bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anticholinergic and sedative drug burden in community-dwelling older people: a national database study
Authors: Byrne Catherine J , Walsh Caroline , Cahir Caitriona , Ryan Cristín , Williams David J , Bennett Kathleen 
Published: July 2018

ObjectivesThe Drug Burden Index (DBI) tool quantifies individual exposure to anticholinergic and sedative medications. The DBI has been internationally validated against adverse health outcomes in older people. DBI exposure has not been reported in the Irish older population. This study aimed to: (1) develop a list of drugs with clinically significant anticholinergic and/or sedative effects (DBI medications) relevant to Ireland; (2) examine, using the DBI formula, the prevalence of exposure to DBI medications in Irish older people and (3) explore patient factors associated DBI exposure.DesignA cross-sectional national pharmacy claims database study.SettingCommunity setting using the General Medical Services (GMS) scheme pharmacy claims database maintained by the Health Service Executive Primary Care Reimbursement Services.ParticipantsIrish older individuals (aged ≥65 years) enrolled in the GMS scheme and dispensed at least one prescription item in 2016 (n=428 516).Main outcome measuresPrevalence of exposure to DBI medications and patient factors associated with DBI exposure.Results282 874 (66%) of the GMS population aged ≥65 years were exposed to at least one DBI medication in 2016. Prevalence of exposure to DBI medications was significantly higher in females than males (females 71.6% vs males 58.7%, adjusted OR 1.65, 95% CI 1.63 to 1.68). Prevalence of DBI exposure increased progressively with the number of chronic drugs used, rising from 42.7% of those prescribed 0–4 chronic drugs to 95.4% of those on ≥12 chronic drugs (adjusted OR 27.8, 95% CI 26.7 to 29.0). The most frequently used DBI medications were codeine/paracetamol combination products (20.1% of patients), tramadol (11.5%), zopiclone (9.5%), zolpidem (8.5%), pregabalin (7.9%) and alprazolam (7.8%).ConclusionsThe majority of older people in Ireland are exposed to medications with anticholinergic and/or sedative effects, particularly females and those with multiple comorbidities. The high use of low-dose codeine/paracetamol combination products, Z-drugs and benzodiazepines, suggests there are opportunities for deprescribing.
The association between systolic blood pressure and in-hospital mortality in older emergency department patients who are hospitalised with a suspected infection
Authors: Warmerdam Mats , Baris Lucia , van Liebergen Margo , Ansems Annemieke , Esteve Cuevas Laura , Willeboer Merel , Rijpsma Douwe , Shetty Amith L , de Groot Bas 
Published: July 2018

ObjectiveIn existing risk stratification and resuscitation guidelines for sepsis, a hypotension threshold of systolic blood pressure (SBP) below 90–100 mmHg is typically used. However, for older patients, the clinical relevance of a SBP in a seemingly ‘normal’ range (>100 mmHg) is still poorly understood, as they may need higher SBP for adequate tissue perfusion due to arterial stiffening. We therefore investigated the association between SBP and mortality in older emergency department (ED) patients hospitalised with a suspected infection.MethodsIn this observational multicentre study in the Netherlands, we interrogated an existing prospective database of consecutive ED patients hospitalised with a suspected infection between 2011 and 2016. We investigated the association between SBP categories (≤100, 101–120, 121–139, ≥140 mmHg) and in-hospital mortality in patients of 70 years and older. We adjusted for demographics, comorbidity, disease severity and admission to ward/intensive care using multivariable logistic regression.ResultsIn the 833 included older patients, unadjusted in-hospital mortality increased from 4.7% (n=359) in SBP ≥140 mmHg to 20.8% (n=96) in SBP ≤100 mmHg. SBP categories were linearly associated with case-mix-adjusted in-hospital mortality. The adjusted ORs (95% CI) for ≤100, 101–120 and 121–139 mmHgcompared with the reference of ≥140 mmHg were 3.8 (1.8 to 7.8), 2.8 (1.4 to 5.5) and 1.9 (0.9 to 3.7), respectively.ConclusionIn older ED patients hospitalised with a suspected infection, we found an inverse linear association between SBP and case-mix-adjusted in-hospital mortality. Our data suggest that the commonly used threshold for hypotension is not clinically meaningful for risk stratification of older ED patients with a suspected infection.
‘Plug and pipe’ strategy for treatment of ruptured intracranial aneurysms
Authors: Howard Brian M , Frerich Jason M , Madaelil Thomas P , Dion Jacques E , Tong Frank C , Cawley C Michael , Grossberg Jonathan A 
Published: July 2018

BackgroundAneurysmal subarachnoid hemorrhage is a potentially devastating condition, and among the first priorities of treatment is aneurysm occlusion to prevent re-hemorrhage. An emerging strategy to treat patients whose aneurysms are not ideal for surgical or endovascular treatment is subtotal coiling followed by flow diversion in the recovery phase or ‘plug and pipe’. However, data regarding the safety and efficacy of this strategy are lacking.MethodsA retrospective cohort study was performed to evaluate the efficacy and safety of ‘plug and pipe’. All patients with a ruptured intracranial aneurysm intentionally, subtotally treated by coiling in the acute stage followed by flow diversion after recovery, were included. The primary outcome was re-hemorrhage. Secondary outcomes included aneurysm occlusion and functional status. Complications were reviewed.Results22 patients were included. No patient suffered a re-hemorrhage, either in the interval between coiling and flow diversion or in follow-up. The median interval between aneurysm rupture and flow diversion was 3.5 months. Roy–Raymond (R-R) class I or II occlusion was achieved in 91% of target aneurysms at the last imaging follow-up (15/22(68%) R-R 1 and 5/22(23%) R-R 2). Complications occurred in 2 (9%) patients, 1 of which was neurological.ConclusionsOverall, these data suggest that subtotal coiling of ruptured intracranial aneurysms followed by planned flow diversion is both safe and effective. Patients who may most benefit from ‘plug and pipe’ are those with aneurysms that confer high operative risk and those whose severity of medical illness increases the risk of microsurgical clip ligation.
Evaluating latent tuberculosis infection diagnostics using latent class analysis
Authors: Stout Jason E , Wu Yanjue , Ho Christine S , Pettit April C , Feng Pei-Jean , Katz Dolly J , Ghosh Smita , Venkatappa Thara , Luo Ruiyan 
Published: July 2018

BackgroundLack of a gold standard for latent TB infection has precluded direct measurement of test characteristics of the tuberculin skin test and interferon-γ release assays (QuantiFERON Gold In-Tube and T-SPOT.TB).ObjectiveWe estimated test sensitivity/specificity and latent TB infection prevalence in a prospective, US-based cohort of 10 740 participants at high risk for latent infection.MethodsBayesian latent class analysis was used to estimate test sensitivity/specificity and latent TB infection prevalence among subgroups based on age, foreign birth outside the USA and HIV infection.ResultsLatent TB infection prevalence varied from 4.0% among foreign-born, HIV-seronegative persons aged <5 years to 34.0% among foreign-born, HIV-seronegative persons aged ≥5 years. Test sensitivity ranged from 45.8% for the T-SPOT.TB among foreign-born, HIV-seropositive persons aged ≥5 years to 80.7% for the tuberculin skin test among foreign-born, HIV-seronegative persons aged ≥5 years. The skin test was less specific than either interferon-γ release assay, particularly among foreign-born populations (eg, the skin test had 70.0% specificity among foreign-born, HIV-seronegative persons aged ≥5 years vs 98.5% and 99.3% specificity for the QuantiFERON and T-SPOT.TB, respectively). The tuberculin skin test’s positive predictive value ranged from 10.0% among foreign-born children aged <5 years to 69.2% among foreign-born, HIV-seropositive persons aged ≥5 years; the positive predictive values of the QuantiFERON (41.4%) and T-SPOT.TB (77.5%) were also low among US-born, HIV-seropositive persons aged ≥5 years.ConclusionsThese data reinforce guidelines preferring interferon-γ release assays for foreign-born populations and recommending against screening populations at low risk for latent TB infection.Trial registration numberNCT01622140.
Ability of a New Smartphone Pulse Pressure Variation and Cardiac Output Application to Predict Fluid Responsiveness in Patients Undergoing Cardiac Surgery
Authors: Joosten Alexandre , Boudart Céline , Vincent Jean-Louis , Vanden Eynden Frederic , Barvais Luc , Van Obbergh Luc , Rinehart Joseph , Desebbe Olivier 
Published: July 2018

BACKGROUND:
Pulse pressure variation (PPV) can be used to predict fluid responsiveness in anesthetized patients receiving controlled mechanical ventilation but usually requires dedicated advanced monitoring. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a novel smartphone application that calculates PPV and cardiac output (CO) from a picture of the invasive arterial pressure waveform obtained from any monitor screen. The primary objective was to compare the ability of PPV obtained using the Capstesia (PPVCAP) and PPV obtained using a pulse contour analysis monitor (PPVPC) to predict fluid responsiveness. A secondary objective was to assess the agreement and the trending of CO values obtained with the Capstesia (COCAP) against those obtained with the transpulmonary bolus thermodilution method (COTD).

METHODS:
We studied 57 mechanically ventilated patients (tidal volume 8 mL/kg, positive end-expiratory pressure 5 mm Hg, respiratory rate adjusted to keep end tidal carbon dioxide [32–36] mm Hg) undergoing elective coronary artery bypass grafting. COTD, COCAP, PPVCAP, and PPVPC were measured before and after infusion of 5 mL/kg of a colloid solution. Fluid responsiveness was defined as an increase in COTD of >10% from baseline. The ability of PPVCAP and PPVPC to predict fluid responsiveness was analyzed using the area under the receiver-operating characteristic curve (AUROC), the agreement between COCAP and COTD using a Bland-Altman analysis and the trending ability of COCAP compared to COTD after volume expansion using a 4-quadrant plot analysis.

RESULTS:
Twenty-eight patients were studied before surgical incision and 29 after sternal closure. There was no significant difference in the ability of PPVCAP and PPVPC to predict fluid responsiveness (AUROC 0.74 [95% CI, 0.60–0.84] vs 0.68 [0.54–0.80]; P = .30). A PPVCAP >8.6% predicted fluid responsiveness with a sensitivity of 73% (95% CI, 0.54–0.92) and a specificity of 74% (95% CI, 0.55–0.90), whereas a PPVPC >9.5% predicted fluid responsiveness with a sensitivity of 62% (95% CI, 0.42–0.88) and a specificity of 74% (95% CI, 0.48–0.90). When measured before surgery, PPV predicted fluid responsiveness (AUROC PPVCAP = 0.818 [P = .0001]; PPVPC = 0.794 [P = .0007]) but not when measured after surgery (AUROC PPVCAP = 0.645 [P = .19]; PPVPC = 0.552 [P = .63]). A Bland-Altman analysis of COCAP and COTD showed a mean bias of 0.3 L/min (limits of agreement: −2.8 to 3.3 L/min) and a percentage error of 60%. The concordance rate, corresponding to the proportion of CO values that changed in the same direction with the 2 methods, was poor (71%, 95% CI, 66–77).

CONCLUSIONS:
In patients undergoing cardiac surgery, PPVCAP and PPVPC both weakly predict fluid responsiveness. However, COCAP is not a good substitute for COTD and cannot be used to assess fluid responsiveness.
Methods of Monitoring Training Load and Their Association With Changes Across Fitness Measures in Hurling Players
Authors: Malone Shane , Hughes Brian , Collins Kieran , Akubat Ibrahim 
Published: July 2018

Abstract
Malone, S, Hughes, B, Collins, K, and Akubat, I. Methods of monitoring training load and their association with changes across fitness measures in hurling players. J Strength Cond Res 34(1): 225–234, 2020—The aim of the current investigation was to assess the dose-response relationship for various methods of monitoring training load (TL) and changes in aerobic and anaerobic fitness in hurling players. Training and match load measures were collected from 30 hurling players (speed at different blood lactate [vLT, vOBLA], maximal oxygen uptake [Vo
2max], speed at Vo
2max [vVo
2max], peak treadmill velocity [PTV] running economy [RE] Yo-Yo intermittent recovery test (Yo-YoIR1, Yo-YoIR2), speed at 5, 10 , 20 m, and repeated sprint ability [6 × 35 m]) before and after during a 12-week in-season period. Mean weekly training and match loads as determined by s-RPE, bTRIMP, luTRIMP, eTRIMP, iTRIMP, and gTRIMP were correlated with each other, percentage change in Vo
2max, vVo
2max, RE, PTV, the speed at blood lactate concentrations of 2 mmol·L−1 (vLT) and 4 mmol·L−1 (vOBLA), and YoYoIR1, Yo-YoIR2 performance. iTRIMP showed a trivial association with s-RPE and a small to moderate association with other heart rate–based methods. Small to large changes (effect size: 0.38–1.12) were observed in aerobic and anaerobic fitness measures were observed across the 12-week period. Trivial to very large associations (r = 0.11–0.78) were observed between TL variables and changes in fitness depending on the variable analyzed. iTRIMP was shown to have large to very large associations with changes in vOBLA {r = 0.78 (95% confidence interval [CI]: 0.71–0.88)}, Vo
2max (r = 0.77 [95% CI: 0.68–0.82]), RE (r = 0.77 [95% CI: 0.67–0.82]), Yo-YoIR1 (r = 0.69 [95% CI: 0.51–0.72]), and RSAb (r = 0.66 [95% CI: 0.60–0.72]) with moderate associations reported between iTRIMP and other variables. All other measures of TL showed trivial to moderate associations (r = 0.11–0.66). The current investigation shows that fully individualized training load (iTRIMP) measures may potentially offer a better understanding of dose-response relationships when compared with subjective and nonindividualized measures of TL to changes in aerobic and anaerobic fitness in team sports athletes; as such, it may be suggested that practitioners should use individualized measures of TL assessment within their day-to-day practices.
Baseline Assessments of Strength and Balance Performance and Bilateral Asymmetries in Collegiate Athletes
Authors: Dai Boyi , Layer Jacob , Vertz Cole , Hinshaw Taylour , Cook Ross , Li Yongming , Sha Zhanxin 
Published: July 2018

Abstract
Dai, B, Layer, J, Vertz, C, Hinshaw, T, Cook, R, Li, Y, and Sha, Z. Baseline assessments of strength and balance performance and bilateral asymmetries in collegiate athletes. J Strength Cond Res 33(11): 3015–3029, 2019—Injuries to upper and lower extremities comprise more than 70% of the total injuries in collegiate athletes. Establishing normative data of upper and lower extremity strength and balance may help guide postinjury rehabilitation and return-to-play decisions. The purposes of the current study were to develop the normative data of performance and bilateral asymmetries during 4 upper and lower extremity strength and balance tests in collegiate athletes and to quantify the correlations between strength and balance performance and bilateral asymmetries. A total of 304 male and 195 female Division I athletes from 14 sports performed a maximum push-up test to assess upper extremity strength, a countermovement jump test to assess lower extremity strength, an upper extremity reaching test to assess upper extremity balance, and a lower extremity reaching test to assess lower extremity balance. Bilateral ground reaction forces were collected for the push-up and jump tests. Reaching distances were measured for the 2 balance tests. Bilateral asymmetries were generally less than 10%. Significant sports effects were observed for all 5 performance variables (p < 0.001) but not for asymmetry variables (p ≥ 0.36). Weak correlations were found between strength and balance performance and asymmetries (r < 0.3). Normative data are sex and sports specific in collegiate athletes. Increased asymmetries could be more individualized rather than sex and sports specific. When return-to-play decisions are made, athletes following injuries need to demonstrate less than 10% of asymmetries to be consistent with the normative data. Strength and balance should be evaluated and improved with specific focuses.
Strength Training in Long-Distance Triathletes: Barriers and Characteristics
Authors: Luckin Kate M. , Badenhorst Claire E. , Cripps Ashley J. , Landers Grant J. , Merrells Robert J. , Bulsara Max K. , Hoyne Gerard F. 
Published: July 2018

Abstract
Luckin, KM, Badenhorst, CE, Cripps, AJ, Landers, GJ, Merrells, RJ, Bulsara, MK, and Hoyne, GF. Strength training in long-distance triathletes: Barriers and characteristics. J Strength Cond Res 35(2): 495–502, 2021—The purpose of this investigation was to identify perceived and physical barriers toward the completion of concurrent strength training and endurance training in long-distance triathletes. Three hundred ninety long-distance triathletes (224 women, 166 men; age [y]: 39 ± 10) completed a 68-question self-administered, semiquantitative survey that assessed endurance and strength training characteristics, experience in triathlon, and perceived barriers regarding the completion of strength training. Mean training hours per week was 14.92 ± 5.25, with 54.6% reporting participation in strength training. Heavy strength training was the most commonly reported (39.4%), with significantly more men completing this form of strength training (p < 0.001). Results from subjects who did not complete strength training indicated that perceived time constraints (53.1%) in addition to lack of knowledge on exercise progression and form (52.5%) are prominent perceived barriers to strength training completion. Identification of the barriers perceived by long-distance triathletes that prevent them from completing concurrent strength training and endurance training may be useful for coaches, athletes, and sports scientists who seek to incorporate strength training for injury prevention and performance improvement.
Recent Advancements in Our Understanding of the Ergogenic Effect of Respiratory Muscle Training in Healthy Humans: A Systematic Review
Authors: Shei Ren-Jay 
Published: July 2018

AbstractShei, R-J. Recent advancements in our understanding of the ergogenic effect of respiratory muscle training in healthy humans: a systematic review.J Strength Cond Res32(9): 2674–2685, 2018—Respiratory muscle training (RMT) has been shown to be an effective ergogenic aid for sport performance. Respiratory muscle training has been documented to improve performance in a wide range of exercise modalities including running, cycling, swimming, and rowing. The physiological effects of RMT that may explain the improvements in performance have been proposed to include diaphragm hypertrophy, muscle fiber–type switching, improved neural control of the respiratory muscles, increased respiratory muscle economy, attenuation of the respiratory muscle metaboreflex, and decreases in perceived breathlessness and exertion. This review summarizes recent studies on the ergogenicity and mechanisms of RMT since 2013 when the topic was last systematically reviewed. Recent evidence confirms the ergogenic effects of RMT and explores different loading protocols, such as concurrent exercise and RMT (i.e., “functional” RMT). These studies suggest that adapting new training protocols may have an additive improvement effect, but evidence of the efficacy of such an approach is conflicting thus far. Other recent investigations have furthered our understanding of the mechanisms underpinning RMT-associated improvements in performance. Importantly, changes in ventilatory efficiency, oxygen delivery, cytokine release, motor recruitment patterns, and respiratory muscle fatigue resistance are highlighted as potential mechanistic factors linking RMT with performance improvements. It is suggested that future investigations focus on development of sport-specific RMT loading protocols, and that further work be undertaken to better understand the mechanistic basis of RMT-induced performance improvements.
Categorizing “Religion”
Authors: Taira Teemu 
Published: July 2018

Transcription ofReligious Studies Project, Podcast with Teemu Taira (19 September 2016).Interviewed by Breann FallonTranscribed by Claire Berlinger.Audio and transcript available at:http://www.religiousstudiesproject.com/podcast/categorising-religion-from-case-studies-to-methodology/
SÜRDÜRÜLEBİLİR KALİTE ALGISININ İŞTEN AYRILMA NİYETİ ÜZERİNDEKİ ETKİSİNDE İŞ TATMİNİNİN ARACI ROLÜ
Authors: ÇANKIR Bilal , ŞAHİN Safiye 
Published: July 2018

Bu
çalışma ile sürdürülebilir kalite algısının iş tatmini aracılığıyla işten ayrılma
niyeti üzerindeki etkisini araştırmak amaçlanmıştır. Araştırmanın örneklemini
İstanbul’da “cam, çimento ve toprak”, “kimya, petrol, lastik ve plastik”,
“metal” ve “otomotiv” sektörlerinde görev yapan 355 çalışan oluşturmuştur.
Veriler, 2017 yılı içerisinde anket yöntemi ile toplanmıştır. Araştırma
değişkenlerinin ölçülmesinde literatürde daha önce kullanılan ve Türkiye’de
geçerlilik-güvenirlik analizi yapılan 5’li Likert tipi ölçekler kullanılmıştır.
Araştırma modelinin test edilmesinde
Yapısal Eşitlik Modeli analizinden yararlanılmıştır. Katılımcıların kurumlarına
yönelik sürdürülebilir kalite algılarının 1,86±0,73 ortalama ile düşük olduğu
belirlenmiştir. Aynı şekilde katılımcıların iş tatmini ortalaması da 2,31±0,87
ile düşük düzeydedir. İşten ayrılma niyeti ortalaması ise 3,67±1,04 ile yüksek
düzeydedir. Araştırmanın sonucunda sürdürülebilir kalite algısının işten
ayrılma niyeti üzerindeki etkisinde iş tatmininin tam aracı rolü olduğu
belirlenmiştir.
Significant Results . Space Makes a Difference Increasing Student Academic Engagement Levels
Authors: Scott-Webber Lennie , Konyndyk Roger , French Raechel , French Jim 
Published: July 2018

Our team consisting of researchers, designers and a statistician are working to establish statistically reliable and valid survey instruments for use in post building occupancy for schools housing students and educators in grades nine to twelve. Two indexes are being created, a Student Engagement Index© and a Teachers Engagement Index©. Our research question is, “Can we demonstrate that the design of the built environment for grades 9-12 impacts student academic engagement levels?” The sample for this survey was four high schools in the USA, in fall 2017. A time-honored Post- Occupancy methodology was used. Findings had strong indicators showing the buildings’ design makes a statistically significant difference regarding student academic engagement levels. Results were excellent on reliability and have convergent validity, with the exception of the last two questions. Statistical evidence from students and educators across all schools, grades, and genders that the buildings’ designs impact their academic engagement levels (p<.0001). When active learning is used students recognize the impact. Concluded that for educators, the overall “culture” of the school is a far more important factor for teacher engagement than the physical layout. Seen as a real effect, all respondents acknowledged that the physical environment impacted engagement in their teaching and learning practices (p<.0001), significant result indicating that space makes a difference and increases student academic engagement levels.