bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Demands and Performance Indicators in Male Professional Cyclists During a Grand Tour: WorldTour Versus ProTeam Category
Authors: Muriel Xabier , Valenzuela Pedro L. , Mateo-March Manuel , Pallarés Jesús G. , Lucia Alejandro , Barranco-Gil David 
Published: August 2021

Purpose: To compare the physical demands and performance indicators of male professional cyclists of 2 different categories (Union Cycliste Internationale WorldTour [WT] and ProTeam [PT]) during a cycling grand tour. Methods: A WT team (n = 8, 31.4 [5.4] y) and a PT team (n = 7, 26.9 [3.3] y) that completed “La Vuelta 2020” volunteered to participate. Participants’ power output (PO) was registered, and measures of physical demand and physiological performance (kilojoules spent, training stress score, time spent at different PO bands/zones, and mean maximal PO [MMP] for different exertion durations) were computed. Results: WT achieved a higher final individual position than PT (31 [interquartile range = 33] vs 71 [59], P = .004). WT cyclists showed higher mean PO and kilojoule values than their PT peers and spent more time at high-intensity PO values (>5.25 W·kg−1) and zones (91%–120% of individualized functional threshold power) (Ps < .05). Although no differences were found for MMP values in the overall analysis (P > .05), subanalyses revealed that the between-groups gap increased through the race, with WT cyclists reaching higher MMP values for ≥5-minute efforts in the second and third weeks (Ps < .05). Conclusions: Despite the multifactorial nature of cycling performance, WT cyclists spend more time at high intensities and show higher kilojoules and mean PO than their PT referents during a grand tour. Although the highest MMP values attained during the whole race might not differentiate between WT and PT cyclists, the former achieve higher MMP values as the race progresses.
Study protocol of a randomised trial of Summer STRIPES: a peer-delivered high school preparatory intervention for students with ADHD
Authors: Zulauf-McCurdy Courtney A. , Coxe Stefany J. , Lyon Aaron R. , Aaronson Ben , Ortiz Mercedes , Sibley Margaret H. 
Published: August 2021

IntroductionHigh schoolers with attention-deficit/hyperactivity disorder (ADHD) experience substantial impairments, particularly in the school setting. However, very few high school students with ADHD receive evidence-based interventions for their difficulties. We aim to improve access to care by adapting evidence-based psychosocial intervention components to a low-resource and novel school-based intervention model, Summer STRIPES (Students Taking Responsibility and Initiative through Peer Enhanced Support). Summer STRIPES is a brief peer-delivered summer orientation to high school with continued peer-delivered sessions during ninth grade.Methods and analysisParticipants will be 72 rising ninth grade students with ADHD who are randomised to receive either Summer STRIPES or school services as usual. Summer STRIPES will be delivered by 12 peer interventionists in a school setting. Outcomes will be measured at baseline, start of ninth grade, mid-ninth grade and end-of-ninth grade. At each assessment, self, parent and teacher measures will be obtained. We will test the effect of Summer STRIPES (compared with school services as usual) on ADHD symptoms and key mechanisms (intrinsic motivation, extrinsic motivation, executive functions) as well as key academic outcomes during the ninth-grade year (Grade Point Average (GPA), class attendance).Ethics and disseminationFindings will contribute to our understanding of how to improve access and utilisation of care for adolescents with ADHD. The protocol is approved by the institutional review board at Seattle Children’s Research Institute. The study results will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences.Trials registration numberNCT04571320; pre-results.
Care willingness and demand of residents under 60 years of age in western China: a cross-sectional study
Authors: Cheng Li nan , Zhao Li , Xie Xiao feng , Wang Liang , Hu Xiu ying , Dong Xiao yang , Zhang Feng ying 
Published: August 2021

ObjectivesThe objective was to examine care willingness and demand of residents under 60 years of age after retirement.SettingThe staged cluster sampling method was used between August and October 2018 in Dujiangyan, Sichuan Province, China.Participants2282 participants under 60 years of age were surveyed in 2018 by the staged cluster sampling method in China.Primary and secondary outcome measuresThe results of care willingness and demand were assessed by multiple comparisons of χ2test and multivariable logistic regression.ResultsThe respondents who preferred institution-based care, home-based care and community-based care accounted for 39.5%, 38.3% and 20.2% respectively, whereas only 2.1% preferred home-based self-care. The main reasons for the respondents to choose institution-based care included better medical care (31.9%), better daily care (27.0%), burden reduction for children (26.3%), better accommodation (22.8%), satisfied living environment (21.6%) and low consumption (12.3%). The factors that affected care willingness and demand included age, ethnicity, educational attainment, marital status, occupation and the current type of residence.ConclusionsThe results revealed the care willingness and demand of residents under 60 years of age after retirement and relevant decision factors. This study provides a certain theoretical and practical significance for the development of the care willingness mode and promotes the cognition of policy-makers and researchers, and also provides the basis for decision-making.
Risk of aspiration pneumonia in paediatric patients with dysphagia who were found to have laryngeal penetration on the instrumental swallow evaluation: a systematic review protocol
Authors: Adlakha Vaishali , Ramos Leona , Smith Abigail , Tsistinas Olivia , Tanner-Smith Emily , Merrow Jill , Soultan Zafer , Mortelliti Anthony , Rosen Rachel , Imdad Aamer 
Published: August 2021

IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.
The Rist radial access system: a multicenter study of 152 patients
Authors: Abecassis Isaac Josh , Saini Vasu , Crowley R Webster , Munich Stephan A , Singer Justin , Osbun Joshua W , Gross Bradley A , Walcott Brian P , Peebles Todd R , Bain Mark , Storey Christopher M , Yavagal Dileep R , Starke Robert M , Peterson Eric C 
Published: August 2021

BackgroundTransradial access (TRA) for neurointervention is becoming increasingly popular as experience with the technique grows. Despite reasonable efficacy using femoral catheters off-label, conversion to femoral access occurs in approximately 8.6–10.3% of TRA cases, due to an inability of the catheter to track into the vessel of interest, lack of support, or radial artery spasm.MethodsThis is a multicenter, retrospective case series of patients undergoing neurointerventions using the Rist Radial Access System. We also present our institutional protocol for using the system.Results152 patients were included in the cohort. The most common procedure was flow diversion (28.3%). The smallest radial diameter utilized was 1.9 mm, and 44.1% were performed without an intermediate catheter. A majority of cases (96.1%) were completed successfully; 3 (1.9%) required conversion to a different radial catheter, 2 (1.3%) required conversion to femoral access, and 1 (0.7%) was aborted. There was 1 (0.7%) minor access site complication and 4 (2.6%) neurological complications.ConclusionsThe Rist catheter is a safe and effective tool for a wide range of complex neurointerventions, with lower conversion rates than classically reported.
Heart failure in pregnancy: what is the long-term impact of pregnancy on cardiac function? A tertiary care centre experience and systematic review
Authors: Dodeja Anudeep K , Siegel Francesca , Dodd Katherine , Ma'ayeh Marwan , Mehta Laxmi S , Fuchs Margaret M , Rood Kara M , Mah May Ling , Bradley Elisa A 
Published: August 2021

BackgroundWomen with cardiomyopathy (CM) are often advised against pregnancy due to risk for major adverse cardiovascular events (MACE). However, the impact of CM subtype on maternal MACE is not understood, and so we sought to evaluate the influence of CM phenotype on maternal outcomes, as well as the effect on immediate and late left ventricular function.MethodsWe evaluated all pregnant women in our high-risk maternal cardiovascular programme (2009–2019). Composite maternal MACE included: death, inotrope use, left ventricular assist device, orthotopic heart transplant and/or escalation in transplant listing status, acute decompensated heart failure and sustained ventricular arrhythmia.ResultsAmong 875 women followed, 32 had CM (29±7 years old, left ventricular ejection fraction (LVEF) 41%±12%): 3 ischaemic CM (ICM), 10 peripartum CM (PPCM) and 19 non-ICM (NICM). MACE events occurred in 6 (18%) women (PPCM: 2 (33%), NICM: 4 (67%)). There was no difference in LVEF at baseline, however, women with MACE had significantly lower LVEF both early (LVEF: 27±5% vs . 41±2%, p<0.05) and late post partum (LVEF: 28±5% vs . 44±2%, p<0.01).ConclusionsIn this contemporary cohort of women with CM, maternal MACE rates were lower than previously reported, and were less common in PPCM as compared with ICM and NICM. Heart function in women with MACE was negatively impacted immediately after delivery and in late postpartum follow-up, suggesting that pregnancy itself likely has influence on future left ventricular function in women with underlying CM.
Efficacy of acid treatments used in archaeological ceramics for the removal of calcareous deposits
Authors: Sáenz-Martínez Águeda , Pérez-Estébanez Marta , San Andrés Margarita , Alvarez de Buergo Mónica , Fort Rafael 
Published: August 2021

AbstractCalcareous deposits are one of the most common alterations that archaeological ceramics can exhibit, and they can damage their artistic and historical values. For this reason, it becomes necessary to remove these deposits. However, there is no agreement in the conservation field about the conditions of the cleaning treatments. Moreover, little has been studied about the consequences that archaeological ceramics might suffer. The main purpose of this research is to study the efficacy and safety of several cleaning treatments that are or can be used in archaeological ceramics. To this aim, it was necessary, in first place, elaborating ceramic specimens, simulating archaeological ones, and artificially growing calcareous deposits on their surface. Afterwards, effective and little damaging cleaning treatments based on the immersion of the elaborated ceramics on acid products were developed. Acetic and nitric acid solutions were prepared at the minimum concentration and applied during the minimum time to be effective. Ceramic specimens were elaborated with a commercial red clay simulating archaeological ceramics to avoid trials on real cultural objects. The mineralogical composition of the ceramics was studied by X-ray powder diffraction to establish if changes occurred after the carbonation process and after the cleaning treatments, and thermogravimetric analysis allowed to quantify the calcium carbonate content in every step of the process and to determine the efficacy and safety of such cleaning treatments. According to the results obtained so far, the acid treatments (acetic and nitric acid) were both effective in the removal of the deposits and did not modify the initial mineralogical composition of the ceramic specimens. Besides, no significant differences among them were detected regarding their efficacy.
Mitochondria as Playmakers of CAR T-cell Fate and Longevity
Authors: Rostamian Hosein , Khakpoor-Koosheh Mohammad , Fallah-Mehrjardi Keyvan , Mirzaei Hamid R. , Brown Christine E. 
Published: August 2021

AbstractThe development of chimeric antigen receptor (CAR) T-cell therapy has led to a paradigm shift in cancer treatment. However, patients often do not benefit from CAR T-cell therapy due to poor persistence of the adoptively transferred cells. Development of strategies based on the generation and maintenance of long-lasting memory T cells may expand the therapeutic effects of CAR T cells. Mitochondrial metabolic pathways play crucial roles in regulating the fate, function, and longevity of T cells. Here, we discuss how reprogramming of mitochondrial metabolic pathways influences function, persistence, and determination of CAR T-cell fate toward a memory phenotype. Moreover, we explore how mitochondrial activity determines persistence and the clinical outcome of CAR T-cell therapy. In addition, we review some strategies for manipulating CAR T-cell mitochondria to improve the survival of CAR T cells.
Aperfeiçoamento e Capacitação em Performance Musical: estratégias de trabalho na pandemia
Authors: Domingues Ravi Shankar Viana , Noda Luciana 
Published: August 2021

O presente trabalho apresenta as estratégias adotadas pela classe de oboé da Universidade Federal da Paraíba (UFPB) durante a pandemia. Essas atividades fazem parte do Projeto de Capacitação e Aperfeiçoamento em Performance Musical, criado em 2018. O projeto tem como objetivo fomentar atividades que contribuam para o desenvolvimento integral da performance de instrumentistas e cantores brasileiros. Nas duas primeiras edições do projeto foram realizadas mais de 50 ações cujo foco principal foram os aspectos psicofísicos da performance através de workshops sobre Yoga, Tai-Chi Chuan, Meditação e Psicologia da Performance, além de recitais em diferentes espaços da cidade de João Pessoa. Em 2020, devido às restrições de isolamento social impostas pela pandemia de COVID-19, todas as atividades do projeto foram adaptadas ao formato remoto, com o intuito de mantermos "atividades de resistência" que pudessem contribuir para a motivação e desenvolvimento dos estudantes de música no Brasil. Apesar de todas as adversidades, o projeto foi expandido e contou com a colaboração de músicos de diversas instituições musicais brasileiras e internacionais e a participação de pessoas de todo o mundo.
Placebo-Controlled Efficacy of Percutaneous Coronary Intervention for Focal and Diffuse Patterns of Stable Coronary Artery Disease
Authors: Rajkumar Christopher A. , Shun-Shin Matthew , Seligman Henry , Ahmad Yousif , Warisawa Takayuki , Cook Christopher M. , Howard James P. , Ganesananthan Sashiananthan , Amarin Laura , Khan Caitlin , Ahmed Ayesha , Nowbar Alexandra , Foley Michael , Assomull Ravi , Keenan Niall G. , Sehmi Joban , Keeble Thomas R. , Davies John R. , Tang Kare H. , Gerber Robert , Cole Graham , O’Kane Peter , Sharp Andrew S.P. , Khamis Ramzi , Kanaganayagam Gajen , Petraco Ricardo , Ruparelia Neil , Malik Iqbal S. , Nijjer Sukhjinder , Sen Sayan , Francis Darrel P. , Al-Lamee Rasha 
Published: August 2021

Background:
Physiological assessment with pressure wire pullback can characterize coronary artery disease (CAD) with a focal or diffuse pattern. However, the clinical relevance of this distinction is unknown. We use data from the ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) to test if the pattern of CAD predicts the placebo-controlled efficacy of percutaneous coronary intervention (PCI) on stress echocardiography ischemia and symptom end points.

Methods:
One hundred sixty-four patients in ORBITA underwent blinded instantaneous wave-free ratio (iFR) pullback assessment before randomization. Focal disease was defined as a ≥0.03 iFR unit drop within 15 mm, rather than over a longer distance. Analyses were performed using regression modeling.

Results:

In the PCI arm (n=85), 48 were focal and 37 were diffuse. In the placebo arm (n=79), 35 were focal and 44 were diffuse. Focal stenoses were associated with significantly lower fractional flow reserve (FFR) and iFR values than diffusely diseased vessels (mean FFR and iFR, focal 0.60±0.15 and 0.65±0.24, diffuse 0.78±0.10 and 0.88±0.08, respectively,
P
<0.0001). With adjustment for this difference, PCI for focal stenoses resulted in significantly greater reduction in stress echo ischemia than PCI for diffuse disease (
P
<0.05). The effect of PCI on between-arm pre-randomization adjusted exercise time was 9.32 seconds (95% CI, −17.1 to 35.7 seconds;
P
=0.487). When stratified for pattern of disease, there was no detectable difference between focal and diffuse CAD (
P
interaction=0.700). PCI improved Seattle Angina Questionnaire angina frequency score and freedom from angina more than placebo (
P
=0.034;
P
=0.0035). However, there was no evidence of interaction between the physiological pattern of CAD and these effects (
P
interaction=0.436;
P
interaction=0.908).

Conclusions:
PCI achieved significantly greater reduction of stress echocardiography ischemia in focal compared with diffuse CAD. However, for symptom end points, no such difference was observed.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT02062593.
External Validations of Cardiovascular Clinical Prediction Models: A Large-Scale Review of the Literature
Authors: Wessler Benjamin S. , Nelson Jason , Park Jinny G. , McGinnes Hannah , Gulati Gaurav , Brazil Riley , Van Calster Ben , van Klaveren David , Venema Esmee , Steyerberg Ewout , Paulus Jessica K. , Kent David M. 
Published: August 2021

Background:
There are many clinical prediction models (CPMs) available to inform treatment decisions for patients with cardiovascular disease. However, the extent to which they have been externally tested, and how well they generally perform has not been broadly evaluated.

Methods:
A SCOPUS citation search was run on March 22, 2017 to identify external validations of cardiovascular CPMs in the Tufts Predictive Analytics and Comparative Effectiveness CPM Registry. We assessed the extent of external validation, performance heterogeneity across databases, and explored factors associated with model performance, including a global assessment of the clinical relatedness between the derivation and validation data.

Results:

We identified 2030 external validations of 1382 CPMs. Eight hundred seven (58%) of the CPMs in the Registry have never been externally validated. On average, there were 1.5 validations per CPM (range, 0–94). The median external validation area under the receiver operating characteristic curve was 0.73 (25th–75th percentile [interquartile range (IQR)], 0.66–0.79), representing a median percent decrease in discrimination of −11.1% (IQR, −32.4% to +2.7%) compared with performance on derivation data. 81% (n=1333) of validations reporting area under the receiver operating characteristic curve showed discrimination below that reported in the derivation dataset. 53% (n=983) of the validations report some measure of CPM calibration. For CPMs evaluated more than once, there was typically a large range of performance. Of 1702 validations classified by relatedness, the percent change in discrimination was −3.7% (IQR, −13.2 to 3.1) for closely related validations (n=123), −9.0 (IQR, −27.6 to 3.9) for related validations (n=862), and −17.2% (IQR, −42.3 to 0) for distantly related validations (n=717;
P
<0.001).

Conclusions:
Many published cardiovascular CPMs have never been externally validated, and for those that have, apparent performance during development is often overly optimistic. A single external validation appears insufficient to broadly understand the performance heterogeneity across different settings.
Revisiting the Tropical Atlantic Influence on El Niño–Southern Oscillation
Authors: Richter Ingo , Tokinaga Hiroki , Kosaka Yu , Doi Takeshi , Kataoka Takahito 
Published: August 2021

AbstractThe influence of the tropical Atlantic on El Niño–Southern Oscillation (ENSO) is examined using sensitivity experiments with the SINTEX-F general circulation model with prescribed sea surface temperature (SST) distributions based on observations for the period 1982–2018. In the control experiment (CTRL) observed SSTs are prescribed over the global oceans; in the sensitivity experiment observed SSTs are prescribed in the tropical Atlantic only, while in other regions the climatological annual cycle is prescribed. A composite analysis of the model output suggests that cold SST events in the northern tropical Atlantic during boreal spring are associated with near-surface wind changes over the equatorial and subtropical Pacific that are conducive to the development of El Niño, consistent with previous studies. The amplitude of these changes, however, is at most 20% of those observed during typical El Niño events. Likewise, warm events in the equatorial Atlantic produce only about 10% of the wind changes seen in the western equatorial Pacific during the developing phase of typical La Niña events. Similar results are obtained from a partial regression analysis performed on an ensemble of atmosphere-only simulations from phase 6 of the Atmospheric Model Intercomparison Project (AMIP) although the equatorial Atlantic influence is stronger in AMIP. Further analysis of the AMIP models indicates that model biases do not have a major impact on the Atlantic-to-Pacific influence. Overall, the results suggest that the tropical Atlantic has a rather weak influence on ENSO development and mostly acts to modulate ongoing events rather than initiate them.