bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Cycling Cadence on Respiratory and Hemodynamic Responses to Exercise
Authors: MITCHELL REID A. , BOYLE KYLE G. , RAMSOOK ANDREW H. , PUYAT JOSEPH H. , HENDERSON WILLIAM R. , KOEHLE MICHAEL S. , GUENETTE JORDAN A. 
Published: March 2019

ABSTRACT

Purpose
The physiological consequences of freely chosen cadence during cycling remains poorly understood. We sought to determine the effect of cadence on the respiratory and hemodynamic response to cycling exercise.

Methods
Eleven cyclists (10 males, 1 female; age, 27 ± 6 yr; V˙O2max = 60.8 ± 3.7 mL·kg−1·min−1) completed four, 6-min constant-load cycling trials at 10% below their previously determined gas exchange threshold (i.e., 63% ± 5% peak power) while pedaling at 60, 90, and 120 rpm, and a freely chosen cadence (94.3 ± 6.9 rpm) in randomized order. Standard cardiorespiratory parameters were measured and an esophageal electrode balloon catheter was used to assess electromyography of the diaphragm (EMGdi) and the work of breathing (W
b). Leg blood flow index (BFI) was determined on four muscles using near-infrared spectroscopy with indocyanine green dye injections.

Results
Oxygen uptake (V˙O2) increased as a function of increasing cadence (all pairwise comparisons, P < 0.05). The EMGdi and W
b were significantly greater at 120 rpm compared with all other conditions (all P < 0.01). Vastus medialis and semitendinosus BFI were significantly greater at 120 rpm compared with 60 and 90 rpm (all P < 0.05). Gastrocnemius BFI was higher at 120 rpm compared with all other cadences (all P < 0.01). No difference in BFI was found in the vastus lateralis (P = 0.06). Blood flow index was significantly correlated with the increase in V˙O2 with increasing cadence in the medial gastrocnemius (P < 0.001) and approached significance in the vastus lateralis (P = 0.09), vastus medialis (P = 0.06), and semitendinosus (P = 0.09). There was no effect of cadence on Borg 0–10 breathing or leg discomfort ratings (P > 0.05).

Conclusions
High cadence cycling at submaximal exercise intensities is metabolically inefficient and increases EMGdi, W
b, and leg muscle blood flow relative to slower cadences.
Bone Biomarker Response to Walking under Different Thermal Conditions in Older Adults
Authors: WHERRY SARAH J. , SWANSON CHRISTINE M. , WOLFE PAMELA , WELLINGTON TOBY , BOXER REBECCA S. , SCHWARTZ ROBERT S. , KOHRT WENDY M. 
Published: March 2019

ABSTRACTEndurance exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and c-terminal telopeptide of type I collagen (CTX), which may be due to Ca loss in sweat.PurposeThis study aimed to determine whether exercise in a warm environment exaggerates the decrease in iCa and increases in PTH and CTX compared with a cool environment in older adults.MethodsTwelve women and men 61–78 yr old performed two identical 60-min treadmill bouts at ~75% of maximal heart rate under warm and cool conditions. Serum iCa, PTH, and CTX were measured every 15 min starting 15 min before and continuing for 60 min after exercise. Sweat Ca loss was estimated from sweat volume and sweat Ca concentration.ResultsSweat volume was low and variable; there were no differences in sweat volume or Ca concentration between conditions. iCa decreased after 15 min of exercise, and the change was similar in both conditions. Increases in PTH (warm: 16.4, 95% confidence interval [CI] = 6.2, 26.5 pg·mL−1; cool: 17.3, 95% CI = 8.1, 26.4 pg·mL−1) and CTX (warm: 0.08, 95% CI = 0.05, 0.11 ng·mL−1; cool: 0.08, 95% CI = 0.01, 0.16 ng·mL−1) from before to immediately after exercise were statistically significant and similar between conditions. Adjusting for plasma volume shifts did not change the results.ConclusionThe increases in PTH and CTX, despite the low sweat volume, suggest that dermal Ca loss is not a major factor in the decrease in iCa and increases in PTH and CTX observed during exercise in older adults.
Immunophenotypic characterisation of morphologically diagnosed cases of Acute Myeloid Leukaemia (AML)
Authors: Basharat Maria , Khan Saleem Ahmed , Ud din Nasir , Ahmed Dawood 
Published: March 2019

Objective: To determine immunophenotypic pattern in newly diagnosed cases of acute myeloid leukaemia by flow cytometry and its correlation with morphological findings.
Methods: This study was conducted at Haematology (Pathology) department, Army Medical College, in collaboration with Immunology Department Armed Forces Institute of Pathology, Rawalpindi from 16 November 2016 to 16 November 2017. One hundred and six patients of both genders and all age groups diagnosed as acute myeloid leukaemia were included in the study. Demographic data was noted. Complete blood counts, bone marrow examination and cytochemical stains were carried out and evaluated microscopically for blast percentage and morphology. Immunophenotyping was performed by flow cytometry using standard panel on peripheral blood or bone marrow samples. The surface and cytoplasmic antigens of interest were analysed and correlated with morphological findings.
Results: The most commonly expressed antigens were CD13, CD33, CD45 and HLA-DR. Almost all blasts expressed CD45 with no remarkable difference among the subtypes of AML. The mean positivity for CD13 among all AML subtypes was 57% and for CD33 was 67%. Aberrant expression of CD7 and CD19 were expressed in 26.4% and 1.1% of all cases respectively. There was concordance rate of 90% between morphology and FCM in our study.
Conclusion: Flow cytometric analysis of acute leukaemia done by a combination of patterns and intensity of antigen expression improves diagnostic yield in AML. CD13, CD33 and CD45 are the most frequently expressed antigens in AML. Our findings suggest a 90% concordance between morphology and flow cytometry. It is pertinent to conclude that flow cytometry results interpreted with morphology are complementary.
How to cite this:Basharat M, Khan SA, Nasir ud Din, Ahmed D. Immunophenotypic characterisation of morphologically diagnosed cases of Acute Myeloid Leukaemia (AML). Pak J Med Sci. 2019;35(2):470-476. doi: https://doi.org/10.12669/pjms.35.2.614
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy of Therapeutic Endoscopy for Gastrointestinal Lesion (GI): A network meta-analysis
Authors: Wang Tian-xi , Zhang Jun , Cui Li-hong , Tian Jingjing , Wei Rongna 
Published: March 2019

Objective: Endoscopic therapy can reduce the risks of rebleeding, continued bleeding, need for surgery, and mortality. The objective of this systematic review was to compare the different modalities of endoscopic therapy for GI bleeding.
Methods: Studies were identified by searching electronic databases MEDLINE. We selected all available clinical studies published after 2000 that assessed efficacy and/or safety of different endoscopic hemostatic techniques in treating GI bleeding. The outcomes evaluated included initial hemostasis, rebleeding rate, and 30-day all-cause mortality. Network meta-analyses were performed to summarize the treatment effects.
Results: Total 20 studies involving 1845 patients were evaluated. Ten different treatment categories including mechanic, ablative, injection, and combined therapy were compared in our analysis in terms of their efficacy in stopping bleeding and complications. Band ligation [rate: 0.757; 95% Credible Interval (0.565, 0.887)] and injection therapy [rate: 0.891; 95% CI (0.791, 0.944)] had inferior efficacy in attaining initial hemostasis compared to others. Combined therapy of band ligation and HPC and hemoclip may represent the best options for preventing rebleeding and mortality respectively. No significant difference was found among other treatments in terms of complications.
Conclusions: We recommend the application of hemoclips in treating GI bleeding due to its high hemostasis efficacy and low risk of 30-day mortality.
How to cite this:Wang TX, Zhang J, Cui LH, Tian JJ Wei R. Efficacy of Therapeutic Endoscopy for Gastrointestinal Lesion (GI): A network meta-analysis. Pak J Med Sci. 2019;35(2):561-568. doi: https://doi.org/10.12669/pjms.35.2.636
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Grooming and etiquette as part of nurse’s professionalism: An essential curricular competency
Authors: Safdar Sachal Aqeel , Safdar Lubna 
Published: March 2019

Objective: The B.Sc. Nursing has limited hours dedicated to grooming and personal development. A smartly turned out, trained empathetic and efficient nurse helps in alleviating the miseries of the patients. The objective of this study was to see the acceptability and perceived usefulness of a course on grooming and etiquette.
Methods: A proforma based qualitative study was carried out at College of Nursing, AFPGMI & National University of Medical Sciences (NUMS), Rawalpindi, from Jan to Dec, 2017. An eight week course, with weekly lectures was conducted for first to fourth year classes. At the end a semistructured proforma with simple open ended questions was administered. The questions were both in English and Urdu. The results were analyzed by finding percentages of positive and negative responses. The descriptive responses were grouped in recurring themes and analyzed for content and their constructive value.
Results: There were 186 nursing cadets who completed the course and filled the proforma (55, 52, 45 and 34 from first year to fourth year, respectively). Out of 186, 98.9% (184) thought that this was a useful course. All topics were considered useful. Most liked were communication skills, teaching visits to wards, hostels and balancing home and work. About 7% disagreed about the strict dress codes, but agreed with the proper demeanor. Many suggested that senior nurses also have a dire need of these grooming lectures as many used derogatory language. Also pointed out was absence of a mechanism to report a lapse in ethical conduct seen in a colleague or a senior.
Conclusion: Nursing is a demanding profession. It is important that our training includes sensitization to the non-technical attributes. They have to be groomed to become role models for young talented girls to join this noble profession. Even a short course may help to sensitize these young ladies to a very important aspect of their lives and profession.
How to cite this:Safdar SA, Aqeel L. Grooming and etiquette as part of nurse’s professionalism- An essential curricular competency. Pak J Med Sci. 2019;35(2):404-408. doi: https://doi.org/10.12669/pjms.35.2.647
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Prevalence of antenatal depression among women receiving antenatal care during last trimester of pregnancy in a tertiary care private institute of Lahore
Authors: Sabir Mahrukh , Farrukh Nagi Muhammad Luqman , Kazmi Tahseen Haider 
Published: March 2019

Objective: Pregnancy and depression affect each other. The main objective of our study was to find out frequency of antenatal depression during last trimester and associated risk factors among pregnant female visiting a tertiary care private institution of Lahore, Pakistan.
Methods: This study was conducted at Shalamar Hospital a private tertiary care institution of Lahore during May 2017 to June 2018. Assuming 18% prevalence with design effect 1.5 and 97% confidence interval the calculated sample size was 417. To avoid dropouts the questionnaire was administered to 450 pregnant females in their last trimester that is with gestational age above 28 weeks. In this study we used a modified version of Goldberg’s depression scale in Urdu language for data collection. Wherever needed the data collection team read out aloud the questionnaire to the participants who did not know how to read and write. Informed consent in a written form (in Urdu language) was taken from every study participant after explaining the participants about the research. If the participant did not know how to read and write, the interviewers narrated out aloud the script of informed consent for them and got it signed later by the participants. The confidentiality, anonymity and privacy of the study participants were preserved. Ethical approval of this study was obtained from Institutional Review Board of Shalamar Institute of Health Sciences. Data entry and analysis was finalized by using SPSS version 20.
Results: The prevalence of depression among women seeking antenatal care during their last trimester according to Goldberg Depression Scale was 40.89% (n=184).Whereas, 30.4% (n=137), 8.67% (n=39) and 1.78% (n=8) suffered from mild, moderate and severe depression respectively. The associations between passive smoking (p < 0.01), family history of preeclampsia (p < 0.05) and depression among family members (p < 0.05) with antenatal depression during last trimester were significant.
Conclusion: According to Goldberg Depression Scale, 40.89% (n=184) of pregnant women seeking antenatal care in private tertiary care institution of Lahore suffered from depression.
How to cite this:Sabir M, Nagi MLF, Kazmi TH. Prevalence of antenatal depression among women receiving antenatal care during last trimester of pregnancy in a tertiary care private institute of Lahore. Pak J Med Sci. 2019;35(2):527-531. doi: https://doi.org/10.12669/pjms.35.2.649
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Compression therapy and exercise: enhancing outcomes
Authors: Rooney Louise , Cooper-Stanton Garry , Cave-Senior Jayne 
Published: March 2019

Compression therapy is the main method used in treating lymphoedema and chronic oedema. When combined with exercise, the authors found that patients in their practice had improved outcomes; making it vital for health professionals to keep up-to-date with this practice Compression therapy is the main method used in the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap-based systems led to a decrease in limb volume in one case study. The results of the programme indicate that the approach is beneficial and requires embedding further in Walsall lymphoedema service, due to improved patient outcomes, and cost effectiveness in terms of resources.
Development and Validation of a Prognostic Score to Predict Covert Hepatic Encephalopathy in Patients With Cirrhosis
Authors: Labenz Christian , Toenges Gerrit , Huber Yvonne , Nagel Michael , Marquardt Jens U. , Schattenberg Jörn M. , Galle Peter R. , Labenz Joachim , Wörns Marcus-Alexander 
Published: March 2019

OBJECTIVES:
Diagnosis of covert hepatic encephalopathy (CHE) is challenging and often neglected in clinical practice. The aim of this study was to develop an easy-to-perform score to predict CHE in patients with cirrhosis.

METHODS:
For the development or validation cohort of the proposed clinical CHE score, 142 or 96 consecutive patients with cirrhosis were prospectively enrolled. The Psychometric Hepatic Encephalopathy Score was used to detect minimal hepatic encephalopathy. All patients were examined with the simplified animal naming test and were asked to complete the Chronic Liver Disease Questionnaire. We followed the TRIPOD guideline for development, validation, and reporting of the proposed score.

RESULTS:
The clinical covert hepatic encephalopathy score containing the variables—clinically detectable ascites, history of overt hepatic encephalopathy (OHE), albumin serum level, activity subdomain of the Chronic Liver Disease Questionnaire, and simplified animal naming test—discriminated best between patients with and without CHE. We generated 2 cutoff values for the identification of the high-, intermediate- (with need for additional specialized testing), and low-risk groups for CHE. By applying these cutoffs, the sensitivity, specificity, positive predictive value, and negative predictive value were 90%, 91%, 85%, and 94%, respectively. The AUC was 0.908 or 0.872 for the development or the validation cohort, respectively. Higher scores were further associated with poorer quality of life, and the high-risk group was predictive for first-time OHE within 180 days.

CONCLUSIONS:
We developed an easy-to-perform score to identify patients with cirrhosis at risk of CHE, which correlates with quality of life and risk of first-time OHE.
Supplementation With Lactoferrin and Lysozyme Ameliorates Environmental Enteric Dysfunction: A Double-Blind, Randomized, Placebo-Controlled Trial
Authors: Cheng William D. , Wold Karl J. , Bollinger Lucy B. , Ordiz M. Isabel , Shulman Robert J. , Maleta Kenneth M. , Manary Mark J. , Trehan Indi 
Published: March 2019

INTRODUCTION:
Environmental enteric dysfunction (EED) predisposes children throughout the developing world to high rates of systemic exposure to enteric pathogens and stunting. Effective interventions that treat or prevent EED may help children achieve their full physical and cognitive potential. The objective of this study is to test whether 2 components of breast milk would improve a biomarker of EED and linear growth during the second year of life.

METHODS:
A prospective, randomized, double-blind, placebo-controlled clinical trial among children aged 12–23 months was conducted in rural Malawi. The experimental group received a daily supplement of 1.5 g of lactoferrin and 0.2 g of lysozyme for 16 weeks. The primary outcome was an improvement in EED, as measured by the change in the percentage of ingested lactulose excreted into the urine (Δ%L).

RESULTS:
Among 214 children who completed the study, there was a significant difference in Δ%L between the control and experimental groups over 8 weeks (an increase of 0.23% vs 0.14%, respectively; P = 0.04). However, this relative improvement was not as strongly sustained over the full 16 weeks of the study (an increase of 0.16% vs 0.11%, respectively; P = 0.17). No difference in linear growth over this short period was observed. The experimental intervention group had significantly lower rates of hospitalization and the development of acute malnutrition during the course of the study (2.5% vs 10.3%, relative risk 0.25; P < 0.02).

DISCUSSION:
Supplementation with lactoferrin and lysozyme in a population of agrarian children during the second year of life has a beneficial effect on gut health. This intervention also protected against hospitalization and the development of acute malnutrition, a finding with a significant clinical and public health importance. This finding should be pursued in larger studies with longer follow-up and optimized dosing.
Risk of Upper Gastrointestinal Bleeding and Gastroduodenal Ulcers in Persons With Schizophrenia: A Danish Cohort Study
Authors: Cotton Cary C. , Farkas Dóra K. , Foskett Nadia , Sørensen Henrik T. , Milosavljevic-Ristic Smiljana , Balas Bogdan , Ehrenstein Vera 
Published: March 2019

INTRODUCTION:
There is little evidence about gastrointestinal (GI) disorders in patients with schizophrenia. We examined association of schizophrenia with upper GI bleeding (UGIB) and nonbleeding ulcers and associated risk factors and mortality.

METHODS:
We used the data linked from population-based registries in Denmark. Among patients with incident schizophrenia in 1980–2011, we computed cumulative incidences and standardized incidence ratios of UGIB, bleeding ulcers, and nonbleeding ulcers compared with the general population; evaluated risk factors for the 3 GI endpoints, including somatic and psychiatric comorbidity; and examined subsequent all-cause mortality.

RESULTS:
Among 39,998 patients with schizophrenia, the standardized incidence ratios were 2.92 (95% confidence interval (CI), 2.76–3.08) for UGIB, 2.36 (95% CI, 2.15–2.58) for bleeding ulcers, and 2.00 (95% CI, 1.87–2.15) for nonbleeding ulcers. Risk factors for UGIB and nonbleeding ulcers included age, somatic comorbidity, and medication use. UGIB and nonbleeding ulcers were associated with the subsequent increase in mortality.

CONCLUSIONS:
Schizophrenia is associated with an increased risk of UGIB and nonbleeding ulcers, whose risk factors in patients with schizophrenia are similar to those in the general population.
Impact of Non-Alcoholic Fatty Liver Disease on Cardiovascular Outcomes in Patients With Stable Coronary Artery Disease: A Matched Case–Control Study
Authors: Liu Hui-Hui , Cao Ye-Xuan , Sun Di , Jin Jing-Lu , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Gao Ying , Dong Qiu-Ting , Zhao Xi , Li Sha , Zhang Yan , Liu Geng , Li Jian-Jun 
Published: March 2019

INTRODUCTION:
Whether non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular risk has still been controversial. The reasons for this disparity may be associated with subject selection, events definition, diagnostic criteria of NAFLD, or research methods. The aim of this study was to determine the relationship of NAFLD to cardiovascular disease (CVD) outcomes in patients with stable, new-onset coronary artery disease (CAD).

METHODS:
A matched case–control study based on the cohort with stable, new-onset CAD was implemented in 162 cases (patients who developed all-cause death, non-fatal myocardial infarction and stroke during an average of 11,484 patient-years of follow-up) and 162 controls without cardiovascular events matched with the same sex, the age difference ≤3 years old, and the admission date within 3 months. Abdominal ultrasonography and coronary angiography were performed at admission. COX proportional hazard models and conditional logistic regression analysis were used to assess the effect of NAFLD on CVD outcomes.

RESULTS:
NAFLD was more common in the event group than in the control group (P = 0.012). Kaplan-Meier analysis showed a significant association between NAFLD and CVD outcomes (P = 0.007). Moreover, Cox regression (hazard ratios 1.56; 95% confidence interval, 1.04–2.34, P = 0.031) and conditional logistic regression (odds ratio 2.72, 95% confidence interval, 1.16–6.39, P = 0.022) analyses further demonstrated that NAFLD was an independent risk factor for CVD outcomes.

Conclusions:
NAFLD is indeed an independent predictor of CVD outcomes in patients with stable, new-onset CAD. Further randomized controlled trials may be needed to confirm our findings.
„Arbeitgebermarke Bibliothek“ für kleine und mittlere Bibliotheken
Authors: Haß Torsten 
Published: March 2019

Zusammenfassung
Nicht zuletzt vor dem Hintergrund des demographischen Wandels wird es Bibliotheken künftig eventuell schwerfallen, geeignetes Personal zu gewinnen und zu halten. Das gilt auch für die Anwerbung von Auszubildenden. Der Beitrag beschäftigt sich mit einer Stärkung der „Arbeitgebermarke Bibliothek“ durch zwei Maßnahmen, die einer begrenzten Ressourcen-Verfügbarkeit (Personal, Geld) gerecht werden sollen: einen möglichst interessanten Eintrag in Wikipedia und unorthodoxe Stellenausschreibungen.