bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamics of Locomotor Fatigue during Supra-critical Power Exercise
Authors: SWISHER AUSTIN R. , KOEHN BLAKE , YONG STANLEY , CUNHA JONATHAN , FERGUSON CARRIE , CANNON DANIEL T. 
Published: March 2019

ABSTRACT

Purpose
We aimed to measure 1) the dynamics of locomotor fatigue during constant supra-critical power cycling and 2) the magnitude of any reserve in locomotor power at intolerance to constant and ramp-incremental cycling in recreationally active volunteers.

Methods
Fifteen participants (7 women and 8 men, 22 ± 3 yr, 3.34 ± 0.67 L·min−1 V˙O2peak) completed ramp-incremental and very-heavy constant power (205 ± 46 W) exercise to the limit of tolerance. Immediately after intolerance, the ergometer was switched into the isokinetic mode, and participants completed a short (~5 s) maximal isokinetic effort at 70 rpm. The time course of locomotor fatigue during constant supra-critical power exercise was characterized with these short maximal isokinetic sprints at 30, 60, 120, and 180 s and at the limit of tolerance. Each bout was terminated after the isokinetic sprint.

Results
Constant power exercise duration was 312 ± 37 s. Isokinetic power production values at 30, 60, 120, and 180 s and at the limit of tolerance (at 312 ± 37 s) was 609 ± 165, 503 ± 195, 443 ± 157, 449 ± 133, and 337 ± 94 W, respectively. Of the total decline in isokinetic power, ~36% occurred within the first minute of exercise, and significant (P < 0.05) reductions in isokinetic power occurred at all time points versus the baseline maximal isokinetic power (666 ± 158 W). In addition, a significant power reserve of 132 ± 74 W (64% of the task requirement) and 119 ± 80 W (47%) was present at the limit of constant power and ramp-incremental exercise, respectively.

Conclusions
Locomotor fatigue occurred rapidly during supracritical power exercise with pseudo-exponential kinetics. Instantaneous isokinetic power production at the limit of tolerance exceeded that of the task requirement, regardless of the constant or ramp work rate profile. Thus, the perceptual and physiologic limits were dissociated at the limit of tolerance in recreationally active volunteers.
Prevalence of human immunodeficiency virus and Hepatitis (B & C) among drug users in a tertiary care public hospital
Authors: Asif Aftab , Ayub Sumaira , Komal Afreen , Noor Shahbaz , Jalal Umer 
Published: March 2019

Objective: To find out the prevalence of human immunodeficiency virus (HIV) and Hepatitis (B & C) among the drug users in a tertiary care public hospital.
Methods: The study was conducted at addiction ward of Mayo Hospital Lahore. A total of 453 drug users were admitted in drug addiction ward from 1st of August 2016 to 31st of July 2017. Their history was taken using self-constructed case history form and they were screened for HIV and hepatitis (B & C). Additionally three types of screening tests including Unigold, Determine and Bioline were used for HIV screening.
Results: Of 402 (100%) drug users, 394 (98%) were male and 8 (2%) were female. Their mean age was 32.2 (8.8) years. Overall prevalence of HIV virus was 21.1%, Hepatitis C 34.3% and Hepatitis B 3.2% in drug users. Among HIV positive drug users, 84.7% drug users took drugs through injections as compared to 15.3% who took drugs orally. Among HCV positive drug users, 68.9% drug users took drugs through injections as compared to 31.1% oral drug users. Relapse rate of drug use among all drug users was also very high as 83.3%. Of these drug users, 47.2% had previously sought treatment while other 52.8% never sought any treatment. Family history of drug abuse indicated that 32.2% drug users had family members who were also drug users. Moreover, about 11.4% drug users had previous history of blood transfusion.
Conclusion: HIV and hepatitis B & C were prevalent among drug users specially those who took drugs through injections. Relapse rate was significantly high and history of drug use in family may also predispose an individual towards becoming a drug addict.
How to cite this:Asif A, Ayub S, Komal A, Noor S, Jalal U. Prevalence of human immunodeficiency virus and Hepatitis (B & C) among drug users in a tertiary care public hospital. Pak J Med Sci. 2019;35(2):459-463. doi: https://doi.org/10.12669/pjms.35.2.500
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.
When is deceased organ donation suitable? A critical reflection on medical criteria
Authors: Ahmad HR , Haider SG , Rizvi Adib , Naqvi Anwar 
Published: March 2019

How to cite this:Ahmad HR , Haider SG , Rizvi A, Naqvi A. When is deceased organ donation suitable? A critical reflection on medical criteria. Pak J Med Sci. 2019;35(2):581-582. doi: https://doi.org/10.12669/pjms.35.2.570
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.
Sociodemographic determinants associated with parental knowledge of screening services for thalassemia major in Lahore
Authors: Manzoor Iram , Zakar Rubeena 
Published: March 2019

Objective: To assess the sociodemographic factors affecting parental knowledge regarding availability of screening services for thalassemia major.
Methods: A cross sectional study was conducted among biological parents of thalassemic children at three registered centers of blood transfusion in Lahore. A sample of 186 parents was selected through systematic random sampling. A pretested questionnaire was used to collect data. IRB clearance was obtained and informed consent was taken before data collection. Data was analyzed at SPSS version 23 and chi square test was applied and p value was fixed at ≤ 0.05 as significant.
Results: Parents of registered thalassemic children have adequate knowledge about Disease transmission and screening services. 91% of the participants knew that thalassemia major gets transmitted through parents. Cousin marriage was mentioned as a source of transmission by 77% of the participants. 91% of the parents knew about prenatal screening and 89% about premarital screening. Knowledge of parents was significantly associated with male gender, higher education and income.
Conclusion: Male gender, higher education and income are associated with better knowledge of parents.
How to cite this:Manzoor I, Zakar R. Sociodemographic determinants associated with parental knowledge of screening services for thalassemia major in Lahore. Pak J Med Sci. 2019;35(2):483-488. doi: https://doi.org/10.12669/pjms.35.2.613
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.
Needle temperature and pain perception in the treatment of rheumatic heart disease
Authors: Thomas Nisha , Andrews Rachel , Kaur Sukhpal , Juneja Rajnish , Saxena Anita 
Published: March 2019

Aim: Patients with rheumatic heart disease (RHD) are committed to lifelong secondary prophylaxis with antibiotics. The study was conducted to evaluate the effect of cold needle to decrease the pain associated with this injection. Material and methods: A randomised crossover single-blinded study was conducted among 100 patients receiving penicillin with room-temperature needle and cold needle (0–2oC) in random order. Pain was evaluated using numerical pain rating scale and bio-physiological measures. Results: There was a significant decrease in subjective pain score when cold needle was used as compared to room-temperature needle (3.37 ±1.75 vs 5.58 ±1.68, P≤0.0001). Conclusion: Cold needle decreased pain perception of patients receiving intramuscular injection of benzathine penicillin. Pain-reducing technique may be useful in improving compliance of patients receiving benzathine penicillin.
Osteoarthritis management in primary care
Authors: Finney Andrew , Lambourne Hazel , Cottrell Elizabeth 
Published: March 2019

Osteoarthritis is one of the most common forms of musculoskeletal conditions seen in general practice. Not only can it cause pain and discomfort, but it can greatly affect the quality of life of patients who live with this condition Joint pain attributed to osteoarthritis is a leading cause of disability worldwide. In the UK, the burden of osteoarthritis in primary care on both the individual and society is increasing. The National Institute for Health and Care Excellence offer a guideline for osteoarthritis with recommended core treatments that are at the centre of disease management and suitable for all patients. This article will focus on osteoarthritis and its management, and suggest ways in which practice nurses can address joint pain with their patients.
How group consultations are changing respiratory care
Authors: Nelson Sara , Craig Georgina 
Published: March 2019

Group consultations have been used in practice for over a decade; however, evidence of its use for children and young people is limited. Sara Nelson and Georgina Craig explore their effectiveness in paediatric respiratory reviews across three London practices Group consultations have been recognised as an effective way of delivering planned care and reviews of adult patients for a number of years. They improve the experience of care for both patients and staff. This project sought to establish if group consultations could be used in the care of children and young people and their families within three community settings. This small study demonstrated a positive impact for both clinicians and patients and highlighted the opportunities group consultations create to provide more holistic, integrated care by applying this new model of care delivery.
Key developments in case law: assessing competence in minors
Authors: Young Andy 
Published: March 2019

In this article, Andy Young discusses the complicated legal structure of medical consent for minors. When patients are minors, it is important for the health professional to be aware of what the law requires to treat and manage these patients Primary care is fundamentally about first-contact healthcare accessible to all. It is undifferentiated by age, gender or disease modality, and it is about the continuity of a clinical relationship over time, coordinated across sectors, and interventions that focus on both the individual and the wider population and community. Conveying relevant information about treatment and risk can be problematic, particularly in relation to minors, but it is nevertheless vital that health professionals promote autonomy in decision-making. This requires effective and sensitive communication, with consideration as to how information is framed and presented to patients and their families, as the communication process has a strong influence on how people understand, remember and evaluate information ( Brown, 2006 ).
Diagnostic Accuracy of Neutrophil Gelatinase-Associated Lipocalin for Predicting Early Diabetic Nephropathy in Patients with Type 1 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis
Authors: Kapoula Georgia V , Kontou Panagiota I , Bagos Pantelis G 
Published: March 2019

AbstractBackgroundCurrently, there is a lack of prediction markers for diabetic nephropathy (DN) in patients with type 1 and type 2 diabetes mellitus (T1DM/T2DM). The aim of this systematic review and meta-analysis was to evaluate the value of a promising biomarker, neutrophil gelatinase-associated lipocalin (NGAL), in both serum and urine for the diagnosis of early DN in T1DM and T2DM patients with different stages of albuminuria.MethodsA comprehensive search was performed on PubMed by 2 reviewers until September 2018. Studies in which (a) the degree of DN was determined according to the urinary albumin/creatinine ratio and (b) NGAL was measured in healthy individuals and in diabetes patients with DN were included in the meta-analysis. For each study, a 2 × 2 contingency table was formulated. Sensitivity, specificity, and other estimates of accuracy were calculated using a bivariate random effects model. The hierarchical summary ROC method was used to pool data and to evaluate the area under the curve (AUC). The sources of heterogeneity were explored by subgroup analysis. Publication bias was assessed using the Deeks test.ResultsThe meta-analysis enrolled 22 studies involving 683 healthy individuals and 3249 patients with diabetes, of which 488 were T1DM and 2761 were T2DM patients. Overall, pooled sensitivity and specificity among the different settings analyzed ranged from 0.42 (95% CI, 0.22–0.66) to 1.00 (95% CI, 0.99–1.00) and 0.72 (95% CI, 0.62–0.80) to 0.98 (95% CI, 0.50–1.00) in T2DM patients, respectively. For T1DM patients, the corresponding estimates were 0.71 (95% CI, 0.59–0.81) to 0.89 (95% CI, 0.64–0.97) and 0.72 (95% CI, 0.62–0.80) to 0.79 (95% CI, 0.67–0.87). The AUC of NGAL for T2DM patients ranged from 0.69 (95% CI, 0.65–0.73) to 1.00 (95% CI, 0.99–1.00) in the different settings.ConclusionThe results of this meta-analysis suggest that NGAL in both serum and urine can be considered a valuable biomarker for early detection of DN in diabetes patients.
Optical Technologies for Endoscopic Real-Time Histologic Assessment of Colorectal Polyps: A Meta-Analysis
Authors: Mason Sam E. , Poynter Liam , Takats Zoltan , Darzi Ara , Kinross James M. 
Published: March 2019

OBJECTIVES:
Accurate, real-time, endoscopic risk stratification of colorectal polyps would improve decision-making and optimize clinical efficiency. Technologies to manipulate endoscopic optical outputs can be used to predict polyp histology in vivo; however, it remains unclear how accuracy has progressed and whether it is sufficient for routine clinical implementation.

METHODS:
A meta-analysis was conducted by searching MEDLINE, Embase, and the Cochrane Library. Studies were included if they prospectively deployed an endoscopic optical technology for real-time in vivo prediction of adenomatous colorectal polyps. Polyposis and inflammatory bowel diseases were excluded. Bayesian bivariate meta-analysis was performed, presenting 95% confidence intervals (CI).

RESULTS:
One hundred two studies using optical technologies on 33,123 colorectal polyps were included. Digital chromoendoscopy differentiated neoplasia (adenoma and adenocarcinoma) from benign polyps with sensitivity of 92.2% (90.6%–93.9% CI) and specificity of 84.0% (81.5%–86.3% CI), with no difference between constituent technologies (narrow-band imaging, Fuji intelligent Chromo Endoscopy, iSCAN) or with only diminutive polyps. Dye chromoendoscopy had sensitivity of 92.7% (90.1%–94.9% CI) and specificity of 86.6% (82.9%–89.9% CI), similarly unchanged for diminutive polyps. Spectral analysis of autofluorescence had sensitivity of 94.4% (84.0%–99.1% CI) and specificity of 50.9% (13.2%–88.8% CI). Endomicroscopy had sensitivity of 93.6% (85.3%–98.3% CI) and specificity of 92.5% (81.8%–98.1% CI). Computer-aided diagnosis had sensitivity of 88.9% (74.2%–96.7% CI) and specificity of 80.4% (52.6%–95.7% CI). Prediction confidence and endoscopist experience alone did not significantly improve any technology. The only subgroup to demonstrate a negative predictive value for adenoma above 90% was digital chromoendoscopy, making high confidence predictions of diminutive recto-sigmoid polyps. Chronologic meta-analyses show a falling negative predictive value over time. A significant publication bias exists.

DISCUSSION:
This novel approach to meta-analysis demonstrates that existing optical technologies are increasingly unlikely to allow safe “resect and discard” strategies and that step-change innovation may be required. A “diagnose and leave” strategy may be supported for diminutive recto-sigmoid polyps diagnosed with high confidence; however, limitations exist in the evidence base for this cohort.
Considering the Supraorganism: Harnessing the Gut Microbiome for Cancer Prevention, Detection, and Treatment
Authors: Hollister Emily B. 
Published: March 2019

Abstract
Although causal relationships between specific microbes and cancer are well recognized, a growing body of evidence suggests that the broader community of gut microbes may influence cancer risk, provide diagnostic insight, shape clinical course, and impact treatment success in the gastrointestinal tract and beyond. In this issue, Murphy et al. reviewed evidence for the role of the microbiome in clinical oncology. Given that the gut microbiome may be modified by treatments ranging from diet and live biotherapeutics to microbial transplantation, microbiome-directed therapies hold tremendous promise for personalized therapies and improved treatment outcomes.
Role of Adjuvant Chemotherapy in Extranodal Follicular Dendritic Cell Sarcoma
Authors: Gupta Amit M. , Goel Mahesh , Sahay Ayushi , Janjal Sneha P. , Patkar Shraddha 
Published: March 2019

Abstract
Extranodal follicular dendritic cell sarcomas (FDCSs) are an uncommon entity, commonly misdiagnosed because of the morphologic similarities with other neoplasias. Previously, FDCSs were not considered a differential diagnosis because of the limited use of immunohistochemistry. Surgical excision is the treatment of choice for localized FDCS. The role of chemotherapy has not been determined for this rare disease. We report 2 cases of metastatic extranodal intra-abdominal FDCS, initially misdiagnosed as gastrointestinal stromal tumor, their clinicopathological features, literature review, and the role of adjuvant chemotherapy.
Strategies to Improve Follow-up After Positive Fecal Immunochemical Tests in a Community-Based Setting: A Mixed-Methods Study
Authors: Selby Kevin , Jensen Christopher D. , Zhao Wei K. , Lee Jeffrey K. , Slam Arielle , Schottinger Joanne E. , Bacchetti Peter , Levin Theodore R. , Corley Douglas A. 
Published: March 2019

OBJECTIVES:
The effectiveness of fecal immunochemical test (FIT) screening for colorectal cancer depends on timely colonoscopy follow-up of positive tests, although limited data exist regarding effective system-level strategies for improving follow-up rates.

METHODS:
Using a mixed-methods design (qualitative and quantitative), we first identified system-level strategies that were implemented for improving timely follow-up after a positive FIT test in a large community-based setting between 2006 and 2016. We then evaluated changes in time to colonoscopy among FIT-positive patients across 3 periods during the study interval, controlling for screening participant age, sex, race/ethnicity, comorbidity, FIT date, and previous screening history.

RESULTS:
Implemented strategies over the study period included setting a goal of colonoscopy follow-up within 30 days of a positive FIT, tracking FIT-positive patients, early telephone contact to directly schedule follow-up colonoscopies, assigning the responsibility for follow-up tracking and scheduling to gastroenterology departments (vs primary care), and increasing colonoscopy capacity. Among 160,051 patients who had a positive FIT between 2006 and 2016, 126,420 (79%) had a follow-up colonoscopy within 180 days, including 67% in 2006–2008, 79% in 2009–2012, and 83% in 2013–2016 (P < 0.001). Follow-up within 180 days in 2016 varied moderately across service areas, between 72% (95% CI 70–75) and 88% (95% CI 86–91), but there were no obvious differences in the pattern of strategies implemented in higher- vs lower-performing service areas.

CONCLUSIONS:
The implementation of system-level strategies coincided with substantial improvements in timely colonoscopy follow-up after a positive FIT. Intervention studies are needed to identify the most effective strategies for promoting timely follow-up.
Alterations of Gut Microbiota in Patients With Irritable Bowel Syndrome Based on 16S rRNA-Targeted Sequencing: A Systematic Review
Authors: Duan Ruqiao , Zhu Shiwei , Wang Ben , Duan Liping 
Published: March 2019

INTRODUCTION:
Alterations of gut microbiota have been thought to be associated with irritable bowel syndrome (IBS). Many studies have reported significant alterations of gut microbiota in patients with IBS based on 16S ribosomal RNA-targeted sequencing. However, results from these studies are inconsistent or even contradictory. We performed a systematic review to explore the alterations of gut microbiota in patients with IBS compared with healthy controls (HCs).

METHODS:
The databases PubMed, Cochrane Library, Web of Science, and Embase were searched for studies published until February 28, 2018, for case–control studies detecting gut microbiota in patients with IBS. Methodological quality was assessed using the Newcastle–Ottawa Scale. The α-diversity and alterations of gut microbiota in patients with IBS compared with HCs were analyzed.

RESULTS:
Sixteen articles involving 777 patients with IBS and 461 HCs were included. Quality assessment scores of the studies ranged from 5 to 7. For most studies, patients with IBS had a lower α-diversity than HCs in both fecal and mucosal samples. Relatively consistent changes in fecal microbiota for patients with IBS included increased Firmicutes, decreased Bacteroidetes, and increased Firmicutes:Bacteroidetes ratio at the phylum level, as well as increased Clostridia and Clostridiales, decreased Bacteroidia and Bacteroidales at lower taxonomic levels. Results for mucosal microbiota were inconsistent.

CONCLUSIONS:
Alterations of gut microbiota exist in patients with IBS and have significant association with the development of IBS. Further studies are needed to draw conclusions about gut microbiota changes in patients with IBS.

TRANSLATIONAL IMPACT:
This knowledge might improve the understanding of microbial signatures in patients with IBS and would guide future therapeutic strategies.
Nutzeranforderungen an Computerarbeitsplätze in Bibliotheken
Authors: Köppen Veit 
Published: March 2019

Zusammenfassung
Anforderungen an den digitalen Wandel erfordern eine kontinuierliche Auseinandersetzung mit der IT-Infrastruktur. Insbesondere in Bibliotheken sind die Meinungen bezüglich der zu bereitstellenden Infrastruktur sehr divergierend. Diese können von reinen Lesearbeitsplätzen bis hin zu VR-Umgebungen reichen. Um wechselnde Anforderungen und Möglichkeiten in einen geeigneten Kontext zu setzen und Entscheidungen für Investitionen in die IT-Infrastruktur auf eine solide Basis zu stellen, sind Befragungen der Nutzer ein adäquates Mittel. In diesem Beitrag wird ein Fragebogen zur Ermittlung des Softwarebedarfs einer Bibliothek vorgestellt. Ausgehend von den Ergebnissen einer Nutzerbefragung in der Universitätsbibliothek der Otto-von-Guericke-Universität Magdeburg werden Schlussfolgerungen für die weitere Entwicklung der Computerarbeitsplätze gezogen.
Die Öffentliche Woiwodschaftsbibliothek Emanuel Smołka in Opole
Authors: Pindera Małgorzata , Wąsowicz Mirosława 
Published: March 2019

Zusammenfassung
Die Veränderungen durch die digitale Revolution betreffen auch die Bibliothekswelt. Bibliotheken müssen im virtuellen Raum präsent sein und ihre Services in sozialen Netzwerken bewerben. Die Woiwodschaftsbibliothek in Opole geht auf die Bedürfnisse des modernen Lesers ein, indem sie ihre Internet-Services und Web 2.0-Aktivitäten ausbaut und verbessert. Der Aufsatz beleuchtet Bibliotheksportale und E-Services in Polen am Beispiel der Woiwodschaftsbibliothek in Opole.
Stärkung des Sonntags, Öffnung der Bibliotheken
Authors: Claßen Marie-Charlotte , Deutsch Lorenz 
Published: March 2019

Zusammenfassung
Bibliotheken haben sich in den letzten 15 Jahren von einem reinen Ausleihort zu einer niederschwelligen Kulturinstitution im Sinne der „dritten Orte“ verändert. Sie sind zu Lern-, Begegnungs- und Ausleihorten geworden, die interkulturelle und intergenerationelle Funktionen übernehmen. Bibliotheken stehen als öffentliche Einrichtung demnach in einer Reihe mit Museen, wissenschaftlichen Bibliotheken, Theatern und Kinos. Anders als diese Einrichtungen dürfen sie sonntags aber nicht geöffnet haben. Es ist Zeit das zu ändern.