bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of combined exercise and nutrition interventions in prefrail or frail older hospitalised patients: a systematic review and meta-analysis
Authors: Han Chad Yixian , Miller Michelle , Yaxley Alison , Baldwin Claire , Woodman Richard , Sharma Yogesh 
Published: December 2020

ObjectivesTo determine the effectiveness of combined exercise-nutrition interventions in prefrail/frail hospitalised older adults on frailty, frailty-related indicators, quality of life (QoL), falls and its cost-effectiveness.DesignRandomised controlled trials (RCTs) of combined exercise-nutrition interventions on hospitalised prefrail/frail older adults ≥65 years were collated from MEDLINE, Emcare, CINAHL, Ageline, Scopus, Cochrane and PEDro on 10 October 2019. The methodological quality was appraised, and data were summarised descriptively or by meta-analysis using a fixed effects model. The standardised mean difference (SMD) or difference of means (MD) with 95% CIs was calculated.ResultsTwenty articles from 11 RCTs experimenting exercise-nutrition interventions on hospitalised older adults were included. Seven articles were suitable for the meta-analyses. One study had low risk of bias and found improvements in physical performance and frailty-related biomarkers. Exercise interventions were mostly supervised by a physiotherapist, focusing on strength, ranging 2–5 times/week, of 20–90 min duration. Most nutrition interventions involved counselling and supplementation but had dietitian supervision in only three studies. The meta-analyses suggest that participants who received exercise-nutrition intervention had greater reduction in frailty scores (n=3, SMD 0.25; 95% CI 0.03 to 0.46; p=0.02) and improvement in short physical performance battery (SPPB) scores (n=3, MD 0.48; 95% CI 0.12 to 0.84; p=0.008) compared with standard care. Only the chair-stand test (n=3) out of the three SPPB components was significantly improved (MD 0.26; 95% CI 0.09 to 0.43; p=0.003). Patients were more independent in activities of daily living in intervention groups, but high heterogeneity was observed (I2=96%, p<0.001). The pooled effect for handgrip (n=3)±knee extension muscle strength (n=4) was not statistically significant. Nutritional status, cognition, biomarkers, QoL, falls and cost-effectiveness were summarised descriptively due to insufficient data.ConclusionsThere is evidence, albeit weak, showing that exercise-nutrition interventions are effective to improve frailty and frailty-related indicators in hospitalised older adults.
The value of inquiring about functional impairments for early identification of inflammatory arthritis: a large cross-sectional derivation and validation study from the Netherlands
Authors: van Dijk Bastiaan T , van Steenbergen Hanna W , Niemantsverdriet Ellis , Brouwer Elisabeth , van der Helm-van Mil Annette HM 
Published: December 2020

ObjectivesHealthcare professionals other than rheumatologists experience difficulties in detecting early inflammatory arthritis (IA) by joint examination. Self-reported symptoms are increasingly considered as helpful and could be incorporated in online tools to assist healthcare professionals, but first their discriminative ability must be assessed. As part of this effort, we evaluated whether inquiring about functional impairments could aid early IA identification.DesignCross-sectional derivation and validation study.SettingData from two Early Arthritis Recognition Clinics (EARC) in the Netherlands were studied, which are easy access outpatient rheumatology clinics intermediary between primary and secondary care for patients in whom general practitioners suspect but are unsure about IA presence.ParticipantsBetween 2010 and 2014, 997 patients consecutively visited the Leiden-EARC (derivation cohort). Patients consecutively visiting the Groningen EARC (2010–2014, n=506) and Leiden-EARC (2015–2018, n=557) served as validation cohorts.Primary and secondary outcome measuresPhysical functioning was assessed with the Health Assessment Questionnaire Disability-Index (HAQ); IA presence by physical joint examination by rheumatologists. HAQ questions were studied individually regarding discriminative ability for IA presence. For the best discriminating question, ORs and positive predictive values (PPVs) for IA presence were determined.ResultsIA was ascertained in 43% (derivation cohort), 53% and 35% (validation cohorts). In the derivation cohort, IA presence associated with higher mean HAQ scores (0.84 vs 0.73, p=0.003). One question on difficulties with dressing equalled discriminative ability of the total HAQ score. ‘Difficulties with dressing’ yielded ORs for IA presence of 1.8 (95% CI 1.4 to 2.4) in the derivation cohort; 2.0 (1.4 to 2.9) and 2.1 (1.5 to 3.1) in the validation cohorts. After adjustments for clinical characteristics these were 1.7 (1.3 to 2.3), 1.6 (1.1 to 2.5) and 1.9 (1.2 to 2.9). PPVs (probabilities of IA for positive answers) ranged 42%–60% and negative predictive values (probabilities of no IA for negative answers) ranged 57%–74%.ConclusionsPatient-reported difficulties with dressing in patients with suspected IA associated with actual IA presence. Although further validation is required, for example, in primary care, this simple question could be of help in future early IA detection tools for healthcare professionals with limited experience in joint examination.
Protocol for the Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: a prospective observational study of delirium in elderly cardiac surgical patients
Authors: Smith S Kendall , Nguyen Thomas , Labonte Alyssa K , Kafashan MohammadMehdi , Hyche Orlandrea , Guay Christian S , Wilson Elizabeth , Chan Courtney W , Luong Anhthi , Hickman L Brian , Fritz Bradley A , Emmert Daniel , Graetz Thomas J , Melby Spencer J , Lucey Brendan P , Ju Yo-El S , Wildes Troy S , Avidan Michael S , Palanca Ben J A 
Published: December 2020

IntroductionDelirium is a potentially preventable disorder characterised by acute disturbances in attention and cognition with fluctuating severity. Postoperative delirium is associated with prolonged intensive care unit and hospital stay, cognitive decline and mortality. The development of biomarkers for tracking delirium could potentially aid in the early detection, mitigation and assessment of response to interventions. Because sleep disruption has been posited as a contributor to the development of this syndrome, expression of abnormal electroencephalography (EEG) patterns during sleep and wakefulness may be informative. Here we hypothesise that abnormal EEG patterns of sleep and wakefulness may serve as predictive and diagnostic markers for postoperative delirium. Such abnormal EEG patterns would mechanistically link disrupted thalamocortical connectivity to this important clinical syndrome.Methods and analysisP-DROWS-E (Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography) is a 220-patient prospective observational study. Patient eligibility criteria include those who are English-speaking, age 60 years or older and undergoing elective cardiac surgery requiring cardiopulmonary bypass. EEG acquisition will occur 1–2 nights preoperatively, intraoperatively, and up to 7 days postoperatively. Concurrent with EEG recordings, two times per day postoperative Confusion Assessment Method (CAM) evaluations will quantify the presence and severity of delirium. EEG slow wave activity, sleep spindle density and peak frequency of the posterior dominant rhythm will be quantified. Linear mixed-effects models will be used to evaluate the relationships between delirium severity/duration and EEG measures as a function of time.Ethics and disseminationP-DROWS-E is approved by the ethics board at Washington University in St. Louis. Recruitment began in October 2018. Dissemination plans include presentations at scientific conferences, scientific publications and mass media.Trial registration numberNCT03291626.
Generalization of Geyer’s commutation relations with respect to the orthogonal group in even dimensions
Authors: Markov Yu. A. , Markova M. A. 
Published: December 2020

AbstractA connection between the deformed Duffin–Kemmer–Petiau (DKP) algebra and an extended system of the parafermion trilinear commutation relations for the creation and annihilation operators $$a^{\pm }_{k}$$

a
k
±

and for an additional operator $$a_{0}$$

a
0

obeying para-Fermi statistics of order 2 based on the Lie algebra $${\mathfrak {s}}{\mathfrak {o}}(2M+2)$$

s
o
(
2
M
+
2
)

is established. An appropriate system of the parafermion coherent states as functions of para-Grassmann numbers is introduced. The representation for the operator $$a_{0}$$

a
0

in terms of generators of the orthogonal group SO(2M) correctly reproducing action of this operator on the state vectors of Fock space is obtained. A connection of the Geyer operator $$a_{0}^{2}$$

a

0

2

with the operator of so-called G-parity and with the CPT- operator $${\hat{\eta }}_{5}$$

η
^

5

of the DKP-theory is established. In a para-Grassmann algebra a noncommutative, associative star product $$*$$

∗

(the Moyal product) as a direct generalization of the star product in the algebra of Grassmann numbers is introduced. Two independent approaches to the calculation of the Moyal product $$*$$

∗

are considered. It is shown that in calculating the matrix elements in the basis of parafermion coherent states of various operator expressions it should be taken into account constantly that we work in the so-called Ohnuki and Kamefuchi’s generalized state-vector space $${\mathfrak {U}}_{\;G}$$

U

G

, whose state vectors include para-Grassmann numbers $$\xi _{k}$$

ξ
k

in their definition, instead of the standard state-vector space $${\mathfrak {U}}$$
U
(the Fock space).
Estimating tie strength in social networks using temporal communication data
Authors: Ureña-Carrion Javier , Saramäki Jari , Kivelä Mikko 
Published: December 2020

AbstractEven though the concept of tie strength is central in social network analysis, it is difficult to quantify how strong social ties are. One typical way of estimating tie strength in data-driven studies has been to simply count the total number or duration of contacts between two people. This, however, disregards many features that can be extracted from the rich data sets used for social network reconstruction. Here, we focus on contact data with temporal information. We systematically study how features of the contact time series are related to topological features usually associated with tie strength. We focus on a large mobile-phone dataset and measure a number of properties of the contact time series for each tie and use these to predict the so-called neighbourhood overlap, a feature related to strong ties in the sociological literature. We observe a strong relationship between temporal features and the neighbourhood overlap, with many features outperforming simple contact counts. Features that stand out include the number of days with calls, number of bursty cascades, typical times of contacts, and temporal stability. These are also seen to correlate with the overlap in diverse smaller communication datasets studied for reference. Taken together, our results suggest that such temporal features could be useful for inferring social network structure from communication data.
Aspects of wave turbulence in preheating III: The case of the two-field models
Authors: Crespo J. A. , de Oliveira H. P. 
Published: December 2020

This work is the continuation of the investigation of aspects of wave turbulence in preheating we started in [J. A. Crespo and H. P. de Oliveira, J. Cosmol. Astropart. Phys. 12 (2019) 045; (2014) 006] but considering several classes of inflationary two-field models. We exhibit the main elements of the wave turbulence phase imprinted in the power spectra of relevant quantities in the time and space domains. As a general feature, the power spectra resemble in their structure to those obtained using the single nonminimally coupled scalar field of the previous work. As a consequence, we obtained an estimate of the temperature corresponding to the thermalized phase from the power spectrum of the total energy density. Another feature allowed by the simulations was the determination of the effective equation of state after taking into account the backreaction of the produced particles.
Unconventional Secretion of PKCδ Exerts Tumorigenic Function via Stimulation of ERK1/2 Signaling in Liver Cancer
Authors: Yamada Kohji , Oikawa Tsunekazu , Kizawa Ryusuke , Motohashi Saya , Yoshida Saishu , Kumamoto Tomotaka , Saeki Chisato , Nakagawa Chika , Shimoyama Yuya , Aoki Katsuhiko , Tachibana Toshiaki , Saruta Masayuki , Ono Masaya , Yoshida Kiyotsugu 
Published: December 2020

Abstract

Expression of human protein kinase C delta (PKCδ) protein has been linked to many types of cancers. PKCδ is known to be a multifunctional PKC family member and has been rigorously studied as an intracellular signaling molecule. Here we show that PKCδ is a secretory protein that regulates cell growth of liver cancer. Full-length PKCδ was secreted to the extracellular space in living liver cancer cells under normal cell culture conditions and in xenograft mouse models. Patients with liver cancer showed higher levels of serum PKCδ than patients with chronic hepatitis or liver cirrhosis or healthy individuals. In liver cancer cells, PKCδ secretion was executed in an endoplasmic reticulum (ER)-Golgi–independent manner, and the inactivation status of cytosolic PKCδ was required for its secretion. Furthermore, colocalization studies showed that extracellular PKCδ was anchored on the cell surface of liver cancer cells via association with glypican 3, a liver cancer–related heparan sulfate proteoglycan. Addition of exogenous PKCδ activated IGF-1 receptor (IGF1R) activation and subsequently enhanced activation of ERK1/2, which led to accelerated cell growth in liver cancer cells. Conversely, treatment with anti-PKCδ antibody attenuated activation of both IGF1R and ERK1/2 and reduced cell proliferation and spheroid formation of liver cancer cells and tumor growth in xenograft mouse models. This study demonstrates the presence of PKCδ at the extracellular space and the function of PKCδ as a growth factor and provides a rationale for the extracellular PKCδ-targeting therapy of liver cancer.

Significance:
PKCδ secretion from liver cancer cells behaves as a humoral growth factor that contributes to cell growth via activation of proliferative signaling molecules, which may be potential diagnostic or therapeutic targets.
A Call to Action: Dismantling Racial Injustices in Preclinical Research and Clinical Care of Black Patients Living with Small Cell Lung Cancer
Authors: Thomas Portia L. , Madubata Chioma J. , Aldrich Melinda C. , Lee Montessa M. , Owonikoko Taofeek K. , Minna John D. , Rudin Charles M. , Sage Julien , Lovly Christine M. 
Published: December 2020

Abstract

Summary:
Small cell lung cancer (SCLC) is an aggressive disease with dismal survival rates and limited therapeutic options. SCLC development is strongly associated with exposure to tobacco carcinogens. However, additional genetic and environmental risk factors that contribute to SCLC pathogenesis are beginning to emerge. Here, we specifically assess disparities pertaining to SCLC in Black populations. In contrast to non–small cell lung cancer, preliminary data suggest that Black individuals may actually be at a lower risk of developing SCLC relative to white individuals. This difference remains unexplained but urgently needs to be verified in larger data sets, because it could provide important new insights and approaches to understanding this recalcitrant tumor. Importantly, little biological information exists on SCLC in Black individuals, and few patient-derived preclinical SCLC models from diverse ancestries are available in the laboratory. Unfortunately, we note strikingly low numbers of Black participants in clinical trials testing new treatments for SCLC. Evidence further indicates that care for patients with SCLC may vary between communities with a large fraction of Black patients and those without. Together, these observations underscore the need to better investigate genetic, environmental, and socioeconomic factors associated with SCLC development, preclinical research, clinical care, and outcomes.
Unanticipated Admission Following Outpatient Laparoscopic Cholecystectomy: Identifying Opportunities for Improvement
Authors: Beck Anna C. , Goffredo Paolo , Gao Xiang , McGonagill Patrick W. , Weigel Ronald J. , Hassan Imran 
Published: December 2020

Background Unanticipated admissions are a burden to the health care system. Over 400 000 outpatient laparoscopic cholecystectomies (LCs) are performed annually in the United States. The aim of this study is to identify causes of unanticipated admissions and modifiable risk factors. Methods Patients undergoing elective outpatient LCs were identified from the 2013-2015 American College of Surgeons National Surgical Quality Improvement Program database. Results A total of 69 376 patients underwent outpatient LC or LC+ intraoperative cholangiogram (IOC); 2027 (2.9%) were admitted after a median of 5 days (interquartile range 3-8). Admission rates varied by preoperative indications: pancreatitis (4.9%), gallstones with obstruction (3.9%), cholecystitis (3.0%), and gallstones without obstruction (2.6%) ( P = .003). The most frequent causes were infection, retained stones, and other GI complications. Patients admitted for infection or cardiopulmonary complications were older with higher American Society of Anesthesiologists (ASA) ( P < .01), while patients with pain and retained stones were younger with lower ASA ( P < .01). Patients who underwent LC+IOC had a lower admission rate due to retained stones (.17% vs. .31% LC, P = .006). Conclusions Unanticipated admissions following outpatient LC occur infrequently for diverse reasons usually within the first week after surgery. Associated factors are patient and disease related and not at all modifiable. In selected patients, increased IOC use may decrease admissions from retained stones.
Factors Affecting Total Operating Time in Patients Undergoing Mastectomy With and Without Reconstruction
Authors: Huang Julian , Wang Melinda , Chagpar Anees 
Published: December 2020

Background Operating room (OR) time varies significantly in patients undergoing mastectomy. We sought to determine factors influencing OR time such that more accurate predictions could be made. Methods Records of patients undergoing mastectomy at our institution between January 2010 and June 2018 were reviewed. Operating Room time was defined as time from incision to dressing. Nonparametric analyses were performed to determine factors associated with OR time. A predictive model using linear regression was created on a training set and evaluated in a separate testing set. Results Our cohort included 1008 female patients who underwent either unilateral or bilateral mastectomy (BM), with or without reconstruction, and with or without concomitant axillary lymph node staging at our institution. The median OR time was 4.67 hours (range; .70-16.35 hours). To create a predictive model, we divided our cohort into a training set of 504 patients and a testing set of 504 patients. Across the training set, body mass index (BMI), BM, nonconventional mastectomies, intraoperative frozen sections, receipt of neoadjuvant chemotherapy, and reconstruction were associated with longer OR times on linear regression. A model generated from these findings on the training set was run on the testing set (Pearson correlation = .743 for predicted vs. actual OR times, P < .001). Conclusion A number of preoperative factors such as BMI, unilateral vs. BM, type of mastectomy and reconstruction, use of intraoperative frozen sections, and receipt of neoadjuvant chemotherapy can influence OR times. Accurate predictions can be made using a simple model incorporating these factors.
From darkness to light: Barriers and facilitators to mental health recovery in the South African context
Authors: de Wet Anneliese , Pretorius Chrisma 
Published: December 2020

Background: South Africa is a low and middle income country facing many challenges in public mental health care and implementation of recovery. Aims: To contribute to what barriers and facilitators to recovery might be for service users in South Africa, from the perspective of service users, carers and service providers from three psychiatric hospitals in the Western Cape province. Method: Interviews and focus groups were conducted with service users, carers and service providers. Interviews and focus groups were transcribed and analysed using atlas.ti software and reflexive thematic analysis, from the bottom up. Results: The barriers, environment, family, public mental health services, stigma and service users’ attitude or behaviour generated, were found to be the most salient. The facilitators to recovery generated were support, family or friends, service providers, structure and empowerment. The need for support was identified as an underlying component to all these themes. Conclusion: Barriers and facilitators to recovery seemed to have both intrapersonal and external sources that intersect at times. Recovery needs to be supported at an individual level, especially through an under-utilised resource such as peer support work, but in conjunction with the development of recovery-enabling environments in services and communities in South Africa.
Nested active learning for efficient model contextualization and parameterization: pathway to generating simulated populations using multi-scale computational models
Authors: Cockrell Chase , Ozik Jonathan , Collier Nick , An Gary 
Published: December 2020

There is increasing interest in the use of mechanism-based multi-scale computational models (such as agent-based models (ABMs)) to generate simulated clinical populations in order to discover and evaluate potential diagnostic and therapeutic modalities. The description of the environment in which a biomedical simulation operates (model context) and parameterization of internal model rules (model content) requires the optimization of a large number of free parameters. In this work, we utilize a nested active learning (AL) workflow to efficiently parameterize and contextualize an ABM of systemic inflammation used to examine sepsis. Contextual parameter space was examined using four parameters external to the model’s rule set. The model’s internal parameterization, which represents gene expression and associated cellular behaviors, was explored through the augmentation or inhibition of signaling pathways for 12 signaling mediators associated with inflammation and wound healing. We have implemented a nested AL approach in which the clinically relevant (CR) model environment space for a given internal model parameterization is mapped using a small Artificial Neural Network (ANN). The outer AL level workflow is a larger ANN that uses AL to efficiently regress the volume and centroid location of the CR space given by a single internal parameterization. We have reduced the number of simulations required to efficiently map the CR parameter space of this model by approximately 99%. In addition, we have shown that more complex models with a larger number of variables may expect further improvements in efficiency.