bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial
Authors: Blumenthal James A. , Hinderliter Alan L. , Smith Patrick J. , Mabe Stephanie , Watkins Lana L. , Craighead Linda , Ingle Krista , Tyson Crystal , Lin Pao-Hwa , Kraus William E. , Liao Lawrence , Sherwood Andrew 
Published: September 2021

Background:
Although lifestyle modifications generally are effective in lowering blood pressure (BP) among patients with unmedicated hypertension and in those treated with 1 or 2 antihypertensive agents, the value of exercise and diet for lowering BP in patients with resistant hypertension is unknown.

Methods:
One hundred forty patients with resistant hypertension (mean age, 63 years; 48% female; 59% Black; 31% with diabetes; 21% with chronic kidney disease) were randomly assigned to a 4-month program of lifestyle modification (C-LIFE [Center-Based Lifestyle Intervention]) including dietary counseling, behavioral weight management, and exercise, or a single counseling session providing SEPA (Standardized Education and Physician Advice). The primary end point was clinic systolic BP; secondary end points included 24-hour ambulatory BP and select cardiovascular disease biomarkers including baroreflex sensitivity to quantify the influence of the baroreflex on heart rate, high-frequency heart rate variability to assess vagally mediated modulation of heart rate, flow-mediated dilation to evaluate endothelial function, pulse wave velocity to assess arterial stiffness, and left ventricular mass to characterize left ventricular structure.

Results:

Between-group comparisons revealed that the reduction in clinic systolic BP was greater in C-LIFE (–12.5 [95% CI, –14.9 to –10.2] mm Hg) compared with SEPA(–7.1 [–95% CI, 10.4 to –3.7] mm Hg) (
P
=0.005); 24-hour ambulatory systolic BP also was reduced in C-LIFE (–7.0 [95% CI, –8.5 to –4.0] mm Hg), with no change in SEPA (–0.3 [95% CI, –4.0 to 3.4] mm Hg) (
P
=0.001). Compared with SEPA, C-LIFE resulted in greater improvements in resting baroreflex sensitivity (2.3 ms/mm Hg [95% CI, 1.3 to 3.3] versus –1.1 ms/mm Hg [95% CI, –2.5 to 0.3];
P
<0.001), high-frequency heart rate variability (0.4 ln ms
2
[95% CI, 0.2 to 0.6] versus –0.2 ln ms
2
[95% CI, –0.5 to 0.1];
P
<0.001), and flow-mediated dilation (0.3% [95% CI, –0.3 to 1.0] versus –1.4% [95% CI, –2.5 to –0.3];
P
=0.022). There were no between-group differences in pulse wave velocity (
P
=0.958) or left ventricular mass (
P
=0.596).

Conclusions:
Diet and exercise can lower BP in patients with resistant hypertension. A 4-month structured program of diet and exercise as adjunctive therapy delivered in a cardiac rehabilitation setting results in significant reductions in clinic and ambulatory BP and improvement in selected cardiovascular disease biomarkers.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02342808.
The Venice Commission and Rule of Law Backsliding in Turkey, Poland and Hungary
Authors: Turkut Emre 
Published: September 2021

Abstract
How did the Council of Europe cope with its member states that engaged in rule of law backsliding? This article analyses the responses of the Venice Commission, the Council of Europe’s expert body on constitutional matters, to Turkey, Hungary, and Poland as their governments eliminated key checks and balances on their power, curtailed judicial independence, and undermined political pluralism and civil society. It finds that the Venice Commission managed to address a set of particularly vital issues that get to the heart to rule of law backsliding in these countries. Despite the breadth of the Venice Commission’s forthright involvement, these case studies display the limitations on the part of other Council of Europe bodies in forming a coordinated approach and response to rule of law backsliding.
Assimilating Cloud Optical Depth for Applications to Extreme Weather Events
Authors: PENG JUXIANG , XIE YUANFU , KANG ZHAOPING 
Published: September 2021

AbstractThis paper reports the assimilation of cloud optical depth datasets into a variational data assimilation system to improve cloud ice, cloud water, rain, snow, and graupel analysis in extreme weather events for improving forecasts. A cloud optical depth forward operator was developed and implemented in the Space and Time Multiscale Analysis System (STMAS), a multiscale three-dimensional variational analysis system. Using this improved analysis system, the NOAA GOES-15 DCOMP (Daytime Cloud Optical and Microphysical Properties) cloud optical depth products were assimilated to improve the microphysical states. For an eight-day period of extreme weather events in September 2013 in Colorado, the United States, the impact of the cloud optical depth assimilation on the analysis results and forecasts was evaluated. The DCOMP products improved the cloud ice and cloud water predictions significantly in convective and lower levels. The DCOMP products also reduced errors in temperature and relative humidity data at the top (250–150 hPa) and bottom (850–700 hPa) layers. With the cloud ice improvement at higher layers, the DCOMP products provided better forecasts of cloud liquid at low layers (900–700 hPa), temperature and wind at all layers, and relative humidity at middle and bottom layers. Furthermore, for this extreme weather event, both equitable threat score (ETS) and bias were improved throughout the 12 h period, with the most significant improvement observed in the first 3 h. This study will raise the expectation of cloud optical depth product assimilation in operational applications.
The effects of performance evaluation on punishment in organisations
Authors: Yu Seungwon , Yoo Eun Ji , Kim Suhee 
Published: September 2021

This article expands understanding of the relationship between punishment and performance in organisations. We analyse Korean data on performance and punishment as follows. While prior literature has focused on the effect of punishment on performance, this article examines the effect of performance gaps on punishment. Based on behavioural theory, strategic reference point theory and principal–agent theory, it sheds light on the negative relationship between performance gaps (cause) and punishment (effect). The article demonstrates that low performers are more often punished and high performers less so (i.e. a negativity bias). Our results also show that organisations prioritise light punishment over heavy punishment when disciplining employees in response to performance. Points for practitioners Low-performing organisations are more often punished and high-performing organisations less often so. The degree to which negative performance increases punishment is greater than that to which positive performance decreases punishment. Organisations prioritise light punishment over heavy punishment when disciplining employees in response to performance.
Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach
Authors: Kamel Serageldin , Dobson Jessica L. , Patel Parth , Khatchikian Aline D , Rohren Scott A , Cheung Jeffrey Lam Shin , Rooprai Paul , Gorman Mathew , Tomasso Daniel , Greidanus Paul , Xiong Wei Ting , Kielar Ania , Wilson Nagwa , Stein Lawrence , Ibrahim Mohannad , He Hongying , Elsayes Khaled M 
Published: September 2021

Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students. Methods: A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students’ perceptions of this experience. Results: An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or exceed their expectations. Over 80% of students agreed that the course increased their interest in radiology and about 81% agree that the topics presented were excellent and clinically important. The ratings in the final survey results also indicate that students increased their confidence in basic radiology skills after completing the course. Conclusions: The implementation of an integrative clinical approach to teaching radiology in a virtual setting is achievable. It provides efficient use of educational resources while being accessible by a large number of students across different medical schools.
COVID-19 in systemic lupus erythematosus: A pooled analysis and systematic review of case reports and series
Authors: Sakthiswary Rajalingham , Chuah Hui Yuan , Chiang Ker Shing , Liew Yee Shan , Muhammad Aizat Noor Azman 
Published: September 2021

Objective In the recent months, there have been several case reports and case series on COVID-19 in patients with systemic lupus erythematosus(SLE). We conducted a pooled analysis and systematic review to summarise the findings of these articles. Besides, we aimed to determine the predictors of severe COVID-19 infection in SLE by comparing the mild to moderate cases with the severe to critical ones. Method All case reports and case series pertaining to COVID-19 in SLE were retrieved from Pubmed, Wiley Online Library, Springer Link, Science Direct and Web of Science databases using ‘lupus’, ‘systemic lupus erythematosus’, ‘coronavirus’, ‘SARS-CoV-2’, ‘SLE’ and “Covid-19” as keywords. The following data were extracted from the selected articles: country, age of the patient and the characteristics of SLE such as disease duration, organ or system involved, baseline medications and the severity of the COVID-19 infection. Data extracted from the articles were utilised to perform the pooled analysis. Results A total of 24 articles with 48 patients met the eligibility criteria. The median age at diagnosis of COVID-19 infection was 41 years (IQR: 11–66 years). The median SLE disease duration prior to the diagnosis of COVID-19 was 9 years (IQR: 0–30 years). A total of 22 (45.83%) patients had severe to critical COVID-19. This pooled data did not demonstrate any difference in the baseline medications between the 2 groups. Patients with lupus nephritis were significantly more prone to develop severe to critical disease ( p = 0 .036) with an odds ratio of 5.40 (95% confidence interval of 1.120–26.045). Conclusion We found that lupus nephritis was the only predictor of severe to critical COVID-19 in SLE.
Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis
Authors: Fell Matthew , Dack Kyle , Chummun Shaheel , Sandy Jonathan , Wren Yvonne , Lewis Sarah 
Published: September 2021

A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Medline, Embase, Web of Science and the Cochrane Library from inception to November, 2020. Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip  ±  palate and cleft palate only. Publication bias analyses were performed and the Newcastle Ottawa scales were used to assess study quality. Fixed or random effect models were used in the meta-analysis, dependent on risk of statistical heterogeneity. Forty-five studies were eligible for inclusion of which 11 were cohort and 34 were case–control studies. Sixteen studies were of sufficient standard for inclusion in the meta-analysis. The summary odds ratio for the association between smoking and cleft lip and/or palate was 1.42 (95%CI 1.27-1.59) with a population attributable fraction of 4% (95%CI 3%-5%). There was limited evidence to show a dose–response effect of smoking. This review reports a moderate association between maternal smoking and orofacial cleft but the overall quality of the conventional observational studies included was poor. There is a need for high quality and novel research strategies to further define the role of smoking in the etiology of cleft lip and palate.
Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: A case of acute pancreatitis
Authors: Unsal Oktay , Sütcüoğlu Osman , Yazıcı Ozan 
Published: September 2021

Introduction Acute pancreatitis associated with Pazopanib has been reported in the literature. Bitter Melon (Momordica Charantia) is traditionally used as a folk medicine in many regions. In this report, we describe a 65-year-old patient with a diagnosis of renal cell carcinoma, admitted to the hospital with symptoms of acute pancreatitis at the 8th year of pazopanib treatment. Case Report The patient diagnosed with renal cell carcinoma was admitted to the hospital with the complaint of abdominal pain, nausea, and vomiting in the 8th year of Pazopanib treatment. It was noticed from the patient's history that he had received Bitter Melon extract for 4 days prior to the beginning of his complaints (100–150 ml/day). Levels of serum amylase and lipase were measured as 9163 U/L and 14,206 U/L, respectively. Management & Outcome Pazopanib drug was held. The patient was treated for acute pancreatitis. Pazopanib treatment was started again after the clinical condition of the patient had improved and levels of serum amylase and lipase had returned to normal levels. Levels of serum amylase and lipase did not increase again after re-administration of pazopanib treatment. Discussion It is thought that Bitter Melon extract and pazopanib interaction might have led to acute pancreatitis. To the best of our knowledge, this case is the first to highlight the interaction of Bitter Melon extract with pazopanib. The Drug Interaction Probability Scale indicates that there is a probable association between bitter melon and acute pancreatitis.
Impact of brief educational intervention on knowledge of cancer among community pharmacists
Authors: Mensah Kofi Boamah , Boamah Mensah Adwoa Bemah , Wiafe Ebenezer , Padayachee Neelaveni , Aduse Poku Abena Yeboah , Dwobeng Amo Bismark , Hoyte Williams Margaret , Bangalee Varsha , Oosthuizen Frasia 
Published: September 2021

Introduction Community pharmacists may play a vital role in early detection and prevention of cancer. Findings from our pre-assessment studies showed that the Ghanaian community have inadequate knowledge of cancer. We assessed the impact of a brief educational intervention on knowledge level of cancer among Ghanaian community pharmacists. Method The study was a descriptive interventional study. Knowledge of cancer, signs and symptoms, risk factors and cancer screening tests were assessed before in a pre-assessment study and after a brief online education in our current study. A total of 435 community pharmacists were recruited in both studies. Results The mean ± SD total knowledge score of cancer increased from 9.03 ± 2.65 to 12.97 ± 1.43 out of a maximum score of 15 points. The mean ± SD total knowledge score of signs and symptoms of cancer increased from 4.15 ± 2.14 to 6.86 ± 0.76 out of a maximum score of 7 points. For the total knowledge score of causes and risk factors of cancer, the mean ± SD score increased from 8.13 ± 3.31 to 11.59 ± 0.87 out of a maximum score of 12 points. Lastly, the mean ± SD total knowledge score of cancer screening tests increased from 9.04 ± 5.01 to 16.39 ± 0.86 out of a maximum score of 18 points. Conclusion There were overall statistically significant improvements of participants knowledge in all aspects of cancer in this study compared to the pre-assessment study. Our study presents evidence of the effectiveness of a brief educational intervention tailor-made for Ghanaian community pharmacists.
Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty
Authors: Ninomiya Kazunari , Takahira Naonobu , Ikeda Takashi , Suzuki Koji , Sato Ryoji , Kazuo Hirakawa 
Published: September 2021

Objective: To evaluate the prevalence of frailty and associated factors among community-dwelling older adults who have undergone total hip arthroplasty (THA). Materials and methods: This study, which employed a cross-sectional, observational design, was conducted between April and November 2020. The participants were older adults (⩾65 years) who had undergone primary THA at the study hospital. Based on Fried’s modified phenotype, frailty was stratified into 3 degrees according to the presence of 3 or more of the following components: weight loss, weakness, exhaustion, low activity level, and slow walking speed. Multinomial logistic regression was used to analyse the associations of frailty with its potential risk factors. Results: The data of 518 participants were analysed. The overall prevalence of frailty and prefrailty was 11.4% and 51.0%, respectively. The multinomial logistic regression analysis showed that calf circumference (odds ratio [OR] 0.716, 95% confidence interval [CI], 0.611–0.839; p < 0.001), fall history (OR 2.435, 95% CI, 1.114–5.322; p = 0.026), hip abductor muscle strength (OR 0.962, 95% CI, 0.938–0.987; p = 0.003), knee extensor muscle strength (OR 0.980, 95% CI, 0.964–0.996; p = 0.013), and Timed Up and Go test (TUG) performance (OR 1.802, 95% CI, 1.458–2.228; p < 0.001) were associated with frailty. Conclusions: Frailty was highly prevalent in community-dwelling older adults after THA. Further, its potential associations with calf circumference, hip abductor and knee extensor muscle strength, TUG performance, and fall history highlight the significance of these factors for interventions.
The effectiveness of interventions to increase patient involvement in decision-making in orthodontics: A systematic review
Authors: Shelswell Jonathan , Patel Veena Abigale , Barber Sophy 
Published: September 2021

Objectives: To examine the effectiveness of interventions that aim to increase patient involvement in treatment decisions in orthodontic, orthognathic and cleft treatment, based on patient-reported outcomes and patient knowledge. Design: Systematic review. Data sources: OVID databases (MEDLINE, EMBASE and EBM reviews), CENTRAL, WHO’s International Clinical Trials Registry Platform and reference lists of included studies. Data selection: Studies were selected by two reviewers independently and in duplicate based on pre-defined eligibility criteria: Population: People considering or undergoing orthodontic, orthognathic or cleft treatment. Intervention: Any intervention that aims to increase patient involvement in decision-making. Outcomes: Patient-reported outcomes and patient knowledge. Studies: All experimental studies published in English from January 2000 to October 2019 were eligible. Data extraction: Standardised data extraction of study information and assessment of risk of bias using the Cochrane Risk of Bias Tool for RCTs and ROBINS-I for non-randomised studies of interventions. Data synthesis: 13 randomised controlled trials were included. Due to heterogeneity in the studies, a narrative synthesis was undertaken. The majority (n=11) of studies involved orthodontic patients, with one study of cleft patients and one study of orthognathic and orthodontic patients. Six included studies reported significant differences between intervention and control groups with improved patient knowledge or better patient-reported outcomes. Conclusions: A variety of different interventions and outcome measures were used making data synthesis challenging. There is some evidence that interventions to increase patient involvement in decision-making can improve patient-reported outcomes and patient knowledge.
The art of touch: lending a hand to the sighted majority
Authors: Kleege Georgina 
Published: September 2021

This article describes three collaborative projects designed to explore tactile and haptic encounters with visual art. As a blind person, the author takes advantage of touch tours offered in many of the world’s museums. As rewarding as these can be, she often leaves feeling that there is something missing. She is aware that people who witness a touch tour for blind people, both companions who might be with them and strangers who might observe it, are curious, even envious. It seems only right that she, and other blind people who enjoy this privilege, have a responsibility to share the experience as a way to expand cultural knowledge about art. The projects described here enable her to begin to establish a taxonomy and vocabulary of tactile and haptic aesthetics, and model tactile descriptions of art that can benefit anyone. She does this both to reciprocate for the privilege cultural institutions bestowed on her, as well as to show that touch is not merely a poor substitute for sight, but rather a different mode of inquiry and appreciation. She hopes this work will support challenges to the ocularcentrism of the museum sector by showing how art can engage the full human sensorium. These projects all took place in the years leading up to the Covid-19 global pandemic and were a small part of initiatives at arts institutions to promote equity and inclusion by drawing on the knowledge and expertise of members of marginalized communities. As these institutions reopen post-pandemic and restructure their staff and programming, it remains to be known if they will continue the progress toward greater inclusion or return to previous models designed to serve only normative audiences. In her conclusion, the author speculates on the kind of systematic changes that will need to happen to continue to diversify museum audiences and increase multisensory access to art.
Assessment of Telemedicine and Phone Consultation Effects on Rate of Hand Transfers to Trauma Centers and Specialty Services Referrals
Authors: Bracey John , Morell Sean , Tait Mark , Frazier G. Tom , Wyrick Theresa O. 
Published: September 2021

Background Telemedicine consultation can increase patients’ access to subspecialty care and decrease the number of unnecessary hospital transfers. In 2014, the Arkansas Hand Trauma Telemedicine Program (AHTTP) was established to extend specialized hand care throughout Arkansas. The purpose of this study is to assess whether transfers are affected when consultation with a hand specialist is performed by phone compared with using a live audiovisual consultation. Methods We reviewed data from the first year of the AHTTP. Data collection included type of consultation (telephone only or live audiovisual), need for transfer, and type of transfer (general orthopedic or hand specialist). Results In 2014, the first year of AHTTP there were 331 hand injuries identified; of those, 298 used the AHTTP with 195 (65%) using telemedicine and 103 (35%) using phone consultation only. The use of video when compared with phone consultation did not significantly affect the decision to transfer ( P = .42) or alter the rate of transfer for general orthopedic or hand specialist care ( P = .25). Conclusions The assessment of both phone and telemedicine modalities showed that there was no significant difference in transfer rates for either consultation, highlighting that communication with a hand surgeon was the key to accurate assessment of the need for transfer.