bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Choosing Wisely Australia 5 Questions resource and a shared decision-making preparation video: protocol for an online experiment
Authors: Muscat Danielle Marie , Chang Edward Hoi-fan , Thompson Rachel , Cvejic Erin , Tracy Marguerite , Zadro Joshua , Smith Jessica Kathleen , Lindner Robyn , McCaffery Kirsten 
Published: November 2019

IntroductionChoosing Wisely, an international effort to reduce low value care worldwide, considers communication between clinicians and patients during routine clinical encounters a key mechanism for change. In Australia, Choosing Wisely has developed a 5 Questions resource to facilitate better conversations. The primary aim of this study is to evaluate the impact of the Choosing Wisely Australia 5 Questions resource and a video designed to prepare patients for question-asking and participation in shared decision-making on (a) self-efficacy to ask questions and participate in shared decision-making, (b) intention to participate in shared decision-making and (c) a range of secondary outcomes. The secondary aim of this study is to determine whether participants’ health literacy modifies the effects of the interventions.Methods and analysisWe will use 2×2×2 between-subjects factorial design (preparation video: yes, no × Choosing Wisely 5 Questions resource: yes, no × health literacy: adequate, inadequate). Participants will be recruited by an online market research company, presented with a hypothetical non-specific low back pain scenario, and randomised to study groups stratified by health literacy. Quantitative primary and secondary outcome data will be analysed as intention-to-treat using appropriate regression models (ie, linear regression for continuous outcomes, logistic regression for dichotomous categorical outcomes).Ethics and disseminationEthical approval for this study was obtained from the University of Sydney Human Research Ethics Committee (protocol number: 2018/965). The results from this work will be disseminated through peer-reviewed international journals, conferences and updates with collaborating public health bodies. Resources developed for this study will be made available to patients and clinicians following trial completion.Trial registration numberThis trial has been registered with the Australia New Zealand Clinical Trials Registry (trial number: 376477) and the stage is Pre-results.
The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision
Authors: Kellezi Blerina , Wakefield Juliet Ruth Helen , Stevenson Clifford , McNamara Niamh , Mair Elizabeth , Bowe Mhairi , Wilson Iain , Halder Moon Moon 
Published: November 2019

ObjectivesThis study aimed to assess the degree to which the ‘social cure’ model of psychosocial health captures the understandings and experiences of healthcare staff and patients in a social prescribing (SP) pathway and the degree to which these psychosocial processes predict the effect of the pathway on healthcare usage.DesignMixed-methods: Study 1: semistructured interviews; study 2: longitudinal survey.SettingAn English SP pathway delivered between 2017 and 2019.ParticipantsStudy 1: general practitioners (GPs) (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a 4-month follow-up after initial referral assessment.InterventionChronically ill patients experiencing loneliness referred onto SP pathway and meeting with a health coach and/or link worker, with possible further referral to existing or newly created relevant third-sector groups.Main outcome measureStudy 1: health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: patients’ primary care usage.ResultsHealthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging and reduced loneliness.ConclusionsMethodological triangulation offers robust conclusions that ‘social cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating social cure processes into SP initiatives are discussed.
Hepatitis E virus replication in human intestinal cells
Authors: Marion Olivier , Lhomme Sebastien , Nayrac Manon , Dubois Martine , Pucelle Mélanie , Requena Mary , Migueres Marion , Abravanel Florence , Peron Jean Marie , Carrere Nicolas , Suc Bertrand , Delobel Pierre , Kamar Nassim , Izopet Jacques 
Published: November 2019

ObjectiveHepatitis E virus (HEV), one of the most common agent of acute hepatitis worldwide, is mainly transmitted enterically, via contaminated water for HEV genotypes 1 (HEV1) and HEV2, or by eating raw or undercooked infected meat for HEV genotype 3 (HEV3) and HEV4. However, little is known about how the ingested HEV reaches the liver or its ability to replicate in intestinal cells.DesignWe developed human primary cultures of small intestine epithelial cells and intestinal explants obtained from small bowel resections. The epithelial cells were also polarised on transwells. Cells were infected with Kernow-p6 strain or clinically derived virions.ResultsPrimary intestinal cells supported the growth of Kernow-p6 strain and HEV1 and HEV3 clinically derived virions. Polarised enterocytes infected with HEV1 and HEV3 strains released HEV particles vectorially: mostly into the apical compartment with a little basally. Iodixanol density gradient centrifugation of enterocyte-derived HEV virions gave bands at a density of 1.06–1.08 g/cm3, corresponding to that of quasi-enveloped HEV particles. Ribavirin therapy inhibited HEV excretion from the basal surface but not from the apical side of infected human enterocytes. HEV virions also infected intestinal tissue explants. Lastly, HEV RNA and antigen were detected in the intestinal crypts of a chronically infected patient.ConclusionHEV can replicate in intestinal cells and reaches the liver as quasi-enveloped virions.
Curvature invariants and lower dimensional black hole horizons
Authors: Gregoris Daniele , Ong Yen Chin , Wang Bin 
Published: November 2019

AbstractIt is known that the event horizon of a black hole can often be identified from the zeroes of some curvature invariants. The situation in lower dimensions has not been thoroughly clarified. In this work we investigate both ($$2+1$$2+1)- and ($$1+1$$1+1)-dimensional black hole horizons of static, stationary and dynamical black holes, identified with the zeroes of scalar polynomial and Cartan curvature invariants, with the purpose of discriminating the different roles played by the Weyl and Riemann curvature tensors. The situations and applicability of the methods are found to be quite different from that in 4-dimensional spacetime. The suitable Cartan invariants employed for detecting the horizon can be interpreted as a local extremum of the tidal force suggesting that the horizon of a black hole is a genuine special hypersurface within the full manifold, contrary to the usual claim that there is nothing special at the horizon, which is said to be a consequence of the equivalence principle.
Cosmological aspects of sound speed parameterizations in fractal universe
Authors: Jawad Abdul , Butt Sadaf , Rani Shamaila , Asif Khadija 
Published: November 2019

AbstractIn the framework of fractal universe, the unified models of dark energy and dark matter are being presented with the background of homogenous and isotropic FLRW geometry. The aspects of fractal cosmology helps in better understanding of the universe in different dimensions. Relationship between the squared speed of the sound and the equation of state parameter is the key feature of these models. We have used constant as well as variable forms of speed of sound and express it as a function of equation of state parameter. By utilizing the four different forms of speed of sound, we construct the energy densities and pressures for these models and then various cosmological parameters like hubble parameter, EoS parameter, deceleration parameter andOm- diagnostic are investigated. Graphical analysis of these parameters show that in most of the cases EoS parameters and trajectories ofOm-diagnostic corresponds to the quintessence like nature of the universe and the deceleration parameters represent accelerated and decelerated phase. In the end, we remark that cosmological analysis of these models indicates that these models correspond to different well known dark energy models.
Help Me to Help You
Authors: Wright Darryl E. , Fortson Lucy , Lintott Chris , Laraia Michael , Walmsley Mike 
Published: November 2019

The increasing size of datasets with which researchers in a variety of domains are confronted has led to a range of creative responses, including the deployment of modern machine learning techniques and the advent of large scale “citizen science projects.” However, the ability of the latter to provide suitably large training sets for the former is stretched as the size of the problem (and competition for attention amongst projects) grows. We explore the application of unsupervised learning to leverage structure that exists in an initially unlabelled dataset. We simulate grouping similar points before presenting those groups to volunteers to label. Citizen science labelling of grouped data is more efficient, and the gathered labels can be used to improve efficiency further for labelling future data.
To demonstrate these ideas, we perform experiments using data from the Pan-STARRS Survey for Transients (PSST) with volunteer labels gathered by the Zooniverse project, Supernova Hunters and a simulated project using the MNIST handwritten digit dataset. Our results show that, in the best case, we might expect to reduce the required volunteer effort by 87.0% and 92.8% for the two datasets, respectively. These results illustrate a symbiotic relationship between machine learning and citizen scientists where each empowers the other with important implications for the design of citizen science projects in the future.
Visualizing and quantifying the impact of reactive hyperemia on cutaneous microvessels in humans
Authors: Argarini Raden , Smith Kurt J. , Carter Howard H. , Naylor Louise H. , McLaughlin Robert A. , Green Daniel J. 
Published: November 2019

The mechanisms underlying reactive hyperemia (RH) responses in microvessels are poorly understood. Previous assessment tools have not been capable of directly visualizing microvessels during physiological stimulation in humans. Optical coherence tomography (OCT) is capable of imaging and quantifying subcutaneous microvessels as small as ~30 µm. In this study we use OCT to visualize and quantify skin microvascular changes in response to RH for the first time in humans. We also assessed the reproducibility of this technique. OCT and laser Doppler flowmetry (LDF) were used simultaneously to scan cutaneous microvessels in 10 young healthy subjects on 2 days. We applied a speckle decorrelation algorithm to assess OCT images and calculated flow rate, speed, diameter, and density parameters. Measures were obtained at rest (baseline) and 30-s following a 5-min cuff inflation (RH). All data were compared between days. The RH stimulus significantly increased ( P < 0.0001) OCT-derived microvascular diameter (37.6 ± 3.4 vs. 44.5 ± 5.2 µm), flow rate (82.4 ± 23.4 vs. 240.1 ± 58.6 pl/s), speed (48 ± 5.7 vs. 101.5 ± 17.1 µm/s), density (5.1 ± 1.7 vs. 14.6 ± 2.6%), and also LDF-derived flux (12.3 ± 5.7 vs. 31.6 ± 9.1 perfusion units). At baseline, OCT-derived diameter ( r = 0.55), flow rate ( r = 0.64), speed ( r = 0.55), and density ( r = 0.75) showed significant between-day correlations ( P < 0.05), as did LDF results ( r = 0.74). In response to RH, OCT-derived diameter ( r = 0.63) and density ( r = 0.64) showed significant correlations ( P < 0.05), whereas flow rate ( r = 0.45), speed ( r = 0.43), and LDF ( r = 0.26) were less reproducible. Our study is novel in that it establishes the feasibility of using OCT to visualize and quantify microvascular structure and function responses to RH in humans. NEW & NOTEWORTHY This study describes the first evidence in humans that optical coherence tomography provides direct visualization and comprehensive quantification of cutaneous microvascular hemodynamics as a response to reactive hyperemia. This imaging technique will greatly improve human cutaneous microvascular assessment in physiological and clinical settings.
Effect of fatigue-related group III/IV afferent firing on intracortical inhibition and facilitation in hand muscles
Authors: Latella Christopher , van der Groen Onno , Ruas Cassio V. , Taylor Janet L. 
Published: November 2019

Fatiguing exercise causes a reduction in motor drive to the muscle. Group III/IV muscle afferent firing is thought to contribute to this process; however, the effect on corticospinal and intracortical networks is poorly understood. In two experiments, participants performed sustained maximal isometric finger abductions of the first dorsal interosseous (FDI) muscle, with postexercise blood flow occlusion (OCC) to maintain the firing of group III/IV afferents or without occlusion (control; CON). Before and after exercise, single- and paired-pulse transcranial magnetic stimulation (TMS) tested motor evoked potentials (MEPs), intracortical facilitation [ICF (12 ms)], and short-interval intracortical inhibition [SICI2 (2 ms), SICI3 (3 ms)]. Ulnar nerve stimulation elicited maximal M waves (MMAX). For experiment 1 ( n = 16 participants), TMS intensities were 70% and 120% of resting motor threshold (RMT) for the conditioning and MEP stimuli, respectively. For experiment 2 ( n = 16 participants), the MEP was maintained at 1 mV before and after exercise and the conditioning stimulus individualized. In experiment 1, MEP/MMAX was reduced after exercise (~48%, P = 0.007) but was not different between conditions. No changes occurred in ICF or SICI. In experiment 2, MEP/MMAX increased (~27%, P = 0.027) and less inhibition (SICI2: ~21%, P = 0.021) occurred after exercise for both conditions, whereas ICF decreased for CON only (~28%, P = 0.006). MEPs and SICI2 were modulated by fatiguing contractions but not by group III/IV afferent firing, whereas sustained afferent firing appeared to counteract postexercise reductions in ICF in FDI. The findings do not support the idea that actions of group III/IV afferents on motor cortical networks contribute to the reduction in voluntary activation observed in other studies. NEW & NOTEWORTHY This is the first study to investigate, in human hand muscles, the action of fatigue-related group III/IV muscle afferent firing on intracortical facilitation and inhibition. In fatigued and nonexercised hand muscles, intracortical inhibition is reduced after exercise but is not modulated differently by the firing of group III/IV afferents. However, facilitation is maintained for the fatigued muscle when group III/IV afferents fire, but these results are unlikely to explain the reduction in voluntary activation observed in other studies.
Low-load blood flow restriction training induces similar morphological and mechanical Achilles tendon adaptations compared with high-load resistance training
Authors: Centner Christoph , Lauber Benedikt , Seynnes Olivier R. , Jerger Simon , Sohnius Tim , Gollhofer Albert , König Daniel 
Published: November 2019

Low-load blood flow restriction (LL-BFR) training has gained increasing interest in the scientific community by demonstrating that increases in muscle mass and strength are comparable to conventional high-load (HL) resistance training. Although adaptations on the muscular level are well documented, there is little evidence on how LL-BFR training affects human myotendinous properties. Therefore, the aim of the present study was to investigate morphological and mechanical Achilles tendon adaptations after 14 wk of strength training. Fifty-five male volunteers (27.9 ± 5.1 yr) were randomly allocated into the following three groups: LL-BFR [20–35% of one-repetition maximum (1RM)], HL (70–85% 1RM), or a nonexercising control (CON) group. The LL-BFR and HL groups completed a resistance training program for 14 wk, and tendon morphology, mechanical as well as material properties, and muscle cross-sectional area (CSA) and isometric strength were assessed before and after the intervention. Both HL (+40.7%) and LL-BFR (+36.1%) training induced significant increases in tendon stiffness ( P < 0.05) as well as tendon CSA (HL: +4.6%, LL-BFR: +7.8%, P < 0.001). These changes were comparable between groups without significant changes in Young’s modulus. Furthermore, gastrocnemius medialis muscle CSA and plantar flexor strength significantly increased in both training groups ( P < 0.05), whereas the CON group did not show significant changes in any of the evaluated parameters. In conclusion, the adaptive change in Achilles tendon properties following low-load resistance training with partial vascular occlusion appears comparable to that evoked by high-load resistance training. NEW & NOTEWORTHY Low-load blood flow restriction (LL-BFR) training has been shown to induce beneficial adaptations at the muscular level. However, studies examining the effects on human tendon properties are rare. The findings provide first evidence that LL-BFR can increase Achilles tendon mechanical and morphological properties to a similar extent as conventional high-load resistance training. This is of particular importance for individuals who may not tolerate heavy training loads but still aim for improvements in myotendinous function.
Muscle pump-induced inhibition of sympathetic vasomotor outflow during low-intensity leg cycling is attenuated by muscle metaboreflex activation
Authors: Katayama Keisho , Barbosa Thales C. , Kaur Jasdeep , Young Benjamin E. , Nandadeva Damsara , Ogoh Shigehiko , Fadel Paul J. 
Published: November 2019

Muscle sympathetic nerve activity (MSNA) decreases during leg cycling at low intensity because of muscle pump-induced increases in venous return and loading of the cardiopulmonary baroreceptors. However, MSNA increases during leg cycling when exercise is above moderate intensity or for a long duration, suggesting that the sympathoinhibitory effect of the cardiopulmonary baroreflex can be overridden by a powerful sympathoexcitatory drive, such as the skeletal muscle metaboreflex. Therefore, we tested the hypothesis that high-intensity muscle metaboreflex activation attenuates muscle pump-induced inhibition of MSNA during leg cycling. MSNA (left radial nerve) was recorded during graded isolation of the muscle metaboreflex in the forearm with postexercise ischemia (PEI) after low (PEI-L)- and high (PEI-H)-intensity isometric handgrip exercise (20% and 40% maximum voluntary contraction, respectively). Leg cycling (15–20 W) was performed alone and during each PEI trial (PEI-L+Cycling, PEI-H+Cycling). Cycling alone induced a significant decrease in MSNA burst frequency (BF) and total activity (TA). MSNA BF and TA also decreased when cycling was performed during PEI-L. However, the magnitude of decrease in MSNA during PEI-L+Cycling [∆BF: –19 ± 2% ( P < 0.001), ∆TA: –25 ± 4% ( P < 0.001); mean ± SE] was less than that during cycling alone [∆BF: –39 ± 5% ( P = 0.003), ∆TA: –45 ± 5% ( P = 0.002)]. More importantly, MSNA did not decrease during cycling with PEI-H [∆BF: –1 ± 2% ( P = 0.845), ∆TA: +2 ± 3% ( P = 0.959)]. These results suggest that muscle pump-induced inhibition of sympathetic vasomotor outflow during low-intensity leg cycling is attenuated by muscle metaboreflex activation in an intensity-dependent manner. NEW & NOTEWORTHY There are no available data concerning the interaction between the sympathoinhibitory effect of muscle pump-induced cardiopulmonary baroreflex loading during leg cycling and the sympathoexcitatory influence of the muscle metaboreflex. In this study, muscle metaboreflex activation attenuated the inhibition of muscle sympathetic nerve activity (MSNA) during leg cycling. This may explain, in part, the response of MSNA to graded-intensity dynamic exercise in which low-intensity leg cycling inhibits MSNA whereas high-intensity exercise elicits graded sympathoexcitation.
Association of Imaging-Based Body Fat Distribution and Mammographic Density in the Multiethnic Cohort Adiposity Phenotype Study
Authors: Maskarinec Gertraud , Ciba Michelle , Ju Dan , Shepherd John A. , Ernst Thomas , Wu Anna H. , Monroe Kristine R. , Lim Unhee , Wilkens Lynne R. , Le Marchand Loïc 
Published: November 2019

AbstractBackground:As the stronger association of obesity with postmenopausal breast cancer in Asian than white women may be due to body fat distribution, we examined the relation of adiposity measures with percent mammographic density (PMD), a strong predictor of breast cancer incidence.Methods:A total of 938 women from five ethnic groups (69.1 ± 2.7 years) in the Adiposity Phenotype Study (APS) underwent DXA and MRI imaging. PMD was assessed in routine mammograms using a computer-assisted method. Spearman correlation coefficients were computed and general linear models were applied to estimate regression coefficients (β) for PMD per 0.5 SD units of adiposity measures while adjusting for known confounders, including DXA total body fat.Results:For 701 (75%) of the participants (69.1 ± 2.7 years), valid mammograms were obtained. Whereas total body fat, the trunk-to-periphery fat ratio (TPFR), visceral fat (VAT), and subcutaneous fat (SAT) were inversely correlated with PMD (P &lt; 0.0001), the VAT/SAT ratio correlated positively (rspearman = 0.10; P = 0.01). In fully adjusted models, PMD remained inversely related to TPFR and SAT and disappeared for VAT, while it was strengthened for VAT/SAT (β = 0.51; P = 0.009). This relation was stronger in Japanese Americans than other ethnic groups.Conclusions:This is the first study to show an association of a high VAT/SAT ratio with greater PMD, a marker of breast cancer risk after taking into account total body fat.Impact:The results indicate a link between the propensity to accumulate VAT and the amount of fat in the breast (1-PMD), which may influence the relation of obesity with breast cancer incidence.
Genomics and Targeted Therapies in Gastroesophageal Adenocarcinoma
Authors: Nagaraja Ankur K. , Kikuchi Osamu , Bass Adam J. 
Published: November 2019

AbstractGastroesophageal adenocarcinomas (GEA) are devastating diseases with stark global presence. Over the past 10 years, there have been minimal improvements in treatment approach despite numerous clinical trials. Here, we review recent progress toward understanding the molecular features of these cancers and the diagnostic and therapeutic challenges posed by their intrinsic genomic instability and heterogeneity. We highlight the potential of genomic heterogeneity to influence clinical trial outcomes for targeted therapies and emphasize the need for comprehensive molecular profiling to guide treatment selection and adapt treatment to resistance and genomic evolution. Revising our clinical approach to GEA by leveraging genomic advances will be integral to the success of current and future treatments, especially as novel targets become therapeutically tractable.Significance:GEAs are deadly cancers with few treatment options. Characterization of the genomic landscape of these cancers has revealed considerable genetic diversity and spatial heterogeneity. Understanding these fundamental properties of GEA will be critical for overcoming barriers to the development of novel, more effective therapeutic strategies.