bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical indications for intravenous immunoglobulin utilization in a tertiary medical center: a 9‐year retrospective study
Authors: Shemer Asaf , Kivity Shaye , Shoenfeld Yehuda 
Published: November 2017

BACKGROUNDIntravenous immunoglobulins (IVIG) are a biologic product originally developed to treat immunocompromised patients. In the past decades, there has been increased utilization of IVIG in autoimmune conditions. The objectives were to evaluate the clinical use of IVIG in the largest tertiary medical center in Israel and to determine top uses, estimate off‐label usage, and assess consumption of this blood product.STUDY DESIGN AND METHODSWe conducted an observational, retrospective study involving all patients who received IVIG from 2007 through 2015. Subjects were classified into five groups according to the indication for treatment.RESULTSA total of 1117 patients were identified. The mean (±SD) ages of adults and children were 55 ± 17 and 8 ± 7 years, respectively. Most common indication for treatment were immune‐mediated conditions (54%), followed by secondary immunodeficiency (28%), primary immunodeficiency (10%), infections (4%), and miscellaneous (4%). The main immune‐mediated conditions treated were hematologic disorders (305 patients, 27%), neurologic disorders (219 patients, 20%), and rheumatologic conditions (79 patients, 7%). Overall, a significant change in study period was observed in the number of patients (p < 0.001), consumption of IVIG (p < 0.01), and amount of IVIG administered per patient (p < 0.01). Fifty‐six percent of the IVIG infusions were given for off‐label Food and Drug Administration (FDA) indications.CONCLUSIONIn this study, we demonstrated that immune‐mediated conditions represent the majority of indications for treatment with IVIG. We observed a 417% increase in IVIG administration (g) over time, attributed mainly to autoimmune diseases. Many indications are still off‐label according to FDA recommendations.
The Effect of Water Loading on Acute Weight Loss Following Fluid Restriction in Combat Sports Athletes
Authors: Reale Reid , Slater Gary , Cox Gregory R. , Dunican Ian C. , Burke Louise M. 
Published: November 2017

Novel methods of acute weight loss practiced by combat sport athletes include “water loading,” the consumption of large fluid volumes for several days prior to restriction. We examined claims that this technique increases total body water losses, while also assessing the risk of hyponatremia. Male athletes were separated into control (n = 10) and water loading (n = 11) groups and fed a standardized energy-matched diet for 6 days. Days 1–3 fluid intake was 40 and 100 ml/kg for control and water loading groups, respectively, with both groups consuming 15 ml/kg on Day 4 and following the same rehydration protocol on Days 5 and 6. We tracked body mass (BM), urine sodium, urine specific gravity and volume, training-related sweat losses and blood concentrations of renal hormones, and urea and electrolytes throughout. Physical performance was assessed preintervention and postintervention. Following fluid restriction, there were substantial differences between groups in the ratio of fluid input/output (39%, p < .01, effect size = 1.2) and BM loss (0.6% BM, p = .02, effect size = 0.82). Changes in urine specific gravity, urea and electrolytes, and renal hormones occurred over time (p < .05), with an interaction of time and intervention on blood sodium, potassium, chloride, urea, creatinine, urine specific gravity, and vasopressin (p < .05). Measurements of urea and electrolyte remained within reference ranges, and no differences in physical performance were detected over time or between groups. Water loading appears to be a safe and effective method of acute BM loss under the conditions of this study. Vasopressin-regulated changes in aquaporin channels may potentially partially explain the mechanism of increased body water loss with water loading.
Energetic Profile of the Basketball Exercise Simulation Test in Junior Elite Players
Authors: Latzel Richard , Hoos Olaf , Stier Sebastian , Kaufmann Sebastian , Fresz Volker , Reim Dominik , Beneke Ralph 
Published: November 2017

Purpose: To analyze the energetic profile of the Basketball Exercise Simulation Test (BEST). Methods: Ten male elite junior basketball players (age 15.5 [0.6] y, height 180 [9] cm, and body mass 66.1 [11.2] kg) performed a modified BEST (20 circuits consisting of jumping, sprinting, jogging, shuffling, and short breaks) simulating professional basketball game play. Circuit time, sprint time, sprint decrement, oxygen uptake (VO2), heart rate, and blood lactate concentration (blc) were obtained. Metabolic energy and metabolic power above rest (Wtot and Ptot), as well as energy share in terms of aerobic (Waer), glycolytic (Wblc), and high-energy phosphates (WPCr), were calculated from VO2 during exercise, net lactate production, and the fast component of postexercise VO2 kinetics, respectively. Results: Waer, Wblc, and WPCr reflect 89% (2%), 5% (1%), and 6% (1%) of total energy needed, respectively. Assuming an aerobic replenishment of PCr energy stores during short breaks, the adjusted energy share yielded Waer 66% (4%), Wblc 5% (1%), and WPCr 29% (1%). Waer and WPCr were negatively correlated (−0.72 and −0.59) with sprint time, which was not the case for Wblc. Conclusions: Consistent with general findings on energy system interaction during repeated high-intensity exercise bouts, the intermittent profile of the BEST relies primarily on aerobic energy combined with repetitive supplementation by anaerobic utilization of high-energy phosphates.
Impact-Induced Muscle Damage and Contact Sports: Etiology, Effects on Neuromuscular Function and Recovery, and the Modulating Effects of Adaptation and Recovery Strategies
Authors: Naughton Mitchell , Miller Joanna , Slater Gary J. 
Published: November 2017

Athletes involved in contact sports are habitually exposed to skeletal-muscle damage in their training and performance environments. This often leads to exercise-induced muscle damage (EIMD) resulting from repeated eccentric and/or high-intensity exercise and to impact-induced muscle damage (IIMD) resulting from collisions with opponents and the playing surface. While EIMD has been an area of extensive investigation, IIMD has received comparatively little research, with the magnitude and time frame of alterations following IIMD not presently well understood. It is currently thought that EIMD results from an overload of mechanical stress that causes ultrastructural damage to the cellular membrane constituents. Damage leads to compromised ability to produce force, which manifests immediately and persists for up to 14 d following exercise exposure. IIMD has been implicated in attenuated neuromuscular performance and recovery and in inflammatory processes, although the underlying course over time remains unclear. Exposure to EIMD leads to an adaptation to subsequent exposures, a phenomenon known as the repeated-bout effect. An analogous adaptation has been suggested to occur following IIMD; however, to date, this contention remains equivocal. While a considerable body of research has explored the efficacy of recovery strategies following EIMD, strategies promoting recovery from IIMD are limited to investigations using animal contusion models. Strategies such as cryotherapy and antioxidant supplementation that focus on attenuating the secondary inflammatory response may provide additional benefit in IIMD and are explored herein. Further research is required to first establish a model of generating IIMD and then explore broader areas around IIMD in athletic populations.
The Effect of Periodization and Training Intensity Distribution on Middle- and Long-Distance Running Performance: A Systematic Review
Authors: Kenneally Mark , Casado Arturo , Santos-Concejero Jordan 
Published: November 2017

This review aimed to examine the current evidence for 3 primary training intensity distribution types: (1) pyramidal training, (2) polarized training, and (3) threshold training. Where possible, the training intensity zones relative to the goal race pace, rather than physiological or subjective variables, were calculated. Three electronic databases (PubMed, Scopus, and Web of Science) were searched in May 2017 for original research articles. After analysis of 493 resultant original articles, studies were included if they met the following criteria: (1) Their participants were middle- or long-distance runners; (2) they analyzed training intensity distribution in the form of observational reports, case studies, or interventions; (3) they were published in peer-reviewed journals; and (4) they analyzed training programs with a duration of 4 wk or longer. Sixteen studies met the inclusion criteria, which included 6 observational reports, 3 case studies, 6 interventions, and 1 review. According to the results of this analysis, pyramidal and polarized training are more effective than threshold training, although the latest is used by some of the best marathon runners in the world. Despite this apparent contradictory finding, this review presents evidence for the organization of training into zones based on a percentage of goal race pace, which allows for different periodization types to be compatible. This approach requires further development to assess whether specific percentages above and below race pace are key to inducing optimal changes.
Validity and Reliability of the Cycleops Hammer Cycle Ergometer
Authors: Lillo-Bevia José R. , Pallarés Jesús G. 
Published: November 2017

Purpose: To validate the new drive indoor trainer Hammer designed by Cycleops®. Methods: A total of 11 cyclists performed 44 randomized and counterbalanced graded exercise tests (100–500 W) at 70-, 85-, and 100-rpm cadences in seated and standing positions on 3 different Hammer units, while a scientific SRM system continuously recorded cadence and power output data. Results: No significant differences were detected between the 3 Hammer devices and the SRM for any workload, cadence, or pedaling condition (P value between 1.00 and .350), except for some minor differences (P = .03 and .04) found in the Hammer 1 at low workloads and for Hammer 2 and 3 at high workloads, all in seated position. Strong intraclass correlation coefficients were found between the power output values recorded by the Hammers and the SRM (≥.996; P = .001), independently from the cadence condition and seated position. Bland–Altman analysis revealed low bias (−5.5 to 3.8) and low SD of bias (2.5–5.3) for all testing conditions, except marginal values found for the Hammer 1 at high cadences and seated position (9.6 [6.6]). High absolute reliability values were detected for the 3 Hammers (150–500 W; coefficient of variation <1.2%; SEM <2.1). Conclusions: This new Cycleops trainer is a valid and reliable device to drive and measure power output in cyclists, providing an alternative to larger and more expensive laboratory ergometers and allowing cyclists to use their own bicycles.
Cell-Free DNA as an Earlier Predictor of Exercise-Induced Performance Decrement Related to Muscle Damage
Authors: Andreatta Michely V. , Curty Victor M. , Coutinho João Victor S. , Santos Miguel Ângelo A. , Vassallo Paula F. , de Sousa Nuno F. , Barauna Valério G. 
Published: November 2017

Purpose: To evaluate whether cell-free DNA (cfDNA) levels increase immediately after an acute light and heavy resistance exercise (RE) bout and whether cfDNA levels are associated with functional muscle capacity up to 48 h after an exercise session. Methods: Twenty healthy volunteers performed 3 sets of leg-press RE with 80% of 1-repetition maximum (1RM) (RE80) or 40% of 1RM (RE40) with similar exercise volume. Blood lactate was measured after completion of the 3 sets. Creatine kinase, cfDNA, and jump performance were evaluated before (pre) exercise, immediately postexercise (post-0h), and every 24 h until 48 h. Results: Lactate concentration increased similarly in both groups (RE40 4.0 [1.3] mmol/L; RE80 4.8 [1.3] mmol/L). No changes were observed in squat-jump and countermovement-jump performance after RE40; however, both jumps remained reduced until 48 h in the RE80 group. Creatine kinase concentration increased post-24h only in the RE80 group (pre 128.8 [73.7] U/L to post-24h 313.8 [116.4] U/L). cfDNA concentration increased post-0h only in the RE80 group (pre 249.8 [82.3] ng/mL to post-0h 406.3 [67.2] ng/mL). There was a negative correlation between post-0h cfDNA concentration and post-24h squat jump (r = −.521; P = .01) and post-0h cfDNA concentration and post-24h countermovement jump (r = −.539; P = .01). Conclusion: cfDNA increases in response to RE intensity even when not performed until exhaustion. cfDNA measured immediately after RE is a promising biomarker for muscle-performance decrement up to 48 h after a RE bout.
Salivary Biomarkers and Training Load During Training and Competition in Paralympic Swimmers
Authors: Sinnott-O’Connor Ciara , Comyns Thomas M. , Nevill Alan M. , Warrington Giles D. 
Published: November 2017

Context: Stress responses in athletes can be attributed to training and competition, where increased physiological and psychological stress may negatively affect performance and recovery. Purpose: To examine the relationship between training load (TL) and salivary biomarkers immunoglobulin A (IgA), alpha-amylase (AA), and cortisol across a 16-wk preparation phase and 10-d competition phase in Paralympic swimmers. Methods: Four Paralympic swimmers provided biweekly saliva samples during 3 training phases—(1) normal training, (2) intensified training, and (3) taper—as well as daily saliva samples in the 10-d Paralympic competition (2016 Paralympic Games). TL was measured using session rating of perceived exertion. Results: Multilevel analysis identified a significant increase in salivary immunoglobulin A (sIgA: 94.98 [27.69] μg·mL−1), salivary alpha-amylase (sAA: 45.78 [19.07] μg·mL−1), and salivary cortisol (7.92 [2.17] nM) during intensified training concurrent with a 38.3% increase in TL. During the taper phase, a 49.5% decrease in TL from the intensified training phase resulted in a decrease in sIgA, sAA, and salivary cortisol; however, all 3 remained higher than baseline levels. A further significant increase was observed during competition in sIgA (168.69 [24.19] μg·mL−1), sAA (35.86 [16.67] μg·mL−1), and salivary cortisol (10.49 [1.89] nM) despite a continued decrease (77.8%) in TL from the taper phase. Conclusions: Results demonstrate that performance in major competition such as Paralympic games, despite a noticeable reduction in TL, induces a stress response in athletes. Because of the elevated stress response observed, modifications to individual postrace recovery protocols may be required to enable athletes to maximize performance across all 10 d of competition.
Effectiveness and Safety of Acupuncture Combined with Madopar for Parkinson—s Disease: A Systematic Review with Meta-Analysis
Authors: Liu Hongjie , Chen Lingxiu , Zhang Zhe , Geng Guozhu , Chen Wenjun , Dong Hanqiu , Chen Liang , Zhan Sha , Li Tianhao 
Published: November 2017

Objective To evaluate the effectiveness and safety of acupuncture combined with Madopar for the treatment of Parkinson's disease (PD), compared to the use of Madopar alone. Methods A systematic search was carried out for randomised controlled trials (RCTs) of acupuncture and Madopar for the treatment of PD published between April 1995 and April 2015. The primary outcome was total effectiveness rate and secondary outcomes included Unified Parkinson's Disease Rating Scale (UPDRS) scores. Data were pooled and analysed with RevMan 5.3. Results were expressed as relative ratio (RR) with 95% confidence interval (CIs). Results Finally, 11 RCTs with 831 subjects were included. Meta-analyses showed that acupuncture combined with Madopar for the treatment of PD can significantly improve the clinical effectiveness compared with Madopar alone (RR=1.28, 95% CI 1.18 to 1.38, P<0.001). It was also found that acupuncture combined with Madopar significantly improved the UPDRS II (SMD=−1.00, 95% CI −1.71 to −0.29, P=0.006) and UPDRS I–IV total summed scores (SMD=−1.15, 95% CI −1.63 to −0.67, P<0.001) but not UPDRS I (SMD=−0.37, 95% CI −0.77 to 0.02, P=0.06), UPDRS III (SMD=−0.93, 95% CI −2.28 to 0.41, P=0.17) or UPDRS IV (SMD=−0.78, 95% CI −2.24 to 0.68, P=0.30) scores. Accordingly, acupuncture combined with Madopar appeared to have a positive effect on activities of daily life and the general condition of patients with PD, but was not better than Madopar alone for the treatment of mental activity, behaviour, mood and motor disability. In the safety evaluation, it was found that acupuncture combined with Madopar was associated with significantly fewer adverse effects including gastrointestinal reactions (RR=0.38, 95% CI 0.23 to 0.65, P<0.001), on–off phenomena (RR=0.27, 95% CI 0.11 to 0.66, P=0.004) and mental disorders (RR=0.24, 95% CI 0.06 to 0.92, P=0.04) but did not significantly reduce dyskinesia (RR=0.64, 95% CI 0.35 to 1.16, P=0.14). Conclusion Acupuncture combined with Madopar appears, to some extent, to improve clinical effectiveness and safety in the treatment of PD, compared with Madopar alone. This conclusion must be considered cautiously, given the quality of most of the studies included was low. Therefore, more high-quality, multicentre, prospective, RCTs with large sample sizes are needed to further clarify the effect of acupuncture combined with Madopar for PD.
Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis
Authors: López-López José A , Sterne Jonathan A C , Thom Howard H Z , Higgins Julian P T , Hingorani Aroon D , Okoli George N , Davies Philippa A , Bodalia Pritesh N , Bryden Peter A , Welton Nicky J , Hollingworth William , Caldwell Deborah M , Savović Jelena , Dias Sofia , Salisbury Chris , Eaton Diane , Stephens-Boal Annya , Sofat Reecha 
Published: November 2017

Abstract

Objective
To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.

Design
Systematic review, network meta-analysis, and cost effectiveness analysis.

Data sources
Medline, PreMedline, Embase, and The Cochrane Library.

Eligibility criteria for selecting studies
Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.

Results
23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2.0-3.0. Apixaban 5 mg twice daily (odds ratio 0.79, 95% confidence interval 0.66 to 0.94), dabigatran 150 mg twice daily (0.65, 0.52 to 0.81), edoxaban 60 mg once daily (0.86, 0.74 to 1.01), and rivaroxaban 20 mg once daily (0.88, 0.74 to 1.03) reduced the risk of stroke or systemic embolism compared with warfarin. The risk of stroke or systemic embolism was higher with edoxaban 60 mg once daily (1.33, 1.02 to 1.75) and rivaroxaban 20 mg once daily (1.35, 1.03 to 1.78) than with dabigatran 150 mg twice daily. The risk of all-cause mortality was lower with all DOACs than with warfarin. Apixaban 5 mg twice daily (0.71, 0.61 to 0.81), dabigatran 110 mg twice daily (0.80, 0.69 to 0.93), edoxaban 30 mg once daily (0.46, 0.40 to 0.54), and edoxaban 60 mg once daily (0.78, 0.69 to 0.90) reduced the risk of major bleeding compared with warfarin. The risk of major bleeding was higher with dabigatran 150 mg twice daily than apixaban 5 mg twice daily (1.33, 1.09 to 1.62), rivaroxaban 20 mg twice daily than apixaban 5 mg twice daily (1.45, 1.19 to 1.78), and rivaroxaban 20 mg twice daily than edoxaban 60 mg once daily (1.31, 1.07 to 1.59). The risk of intracranial bleeding was substantially lower for most DOACs compared with warfarin, whereas the risk of gastrointestinal bleeding was higher with some DOACs than warfarin. Apixaban 5 mg twice daily was ranked the highest for most outcomes, and was cost effective compared with warfarin.

Conclusions
The network meta-analysis informs the choice of DOACs for prevention of stroke in patients with atrial fibrillation. Several DOACs are of net benefit compared with warfarin. A trial directly comparing DOACs would overcome the need for indirect comparisons to be made through network meta-analysis.

Systematic review registration
PROSPERO CRD 42013005324.
Changes in the gut microbiota composition and the plasma ghrelin level in patients withHelicobacter pylori-infected patients with eradication therapy
Authors: Yanagi Hidetaka , Tsuda Ayumi , Matsushima Masashi , Takahashi Shunsuke , Ozawa Genki , Koga Yasuhiro , Takagi Atsushi 
Published: November 2017

ObjectiveTo investigate the influence of antimicrobials on both the gut microbiota structure and the plasma ghrelin level usingHelicobacter pylori-infected patients who underwent eradication therapy.DesignTwentyH. pylori-infected patients (mean age 68.3 years old) who underwent eradication therapy participated in the study. For the therapy, patients had 1 week of triple therapy consisting of amoxicillin, clarithromycin and proton-pump inhibitors. Stool and blood samples were obtained before (S1), immediately after (S2) and/or 3 months after (S3) the therapies. The concentrations of ghrelin and leptin in the blood were assayed using an ELISA. The V3-V4 region of the 16S rRNA gene was amplified using bacterial DNA from the stool, and about 50 000 high-quality amplicons per sample were grouped into operational taxonomic units for bacteriological analyses.ResultsThe Bacteroidetes:Firmicutes (B:F) ratio was significantly greater at S3 than S1 (P<0.01). This increase in the B:F ratio between S3 and S1 was found in 15 out of 20 patients. A significant decrease in the concentration of active ghrelin (P=0.003) in the plasma was observed between S3 and S1. There was a statistically significant correlation between the rate of patients whose B:F ratio increased and that of patients whose active ghrelin level decreased between S3 and S1 according to Fisher’s exact probability test (P=0.03).ConclusionsChanges in the gut microbiota, such as the B:F ratio after treatment with antimicrobials, might cause a change in the plasma ghrelin level, as the direct and earliest target of antimicrobials would be the microbiota rather than the hormone-secreting system.