bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle Oxygenation Responses to Low-intensity Steady Rate Concentric and Eccentric Cycling
Authors: Rakobowchuk Mark , Isacco Laurie , Ritter Ophélie , Represas Alicia , Bouhaddi Malika , Degano Bruno , Tordi Nicolas , Mourot Laurent 
Published: January 2018

AbstractMuscle deoxygenation responses provide information about the training impulse of an exercise session enabling adaptation to be predicted. Our aim was to investigate muscle oxygenation profiles during prolonged low-intensity eccentric and concentric cycling. Twelve healthy men performed two 45-min exercise sessions of concentric (CON) and eccentric (ECC) cycling, matched for the same heart rate at the start of each session. Mechanical power output during ECC was ~2.5 times that of CON (210±40 W vs. 82±16 W). Oxygen uptake, blood lactate, cardiac output and systolic arterial pressure responses did not differ between exercises. Heart rate was similar at 5 min of each exercise bout but progressively increased during ECC and was higher at 15, 30 and 45 min of ECC compared to CON (+10 bpm), with a trend for a lower stroke volume. Diastolic and mean blood pressures were higher during ECC. No significant differences were observed in muscle oxygenation profiles. Muscle oxygenation responses during prolonged low-intensity exercise were not affected by the type of muscle action at the same metabolic demand and cardiac output.
Ihr seht meine Trauer nicht
Authors: Schmidt Annabell 
Published: January 2018

Zusammenfassung
Protokoll systemische Fallbesprechung Im vierten Teil unserer Serie geht es um eine demenzerkrankte Patientin, die um den Verlust
ihrer kognitiven Fähigkeiten und ihrer Tiere trauert. Lesen Sie, wie das Pflegeteam es schafft, mithilfe der systemischen Fallbesprechung
neue Perspektiven für den Umgang mit der Patientin zu entwickeln. Auch hier möchten wir Sie wieder einladen, sich selbst in die
verschiedenen Rollen hineinzuversetzen. Fallen Ihnen weitere Lösungswege ein? Dann schreiben Sie uns an psych.pflegeheute@thieme.de.
Fachliche Kompetenz und Feingefühl
Authors: Melzer Ruth 
Published: January 2018

Zusammenfassung
Zwangsmaßnahmen im stationären Setting Zwangsmaßnahmen erfordern von Pflegenden ein hohes Maß an fachlicher Kompetenz und Feingefühl.
Unsere Autorin beschreibt, wie Pflegende mit freiheitsentziehenden Maßnahmen umgehen sollten und welche Auswirkungen ihr Verhalten auf die
Patienten hat.
Ein Baum, der Mut macht
Authors: Pfennig Ralf 
Published: January 2018

Zusammenfassung
Praxisprojekt zum Thema Hoffnung Wie lässt sich Recovery im Stationsalltag umsetzen? Unser Autor hat dazu auf seiner psychiatrischen
Station einen Mut-mach-Baum gepflanzt und schildert, welche Früchte er trägt.
Effects of Coenzyme Q10 Supplementation on Serum Values of Gamma-glutamyl transferase, Pseudocholinesterase, Bilirubin, Ferritin, and High-Sensitivity C-Reactive Protein in Women with Type 2 Diabetes
Authors: Gholami Mahsa , Rezvanfar Mohammad , Delavar Mostafa , Abdollahi Mahdi , Khosrowbeygi Ali 
Published: January 2018

Abstract
Background Type 2 diabetes mellitus (T2DM) is a disease associated with increased oxidative stress which results from mitochondrial dysfunction. Coenzyme Q10 (CoQ10) is an essential antioxidant for energy production in mitochondria. The purpose of this randomized double-blind clinical trial study was to evaluate the effects of CoQ10 supplementation on serum values of gamma-glutamyl transferase (GGT), pseudocholinesterase (PchE), bilirubin, ferritin, and high-sensitivity c-reactive protein (hs-CRP) and metabolic syndrome biomarkers in women with T2DM.
Material & Methods Eighty women with T2DM enrolled in this study. Thirty six of them were randomized in the drug group (receiving 100 mg/day of CoQ10) and 44 women were randomized in placebo group. Intervention was continued for 12 weeks. In both groups 35 subjects finished the study and were included in the analysis. Serum levels of the variables were measured before and after supplementation.
Results Serum values of FBS (P=0.039), HOMA-IR (P=0.01), ferritin (P<0.001), total cholesterol (TC) (P=0.006), LDL-C (P=0.007) decreased and HDL-C (P=0.02) increased significantly in the drug group after intervention. Serum levels of triglyceride (P=0.09) decreased marginally in CoQ10 group.
Conclusions The results of the current study had shown that after supplementation with 100 mg/day of CoQ10 for 12 weeks, serum values of FBS, HOMA-IR, TC, LDL-C and ferritin were decreased and values of HDL-C were increased in women with T2DM.
Cardiovascular Risk Factors in Acromegaly: What's the Impact of Disease Control?
Authors: Amado Ana , Araújo Fernando , Carvalho Davide 
Published: January 2018

Abstract
Objective Cardiovascular disease is one of the most important causes of death in acromegalic patients. The aim of this study is to compare the prevalence of cardiovascular risk factors among acromegalic patients and to evaluate the impact of disease control on these factors.
Material and Methods 11 acromegalic patients with active disease and 12 controlled patients were evaluated for blood pressure, body mass index, glucose, coagulation status, and lipid profile. A group of 11 patients with non-functioning pituitary adenomas was used as control population.
Results Significant differences were found in lipid profile, glucose and coagulation status in both active and controlled patients. Higher levels of fasting glucose (151.2±102.5 mg/dL, p=0.05 and 108.3±23.4 mg/dL, p=0.02 for active and controlled patients respectively) and fibrinogen (427.1±61.9 mg/dL, p=0.02 and 437.3±106.6 mg/dL, p=0.04 for active and controlled patients respectively) were present in both acromegalic groups. Active patients had higher levels of antithrombin III (1.1±0.1 U/mL, p=0.005) and the controlled ones had higher levels of high density lipoprotein cholesterol (56.1±12.5 mg/dL, p=0.05), compared with the non-functioning group. The differences between active and controlled acromegalic patients are that the latter have reduced total cholesterol (170.4±31.7 vs 201.7±34.6 mg/dL, p=0.02), lower density lipoprotein cholesterol (96,8±25,2 vs 130.8±31.5 mg/dL, p=0.01) and antithrombin III (1.0±0.2 vs 1.1±0.1 U/mL, p=0.05).
Conclusion There is some reduction in cardiovascular risk factors with control of the disease, but possibly without the return to basal levels.
Extracellular vesicle budding is inhibited by redundant regulators of TAT-5 flippase localization and phospholipid asymmetry
Authors: Beer Katharina B. , Rivas-Castillo Jennifer , Kuhn Kenneth , Fazeli Gholamreza , Karmann Birgit , Nance Jeremy F. , Stigloher Christian , Wehman Ann M. 
Published: January 2018

SignificanceCells must interact with their environment to survive. The lipids and proteins of the plasma membrane send and receive signals at the cell surface to respond to stimuli. When the lipid bilayer of the plasma membrane is damaged, cells release membrane-bound extracellular vesicles to repair the membrane. Cells also release signals on extracellular vesicles to communicate at a distance. Here, we identify proteins that regulate the formation of extracellular vesicles from the plasma membrane, providing additional tools to control their release that can be used to test potential functions of extracellular vesicles. Furthermore, we reveal that proteins regulating the asymmetric localization of the lipid phosphatidylethanolamine are critical for extracellular vesicle release, implicating this abundant but understudied lipid.
Measured and perceived indices of fluid balance in professional athletes. The use and impact of hydration assessment strategies
Authors: Love T.D. , Baker D.F. , Healey P. , Black K.E. 
Published: January 2018

ABSTRACTBackground: To determine athletes perceived and measured indices of fluid balance during training and the influence of hydration strategy use on these parameters. Methods: Thirty‐three professional rugby union players completed a 120 minute training session in hot conditions (35°C, 40% relative humidity). Pre‐training hydration status, sweat loss, fluid intake and changes in body mass (BM) were obtained. The use of hydration assessment techniques and players perceptions of fluid intake and sweat loss were obtained via a questionnaire. Results: The majority of players (78%) used urine colour to determine pre‐training hydration status but the use of hydration assessment techniques did not influence pre‐training hydration status (1.025 ± 0.005 vs. 1.023 ± 0.013 g.ml−1, P = .811). Players underestimated sweat loss (73 ± 17%) to a greater extent than fluid intake (37 ± 28%) which resulted in players perceiving they were in positive fluid balance (0.5 ± 0.8% BM) rather than the measured negative fluid balance (−1.0 ± 0.7% BM). Forty‐eight percent of players used hydration monitoring strategies during exercise but no player used changes in BM to help guide fluid replacement. Conclusion: Players have difficulty perceiving fluid intake and sweat loss during training. However, the use of hydration monitoring techniques did not affect fluid balance before or during training.
An Examination of How Gender May Relate to Communication Styles of Introversion and Extroversion in Nursing Students
Authors: Hunter Elaine Hernandez 
Published: January 2018

Abstract
This research brief explores the relationship between introversion and extroversion communication styles and gender in nursing students. Although communication is integral for delivering safe patient care, teaching about individual communication styles is rare in nursing curricula. The Myers-Briggs Type Indicator (MBTI) was administered to 47 nursing students. Chi-square was used to analyze relationships between introversion/extroversion and gender. The data reported no significance relationships between introverts and extroverts and gender. The findings contribute to nursing education by bringing awareness of communication preference tools like the MBTI.
Innovative Multimodal Training Program for Family Physicians Leads to Positive Outcomes Among Their HIV-Positive Patients
Authors: Kang Helen , Cui Zishan , Chia Jason (Tzu Nien) , Khorsandi Zardoshti Amanda , Barrios Rolando , Lima Viviane Dias , Guillemi Silvia 
Published: January 2018

Abstract:
CME programs can increase physicians' uptake and adherence to clinical guidelines for chronic diseases. We developed an intensive multimodal training program for family physicians to increase their competency in the management and treatment of HIV, through group learning and via close interactions with expert clinicians in HIV. We trained 51 physicians from September 2010 to June 2015 and compared their adherence to clinical guidelines 1 year before and 1 year after the program. We observed significant increases in the physicians' HIV-related clinical competencies, in accordance with clinical guidelines, and an increase in the number of HIV-positive patients seen by these physicians and the number of combination antiretroviral therapies prescribed by these physicians. By combining various pedagogical approaches, as well as creating and encouraging communities of practice, we were able to make a durable impact on physician performance and patient-specific outcomes.
Effect of Angiotensin II on Matrix Metalloproteinase-2 Secretion in Human Umbilical Vein Endothelial Cells
Authors: Sato Ryo , Hiraishi Chika , Yoshida Hiroshi 
Published: January 2018

Abstract:
Matrix metalloproteinase (MMP), which is secreted from vascular cells, is an enzyme-degrading extracellular matrix protein. MMP molecules, including MMP-2, are involved in the destabilization of atherosclerotic plaque and plaque rupture during the development of cardiovascular disease. Angiotensin II (Ang-II), a vascular stimulant associated with cardiovascular disease progression, has been demonstrated to be mainly involved in cardiovascular remodeling of atherosclerosis and cardiac hypertrophy. This study was performed to investigate the regulation of MMP-2 by Ang-II in human umbilical vein endothelial cells (HUVECs). Ang-II significantly increased MMP-2 secretion and MMP-2 messenger RNA expression in HUVECs. The effects of Ang-II were suppressed by the coexistence of telmisartan, a blocker of the Ang-II receptor type 1 (AT1 receptor), or PD123319, a blocker of Ang-II receptor type 2 (AT2 receptor). Especially, PD123319 showed marked suppression of the effect of Ang-II on MMP-2. Therefore, Ang-II-induced upregulation of MMP-2 in HUVECs was considered to be mainly achieved through AT2 receptors, although AT1 and AT2 receptors were expressed in HUVECs, but the detailed mechanisms remain undefined. These findings suggest that Ang-II can enhance MMP-2 mainly through AT2 receptors in endothelial cells, but the significance of circulating MMP-2 as a cardiovascular biomarker requires confirmation in further clinical studies.
Therapeutic Drug Monitoring of Second-Generation Antipsychotics for the Estimation of Early Drug Effect in First-Episode Psychosis: A Cross-sectional Assessment
Authors: Bustillo Mariana , Zabala Arantzazu , Querejeta Imanol , Carton Jaione I. , Mentxaka Oiane , González-Pinto Ana , García Sainza , Meana J. Javier , Eguiluz J. Ignacio , Segarra Rafael 
Published: January 2018

Background:
Studies on therapeutic drug monitoring (TDM) of second-generation antipsychotics (SGAs) have provided conflicting results regarding the association between dose, plasma concentrations, and drug effect and have focused rather on analyzing how individual drugs work. No study has attempted to process data from different SGAs globally to offer a panoramic view of the utility of TDM in clinical practice, and data on patients with first-episode psychosis (FEP) are lacking. This study aimed to assess the relationship between dose, plasma concentrations, and drug effect in a sample of patients with FEP, regardless of the SGA prescribed.

Methods:
Data from 64 compliant patients treated with the same SGA during a 2-month follow-up were recorded. Clinical symptoms were assessed using the Positive and Negative Symptoms Scale and the Montgomery–Åsberg Depression Rating Scale. Adverse effects were rated using the Udvalg für Kliniske Undersogelser scale. SGA doses were standardized to chlorpromazine equivalents, and patients were classified into 3 different ranges according to their plasma concentrations (subtherapeutic, therapeutic, and supratherapeutic).

Results:
Plasma concentration ranges were proportionally related to dose. Patients with supratherapeutic plasma concentrations were treated with doses significantly higher than those with subtherapeutic concentrations. Dose and plasma concentrations were not associated with early drug effect.

Conclusions:
TDM seems unable to accurately estimate the early effects of SGAs in FEP. Ours is the first study to categorize plasma concentrations of SGAs into ranges for joint processing of data from a larger number of patients.
SUBRETINAL ENDOSCOPIC SURGERY TO TREAT LARGE SUBRETINAL HEMORRHAGES SECONDARY TO AGE-RELATED MACULAR DEGENERATION
Authors: Kaga Tatsushi , Kojima Takashi , Yokoyama Sho , Sato Hiroyuki , Yoshida Norihiko , Ichikawa Kazuo 
Published: January 2018

Purpose:
To evaluate the potential of subretinal endoscopic surgery as a novel treatment for large subretinal hemorrhage secondary to age-related macular degeneration.

Methods:
Five patients with large subretinal hemorrhage secondary to age-related macular degeneration underwent subretinal endoscopic surgery, with a minimum follow-up of 12 months.

Results:
The large subretinal hemorrhage was completely removed by subretinal endoscopic surgery without a large retinotomy in all cases. The fibrovascular pigment epithelial detachment including choroidal neovascularization was completely removed in four cases. In three of these cases, the bleeding was confirmed to be originating from one point of rupture in the Bruch membrane, which was treated by coagulation using intraocular diathermy. Although visual acuity improved in three cases, it deteriorated and remained stable in one case each. Fibrovascular pigment epithelial detachment persisted in one patient after surgery; he needed anti–vascular endothelial growth factor therapy, whereas the other four did not because their fibrovascular pigment epithelial detachment was removed. At the final follow-up, no severe postoperative complications, such as retinal detachment or proliferative vitreoretinopathy, were noted.

Conclusion:
Subretinal endoscopic surgery can completely remove subretinal hemorrhage and fibrovascular pigment epithelial detachment including choroidal neovascularization without a large retinotomy. It also aids in the direct and detailed confirmation of subretinal lesions by ophthalmic endoscope.
Psychometric Properties of the Glaucoma Treatment Compliance Assessment Tool (GTCAT) in a Brazilian Population
Authors: Abe Ricardo Y. , Wen Lorena de Campos , Barker Gordon T. , Mansberger Steven L. 
Published: January 2018

Purpose:
To determine the psychometric properties of a reduced version of the Glaucoma Treatment Compliance Assessment Tool (GTCAT), which was translated to Brazilian Portuguese.

Patients and Methods:
We translated into Portuguese the GTCAT using validated techniques and administered it to a group of glaucoma patients using at least 1 ocular hypotensive eye drop medication. We used principal components analysis to determine construct validity, Rasch analysis, and Cronbach α for internal consistency reliability, frequency analysis for floor and ceiling effects, and Spearman ρ for test-retest reliability.

Results:
We included 76 glaucoma patients. Principal component analysis loaded 14 questions into 7 components that were consistent with the Health Belief Model. The components were related to “barriers due to lack of drops,” “self-efficacy,” “experience of negative effects of the disease,” “well-being,” “general glaucoma knowledge,” “glaucoma symptoms,” and “cues-to-action.” No statements had floor or ceiling effects, and all statements had acceptable test-retest reliability. Components had internal consistency Cronbach α reliability between 0.125 and 0.794. and average Spearman ρ reliability was 0.73, ranging from 0.44 to 1.00. According to Rasch analysis, the mean (±SD) of the person measures was 0.24±0.15 logits, person separation index was 0.58, and person reliability 0.25.

Conclusions:
The Portuguese-translated version of the GTCAT showed acceptable psychometric properties. With further refinement, clinicians and researchers could use it to better investigate glaucoma adherence issues in the Brazilian population.
Is There an Optimum Duration of Fluid Bolus in Pediatric Septic Shock? A Critical Appraisal of “Fluid Bolus Over 15–20 Versus 5–10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock: A Randomized Controlled Trial” by Sankar et al (Pediatr Crit Care Med 2017; 18:e435–e445)
Authors: Russell Mark J. , Kanthimathinathan Hari Krishnan 
Published: January 2018

Objectives:
To review the findings and discuss the implications of a longer duration for fluid boluses in the resuscitation of children with septic shock.

Data Sources:
We performed a PubMed.gov search using the criteria “Fluid Bolus” and “Children” and “Septic Shock,” which yielded 29 references.

Study Selection:
One trial compared different durations of fluid boluses in pediatric septic shock and was therefore selected for critical appraisal. (Sankar J, Ismail J, Sankar MJ, et al: Fluid Bolus Over 15–20 Versus 5–10 Minutes Each in the First Hour of Resuscitation in Children with Septic Shock: A Randomized Controlled Trial. Pediatr Crit Care Med 2017; 18:e435–e445.)

Data Extraction:
This trial compared the effectiveness of 20 mL/kg fluid boluses, in children with septic shock, given over 15–20 versus 5–10 minutes in terms of need for invasive ventilation and/or increase in oxygenation index by 5 from baseline at 6 and 24 hours post initial fluid resuscitation. The relative risk of the primary outcome was 0.62 (p = 0.04; 95% CI, 0.39–0.99) at 6 hours and 0.63 (p = 0.02; 95% CI, 0.42–0.93) at 24 hours.

Data Synthesis:
Fragility Index calculations for the primary outcomes of this trial were 1 and 2. Therefore, only one and two children would have needed different outcomes to have given nonsignificant p values greater than 0.05. Analysis of the results did not support the early stopping of this trial at the interim period.

Conclusions:
The article reviewed does not support a change in practice to a longer duration of fluid bolus. The “push” technique for titration of fluid boluses in pediatric septic shock should continue to be the method of choice. Critical Care trials using binary outcomes as endpoints should publish Fragility Index results to aid interpretation and generate stronger conclusions.
Analysis of Pediatric Trauma in Combat Zone to Inform High-Fidelity Simulation Predeployment Training*
Authors: Reeves Patrick T. , Auerbach Marc M. , Le Tuan D. , Caldwell Nicole W. , Edwards Mary J. , Mann-Salinas Elizabeth A. , Gurney Jennifer M. , Stockinger Zsolt T. , Borgman Matthew A. 
Published: January 2018

Objectives:
The military uses “just-in-time” training to refresh deploying medical personnel on skills necessary for medical and surgical care in the theater of operations. The burden of pediatric care at Role 2 facilities has yet to be characterized; pediatric predeployment training has been extremely limited and primarily informed by anecdotal experience. The goal of this analysis was to describe pediatric care at Role 2 facilities to enable data-driven development of high-fidelity simulation training and core knowledge concepts specific to the combat zone.

Setting and Patients:
A retrospective review of the Role 2 Database was conducted on all pediatric patients (< 18 yr) admitted to Role 2 in Afghanistan from 2008-2014.

Interventions:
Three cohorts were determined based on commercially available simulation models: Group 1: less than 1 year, Group 2: 1-8 years, Group 3: more than 8 years. The groups were sub-stratified by point of injury care, pre-hospital management, and Role 2 facility medical/surgical management.

Measurements and Main Results:
Appropriate descriptive statistics (chi square and Student t test) were utilized to define demographic and epidemiologic characteristics of this population. Of 15,404 patients in the Role 2 Database, 1,318 pediatric subjects (8.5%) were identified. The majority of patients were male (80.0%) with a mean age of 9.5 years (± sd, 4.5). Injury types included: penetrating (56%), blunt (33%), and burns (7%). Mean transport time from point of injury to Role 2 was 198 minutes (±24.5 min). Mean Glasgow Coma Scale and Revised Trauma Score were 14 (± 0.1) and 7.0 (± 1.4), respectively. Role 2 surgical procedures occurred for 424 patients (32%). Overall mortality was 4% (n = 58).

Conclusions:
We have described the epidemiology of pediatric trauma admitted to Role 2 facilities, characterizing the spectrum of pediatric injuries that deploying providers should be equipped to manage. This analysis will function as a needs assessment to facilitate high-fidelity simulation training and the development of “pediatric trauma core knowledge concepts” for deploying providers.