Δευτέρα 28 Αυγούστου 2017

Word onset phonetic properties and motor artifacts in speech production EEG recordings

Abstract

Electrophysiological research using verbal response paradigms faces the problem of muscle artifacts that occur during speech production or in the period preceding articulation. In this context, this paper has two related aims. The first is to show how the nature of the first phoneme influences the alignment of the ERPs. The second is to further characterize the EEG signal around the onset of articulation, both in temporal and frequency domains. Participants were asked to name aloud pictures of common objects. We applied microstate analyses and time-frequency transformations of ERPs locked to vocal onset to compare the EEG signal between voiced and unvoiced labial plosive word onset consonants. We found a delay of about 40 ms in the set of stable topographic patterns for /b/ relative to /p/ onset words. A similar shift was observed in the power increase of gamma oscillations (30–50 Hz), which had an earlier onset for /p/ trials (∼150 ms before vocal onset). This 40-ms shift is consistent with the length of the voiced proportion of the acoustic signal prior to the release of the closure in the vocal responses. These results demonstrate that phonetic features are an important parameter affecting response-locked ERPs, and hence that the onset of the acoustic energy may not be an optimal trigger for synchronizing the EEG activity to the response in vocal paradigms. The indexes explored in this study provide a step forward in the characterization of muscle-related artifacts in electrophysiological studies of speech and language production.



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Bringing a 'Yes, and' mindset to EMS

By Eric Chase, EMS1 Contributor It was late in December and I was grinding through the holiday season. I was often assessing failures from the last call that didn't end well, compounded with my own feelings of inadequacy. I'd go over the decision points and questions from Monday morning quarterbacks, saying ,"they just don't know what we do anyhow." I wonder why people complain ...

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Temporal Response of Angiogenesis and Hypertrophy to Resistance Training in Young Men.

While endurance exercise training promotes angiogenesis and improves metabolic health, the effect of resistance training on this process is less well defined. We hypothesised that capillarization would increase proportionally, and concurrently, with muscle fiber hypertrophy in response to resistance training in young men. Methods: In this double blind, randomized control trial, 36 males (22 +/- 1 y) were randomized to placebo or protein supplementation, and participated in 12-wk of resistance training. Skeletal muscle biopsies were collected prior to, and following 2, 4, 8, and 12-wk of training. Immunohistochemistry assessed fiber-type specific size and capillarization. Western blot and RT-PCR assessed proteins involved in the molecular regulation of angiogenesis. Results: Resistance training effectively increased type I (15 +/- 4%; P

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Implementing Resistance Training in Secondary Schools: A Cluster RCT.

Purpose: Guidelines recommend that young people engage in muscle-strengthening activities on at least three days per week. The purpose of this study was to examine the impact of a school-based intervention focused on resistance training (RT) for adolescents. Methods: The 'Resistance Training for Teens' intervention was evaluated using a cluster randomized controlled trial with 607 adolescents (50.1% female; 14.1+/-0.5 years) from 16 secondary schools. Teachers were trained to deliver the intervention, which included: (i) an interactive student seminar; (ii) a structured physical activity program, focused on RT; (iii) lunchtime fitness sessions; and, (iv) web-based smartphone apps. The primary outcome was muscular fitness (MF) and secondary outcomes included body mass index (BMI), RT skill competency, flexibility, physical activity, self-efficacy and motivation. Assessments were conducted at baseline, 6- (post-program; primary end-point) and 12-months (follow-up). Outcomes were assessed using linear mixed models, with three potential moderators tested using interaction terms (and sub-group analyses where appropriate). Results: For the primary outcome (MF), a group-by-time effect was observed at 6-months for upper body (2.0 repetitions, 95% confidence interval [CI]: 0.8 to 3.2), but not lower body (-1.4cm, 95% CI: -4.7 to 1.9). At 6-months, there were intervention effects for RT skill competency and self-efficacy, but no other secondary outcomes. Effects for upper body MF and RT skill competency were sustained at 12-months. Despite overall no effect for BMI, there was a group-by-time effect at 12-months among students who were overweight/obese at baseline (-0.55 kg/m2, 95% CI: -1.01 to -0.08). Conclusions: The school-based RT intervention resulted in immediate and sustained improvements in upper body MF and RT skill competency, demonstrating an effective and scalable approach to delivering RT within secondary schools. (C) 2017 American College of Sports Medicine

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Swimming Training Reduces Neuroma Pain by Regulating Neurotrophins.

Introduction: Neuroma formation after peripheral nerve transection leads to severe neuropathic pain in amputees. Previous studies suggested physical exercise could bring beneficial effect on alleviating neuropathic pain. Yet the effect of exercise on neuroma pain still remained unclear. In addition, long-term exercise can affect the expression of neurotrophins (NTs), such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which play key roles in nociceptor sensitization and nerve sprouting following nerve injury. Here, we investigated whether long-term swimming exercise could relieve neuroma pain by modulating NTs expression. Methods: We used a tibial neuroma transposition (TNT) rat model to mimic neuroma pain. Following TNT surgery, rats were performed swimming exercise for 5 weeks. Neuroma pain and tactile sensitivities were detected using von Frey filaments. Immunofluorescence was applied to analyze neuroma formation. NGF and BDNF expression in peripheral neuroma, dorsal root ganglion (DRG) and spinal cord were measured using ELISA and western blotting. Results: TNT led to neuroma formation, induced neuroma pain and mechanical allodynia in hind paw. 5-week swimming exercise inhibited neuroma formation, relieved mechanical allodynia in the hind paw and neuroma pain in the lateral ankle. The analgesic effect lasted for at least one week, even the exercise ceased. TNT elevated the expressions of BDNF and NGF in peripheral neuroma, DRG and spinal cord to different extents. Swimming also decreased the elevation of NTs expression. Conclusions: Swimming exercise not only inhibits neuroma formation induced by nerve transection, but also relieves pain behavior. These effects might be associated with the modulation of NTs. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. (C) 2017 American College of Sports Medicine

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Feedback Leads to Better Exercise Quality in Adolescents with Patellofemoral Pain.

Purpose: Adolescents with patellofemoral pain (PFP) do not comply with their exercise prescription, performing too few and too fast repetitions, compromising recovery. We investigated if real-time feedback on contraction time would improve the ability of adolescents with PFP to perform exercises as prescribed. Methods: A randomised, controlled, participant-blinded, superiority trial with a 6-week intervention of three weekly sessions of three elastic band exercises was undertaken. Forty 15 to 19-year-old adolescents with PFP were randomised to real-time BandCizer(TM)-iPad feedback on contraction time or not by a physiotherapist. The primary outcome was the mean deviation from the prescribed contraction time of 8 seconds per repetition. Secondary outcomes included isometric hip and knee strength, Kujala Patellofemoral Scale and Global Rating of Change. Results: The mean deviation from prescribed 8 seconds per repetition contraction time was 1.5s (+/-0.5) for the feedback group, compared to 4.3s (+/-1.0) for the control group (mean difference: 2.7s (95% CI: 2.2-3.2, P

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Lead Paramedic (Full Time) - Constellis, LLC

Constellis was established in 2010 by a group of operators and investors who sought to combine best-in-class brands, assets and people within the complex risk management industry. Today, the leading provider of risk management and operational support services worldwide, Constellis combines the legacy capabilities and experience of ACADEMI, Triple Canopy, Olive Group, Centerra, Edinburgh International ...

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Paramedic (Part Time) - Constellis, LLC

Constellis was established in 2010 by a group of operators and investors who sought to combine best-in-class brands, assets and people within the complex risk management industry. Today, the leading provider of risk management and operational support services worldwide, Constellis combines the legacy capabilities and experience of ACADEMI, Triple Canopy, Olive Group, Centerra, Edinburgh International ...

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P226 The effect of interstimulus interval between the conditioning and test stimulus on inhibition and fascilitation: A transcranial magnetic stimulation study

Transcranial magnetic stimulation (TMS) technique creates small and temporary electrical current on cerebral cortex via a strong magnetic field. Previous studies investigating the cortical excitability using paired pulse stimulation technique have implemented a suprathreshold test stimulus (TS) conditioned by subthreshold stimulus (CS). If interstimulus interval (ISI) between CS and TS is 1–6ms, motor evoked potential (MEP) amplitude will decrease and it is called short interval intracortical inhibition (SICI).

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S197 Foramen ovale electrodes in epilepsy

Temporal lobe epilepsy is the most prevalent type of epileptic syndrome, and also the most frequent type of surgically treatable epilepsy. But in many cases the laterality is difficult to prove based on non-invasive investigations and scalp EEG. There is broad evidence that suggest that the seizure onset zone may be on the opposite side compared to where the seizure is seen on the scalp EEG due to rapid spread to the contralateral side.Based on these data a technique was developed first by Wieser et al., which allowed direct corticographic recordings from the medial temporal structures without performing invasive surgery.

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O207 Safety and effects on motor cortex excitability of five closely repeated cathodal transcranial direct current stimulations

To assess safety and effects of five cathodal-tDCS (charge density 342,857C/m2) delivered at increasing time intervals in 25h.

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P380 Intelligence is predicted by single-vs-double-sensory brain responses

This research investigated the association between intelligence test scores and gamma-range steady-state power-responses (SS-PR) to an auditory, a visual, and a combined audiovisual stimulation. We hypothesized, and established empirically, that the difference in SS-PR from the mono-modal to the bimodal stimulation (P) is associated with intelligence.

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P222 Diagnostic and therapeutic possibilities of transcranial magnetic stimulation in patients after traumatic brain injury

Recovery of both mental and motor functions is one of the key problems of neurorehabilitation of patients with traumatic brain injury (TBI), accompanied by posttraumatic unconsciousness state (PUS). The purpose of pilot study is to clarify the diagnostic and therapeutic potential of TMS in patients after TBI with impaired motor activity and consciousness.

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Training: How to use the 2016 Emergency Response Guidebook

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Learn the basics on how to use the Emergency Response Guidebook (ERG).

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Training: How to use the 2016 Emergency Response Guidebook

maxresdefault.jpg

Learn the basics on how to use the Emergency Response Guidebook (ERG).

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Training: How to use the 2016 Emergency Response Guidebook

maxresdefault.jpg

Learn the basics on how to use the Emergency Response Guidebook (ERG).

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Training: How to use the 2016 Emergency Response Guidebook

maxresdefault.jpg

Learn the basics on how to use the Emergency Response Guidebook (ERG).

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Top EMS Game Changers – #8: Specialty centers

Hospitals with enhanced capabilities to treat trauma, cardiac care, pediatrics, burns and more are providing specialized care and changing transport algorithms

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Lower airway dimensions in pediatric patients—A computed tomography study

Summary

Background

The aim of this study was to obtain lower airway dimensions in children by means of computed tomography (CT).

Methods

Chest CT scans from 195 pediatric patients (118 boys/77 girls) aged 0.04-15.99 years were analyzed. Tracheal and bronchial lengths, anterior-posterior and lateral diameters, as well as cross-sectional area were assessed at the following levels: mid trachea, right proximal and distal bronchus, proximal bronchus intermedius, and left proximal and distal bronchus. Mediastinal angles of tracheal bifurcation were measured. Data were analyzed by means of linear and polynomial regression plots.

Results

The strongest correlations were found between tracheal and bronchial diameters and age as well as between tracheal and bronchial lengths and body length. All measured airway parameters correlated poorly to body weight. Bronchial angles revealed no association with patient's age, body length, or weight.

Conclusion

This comprehensive anatomical database of lower airway dimensions demonstrates that tracheal and bronchial diameters correlate better to age, and that tracheal and bronchial length correlate better to body length. All measured airway parameters correlated poorly to body weight.



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The role of ultrasound in appropriate endotracheal tube size selection in pediatric patients

Summary

Background

The aim of this prospective study was to investigate the success of ultrasound in pediatric patients in determining the appropriate sized cuffed endotracheal tube and to compare the results with conventional height-based (Broselow) tape and age-based formula tube size.

Methods

One hundred and fifty-two children of 1-10 years of age, who received general anesthesia for adenotonsillectomy were enrolled to the study. In all participants, the transverse diameter of the subglottis was measured with ultrasound during apnea. An endotracheal tube was chosen with the outer diameter matched to the measured subglottic airway diameter. An age-based (Motoyama-Khine) and height-based (Broselow) endotracheal tube size was calculated. If there was resistance to passage of the tube into the trachea or an airway pressure >25 cmH20 was required to detect an audible leak, the endotracheal tube was replaced with internal diameter of 0.5 mm smaller. If there was an audible leak at airway pressure <10 cmH2O, or peak pressure >25 cmH20 or a cuff pressure > 25 cmH2O was required to seal, the tube was changed to the 0.5 mm larger internal diameter. Best-fit tube internal diameter was the resultant tube internal diameter that met the previously stated conditions. The need for endotracheal tube replacement and peak airway pressure were recorded.

Results

The internal diameter of ultrasound determined tube was the same as best-fit tube in 88% of children. Endotracheal tube was replaced in 15 patients with a one size larger, and in three patients with one size smaller tube. Using Bland-Altman analysis, a better agreement was observed with ultrasound measurement rather than height-based estimation and age-based formulas.

Conclusion

Our findings show that subglottic diameter measured by ultrasound appears to be a reliable predictor for the assessment of the subglottic diameter of the airway in estimating appropriate size pediatric endotracheal tube.



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Top EMS Game Changers – #8: Specialty centers

Specialty centers – hospitals with enhanced capabilities to treat specific presenting problems – are far more numerous today than when I transported my first patient on Long Island, New York in 1992. Back then, there were only a few types of emergent patients that we didn't automatically bring to the closest hospital: Major trauma Behavioral disorders dangerous to patients or others ...

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Effect of prolonged vibration to synergistic and antagonistic muscles on the rectus femoris activation during multi-joint exercises

Abstract

Purpose

Unique neuromuscular activation of the quadriceps femoris is observed during multi-joint leg extensions: lower activation of the biarticular rectus femoris (RF) than monoarticular vasti muscles. As one of the potential mechanisms for the lower RF activation, Ia afferent-mediated inhibitory connections between synergistic muscles and/or between agonist and antagonist muscles have been proposed. If this is the major factor, it is hypothesized that RF activation during multi-joint leg extensions increases after prolonged vibration to synergistic and/or antagonist muscles. This study tested the hypothesis.

Methods

Fourteen men exerted maximal voluntary isometric knee extension and flexion and performed submaximal parallel squat before and after one of the following three interventions on different days: prolonged vibration to the vastus lateralis (VL, synergist) or biceps femoris (BF, antagonist), or quiet sitting for 30 min. Muscle activations of the quadriceps femoris and hamstrings were determined using surface electromyography.

Results

After prolonged VL or BF vibration, VL (21%) or BF (30%) activation during isometric contractions significantly decreased, which was significantly correlated with the reduction of the maximal isometric knee extension or flexion strength. The magnitude of RF activation during squat was significantly lower than those of VL and the vastus medialis. No significant increase in RF activation during squat was observed after vibrations.

Conclusion

The findings suggest that lower biarticular RF activation compared with the monoarticular vasti muscles during multi-joint exercises does not result from the modulation by peripheral inhibitory input from Ia afferents originating from synergist and/or antagonist muscles.



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AMP-activated protein kinase and cAMP response element-binding protein activity are associated with distinct postoperative behavioral changes in rats

Abstract

Purpose

To explore the association of AMP-activated protein kinase (AMPK) and cAMP response element-binding protein (CREB) activity with distinct postoperative behavioral changes in rats.

Methods

We performed partial hepatolobectomy in adult rats and aged rats. The learning and memory ability of rats was evaluated by the Barnes maze test on postoperative days 1–4. The expressions of AMPK and phosphorylated CREB (p-CREB) in the CA1 and DG regions of the hippocampus were detected by immunohistochemical assay at 3, 6, 12 and 24 h postoperatively.

Results

Surgery impaired the memory of aged rats but not that of adult rats on postoperative days 2 and 3 (both p < 0.05). Surgery synergistically increased the expressions of AMPK and p-CREB in the CA1 region of hippocampus in aged rats but not in adult rats at 3 and 6 h postoperatively.

Conclusion

Our data suggest that surgery induces cognitive impairment in aged rats. Surgery-induced expression of AMPK and p-CREB in the CA1 region of hippocampus may be involved in this cognitive impairment.



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Doping in Two Elite Athletics Competitions Assessed by Randomized-Response Surveys

Abstract

Background

Doping in sports compromises fair play and endangers health. To deter doping among elite athletes, the World Anti-Doping Agency (WADA) oversees testing of several hundred thousand athletic blood and urine samples annually, of which 1–2% test positive. Measures using the Athlete Biological Passport suggest a higher mean prevalence of about 14% positive tests. Biological testing, however, likely fails to detect many cutting-edge doping techniques, and thus the true prevalence of doping remains unknown.

Methods

We surveyed 2167 athletes at two sporting events: the 13th International Association of Athletics Federations Word Championships in Athletics (WCA) in Daegu, South Korea in August 2011 and the 12th Quadrennial Pan-Arab Games (PAG) in Doha, Qatar in December 2011. To estimate the prevalence of doping, we utilized a "randomized response technique," which guarantees anonymity for individuals when answering a sensitive question. We also administered a control question at PAG assessing past-year use of supplements.

Results

The estimated prevalence of past-year doping was 43.6% (95% confidence interval 39.4–47.9) at WCA and 57.1% (52.4–61.8) at PAG. The estimated prevalence of past-year supplement use at PAG was 70.1% (65.6–74.7%). Sensitivity analyses, assessing the robustness of these estimates under numerous hypothetical scenarios of intentional or unintentional noncompliance by respondents, suggested that we were unlikely to have overestimated the true prevalence of doping.

Conclusions

Doping appears remarkably widespread among elite athletes, and remains largely unchecked despite current biological testing. The survey technique presented here will allow future investigators to generate continued reference estimates of the prevalence of doping.



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Serum Wisteria floribunda agglutinin-positive Mac-2 binding protein predicts hepatocellular carcinoma incidence and recurrence in nucleos(t)ide analogue therapy for chronic hepatitis B

Abstract

Background

Hepatocellular carcinoma (HCC) occurs in chronic hepatitis B (CH-B) patients even after treatment with nucleos(t)ide analogues (NAs) by a mechanism involving an association between the oncogenic factors of integrated HBV and liver fibrosis. An association has been demonstrated between advanced chronic liver disease and elevated levels of Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA(+)-M2BP), a recently discovered serum liver fibrosis marker. Moreover, hepatitis B core-related antigen (HBcrAg) reflects intracellular HBV protein production and its relationship with liver carcinogenesis has been reported. This study aimed to determine whether the incidence and recurrence of HBV-related liver cancer could be predicted using these serum markers.

Methods

We evaluated 141 CH-B cases treated for more than 1 year with NAs. We compared 17 HCC cases with 124 non-HCC cases and evaluated serum WFA(+)-M2BP, HBV markers including HBcrAg, and other clinical factors. We also evaluated 71 CH-B-related HCC cases who started or continued NAs and compared the incidence and recurrence of HCC after successful cancer treatment.

Results

Multivariate analysis showed that the incidence of HCC was significantly associated with higher histological stage and grade before NA treatment and with WFA(+)-M2BP and HBcrAg positivity during NA treatment. The cumulative incidence of HCC was strongly associated with higher WFA(+)-M2BP levels and HBcrAg positivity. HCC recurrence after anti-cancer therapy was also significantly associated with higher WFA(+)-M2BP levels compared with those in cases without recurrence during follow-up.

Conclusion

Serum WFA(+)-M2BP and HBcrAg are useful diagnostic tests for predicting the development and recurrence of HBV-related HCC during NA treatment.



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Combination of alcohol and cigarette smoke induces endoplasmic reticulum stress and cell death in pancreatic acinar cells

Gastroenterology

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Aetna violated HIPAA when envelope windows exposed HIV medication use, attorneys say

Healthcare Finance News

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Adding C-reactive protein and procalcitonin to the MELD score improves mortality prediction in patients with complications of cirrhosis

Journal of Gastroenterology and Hepatology

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MGMA: Medical practices focused on customer service, revenue cycle training

Healthcare Finance News

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Effectiveness of endoscopic treatments for colonic diverticular bleeding

Gastrointestinal Endoscopy

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Induction therapy with biosimilar infliximab in children with Crohn's disease

Journal of Pediatric Gastroenterology and Nutrition

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Persistence of hepatitis B immunity following 3-dose infant primary series in HIV-infected Thai adolescents and immunologic response to revaccination

The Pediatric Infectious Disease Journal

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Preoperative intravenous ibuprofen does not influence postoperative narcotic use in patients undergoing elective hernia repair: A randomized, double-blind, placebo controlled prospective trial

Journal of Pain Research

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Assessment of hepatitis B virus antibody titers in childhood cancer survivors

European Journal of Pediatrics

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Retrospective review of effectiveness and safety of intravenous ferric carboxymaltose given to children with iron deficiency anaemia in one UK tertiary centre

European Journal of Pediatrics

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Combination therapy with capecitabine and cisplatin as second-line chemotherapy for advanced biliary tract cancer

Chemotherapy

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Effects of chronic hepatitis C infection on arterial stiffness

Journal of the American Society of Hypertension

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FDA clears Novo Nordisk's diabetes drug to treat heart diseases

Reuters Health News

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Prevalence of hepatitis B in people living with HIV/AIDS in Latin America and the Caribbean: A systematic review and meta-analysis

BMC Infectious Diseases

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Acute autonomic neuropathy with severe gastrointestinal symptoms in children: A case series

BMC Neurology

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Nicotine chewing gum for the prevention of postoperative ileus after colorectal surgery: A multicenter, double-blind, randomised, controlled pilot study

International Journal of Colorectal Disease

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Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: A systematic review and meta-analysis

International Journal of Epidemiology

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Hepatitis B Virus-Hepatitis D Virus mother-to-child co-transmission: A retrospective study in a developed country

Liver International

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Early faecal microbiota transplantation improves survival in severe clostridium difficile infections

Clinical Infectious Diseases

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Enhanced referral prioritisation for acute adult dietetic services: A randomised control trial to test a web-based decision training tool

Clinical Nutrition

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