabrication and Characterization of Pt-Co/C Catalyst for Fuel Cell Electrode
Authors: Rohendi Dedi , Rachmat Addy , Syarif Nirwan 
Published: October 2018

Abstract
One of the most important components in fuel cell is electrode which hold as center for electrochemical reaction on converting fuel and oxygen into electricity. Special attention hence must be given to this component in order to achieve high performance especially on its catalytic activity and durability. To obtain such performance, some aspect must be take into consideration i.e. the content and type of catalyst as well as preparation method. Impregnation-reduction and electrodeposition method were evaluated on fabrication of fuel cell electrode from Pt-Co/C catalyst using H2PtCl6.6H2O and CoCl2.6H2O in carbon Vulcan XC-72 substrate. Transition metal other than platinum as supporting catalyst was used not only to enhance catalytic activity but also to reduced cost and avoid poisoning which platinum suffers easily. Characterization of catalyst using Cyclic Voltammetry (CV) and Electrochemical Impedance Spectroscopy (EIS) confirmed that catalyst made from Pt-Co/C using ratio Pt : Co = 20:80 has good catalytic activity for fuel cell application. XRD diffractogram showed result of Pt reduction at 2-theta = 39.76° (111) and 46.23° (200) while the present of Co is not clear at 2-theta = 44.51° and 51.85°. Co was not detected due to it became an alloy with Pt and relatively small concentration (20%). Pt-Co/C catalyst prepared by impregnation-reduction and electrodeposition methods can be used as catalyst support in fuel cell electrode.
Transient and Sustained Control Mechanisms Supporting Novel Instructed Behavior
Authors: Palenciano Ana F , González-García Carlos , Arco Juan E , Ruz María 
Published: October 2018

Abstract
The success of humans in novel environments is partially supported by our ability to implement new task procedures via instructions. This complex skill has been associated with the activity of control-related brain areas. Current models link fronto-parietal and cingulo-opercular networks with transient and sustained modes of cognitive control, based on observations during repetitive task settings or rest. The current study extends this dual model to novel instructed tasks. We employed a mixed design and an instruction-following task to extract phasic and tonic brain signals associated with the encoding and implementation of novel verbal rules. We also performed a representation similarity analysis to capture consistency in task-set encoding within trial epochs. Our findings show that both networks are involved while following novel instructions: transiently, during the implementation of the instruction, and in a sustained fashion, across novel trials blocks. Moreover, the multivariate results showed that task representations in the cingulo-opercular network were more stable than in the fronto-parietal one. Our data extend the dual model of cognitive control to novel demanding situations, highlighting the high flexibility of control-related regions in adopting different temporal profiles.
The Burden of Frailty Among U.S. Veterans and Its Association With Mortality, 2002–2012
Authors: Orkaby Ariela R , Nussbaum Lisa , Ho Yuk-Lam , Gagnon David , Quach Lien , Ward Rachel , Quaden Rachel , Yaksic Enzo , Harrington Kelly , Paik Julie M , Kim Dae H , Wilson Peter W , Gaziano J Michael , Djousse Luc , Cho Kelly , Driver Jane A 
Published: October 2018

Abstract

Background
Frailty is a key determinant of clinical outcomes. We sought to describe frailty among U.S. Veterans and its association with mortality.

Methods
Nationwide retrospective cohort study of regular Veterans Affairs (VA) users, aged at least 65 years in 2002–2012, followed through 2014, using national VA administrative and Medicare and Medicaid data. A frailty index (FI) for VA (VA-FI) was calculated using the cumulative deficit method. Thirty-one age-related deficits in health from diagnostic and procedure codes were included and were updated biennially. Survival analysis assessed associations between VA-FI and mortality.

Results
A VA-FI was calculated for 2,837,152 Veterans over 10 years. In 2002, 35.5% were non-frail (FI = 0–0.10), 32.6% were pre-frail (FI = 0.11–0.20), 18.9% were mildly frail (FI = 0.21–0.30), 8.7% were moderately frail (FI = 0.31–0.40), and 4.3% were severely frail (FI > 0.40). From 2002 to 2012, the prevalence of moderate frailty increased to 12.7%and severe frailty to 14.1%. Frailty was strongly associated with survival and was independent of age, sex, race, and smoking; the VA-FI better predicted mortality than age alone. Although prevalence of frailty rose over time, compared to non-frail Veterans, 2 years’ hazard ratios (95% confidence intervals) for mortality declined from a peak in 2004 of 2.01 (1.97–2.04), 3.49 (3.44–3.55), 5.88 (5.79–5.97), and 10.39 (10.23–10.56) for pre-frail, mildly, moderately, and severely frail, respectively, to 1.51 (1.49–1.53), 2.36 (2.33–2.39), 3.68 (3.63–3.73), 6.62 (6.53–6.71) in 2012. At every frailty level, risk of mortality was lower for women versus men and higher for blacks versus whites.

Conclusions
Frailty affects at least 3 of every 10 U.S. Veterans aged 65 years and older, and is strongly associated with mortality. The VA-FI could be used to more accurately estimate life expectancy and individualize care for Veterans.
Commutative regulation between endothelial NO synthase and insulin receptor substrate 2 by microRNAs
Authors: Sun Xiaoli , Lv Huizhen , Zhao Peng , He Jinlong , Cui Qinghua , Wei Minxin , Feng Shiqing , Zhu Yi 
Published: October 2018

Abstract
Endothelial NO synthase (eNOS) expression is regulated by a number of transcriptional and post-transcriptional mechanisms, but the effects of competing endogenous RNAs (ceRNAs) on eNOS mRNA and the underlying mechanisms are still unknown. Our bioinformatic analysis revealed three highly expressed eNOS-targeting miRNAs (miR-15b, miR-16, and miR-30b) in human endothelial cells (ECs). Among the 1103 mRNA targets of these three miRNAs, 15 mRNAs share a common disease association with eNOS. Gene expression and correlation analysis in patients with cardiovascular diseases identified insulin receptor substrate 2 (IRS2) as the most correlated eNOS-ceRNA. The expression levels of eNOS and IRS2 were coincidentally increased by application of laminar shear but reduced with eNOS or IRS2 siRNA transfection in human ECs, which was impeded by Dicer siRNA treatment. Moreover, luciferase reporter assay showed that these three miRNAs directly target the 3′UTR of eNOS and IRS2. Overexpression of these three miRNAs decreased, whereas inhibition of them increased, both mRNA and protein levels of eNOS and IRS2. Functionally, silencing eNOS suppressed the Akt signal pathway, while IRS2 knockdown reduced NO production in ECs. Thus, we identified eNOS and IRS2 as ceRNAs and revealed a novel mechanism explaining the coincidence of metabolic and cardiovascular diseases.
A User’s Guide to Hybrid Tools
Authors: Perl Caleb 
Published: October 2018

AbstractHybrid metaethical theories have significant promise; they would have important upshots if they were true. But they also face severe problems. The problems are severe enough to make many philosophers doubt that they could be true. My ambition is to show that the problems are just instances of a highly general problem: a problem about what are sometimes called ‘intensional anaphora'. I'll also show that any adequate explanation of intensional anaphora immediately solves all the problems for the hybrid theorist. We should regard hybrid tools as among the most legitimate tools in our toolkit—at least when we use them properly.
Physical activity and preventable premature deaths from non-communicable diseases in Brazil
Authors: Rezende Leandro Fórnias Machado de , Garcia Leandro Martin Totaro , Mielke Grégore Iven , Lee Dong Hoon , Giovannucci Edward , Eluf-Neto José 
Published: October 2018

ABSTRACT

Background
Studies on the impact of counterfactual scenarios of physical activity on premature deaths from non-communicable diseases (NCDs) are sparse in the literature. We estimated preventable premature deaths from NCDs (diabetes, ischemic heart disease, stroke, and breast and colon cancers) in Brazil by increasing population-wide physical activity (i) to theoretical minimum risk exposure levels; (ii) reaching the physical activity recommendation; (iii) reducing insufficient physical activity by 10%; and (iv) eliminating the gender differences in physical activity.

Methods
Preventable fractions were estimated using data from a nationally representative survey, relative risks from a meta-analysis and number of premature deaths (30–69 years) from the Brazilian Mortality Information System.

Results
Physical activity could potentially avoid up to 16 700 premature deaths from NCDs in Brazil, corresponding to 5.75 and 3.23% of premature deaths from major NCDs and of all-causes, respectively. Other scenarios suggested the following impact on premature deaths: reaching physical activity recommendation (5000 or 1.74% of major NCDs); 10% reduction in insufficient physical activity (500 or 0.17% of major NCDs); eliminating gender differences in physical activity (1000 or 0.33% of major NCDs).

Conclusions
Physical activity may play an important role to reduce premature deaths from NCD in Brazil.
Quinine, Whisky, and Epsom Salts: Amateur Medical Treatment in the White Settler Communities of British East and South-Central Africa, 1890–1939
Authors: Wells Julia M 
Published: October 2018

Summary
Between 1890 and 1939, many migrants settled in rural areas in Britain’s newly occupied territories in East and South-Central Africa. A number of these settlers produced memoirs about their lives in colonial Africa, many of which contain rich domestic detail, including about health and home medical treatment. This paper examines a selection of memoirs by women who lived in rural British East and South-Central Africa. First, it explores the literary presentation of disease, injury and home treatment in these memoirs, arguing that anecdotes about health played powerful and complex roles. Secondly, it illustrates that most authors regularly treated injuries and illnesses for themselves and their families, making home treatment an important part of their health care. Lastly, it highlights that these memoirs reveal a distinctive set of medicines and techniques used for amateur medical treatment. Overall, this paper positions amateur medical practice as an essential element of health care in the region.
Plain Language Drafting: A Study of the Laws of India (2009–17)
Authors: Bapna Niharika 
Published: October 2018

Abstract
The relation between the threat to rule of law in India and its poorly drafted legislation may not be obvious at first. And yet clear, intelligible laws have been the premise for the success of rule of law. There is little research done in the field of plain language legislative drafting in India. This article analyses three important elements of plain language drafting in nine Indian statutes passed in the last decade. They are as follows: arrangement of provisions, marginal notes, and sentence structure. Each of the selected nine statutes impacts the rights of vulnerable groups. Thus, the need to make these statutes comprehensible by drafting them in plain English is important. By suggesting ways to simplify the language of the nine statutes, this article asserts that these plain language drafting techniques must be adopted by Indian legislative drafters.
Socially Accountable Academic Health Centers: Pursuing a Quadripartite Mission
Authors: Smitherman Herbert C. , Baker Richard S. , Wilson M. Roy 
Published: October 2018

Academic health centers (AHCs) in the United States have had a leading role in educating the medical workforce, generating new biomedical knowledge, and providing tertiary and quaternary clinical care. Yet the health status of the U.S. population lags behind almost every other developed world economy. One reason is that the health care system is not organized optimally to address the major driver of health status, the social determinants of health (SDOH). The United States’ overall poor health status is a reflection of dramatic disparities in health that exist between communities and population groups, and these are associated with variations in the underlying SDOH. Improving health status in the United States thus requires a fundamental reengineering of the health delivery system to address SDOH more explicitly and systematically. AHCs’ tripartite mission, which has served so well in the past, is no longer sufficient to position AHCs to lead and resolve the intractable drivers of poor health status, such as unfair and unjust health disparities, health inequities, or differences in a population’s SDOH.
AHCs enjoy broad public support and have an opportunity—and an obligation—to lead in improving the nation’s health. This Perspective proposes a new framework for AHCs to expand on their traditional tripartite mission of education, research, and clinical care to include explicitly a fourth mission of social accountability. Through this fourth mission, comprehensive community engagement can be undertaken, addressing SDOH and measuring the health impact of interventions by using a deliberate structure and process, yielding defined outcomes.
Management of Anesthesia and Delivery in Women With Chiari I Malformations
Authors: Waters Janet F. R. , O'Neal M. Angela , Pilato Madison , Waters Samuel , Larkin Jacob C. , Waters Jonathan H. 
Published: October 2018

OBJECTIVE:
To estimate whether vaginal delivery or neuraxial anesthesia poses a risk of neurologic deterioration in women with uncorrected Chiari I malformation.

METHODS:
To assemble this case series, electronic record databases were used to identify women with Chiari I malformation who delivered on two busy tertiary care obstetric services over a 5-year period from January 2010 through December 2015. Women who had undergone surgical decompression were not included in the study. The size of the Chiari malformation, neurologic symptoms before delivery, mode of delivery, anesthetic method used, and neurologic complications were recorded.

RESULTS:
Ninety-five deliveries in 63 patients were identified. The size of the Chiari malformation was 9.3±4.3 mm (mean±SD). In 58 pregnancies, women reported no headaches; in 36 they did. There was no association between the size of the Chiari malformation and the incidence of headache. Forty-four neonates were delivered by cesarean delivery and 51 were delivered vaginally. No neurologic deterioration occurred in either group. Neuraxial anesthesia was administered before 62 deliveries. No neurologic complications occurred. None of the women who delivered vaginally or received neuraxial anesthesia had signs of increased intracranial pressure. The upper limit of the 95% CI for the risk of neurologic complications from our study of 95 deliveries was 3.1%.

CONCLUSION:
This case series support that in patients with Chiari I malformation who have no signs of increased intracranial pressure, the mode of delivery should be based on obstetric rather than neurologic considerations. The absence of complications in patients who received epidural or spinal anesthesia suggests that these procedures should be made available to women with Chiari I malformation.
Don’t You Wish You Had Fused to the Pelvis the First Time
Authors: Nielsen Ena , Andras Lindsay M. , Bellaire Laura L. , Fletcher Nicholas D. , Minkara Anas , Vitale Michael G. , Troy Michael , Glotzbecker Michael , Skaggs David L. 
Published: October 2018

Study Design.
A multicenter retrospective study.

Objective.
The aim of this study was to compare pelvic obliquity correction and reoperation rate in neuromuscular scoliosis patients who had their pelvis included in a posterior spinal fusion (pelvic fusion, PF) at their index procedure versus revision procedures.

Summary of Background Data.
There is limited information on outcomes specific to fusing to the pelvis for neuromuscular scoliosis in a revision operation versus index surgery.

Methods.
Charts and radiographs were reviewed of patients with PF for neuromuscular scoliosis from January 2003 to August 2015 at four high-volume pediatric spine centers with >2 year follow-up.

Results.
Two hundred eighty-five patients met inclusion criteria; 271 had PF done at index surgery and 14 had PF done during revision surgery. Before index procedure, there were no significant differences in Cobb angle (P = 0.13). Before PF, there was no difference in pelvic obliquity (P = 0.26). At the time of fusion to the pelvis, estimated blood loss (P = 0.23) and operative time (P = 0.43) did not differ between index and revision groups. Percent correction in pelvic obliquity was similar for both groups (P = 0.72). Overall, 69 patients had complications requiring return to the operating room. Excluding the revision surgery for inclusion of the pelvis for the revision group, there was still a lower reoperation rate with index PF (22.9%, n = 62/271) than revision PF (50.0%, n = 7/14) (P = 0.02). Implant failures were significantly higher in the revision group (index = 7.4%, 20/271; revision = 42.9%, 6/14; P < 0.001).

Conclusion.
PF at the index spinal fusion led to similar correction of pelvic obliquity with approximately half the reoperation rate compared with PF at a revision surgery. Operative time and blood loss were similar between index and revision spinal fusion.

Level of Evidence: 4
How Common Is Medial and Lateral Shoulder Discordance in Lenke 1 and 2 Curves?
Authors: Chung Weng Hong , Chiu Chee Kidd , Ng Sherwin Johan , Goh Saw Huan , Chan Chris Yin Wei , Kwan Mun Keong 
Published: October 2018

Study Design.
Retrospective study of prospectively collected data.

Objective.
To analyze the incidence and the patterns of medial and lateral shoulder discordance among Lenke 1 and 2 patients.

Summary of Background Data.
Postoperative shoulder imbalance (PSI) is still common in Lenke 1 and 2 adolescent idiopathic scoliosis (AIS). This could be due to presence of medial dan lateral shoulder discordance.

Methods.
One hundred fifty-one Lenke 1 and 2 AIS patients were recruited. Lenke 1 curves were subclassified into Lenke 1-ve (flexible) (proximal thoracic side bending [PTSB] Cobb angle <15°) and 1+ve curves (stiff) (PTSB Cobb angle between 15° and 24.9°). T1 tilt represented “medial shoulder balance” and radiological shoulder height (RSH) represented “lateral shoulder balance.” We categorized patients into three concordant shoulder pattern types (medial balanced/lateral balanced [MBLB], medial imbalanced+ve/lateral imbalanced+ve (MI+ve/LI+ve), medial imbalanced–ve/lateral Imbalanced–ve (MI–ve/LI–ve), and six discordant shoulder pattern types.

Results.
The mean age was 16.2 ± 5.7 years. Eighty-one patients (53.6%) had concordant pattern and 70 patients (46.4%) had discordant pattern. Lateral shoulder imbalance was noted in 35.1% of patients and medial shoulder imbalance in 43.7% of patients. In Lenke 1–ve curves, 35 patients (68.6%) had concordant shoulder imbalance with medial imbalanced–ve/lateral imbalanced–ve (MI–ve/LI–ve) being the commonest pattern (68.6%). In Lenke 1+ve curves, 33 patients (55.0%) had concordant shoulder pattern with medial balanced/lateral balanced (MB/LB) being the commonest type (57.6%). In Lenke 2 AIS, 27 patients (67.5%) had discordant pattern with medial imbalanced+ve/lateral balanced (MI+ve/LB) being the commonest pattern (44.4%) (P value = 0.002).

Conclusion.
46.4% Lenke 1 and 2 AIS patients had shoulder discordant pattern. This was more prevalent in Lenke 2 curves (67.5%). In Lenke 1-ve (flexible) curves, MI–ve/LI–ve pattern was the commonest pattern. In Lenke 1+ve curves (stiff), there were almost equal number of concordant and discordant shoulder pattern. In Lenke 2 patients, the most common pattern was MI+ve/LB.

Level of Evidence: 4