bluuebunny/crossref_metadata_2025_split huggingface dataset:
Test‐retest variability of VO2max using total‐capture indirect calorimetry reveals linear relationship of VO2 and Power
Authors: Schoffelen Paul F. M. , den Hoed Marcel , van Breda Eric , Plasqui Guy 
Published: October 2018

This study aimed to analyze the intra‐individual variation in VO2max of human subjects using total‐capture and free‐flow indirect calorimetry. Twenty‐seven men (27 ± 5 year; VO2max 49‐79 mL•kg−1•min−1) performed two maximal exertion tests (CPETs) on a cycle ergometer, separated by a 7 ± 2 day interval. VO2 and VCO2 were assessed using an indirect calorimeter (Omnical) with total capture of exhalation in a free‐flow airstream. Thirteen subjects performed a third maximal exertion test using a breath‐by‐breath calorimeter (Oxycon Pro). On‐site validation was deemed a requirement. For the Omnical, the mean within‐subject CV for VO2max was 1.2 ± 0.9% (0.0%‐4.4%) and for ergometer workload P max 1.3 ± 1.3% (0%‐4.6%). VO2max values with the Oxycon Pro were significantly lower in comparison with Omnical (P < 0.001; t test) with mean 3570 vs 4061 and difference SD 361 mL•min−1. Validation results for the Omnical with methanol combustion were −0.05 ± 0.70% (mean ± SD; n = 31) at the 225 mL•min−1 VO2 level and −0.23 ± 0.80% (n = 31) at the 150 mL•min−1 VCO2 level. Results using gas infusion were 0.04 ± 0.75% (n = 34) and −0.99 ± 1.05% (n = 24) over the respective 500‐6000 mL•min−1 VO2 and VCO2 ranges. Validation results for the Oxycon Pro in breath‐by‐breath mode were ‐ 2.2 ± 1.6% (n = 12) for VO2 and 5.7 ± 3.3% (n = 12) for VCO2 over the 1000‐4000 mL•min−1 range. On a Visual analog scale, participants reported improved breathing using the free‐flow indirect calorimetry (score 7.6 ± 1.2 vs 5.1 ± 2.7, P = 0.008). We conclude that total capturing free‐flow indirect calorimetry is suitable for measuring VO2 even with the highest range. VO2max was linear with the incline in P max over the full range.
Industrial Maize as a Commodity System: Spatial Scale and Relations of Production in Turkey's Agriculture After Economic Restructuring
Authors: Borlu Yetkin , Matthews Stephen A. 
Published: October 2018

AbstractDuring the decade of 2000‐2010, industrial maize production in Turkey doubled to approximately four million tons and the area under maize cultivation increased by ten per cent. Concomitant with the increase in total output, private agri‐food industry came to control 90 per cent of total production by 2010. Using exploratory spatial analysis and spatial regression methods, we are able to have a more detailed and spatially explicit regional study of a commodity system across Turkey. We argue that maize production in Turkey developed in the 2000s along the tenets of a corporate food regime according to demands by agri‐food firms. However, small‐scale farmers are not fully excluded from corporate relations of production, and low‐yield traditional maize farming persists in some provinces as an important field crop for household consumption.
Detection of Tropheryma whipplei in stool samples by one commercial and two in‐house real‐time PCR assays
Authors: Frickmann Hagen , Hanke Miriam , Hahn Andreas , Schwarz Norbert G. , Landt Olfert , Moter Annette , Kikhney Judith , Hinz Rebecca , Rojak Sandra , Dekker Denise , Tannich Egbert , Podbielski Andreas 
Published: October 2018

AbstractObjectiveTropheryma whipplei, the causative agent of Whipple's disease, can also be identified in stool samples of humans without systemic disease. It is much more frequently detected in human stool samples in tropical environments than in industrialized countries. PCR‐screening has been applied for point prevalence studies and environmental assessments in tropical settings, but results depend on the applied assay. We compared one commercial qPCR kit with two well‐described in‐house assays for detection of T. whipplei from stool.MethodsResidual materials from nucleic acid extractions of stool samples from two groups with presumably different prevalences and increased likelihood of being colonized or infected by T. whipplei were tested. One group comprised 300 samples from study participants from western Africa (group 1); the second group was of 300 returnees from tropical deployments (group 2). Each sample was assessed with all three qPCR assays. Cycle threshold (Ct) values were descriptively compared.ResultsBased solely on mathematical modeling, the three PCR assays showed considerably different detection rates of T. whipplei DNA in stool samples (kappa 0.67 (95% confidence interval [0.60, 0.73])). Considering the calculated test characteristics, prevalence of 28.3% for group 1 and 5.0% for group 2 was estimated. Discordant test results were associated with later Ct values. The study did not validate the assays for the detection of T. whipplei in Whipple's disease and for diagnostic purposes since clinical specificity and sensitivity were not investigated.ConclusionsIn spite of the observed diagnostic uncertainty, PCR‐based screening approaches can be used for epidemiological purposes and environmental samples to define the source and reservoir in resource‐limited tropical settings if prevalence is calculated using diagnostic accuracy‐adjusted methods.
Multi‐omics data‐driven investigations of metabolic diversity of plant triterpenoids
Authors: Shang Yi , Huang Sanwen 
Published: October 2018

SummaryThe vast majority of structurally diverse metabolites play essential roles in mediating the interactions between plant and environment, and constitute a valuable resource for industrial applications. Recent breakthroughs in sequencing technology have greatly accelerated metabolic studies of natural plant products, providing opportunities to investigate the molecular basis underlying the diversity of specialized plant metabolites through large‐scale analysis. Here, we focus on the biosynthesis of plant triterpenoids, especially the three diversifying reactions (cyclization, oxidation and glycosylation) that largely contribute to the structural diversity of triterpenoids. Gene mining through large‐scale omics data and functional characterization of metabolic genes including enzymes, transcription factors and transporters could provide important insights into the evolution of specialized plant metabolism and pave the way for the production of high‐value metabolites or derivatives using synthetic biology approaches.
Preventing violence against refugee adolescent girls: findings from a cluster randomised controlled trial in Ethiopia
Authors: Stark Lindsay , Asghar Khudejha , Seff Ilana , Yu Gary , Tesfay Gessesse Teame , Ward Leora , Assazenew Baysa Asham , Neiman Amy , Falb Kathryn L 
Published: October 2018

IntroductionInterpersonal violence is a critical public health concern in humanitarian contexts, but evidence of effective violence prevention programmes targeting adolescent girls is lacking. We investigated the efficacy of a life skills and safe spaces programme to reduce adolescent girls’ experiences of interpersonal violence in a refugee setting.MethodsIn this two-arm, single-blinded, cluster randomised controlled trial, we recruited 919 Sudanese and South Sudanese girls ages 13–19 years residing in refugee camps in Ethiopia. Girls were divided into 31 clusters, with 457 and 462 participants assigned to the intervention and control arms, respectively. Intervention clusters received 30 life skills sessions delivered in safe spaces and 8 complementary sessions for caregivers. The primary outcome was exposure to sexual violence in the previous 12 months. Secondary outcomes included disaggregated forms of sexual violence, physical violence, emotional violence, transactional sex, child marriage, feelings of safety, attitudes around rites of passage and perceptions of social support. Intent-to-treat analysis was used.ResultsAt 12-month follow-up, the intervention was not significantly associated with reduction in exposure to sexual violence (adjusted OR =0.96, 95%  CI 0.59 to 1.57), other forms of violence, transactional sex or feelings of safety. The intervention was associated with improvements in attitudes around rites of passage and identified social supports. Additionally, the intervention showed a decrease in reported child marriage among girls who were married at baseline.ConclusionWhile the intervention impacted key markers along the causal pathway to violence reduction, further research and programmatic adaptations are needed to prevent violence towards adolescents in humanitarian contexts.Trial registrationNCT02506543.
Trends and drivers of change in the prevalence of anaemia among 1 million women and children in India, 2006 to 2016
Authors: Nguyen Phuong Hong , Scott Samuel , Avula Rasmi , Tran Lan Mai , Menon Purnima 
Published: October 2018

IntroductionIndia carries the largest burden of anaemia globally. Progress to reduce anaemia has been slow despite substantial economic growth and 50 years of programmatic efforts. Identification of the factors that contribute to anaemia reductions is needed to accelerate progress. We examined changes in haemoglobin (Hb) and anaemia among women and children in India from 2006 to 2016 and identified drivers of changes in these outcomes over time.MethodsWe used two rounds of National Family Health Survey data collected in 2005–2006 and 2015–2016 (n=245 346 children 6–59 months; 37 165 pregnant women (PW) 15–49 years; 760 460 non-pregnant women (NPW) 15–49 years). We first examined trends in Hb and anaemia, and changes in 30 selected variables (including immediate and underlying determinants, and nutrition and health interventions (NHIs)). We identified drivers of Hb and anaemia using multivariate regression and estimated their contribution to changes in these outcomes over time using regression-based decomposition.ResultsHb and anaemia improved significantly between 2006 and 2016 in children (4.5  g/L and 11 percentage points (pp), respectively) and PW (3.2  g/L and 7.6 pp), but not in NPW. Despite these changes, anaemia is still very high (>50%) and progress varied considerably by state (−33 pp to +16 pp). Most immediate and underlying determinants, and NHIs improved significantly over time. Changes among a set of drivers common to children and PW accounted for the changes in Hb; these included maternal schooling (children, 10%; PW, 24%), coverage of NHIs (children, 18%; PW, 7%), socioeconomic status (children, 7%; PW, 17%), sanitation (children, 3%; PW, 9%), and meat and fish consumption (children, 3%; PW, 1%). The decomposition models moderately explained Hb changes over time (children, 49%; PW, 66%).ConclusionsMultiple common drivers have contributed to the anaemia changes among children and pregnant women in India. Further improvements in these drivers can have population-level effects by simultaneously influencing both maternal and child anaemia.
Prognostic impact of peak mitral inflow velocity in asymptomatic degenerative mitral regurgitation
Authors: Okamoto Chisato , Okada Atsushi , Kanzaki Hideaki , Nishimura Kunihiro , Hamatani Yasuhiro , Amano Masashi , Takahama Hiroyuki , Amaki Makoto , Hasegawa Takuya , Fujita Tomoyuki , Kobayashi Junjiro , Yasuda Satoshi , Izumi Chisato 
Published: October 2018

ObjectiveAppropriate timing of mitral valve surgery in asymptomatic mitral regurgitation (MR) remains controversial. Peak mitral inflow velocity (peak E wave velocity) has been reported as a simple and easy predictor of quantitative MR severity; however, its prognostic significance in asymptomatic MR remains unclear. Therefore, we sought to investigate the prognostic impact of peak E wave velocity in asymptomatic MR.MethodsAmong 529 consecutive patients with degenerative MR of grade 3+ (moderate to severe) or 4+ (severe), 188 asymptomatic patients in sinus rhythm without left ventricular (LV) dysfunction (end-systolic dimension ≥40 mm or ejection fraction <60%) or pulmonary hypertension were studied. Cardiovascular events were defined as a composite endpoint of cardiovascular death or events that indicated mitral surgery including congestive heart failure, atrial fibrillation, LV dysfunction or pulmonary hypertension.ResultsAverage peak E wave velocity was 1.05±0.26 m/s, and was significantly higher in grade 4+ than grade 3+ (1.20±0.28 vs 0.98±0.21 m/s, p<0.001). Peak E wave velocity was associated with quantitative MR severity, as well as clinical characteristics of advanced MR (higher brain natriuretic peptide, larger LV and left atrium, higher tricuspid regurgitation pressure gradient and dilated inferior vena cava). During a median follow-up of 4.3 years, 66 (35%) patients developed cardiovascular events. Multivariate Cox proportional hazards analysis showed that peak E wave velocity was an independent predictor of cardiovascular events (adjusted HR 1.245 (95% CI 1.126 to 1.378) per 0.1 m/s, p<0.001).ConclusionsPeak E wave velocity was an independent predictor of cardiovascular events in asymptomatic degenerative MR with preserved LV function.
Medical consequences of pathogenic CNVs in adults: analysis of the UK Biobank
Authors: Crawford Karen , Bracher-Smith Matthew , Owen David , Kendall Kimberley M , Rees Elliott , Pardiñas Antonio F , Einon Mark , Escott-Price Valentina , Walters James T R , O’Donovan Michael C , Owen Michael J , Kirov George 
Published: October 2018

BackgroundGenomic CNVs increase the risk for early-onset neurodevelopmental disorders, but their impact on medical outcomes in later life is still poorly understood. The UK Biobank allows us to study the medical consequences of CNVs in middle and old age in half a million well-phenotyped adults.MethodsWe analysed all Biobank participants for the presence of 54 CNVs associated with genomic disorders or clinical phenotypes, including their reciprocal deletions or duplications. After array quality control and exclusion of first-degree relatives, we compared 381 452 participants of white British or Irish origin who carried no CNVs with carriers of each of the 54 CNVs (ranging from 5 to 2843 persons). We used logistic regression analysis to estimate the risk of developing 58 common medical phenotypes (3132 comparisons).Results and conclusionsMany of the CNVs have profound effects on medical health and mortality, even in people who have largely escaped early neurodevelopmental outcomes. Forty-six CNV–phenotype associations were significant at a false discovery rate threshold of 0.1, all in the direction of increased risk. Known medical consequences of CNVs were confirmed, but most identified associations are novel. Deletions at 16p11.2 and 16p12.1 had the largest numbers of significantly associated phenotypes (seven each). Diabetes, hypertension, obesity and renal failure were affected by the highest numbers of CNVs. Our work should inform clinicians in planning and managing the medical care of CNV carriers.
Impact of Motor-Evoked Potential Monitoring on Facial Nerve Outcomes after Vestibular Schwannoma Resection
Authors: Tawfik Kareem O. , Walters Zoe A. , Kohlberg Gavriel D. , Lipschitz Noga , Breen Joseph T. , O’Neal Kelly , Zuccarello Mario , Samy Ravi N. 
Published: October 2018

Objectives: Assess the utility of intraoperative transcranial facial motor-evoked potential (FMEP) monitoring in predicting and improving facial function after vestibular schwannoma (VS) resection. Study Design: Retrospective chart review. Methods: Data were obtained from 82 consecutive VS resections meeting inclusion criteria. Sixty-two cases were performed without FMEP and 20 with FMEP. Degradation of FMEP response was defined as a final-to-baseline amplitude ratio of 0.5 or less. House-Brackmann (HB) grade was assessed preoperatively, postoperatively, at follow-up assessments, and it was compared between pre- and post-FMEP cohorts. Positive predictive value (PPV) and negative predictive value (NPV), sensitivity, and specificity of FMEP degradation in predicting facial weakness were calculated. Results: In the pre-FMEP group, at length of follow-up (LOF) ⩾9 months, 83.9% (52/62) of patients exhibited HB 1-2 outcome. In the post-FMEP cohort, 75.0% (15/20) exhibited HB 1-2 function at LOF ⩾9 months. There was no difference in rates of HB 1-2 outcomes between groups in the immediate postoperative period ( P = .35) or at long-term follow-up ( P = 1.0). With respect to predicting immediate postoperative facial function, FMEP demonstrated high specificity (88.9%) and moderate sensitivity (54.5%). The PPV and NPV for immediate postoperative facial function were 85.7% and 61.5%, respectively. With respect to long-term (⩾9 months LOF) facial function, intraoperative FMEP was moderately sensitive (71.4%) and highly specific (84.6%); PPV was moderate (71.4%), and NPV was high (84.6%). Conclusions: Intraoperative FMEP is highly specific and moderately sensitive in predicting postoperative facial function for patients undergoing VS resection, but its use may not be associated with improved facial nerve outcomes. Level of Evidence: 4
Pilot Study Assessing the Feasibility and Clinical Outcomes of Office-Based Ossiculoplasty
Authors: Shoman Nael 
Published: October 2018

Objectives: The aim of this study was to assess the feasibility and safety of ossiculoplasty under local anesthesia in an office setting without sedation. Methods: Between May 2017 and November 2017, patients who presented with conductive hearing loss and known isolated ossicular discontinuities were offered ossiculoplasty under local anesthesia. Inclusion criteria included age ⩾ 18 years, adequate transcanal access, and the ability to lie supine for up to 45 minutes. Exclusion criteria included associated tympanic membrane perforation and the presence of middleear or mastoid cholesteatoma or infection. Results: Fourteen patients underwent the procedure. The mean age was 48.3 years (range, 19-74 years). Six were primary and 8 revision cases. There were 8 partial and 6 total prosthesis placements. The mean operative time was 34 minutes (range, 26-43 minutes). All patients tolerated the procedure to completion. There were no intraoperative complications. The mean air conduction pure-tone average was 76.6 dB and the mean bone conduction pure-tone average was 27.2 dB, with a preoperative air-bone gap of 49.9 dB. Air conduction pure-tone average significantly improved to 45.2 dB ( P < .0001). Air-bone gap significantly improved to 17.8 dB ( P < .0001). Conclusions: Ossiculoplasty using partial or total prostheses can be safely performed in the office setting under local anesthesia without sedation in carefully selected patients. This has potentially significant patient and system benefits.
Vocal Fold Motion Recovery in Patients With Iatrogenic Unilateral Immobility: Cervical Versus Thoracic Injury
Authors: Tracy Lauren F. , Kwak Paul E. , Bayan Semirra L. , Van Stan Jarrad H. , Burns James A. 
Published: October 2018

Objectives: Prognostic information about the return of vocal fold mobility in patients with iatrogenic unilateral vocal fold immobility (UVFI) can help with informed decisions about temporary and permanent treatment options. Although many variables can influence the likelihood of recovery, clinical experience suggests that cervical versus thoracic injury is a determining factor. The purpose of this study was to compare recovery rates from UVFI between cervical and thoracic injuries. Methods: A retrospective review of the medical record was performed on all adult patients diagnosed with complete iatrogenic UVFI from 2005 to 2015 (n = 923). Patients with incomplete data and etiologies of idiopathic, malignancy, or stenosis were excluded, leaving a study cohort of 502 patients who were categorized as having UVFI after cervical (n = 329) or thoracic (n = 173) injury. Data regarding site of iatrogenic injury (cervical vs thoracic), mobility status, and time interval to recovery or surgical intervention were recorded and compared using χ2 analyses. Results: Overall, 15% of patients recovered vocal fold mobility at a median of 4.1 months. Patients with cervical injury (65 of 329 [20%]) were significantly more likely to recover mobility than patients with thoracic injury (11 of 173 [6.4%]) (odds ratio, 3.63). The cervical cohort contained more women (68% vs 31%) and was younger (mean age, 60.4 ± 13.8 vs 64.1 ± 16.1 years; Cohen’s D = 0.25). Conclusions: Patients with cervical injuries resulting in UVFI are 4 times more likely to recover mobility than patients with thoracic injuries. This information can be valuable in counseling patients with UVFI and may affect clinical decision making.
Factors That Affect Quality of Life in Young Adults With Type 1 Diabetes
Authors: Kent Denise A. , Quinn Laurie 
Published: October 2018

Purpose The purpose of this study is to examine in young adults (18-35 years) with type 1 diabetes (T1DM) factors known to be associated with quality of life: fear of complications (including hypoglycemia), self-efficacy for diabetes self-management, and self-management of diabetes. Methods Participants ( N = 180) completed online a Demographic/General Health Survey, Diabetes Quality of Life Measure, Hypoglycemia Fear Scale, Fear of Complications Questionnaire, Diabetes Behavior Rating Scale, Self-Efficacy for Diabetes Self-Management, and Diabetes Knowledge Test. Results Multiple linear regression showed that quality of life was significantly associated with fear of hypoglycemia, fear of complications, and self-efficacy. Quality of life was not associated with either diabetes self-management behaviors or diabetes knowledge. Conclusions Although participants demonstrated appropriate self-management behaviors and moderate self-efficacy, on the Diabetes Quality of Life Instrument, they reported high dissatisfaction with the burden that diabetes places on their families and the amount of time it takes to manage their diabetes. Quality of life was significantly positively correlated with fear of hypoglycemia and fear of complications. Quality of life was significantly negatively correlated with self-efficacy. These observations suggest that, as fear of hypoglycemia and fear of complications increase, quality of life decreases, and as self-efficacy increases, so does quality of life. Thus, fear of hypoglycemia, fear of complications, and self-efficacy may be appropriate primary outcomes to use in interventions designed to improve quality of life in young adults with T1DM. Findings from this study extend our understanding of being a young adult with T1DM.