bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Older Adults With Reduced Bone Mineral Density Benefit From Strength Training? A Critically Appraised Topic
Authors: Zamoscinska Maja , Faber Irene R. , Büsch Dirk 
Published: December 2019

Clinical Scenario:Reduced bone mineral density (BMD) is a serious condition in older adults. The mild form, osteopenia, is often a precursor of osteoporosis. Osteoporosis is a pathological condition and a global health problem as it is one of the most common diseases in developed countries. Finding solutions for prevention and therapy should be prioritized. Therefore, the critically appraised topic focuses on strength training as a treatment to counteract a further decline in BMD in older adults.Clinical Question:Is strength training beneficial in increasing BMD in older people with osteopenia or osteoporosis?Summary of Key Findings:Four of the 5 reviewed studies with the highest evidence showed a significant increase in lumbar spine BMD after strength training interventions in comparison with control groups. The fifth study confirmed the maintenance of lumbar spine density due to conducted exercises. Moreover, 3 reviewed studies revealed increasing BMD at the femoral neck after strength training when compared with controls, which appeared significant in 2 of them.Clinical Bottom Line:The findings indicate that strength training has a significant positive influence on BMD in older women (ie, postmenopausal) with osteoporosis or osteopenia. However, it is not recommended to only rely on strength training as the increase of BMD may not appear fast enough to reach the minimal desired values. A combination of strength training and supplements/medication seems most adequate. Generalization of the findings to older men with reduced BMD should be done with caution due to the lack of studies.Strength of Recommendation:There is grade B of recommendation to support the validity of strength training for older women in postmenopausal phase with reduced BMD.
Realizing the potential of digital development: The case of agricultural advice
Authors: Fabregas Raissa , Kremer Michael , Schilbach Frank 
Published: December 2019

Mobile farming adviceMobile phones are almost universally available, and the costs of information transmission are low. They are used by smallholder farmers in low-income countries, largely successfully, to optimize markets for their produce. Fabregaset al.review the potential for boosting mobile phone use with smartphones to deliver not only market information but also more sophisticated agricultural extension advice. GPS-linked smartphones could provide locally relevant weather and pest information and video-based farming advice. But how to support the financial requirements of such extension services is less obvious, given the unwieldiness of government agencies and the vested interests of commercial suppliers.Science, this issue p.eaay3038
Accommodation outcomes for children of drug-misusing women
Authors: Mitchell Jennifer , Mactier Helen 
Published: December 2019

Children of drug-misusing women are a vulnerable group. Data describing the pattern of accommodation placements are lacking. We investigated 10- to 12-year accommodation outcomes of children born to drug-misusing mothers at a single maternity hospital. 94% of mothers were prescribed maintenance methadone during pregnancy and at least 87% poly-drug used.Data were successfully matched for 132 children (29% of the original cohort of 450 babies). These children had a total of 291 placements (median 2 (range 1–6)), only 28.5% of which were with the birth parents. At 10–12 years, 54 (41%) were in the care of their parent(s).83% (109/132) were discharged from the maternity hospital to their birth parents; 41% of these children (54/132) remained with their parents at 10–12 years. Of the 23 children not discharged from the maternity unit to their parents, 70% remain within the care system or have been adopted at 10–12 years of age.
Performance of the MEDS score in predicting mortality among emergency department patients with a suspected infection: a meta-analysis
Authors: Zhang Gensheng , Zhang Kai , Zheng Xie , Cui Wei , Hong Yucai , Zhang Zhongheng 
Published: December 2019

ObjectivesTo carry out a meta-analysis to examine the prognostic performance of the Mortality in Emergency Department Sepsis (MEDS) score in predicting mortality among emergency department patients with a suspected infection.MethodsElectronic databases—PubMed, Embase, Scopus, EBSCO and the Cochrane Library—were searched for eligible articles from their respective inception through February 2019. Sensitivity, specificity, likelihood ratios and receiver operator characteristic area under the curve were calculated. Subgroup analyses were performed to explore the prognostic performance of MEDS in selected populations.ResultsWe identified 24 studies involving 21 246 participants. The pooled sensitivity of MEDS to predict mortality was 79% (95% CI 72% to 84%); specificity was 74% (95% CI 68% to 80%); positive likelihood ratio 3.07 (95% CI 2.47 to 3.82); negative likelihood ratio 0.29 (95% CI 0.22 to 0.37) and area under the curve 0.83 (95% CI 0.80 to 0.86). Significant heterogeneity was seen among included studies. Meta-regression analyses showed that the time at which the MEDS score was measured and the cut-off value used were important sources of heterogeneity.ConclusionThe MEDS score has moderate accuracy in predicting mortality among emergency department patients with a suspected infection. A study comparison MEDS and qSOFA in the same population is needed.
Method summaries for JPF
Authors: Berglund Lasse , Artho Cyrille 
Published: December 2019

Java Path nder (JPF) is a virtual machine executing Java byte- code that is able to perform model checking using backtracking execution. Due to backtracking, parts of a program may be ex- ecuted multiple times during model checking. Hence, we explore whether method summaries can be used to make JPF's model checking more efficient. We present the design and implementa- tion of dynamically generated summaries as an extension of JPF.
While our summaries incur an overhead that outweighs the bene- ts in most cases, the approach shows promise in certain cases, in particular when stateless model checking is used. We also provide some results related to cases when our summaries are applicable that could provide guidance for future work within this eld.
Laparoscopic and Endoscopic Cooperative Dissection for Small Gastric Gastrointestinal Stromal Tumor without Causing Injury to the Mucosa
Authors: Cao Lei , Zheng Kunming , Wang Honglei , Zhao Yongjie , Yang Zhengduo , Li Wen 
Published: December 2019

Objective. To investigate the feasibility of laparoscopic and endoscopic cooperative dissection (LECD) for small gastric gastrointestinal stromal tumors (GISTs) without causing injury to the mucosa, compared with ESD surgery which is widely used now. Methods. A total of 25 patients with small gastric GISTs who underwent LECD and 20 patients with small gastric GISTs who underwent ESD between October 2014 and June 2016 were included in this study. All patients underwent curative resection for pathologically diagnosed small gastric GISTs. Patients’ clinical data were retrospectively analyzed. Results. In LECD group, the operation was successfully performed in all patients. However, in the ESD group, three patients were transferred to laparoscopic surgery due to intraoperative massive bleeding or intraoperative perforation. No additional targeted chemotherapy drugs for interstitial tumors were prescribed in two groups. There was no difference in the complete tumor capsule rate (100% vs. 90%, p=0.11), operation time (80.76±13.86 ml vs. 84.05±15.33 ml, p=0.45), major intraoperative bleeding (0 vs. 5%, p=0.26), postoperative bleeding (0 vs. 10%, p=0.11), and postoperative infection (0 vs. 10%, p=0.11) between the two groups. Compared to ESD (endoscopic submucosal dissection), LECS patients had shorter postoperative indwelling gastric tube (1.04±0.98 d vs. 2.85±0.24 d, p<0.01), earlier postoperative eating (1.96±0.98 d vs. 3.50±1.15 d, p<0.01), shorter average postoperative hospital stay (3.44±1.00 d vs. 7.85±1.18 d, p<0.01), smaller perforation rate (0 vs. 25%, p < 0.05), and fewer surgical supplies. No recurrence or metastasis cases were found between the two groups during the follow-up period, and there were no cases of death due to gastric GISTs. Conclusion. LECD is a novel surgery for small gastric gastrointestinal stromal tumors that leads to satisfactory short-term outcomes and meets the idea of minimally invasive surgery and rapid recovery; compared with ESD, LECD surgery has some advantages in clinical practice. However, further follow-up is needed to confirm.
Ischemia and No Obstructive Coronary Artery Disease
Authors: Ford Thomas J. , Yii Eric , Sidik Novalia , Good Richard , Rocchiccioli Paul , McEntegart Margaret , Watkins Stuart , Eteiba Hany , Shaukat Aadil , Lindsay Mitchell , Robertson Keith , Hood Stuart , McGeoch Ross , McDade Robert , McCartney Peter , Corcoran David , Collison Damien , Rush Christopher , Stanley Bethany , McConnachie Alex , Sattar Naveed , Touyz Rhian M. , Oldroyd Keith G. , Berry Colin 
Published: December 2019

Background:
Determine the prevalence and correlates of microvascular and vasospastic angina in patients with symptoms and signs of ischemia but no obstructive coronary artery disease (INOCA).

Methods:

Three hundred ninety-one patients with angina were enrolled at 2 regional centers over 12 months from November 2016 (NCT03193294). INOCA subjects (n=185; 47%) had more limiting dyspnea (New York Heart Association classification III/IV 54% versus 37%; odds ratio [OR], 2.0 [1.3–3.0];
P
=0.001) and were more likely to be female (68% INOCA versus 38% in coronary artery disease; OR, 1.9 [1.5 to 2.5];
P
<0.001) but with lower cardiovascular risk scores (ASSIGN score median 20% versus 24%;
P
=0.003). INOCA subjects had similar burden of angina (Seattle Angina Questionnaire) but reduced quality of life compared with coronary artery disease; subjects (EQ5D-5 L index 0.60 versus 0.65 units;
P
=0.041).

Results:

An interventional diagnostic procedure with reference invasive tests including coronary flow reserve, microvascular resistance, and vasomotor responses to intracoronary acetylcholine (vasospasm provocation) was performed in 151 INOCA subjects. Overall, 78 (52%) had isolated microvascular angina, 25 (17%) had isolated vasospastic angina, 31 (20%) had both, and 17 (11%) had noncardiac chest pain. Regression analysis showed inducible ischemia on treadmill testing (OR, 7.5 [95% CI, 1.7–33.0];
P
=0.008) and typical angina (OR, 2.7 [1.1–6.6];
P
=0.032) were independently associated with microvascular angina. Female sex tended to associate with a diagnosis of microvascular angina although this was not significant (OR, 2.7 [0.9–7.9];
P
=0.063). Vasospastic angina was associated with smoking (OR, 9.5 [2.8–32.7];
P
<0.001) and age (OR, 1.1 per year, [1.0–1.2];
P
=0.032].

Conclusions:
Over three quarters of patients with INOCA have identifiable disorders of coronary vasomotion including microvascular and vasospastic angina. These patients have comparable angina burden but reduced quality of life compared to patients with obstructive coronary artery disease. Microvascular angina and vasospastic angina are distinct disorders that may coexist but differ in associated clinical characteristics, symptoms, and angina severity.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT03193294.
Association of Abnormal P‐Wave Indices With Dementia and Cognitive Decline Over 25 Years: ARIC‐NCS (The Atherosclerosis Risk in Communities Neurocognitive Study)
Authors: Gutierrez Alejandra , Norby Faye L. , Maheshwari Ankit , Rooney Mary R. , Gottesman Rebecca F. , Mosley Thomas H. , Lutsey Pamela L. , Oldenburg Niki , Soliman Elsayed Z. , Alonso Alvaro , Chen Lin Y. 
Published: December 2019

Background
Abnormal P‐wave indices (PWIs)—reflecting underlying left atrial abnormality—are associated with increased risk of stroke independent of atrial fibrillation. We assessed whether abnormal PWIs are associated with incident dementia and greater cognitive decline, independent of atrial fibrillation and ischemic stroke.

Methods and Results

We included 13 714 participants (mean age, 57±6 years; 56% women; 23% black) who were followed for dementia through the end of 2015. (Abnormal P‐wave terminal force in lead V1, ≥4000 μV×ms), abnormal P‐wave axis (>75° or <0°), prolonged P‐wave duration (>120 ms), and advanced interatrial block were determined from ECGs at visits 2 to 4. Dementia was adjudicated by an expert panel using data from cognitive tests and hospitalization
International Classification of Diseases
codes. Cognitive function was measured longitudinally using 3 neuropsychological tests. Cox proportional hazards models were used to assess the association between time‐dependent abnormal PWIs with incident dementia. Linear regression models were used to evaluate PWIs with cognitive function over time. At the conclusion of the study, 19%, 16%, 28%, and 1.9% of participants had abnormal P‐wave terminal force in lead V1, abnormal P‐wave axis, prolonged P‐wave duration, and advanced interatrial block, respectively. During mean follow‐up of 18 years, there were 1390 (10%) dementia cases. All abnormal PWIs except advanced interatrial block were associated with an increased risk of dementia even after adjustment for incident atrial fibrillation and stroke: multivariable hazard ratio of abnormal P wave terminal force in lead V1=1.60, 95% CI, 1.41 to 2.83; abnormal P‐wave axis, hazard ratio =1.36, 95% CI, 1.17 to 2.57; prolonged P‐wave duration, hazard ratio=1.60, 95% CI, 1.42 to 1.80. Only abnormal P‐wave terminal force in lead V1 was associated with greater decline in global cognition.

Conclusions
Abnormal PWIs are independently associated with an increased risk of dementia. This novel finding should be replicated in other cohorts and the underlying mechanisms should be evaluated.
Improving Soil Moisture and Surface Turbulent Heat Flux Estimates by Assimilation of SMAP Brightness Temperatures or Soil Moisture Retrievals and GOES Land Surface Temperature Retrievals
Authors: Lu Yang , Steele-Dunne Susan C. , De Lannoy Gabriëlle J. M. 
Published: December 2019

AbstractSurface heat fluxes are vital to hydrological and environmental studies, but mapping them accurately over a large area remains a problem. In this study, brightness temperature (TB) observations or soil moisture retrievals from the NASA Soil Moisture Active Passive (SMAP) mission and land surface temperature (LST) product from the Geostationary Operational Environmental Satellite (GOES) are assimilated together into a coupled water and heat transfer model to improve surface heat flux estimates. A particle filter is used to assimilate SMAP data, while a particle smoothing method is adopted to assimilate GOES LST time series, correcting for both systematic biases via parameter updating and for short-term error via state updating. One experiment assimilates SMAP TB at horizontal polarization and GOES LST, a second experiment assimilates SMAP TB at vertical polarization and GOES LST, and a third experiment assimilates SMAP soil moisture retrievals along with GOES LST. The aim is to examine if the assimilation of physically consistent TB and LST observations could yield improved surface heat flux estimates. It is demonstrated that all three assimilation experiments improved flux estimates compared to a no-assimilation case. Assimilating TB data tends to produce smaller bias in soil moisture estimates compared to assimilating soil moisture retrievals, but the estimates are influenced by the respective bias correction approaches. Despite the differences in soil moisture estimates, the flux estimates from different assimilation experiments are in general very similar.
Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington
Authors: Baer Atar , Fagalde Meaghan S. , Drake Curtis D. , Sohlberg Elisabeth H. , Barash Elizabeth , Glick Sara , Millman Alexander J. , Duchin Jeffrey S. 
Published: December 2019

Introduction: With the goal of eliminating hepatitis C virus (HCV) as a public health problem in Washington State, Public Health–Seattle & King County (PHSKC) designed a Hepatitis C Virus Test and Cure (HCV-TAC) data system to integrate surveillance, clinical, and laboratory data into a comprehensive database. The intent of the system was to promote identification, treatment, and cure of HCV-infected persons (ie, HCV care cascade) using a population health approach. Materials and Methods: The data system automatically integrated case reports received via telephone and fax from health care providers and laboratories, hepatitis test results reported via electronic laboratory reporting, and data on laboratory and clinic visits reported by 6 regional health care systems. PHSKC examined patient-level laboratory test results and established HCV case classification using Council of State and Territorial Epidemiologists criteria, classifying patients as confirmed if they had detectable HCV RNA. Results: The data enabled PHSKC to report the number of patients at various stages along the HCV care cascade. Of 7747 HCV RNA-positive patients seen by a partner site, 5377 (69%) were assessed for severity of liver fibrosis, 3932 (51%) were treated, and 2592 (33%) were cured. Practice Implications: Data supported local public heath surveillance and HCV program activities. The data system could serve as a foundation for monitoring future HCV prevention and control programs.
Use of Potentially Reduced Exposure Tobacco Products Among American Indian Smokeless Tobacco Users: Associations With Cessation Behaviors and Cotinine Levels
Authors: Comiford Ashley L. , Rhoades Dorothy A. , Dvorak Justin D. , Ding Kai , Mehta Toral , Spicer Paul , Wagener Theodore , Doescher Mark P. 
Published: December 2019

Objectives: American Indian/Alaska Native (AI/AN) adults use smokeless tobacco products (eg, chewing and dip tobacco) more often than other racial/ethnic groups do. Although US adults increasingly use potentially reduced exposure tobacco products (PREPs), such as electronic cigarettes and snus, no studies have examined the use of PREPs among AI/AN smokeless tobacco users. We examined associations between current PREPs use and smokeless tobacco–related measures, including cessation attempts and cotinine levels, in a sample of American Indian adults who currently use smokeless tobacco. Methods: We collected survey and tobacco biomarker data from 299 adult American Indian smokeless tobacco users at Cherokee Nation health care facilities and events in 2016 and 2017. We used multivariable analyses to determine associations between current PREPs use and smokeless tobacco–related characteristics. Results: Current PREPs users were younger, less likely to be married or living with a partner, less likely to report a chronic medical condition, and more likely to report other tobacco use than PREPs nonusers. Among participants with annual household incomes ≤$30 000, current PREPs users were less likely than PREPs nonusers to report a definite desire to quit smokeless tobacco ( P = .02). PREPs use was not associated with planning to quit smokeless tobacco, past 12-month smokeless tobacco quit attempts, amount of smokeless tobacco used per week, cotinine levels, or scores on the Fagerström Test for Nicotine Dependence–Smokeless Tobacco. Conclusions: Our study suggests that American Indian smokeless tobacco users may not be using PREPs as a smokeless tobacco cessation aid. Future studies should take this finding into consideration when evaluating the role of PREPs use in smokeless tobacco cessation and in total tobacco cessation in this population.
Saphenous reflux patterns in C2 patients: A record of 1196 ultrasound reports
Authors: Coelho Neto Felipe , de Oliveira Rodrigo Gomes , Gregório Emerson Pereira , Belczak Sergio Quilici , de Araujo Walter Junior Boim 
Published: December 2019

Objectives To describe saphenous reflux patterns in patients classified as CEAP C2 by analysis of 2027 vascular ultrasound examination reports. Methods A total of 2027 venous mapping studies were reviewed and 1196 patients classified as CEAP C2 were selected. Patients were classified according to patterns of reflux for the great saphenous vein and for the small saphenous vein, and rates of great saphenous vein and small saphenous vein reflux were analyzed for both sexes. Results The overall prevalence of saphenous vein reflux was 45%. Males had significantly higher great saphenous vein reflux prevalence than females ( p < 0.001). The most common great saphenous vein reflux pattern in females was segmental reflux and the most common pattern in males was proximal reflux. Conclusions Saphenous vein reflux is common in C2 patients and is more frequent in males. Standardization of classifications of reflux patterns is very important for correct management of the disease.
Ki-67 labeling index and the grading of cerebral gliomas by using intravoxel incoherent motion diffusion-weighted imaging and three-dimensional arterial spin labeling magnetic resonance imaging
Authors: Wang Chaochao , Dong Haibo 
Published: December 2019

Background Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and three-dimensional arterial spin labeling (3D-ASL) have been applied to brain tumors; however, the relationship between their parameters and the Ki-67 labeling index (Ki-67 LI) for the grading of gliomas have yet to be investigated. Purpose The aim of this study is to compare multiple parameters obtained from IVIM-DWI and 3D-ASL with the Ki-67 LI when grading gliomas. Material and Methods Fifty-two patients with pathologically confirmed gliomas had undergone magnetic resonance imaging (MRI), including IVIM-DWI and 3D-ASL imaging. Mann–Whitney U tests were conducted and receiver operating characteristic (ROC) curves were generated to determine parameters for distinguishing high-grade gliomas (HGGs) from low-grade gliomas (LGGs). These parameters included the apparent diffusion coefficient (ADC), true diffusivity (D), pseudo diffusivity (D*), perfusion fraction ( f), cerebral blood flow (CBF), and their relative values (rADC, rD, rD*, r f, and rCBF). Spearman correlation analysis was used to assess the correlations of the parameters of MRI with the Ki-67 LI. Results The rADC, rD, and r f were significantly lower in HGGs than in LGGs ( P < 0.005 for all). The rD had a significantly greater area under the ROC curve than that of the other parameters in the differentiation of HGGs from LGGs ( P < 0.05). Both the rD and r f were moderately negatively correlated with the Ki-67 LI. Conclusion Both the rD and r f can be used for the quantitative prediction of the Ki-67 LI. Among the extracted parameters, the rD had the significantly greatest diagnostic efficacy.