bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired Thermoregulatory Function during Dynamic Exercise in Multiple Sclerosis
Authors: ALLEN DUSTIN R. , HUANG MU , MORRIS NATHAN B. , CHASELING GEORGIA K. , FROHMAN ELLIOT M. , JAY OLLIE , DAVIS SCOTT L. 
Published: October 2018

ABSTRACT

Introduction
Impairments in sudomotor function during passive whole-body heating have been reported in multiple sclerosis (MS), a demyelinating disease of the CNS that disrupts autonomic function. However, the capability of the thermoregulatory system to control body temperature during exercise has never been assessed in MS. Thus, the aim of the present study was to test the hypothesis that thermoregulatory function is impaired in MS patients compared with healthy controls (CON) exercising at similar rates of metabolic heat production.

Methods
Sweating and skin blood flow responses were compared between 12 individuals diagnosed with relapsing-remitting MS (9 females, 3 males) and 12 sex-, age-, mass-, and BSA-matched CON during a single bout of cycling exercise (rate of metabolic heat production: ∼4.5 W·kg−1) for 60 min in a climate-controlled room (25°C, 30% RH).

Results
Individuals with MS exhibited an attenuated increase in cumulative whole-body sweat loss after 30 min (MS, 72 ± 51 g; CON, 104 ± 37 g; P = 0.04) and 60 min (MS, 209 ± 94 g; CON, 285 ± 62 g; P = 0.02), as well as lower sweating thermosensitivity (MS, 0.49 ± 0.26 mg·cm−2·min−1·°C−1; CON, 0.86 ± 0.30 mg·cm−2·min−1·°C−1; P = 0.049). Despite evidence for thermoregulatory dysfunction, there were no differences between MS and CON in esophageal or rectal temperatures at 30- or 60-min time points (P > 0.05). Cutaneous vasculature responses were also not different in MS compared with CON (P > 0.05).

Conclusion
Taken together, MS blunts sweating responses during exercise while cutaneous vasculature responses are preserved. Altered mechanisms of body temperature regulation in persons with MS may lead to temporary worsening of disease symptoms and limit exercise tolerance under more thermally challenging conditions.
The impact of the student companies programme on the development of social skills of the youth
Authors: Saks Katrin , Virnas Janeli 
Published: October 2018

Uurimuse eesmärk on välja selgitada, milline on õpilasfirmade programmi roll noorte sotsiaalsete oskuste ja isiksusomaduste arendamisel. Uuring tehti 2016.−2017. aastal õpilasfirmade programmis osalenud noortega, kes olid pärit Tartu-, Põlva- ja Võrumaalt. Eel- ja järeltestimise käigus koguti enesekohase küsimustikuga andmeid sotsiaalsetele oskustele ja ettevõtlikkusega seotud olulisimatele isiksusomadustele antud hinnangute kohta. Tulemustest selgus, et õpilasfirmade programmis osalemine toetab noorte hinnangul nende enesejuhtimisoskust, akadeemilisi oskusi ja enesekehtestamisoskust ning ettevõtlikkuse, loovuse ja paindlikkuse arengut. Statistiliselt olulised muutused avaldusid vaid Põlva- ja Tartumaa noortel, kellele pakuti peale õpilasfirmade üldise programmi ka lisategevusi ja -tuge. Võrumaa noorte hinnangul ei avaldunud nende sotsiaalsete oskuste ja isiksus omaduste arengus suuri muutusi, mille põhjus võib olla liiga suur õpilaste arv ühe juhendaja kohta. Samuti ei olnud Võrumaa õpilasfirmadel kaasatud õppesse mentoreid ning nad ei osalenud toetavates tegevustes.
Summary
Students’ autonomous motivation in relation to self-management, initiative and creativity when becoming an entrepreneur
Authors: Malleus Elina , Venesaar Urve , Mädamürk Kaja , Arro Grete 
Published: October 2018

Ettevõtluse kontekstis on oluline uurida, mis motiividel alustavad ettevõtjad tegutsemist ning kuidas need mõjutavad edasist ettevõtlusprotsessi. Motiivide uurimine seotuna teiste ettevõtluses oluliste pädevustega (nt enesejuhtimine, algatusvõime ja loovus) võimaldab paremini mõista motivatsiooni olemust ning pöörata kõne alustele teemadele tähelepanu juba ettevõtlusõppes. Uurimusega soovitakse rakendada eri valdkondades (nt haridus, psühholoogia, tervishoid) levinud ise määramisteooriat ettevõtlusõppes. Selleks uuritakse 497 kutse- ja kõrgkoolideõppija kogemust ning motiive ettevõtlusega alustamisel, lähtudes autonoomse ja kontrollitud motivatsiooni teooriast ning sidudes valitud teoreetilise lähtekoha varem ettevõtluse kontekstis esile tõstetud pädevustega. Uurimistulemusena ilmneb, et õppijad, kes lähtuvad ettevõtlusega alustamisel pigem autonoomsele motivatsioonile viitavatest põhjustest, annavad kõrgemaid hinnanguid oma enese juhtimisoskuste, algatusvõime ja loovuse kohta. Seega võib autonoomse motivatsiooni teadlik toetamine ettevõtlushariduses olla seotud ka õppijate edasise parema toimetulekuga ettevõtlusmaastikul.
Summary
The implementation of creative specialties within the context of the model for entrepreneurial competencies
Authors: Männiste Tiiu , Rõigas Andres , Araste Lii , Mäger Marju 
Published: October 2018

Ettevõtlusõpe on jõudnud haridusmaastikule ning selle rakendamise vajadust kinnitavad ka mitmed strateegiad ja uuringud. Looverialade õpetamise seisukohalt on see kasvava tähtsusega kogu maailma majanduses. Alates 2015. aastast on Tartu Ülikooli Viljandi kultuuriakadeemia rakendanud Eesti haridussüsteemis kõigil erialadel kohustuslikku ettevõtlusõpet. Mitmeaastane kogemus võimaldab analüüsida, kuivõrd on ettevõtluspädevused loovainetega lõimitud. Artiklis käsitletakse kvalitatiivsele sisuanalüüsile tuginedes ettevõtluspädevustega seonduvaid õpiväljundeid ja ettevõtlust arendavaid õppetöövorme Viljandi kultuuriakadeemia 2015/2016. ja 2016/2017. õa rakenduskõrghariduse õppekavades. Analüüsist selgub, et õppeasutuse spetsiifika tõttu keskenduvad õppekavad eelkõige kultuurilistele pädevustele. Ettevõtlusega seotud teadmised on väljunditena fikseeritud peamiselt ettevõtlusainetes ja erialaülestes projektides, millel on ettevõtluskultuuri toetava hariduskeskkonna tunnuseid. Kuigi ettevõtlust arendavate õppeainete ja loovainete õpiväljundite seos on nõrk ning ettevõtlust toetav kultuur on veel tervikuks sidumata, võib õppekavade erialamoodulite õpiväljunditest leida ka ettevõtlusele omaseid pädevusi.
Summary
Participación económica femenina y emprendimiento en el Estado de Nayarit, México
Authors: Chong González Elizabeth Guadalupe , Pérez Pina Yoslin 
Published: October 2018

Con base en información estadística de los censos y del Global Entrepreneurship Monitor (GEM), el objetivo principal del trabajo es dar cuenta de las actividades económicas que desarrolla la población ocupada femenina de Nayarit; así mismo identificar los cambios que presentan en su mercado de trabajo, con la finalidad de conocer las principales ocupaciones que desarrollan, su situación ocupacional, así como su participación en la actividad emprendedora. Los resultados muestran que entre 1970 y 1990 las mujeres participaban considerablemente en actividades relativas al sector primario, sin embargo han tomado mayor relevancia las actividades del sector terciario. En lo referente a situación en el trabajo, en su mayoría son asalariadas y trabajadoras por cuenta propia, en algunos casos estas últimas han fortalecido su negocio convirtiéndose así en empleadoras, destacando el emprendimiento como uno de los principales cambios en el mercado de trabajo.
Mecanismos de Financiación y Gestión de Recursos Financieros del Sector de la Construcción, Infraestructura y Megaproyectos en Colombia
Authors: Gutiérrez Ossa Jahir Alexander , Vega Juan David , Osorio Alvarez Santiago 
Published: October 2018

El escrito plantea la consecuencia que debe tener los mecanismos de financiación y de gestión de recursos financieros con respecto al tamaño de las obras de construcción, infraestructura y Megaproyectos en Colombia. La tendencia a medir la relación financiera y los costos que dichas intervenciones exigen, es tan desconocida, como la propia consideración de los impactos, luego de la terminación de las obras. El análisis exploratorio y descriptivo, sirve de sustento básico para ampliar las razones por las cuales se cree que el propio tamaño de las obras reduce el análisis académico e investigativo sobre ello. El análisis financiero de las grandes obras no termina con la disposición de ellas, al contrario, implica la internalización de ellas en donde son asentadas.
El Individuo y sus motivaciones en el proceso emprendedor
Authors: Marulanda-Valencia Flor Ángela , Montoya Restrepo Iván Alonso , Vélez Restrepo Juan Manuel 
Published: October 2018

Con el fin de identificar las motivaciones más importantes en el proceso de creación de empresa, en esta investigación se combinan aspectos cualitativos y cuantitativos. En primer lugar se realizó un estudio exploratorio con emprendedores de Medellín a los que se aplicó un cuestionario semiestructurado en el que se indagó, mediante pregunta abierta, por las motivaciones para crear y administrar su empresa. Con base en los resultados de éste, y la revisión de literatura, que se basa más en aportes teóricos sobre el comportamiento humano y aspectos motivacionales, que en desarrollos empíricos más recientes, se diseñó un constructo con escala tipo Likert, conformado por 6 dimensiones y 35 sub-dimensiones, que fue aplicado a otro grupo de emprendedores. Finalmente se realizaron entrevistas en profundidad con algunos de los respondientes del último grupo. Se encontró que factores como el cumplimiento de un sueño, el crecimiento personal, los nuevos desafíos y la necesidad de independencia, fueron los más importantes para tomar la decisión. Mientras que aspectos económicos y del entorno, fueron menos significativos. Como contribución a la teoría de las motivaciones, entre otros, se propone romper con el paradigma de la clasificación tradicional entre emprendimiento por necesidad y emprendimiento de oportunidad
Oral health risk assessment
Authors: Chapple Liz , Yonel Zehra 
Published: October 2018

Evidence shows that the use of validated risk assessment tools helps healthcare professionals to predict patients' likelihood of developing a disease with greater accuracy. Risk assessment tools have been shown to be beneficial in assisting professionals to communicate findings to patients. The psychological benefits of risk assessment tools have also been demonstrated in terms of positive behavioural change. CPD/Clinical Relevance: With the current shift towards preventive approaches to healthcare, risk assessment can assist in directing resources and prevention programmes to those patients most in need.
Sports mouthguards and orthodontic treatment
Authors: Meade Maurice J 
Published: October 2018

It is recommended that all those participating in sports involving physical contact wear a sports mouthguard (MG) to prevent or reduce the severity of dental trauma. Fixed orthodontic appliances are potentially an additional risk factor for traumatic dental injuries during sports participation. Non-custom-made MGs may be ill-fitting, poorly retentive and ineffective in minimizing injury to the teeth and associated structures compared with custom-made MGs. The presence of fixed orthodontic appliances and prospective tooth movement, however, present a challenge in the provision of custom-made MGs for the orthodontic patient. CPD/Clinical Relevance: Most orthodontic treatment is carried out in the age group of patients where there is a reported peak in the incidence of dental injury during sports activity. Oral health professionals need to be aware of the role MGs play in minimizing injury to the teeth and associated structures.
Effects of music on patient anxiety during surgery: literature review
Authors: Gupta Ashana , Ahmed Bilal 
Published: October 2018

The dental surgery induces some degree of anxiety in many patients: 12% of the UK adult population who had visited a dentist were extremely dentally anxious. Such patients can be unco-operative and difficult to manage as they avoid dental visits and suffer a greater amount of dental disease. Furthermore, patients believe that their oral health has an impact on their quality of life. Sedation is an option to relieve anxiety, however this is associated with risks, including respiratory depression and over sedation. Erdal et al found that music was as effective as midazolam in terms of its sedative and anxiolytic properties during surgery. CPD/Clinical Relevance: Music has demonstrated its usefulness in terms of calming anxious patients.
Multi-professional-delivered enhanced supportive care improves quality of life for patients with incurable cancer
Authors: Monnery Daniel , Benson Sinead , Griffiths Ann , Cadwallader Claire , Hampton-Matthews Julian , Coackley Alison , Cooper Malcolm , Watson Amanda 
Published: October 2018

Background: Enhanced supportive care (ESC) promotes the earlier implementation of supportive care within cancer care. While earlier supportive care has been demonstrated to improve patient outcomes, the model of delivery is variable. The Clatterbridge Cancer Centre has developed a multi-professional delivered model with clinical nurse specialists providing ongoing patient review and care. Method: A retrospective single-system design was used to assess longitudinal changes in Integrated Palliative Care Outcome Scale (IPOS) scores as indicators of quality of life. For other outcomes, a retrospective case control analysis was undertaken. Results: Statistically significant improvements in all IPOS scores were observed for patients attending ESC. Compared to controls, quantitative outcomes included prolonged survival and reduced chemotherapy-related mortality. Multi-professional delivered ESC successfully improves quality of life and outcomes.
Time-dependent behaviour of bone accentuates loosening in the fixation of fractures using bone-screw systems
Authors: Xie S. , Manda K. , Pankaj P. 
Published: October 2018

AimsLoosening is a well-known complication in the fixation of fractures using devices such as locking plates or unilateral fixators. It is believed that high strains in the bone at the bone-screw interface can initiate loosening, which can result in infection, and further loosening. Here, we present a new theory of loosening of implants. The time-dependent response of bone subjected to loads results in interfacial deformations in the bone which accumulate with cyclical loading and thus accentuates loosening.MethodsWe used an ‘ideal’ bone-screw system, in which the screw is subjected to cyclical lateral loads and trabecular bone is modelled as non-linear viscoelastic and non-linear viscoelastic-viscoplastic material, based on recent experiments, which we conducted.ResultsWe found that the interfacial deformation in the bone increases with the number of cycles, and the use of a non-linear viscoelastic-viscoplastic model results in larger deformations, some of which are irrecoverable. There is an apparent trend in which interfacial deformations increase with increasing porosity of bone.ConclusionThe developed time-dependent model of the mechanical behaviour of bone permits prediction of loosening due to cyclical loads, which has not been possible previously. Application of this model shows that implant loosening will be accentuated by cyclical loading due to physiological activities, and the risks of loosening are greater in osteoporotic patients. Cite this article: S. Xie, K. Manda, P. Pankaj. Time-dependent behaviour of bone accentuates loosening in the fixation of fractures using bone-screw systems. Bone Joint Res 2018;7:580–586. DOI: 10.1302/2046-3758.710.BJR-2018-0085.R1.
Interaction Network and Niche Analysis of Natural Enemy Communities and their Host Bees (Hymenoptera: Apoidea) in fragments of Cerrado and Atlantic Forest
Authors: Lima Reinanda , Oliveira Diego Moure , Garófalo Carlos Alberto 
Published: October 2018

Natural enemies are important components of solitary bee communities that nest in preexisting cavities because they act as a relevant mortality factor and can regulate population growth. Despite this, the natural enemy-host interaction remains poorly investigated. This research aimed to determine the composition of the community, the structure of the interaction network, and niche overlap and breadth of natural enemy species in areas of Cerrado (Brazilian savanna) and Semideciduous seasonal forest (Atlantic Forest) in the state of São Paulo, Brazil. Trap-nests made of black cardboard and bamboo canes were provided in the field and inspected monthly in each area, from August 2001 to July 2003 at Cerrado and from June 2006 to May 2008 at the Semideciduous seasonal forest. A modular structure in the interaction network was observed for both areas with the populations of natural enemies showing high degrees of specialization. This structure confers higher stability against disturbances than less specialized webs since these adversities must spread more slowly through the network. The niche analysis showed low degrees of overlap for both, trophic and temporal, among the natural enemy populations.
Improving the Delivery of Healthcare through Clinical Diagnostic Insights: A Valuation of Laboratory Medicine through “Clinical Lab 2.0”
Authors: Swanson Kathleen , Dodd Monique R , VanNess Richard , Crossey Michael 
Published: October 2018

Abstract

Background
As healthcare payment and reimbursement begin to shift from a fee-for-service to a value-based model, ancillary providers including laboratories must incorporate this into their business strategy. Laboratory medicine, while continuing to support a transactional business model, should expand efforts to include translational data analytics, proving its clinical and economic valuation. Current literature in this area is limited.

Content
This article is a summary of how laboratory medicine can support value-based healthcare. Population health management is emerging as a method to support value-based healthcare by aggregating patient information, providing data analysis, and contributing to clinical decision support. Key issues to consider with a laboratory-developed population health management model are discussed, including changing reimbursement models, the use of multidisciplinary committees, the role of specialists in data analytics and programming, and barriers to implementation. Examples of data considerations and value are given.

Summary
Laboratory medicine is able to provide meaningful clinical diagnostic insights for population health initiatives that result in improved short- and long-term patient outcomes and drive cost-effective care. Opportunities include data analysis with longitudinal laboratory data, identification of patient-specific targeted interventions, and development of clinical decision support tools. Laboratories will need to leverage the skills and knowledge of their multidisciplinary staff, along with their extensive patient data sets, through innovative analytics to meet these objectives.
Intervention to Reduce Unnecessary Glucose Tolerance Testing in Pregnant Women
Authors: Buse Joshua D , Donovan Lois E , Naugler Christopher T , Sadrzadeh S M Hossein , de Koning Lawrence 
Published: October 2018

Abstract

Background
Gestational diabetes mellitus (GDM) can be diagnosed in pregnant women by increased fasting plasma glucose alone, which eliminates the need for performing a 75 g oral glucose tolerance test (OGTT). If whole blood glucose meters are used to triage fasting samples in order to decide whether to give the glucose drink, a cutpoint with appropriate sensitivity and specificity for elevated fasting plasma glucose is needed.

Methods
The number of GDM diagnoses by increased fasting plasma glucose alone was determined from specimens collected and tested at core laboratories in urban hospitals, rural health centers, and from specimens collected at patient phlebotomy service centers (PSCs) for plasma testing at a central laboratory. The number of glucose drinks avoided was counted after implementing the diagnostic cutoff of ≥95 mg/dL (5.3 mmol/L) at urban hospitals and rural health centers, which have on-site plasma testing, and after selecting a PSC meter fasting venous whole blood glucose cutpoint after calculating sensitivity and specificity for plasma glucose ≥95 mg/dL (5.3 mmol/L) using logistic regression.

Results
Among 4850 OGTTs, there were 1315 GDM diagnoses annually, of which 409 were from increased fasting plasma glucose. Ninety-one percent of OGTTs were performed at PSCs. If a fasting plasma glucose cutpoint of ≥95 mg/dL (5.3 mmol/L) was implemented at urban hospitals and rural health centers and a meter fasting venous whole blood glucose cutpoint of ≥108 mg/dL (6.0 mmol/L) (25% sensitivity, 99.9% specificity) was implemented at PSCs, the drink would be appropriately avoided by 145 patients/year, and inappropriately avoided by 3 patients/year. After implementing these cutpoints, the drink was appropriately avoided in 91 patients during a 36-week period, with none inappropriately avoiding it.

Conclusion
Modifying fasting glucose cutpoints reduced unnecessary diagnostic OGTTs in pregnant women.
Direct Immunoassay for Free Pregnancy-Associated Plasma Protein A (PAPP-A)
Authors: Tuunainen Emilia , Lund Juha , Danielsson Joanna , Pietilä Pirjo , Wahlroos Veikko , Pudge Keira , Leinonen Isto , Porela Pekka , Ilva Tuomo , Lepäntalo Mauri , Pulkki Kari , Voipio-Pulkki Liisa-Maria , Pettersson Kim , Wittfooth Saara 
Published: October 2018

Abstract

Background
Pregnancy-associated plasma protein A (PAPP-A), especially in its noncomplexed form (fPAPP-A), is linked to vulnerable atherosclerotic plaques and risk of cardiac events. An assay for sensitive detection of fPAPP-A has been lacking. Our aim was to develop and validate a direct fPAPP-A assay to meet this need.

Methods
Monoclonal antibodies binding exclusively fPAPP-A were produced by immunizing mice with recombinant PAPP-A. In the optimized immunoassay, we used an fPAPP-A–specific capture antibody together with a lanthanide-chelate–labeled monoclonal antibody recognizing all PAPP-A forms. The assay was evaluated with CLSI guidelines and compared to a 2-assay subtractive fPAPP-A approach. Clinical performance was assessed with acute coronary syndrome patients.

Results
The limits of detection and quantitation were 0.4 mIU/L and 1.3 mIU/L, respectively, and the assay was linear up to 1000 mIU/L (R 2 = 0.999). Both serum and heparin plasma were suitable matrices, and the complexed form of PAPP-A caused no significant interference. Correlation between the developed assay and the 2-assay approach was fair (Pearson's r = 0.819). Median concentration in healthy individuals was 1.0 mIU/L. fPAPP-A concentration was higher in patients who had myocardial infarction or died during the 1-year follow-up period than in those who did not (1.13 mIU/L vs 0.82 mIU/L, P = 0.008, model adjusted with age and sex). fPAPP-A measured with this direct assay predicted this end point as well as (follow-up 1 year) or better (30 days) than the 2-assay fPAPP-A alone or in combination with cTnI.

Conclusions
The new assay enables sensitive and reliable measurement of low cardiac-related fPAPP-A concentrations from blood samples.