bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supervised exercise delivered via telehealth in real time to manage chronic conditions in adults: a protocol for a scoping review to inform future research in stroke survivors
Authors: Ramage Emily R , Fini Natalie A , Lynch Elizabeth A , Patterson Amanda , Said Catherine M , English Coralie 
Published: March 2019

IntroductionIncreasing physical activity reduces secondary stroke risk factors, but many stroke survivors have low levels of physical activity. Supervised exercise delivered via telehealth has the potential to overcome barriers to increased physical activity in stroke survivors. Our scoping review will examine the emerging field of supervised exercise delivered via telehealth to map the available evidence in relation to its efficacy, acceptability, safety and feasibility in chronic conditions to inform future research into its ability to increase physical activity.Methods and analysisThe methodological framework of Arksey and O’Malley will be applied to our scoping review. A systematic search of Medline, CINAHL, Scopus, Cochrane, Pedro and Embase; hand searching of pertinent studies’ reference lists; and consultation with experts in the field will identify relevant papers. Studies involving participants with a chronic condition who undertake supervised exercise delivered by a health professional via telehealth targeted at improving secondary stroke risk factors or involving lower limb weight-bearing exercise will be included. Study selection and critical appraisal of individual studies will be carried out independently by two authors with discrepancies resolved by a third author. Quantitative and qualitative data will be charted using a standardised form. Results will be tabulated and narratively summarised to highlight findings relevant to the review’s research questions and to inform recommendations for future research.Ethics and disseminationOur review will significantly contribute to the knowledge base of exercise and rehabilitation delivered via telehealth and its application in chronic conditions, including stroke. Findings will be relevant to researchers, healthcare workers and policy-makers and will be disseminated through publication and presentations. Only secondary deidentified data will be included, therefore ethics approval will not be sought. This protocol is not registered as PROSPERO currently excludes scoping reviews.
Reporting of data monitoring committees and adverse events in paediatric trials: a descriptive analysis
Authors: Gates Allison , Caldwell Patrina , Curtis Sarah , Dans Leonila , Fernandes Ricardo M , Hartling Lisa , Kelly Lauren E , Vandermeer Ben , Williams Katrina , Woolfall Kerry , Dyson Michele P 
Published: March 2019

ObjectivesFor 300 paediatric trials, we evaluated the reporting of: a data monitoring committee (DMC); interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints.MethodsFor this cross-sectional evaluation, we randomly selected 300 paediatric trials published in 2012 from the Cochrane Central Register of Controlled Trials. We collected data on the reporting of a DMC; interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints. We reported the findings descriptively and stratified by trial characteristics.ResultsEighty-five (28%) of the trials investigated drugs, and 18% (n=55/300) reported a DMC. The reporting of a DMC was more common among multicentre than single centre trials (n=41/132, 31% vs n=14/139, 10%, p<0.001) and industry-sponsored trials compared with those sponsored by other sources (n=16/50, 32% vs n=39/250, 16%, p=0.009). Trials that reported a DMC enrolled more participants than those that did not (median [range]): 224 (10–60480) vs 91 (10–9528) (p<0.001). Only 25% of these trials reported interim analyses, and 42% reported stopping rules. Less than half (n=143/300, 48%) of trials reported on adverse events, and 72% (n=215/300) reported on harm-related endpoints. Trials that reported a DMC compared with those that did not were more likely to report adverse events (n=43/55, 78% vs 100/245, 41%, p<0.001) and harm-related endpoints (n=52/55, 95% vs. 163/245, 67%, p<0.001). Only 32% of drug trials reported a DMC; 18% and 19% did not report on adverse events or harm-related endpoints, respectively.ConclusionsThe reporting of a DMC was infrequent, even among drug trials. Few trials reported stopping rules or interim analyses. Reporting of adverse events and harm-related endpoints was suboptimal.
External validation and recalibration of the Brock model to predict probability of cancer in pulmonary nodules using NLST data
Authors: Winter Audrey , Aberle Denise R , Hsu William 
Published: March 2019

IntroductionWe performed an external validation of the Brock model using the National Lung Screening Trial (NLST) data set, following strict guidelines set forth by the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis statement. We report how external validation results can be interpreted and highlight the role of recalibration and model updating.Materials and methodsWe assessed model discrimination and calibration using the NLST data set. Adhering to the inclusion/exclusion criteria reported by McWilliamset al, we identified 7879 non-calcified nodules discovered at the baseline low-dose CT screen with 2 years of follow-up. We characterised differences between Pan-Canadian Early Detection of Lung Cancer Study and NLST cohorts. We calculated the slope on the prognostic index and the intercept coefficient by fitting the original Brock model to NLST. We also assessed the impact of model recalibration and the addition of new covariates such as body mass index, smoking status, pack-years and asbestos.ResultsWhile the area under the curve (AUC) of the model was good, 0.905 (95% CI 0.882 to 0.928), a histogram plot showed that the model poorly differentiated between benign and malignant cases. The calibration plot showed that the model overestimated the probability of cancer. In recalibrating the model, the coefficients for emphysema, spiculation and nodule count were updated. The updated model had an improved calibration and achieved an optimism-corrected AUC of 0.912 (95% CI 0.891 to 0.932). Only pack-year history was found to be significant (p<0.01) among the new covariates evaluated.ConclusionWhile the Brock model achieved a high AUC when validated on the NLST data set, the model benefited from updating and recalibration. Nevertheless, covariates used in the model appear to be insufficient to adequately discriminate malignant cases.
PinPinKorori or NenNenKorori: the historical and socioeconomic background of geriatric trauma care in Japan
Authors: Fujita Takashi 
Published: March 2019

IntroductionAging is one of the most serious social issues, not only in Japan. A country’s socioeconomic conditions must be taken into account when considering the issue of rapid aging. The purpose of this review was to introduce the historical and socioeconomic background of geriatric trauma care in Japan.MethodLiterature review regarding the trauma care for the elderly written in Japanese and English.Results“PinPinKorori” is a Japanese word which symbolizes an ideal, healthy life. “NenNenkorori” is the opposite of PinPinKorori. The Japanese elderly desire to live a healthy, active life and die (PinPinKorori) rather than being bedridden and dying in agony. A bedridden individual (NenNenKorori) is a candidate for receiving end-of-life care. End-of-life care is a form of trauma care for the elderly that ensures quality of death for those in need.ConclusionsI encourage the elderly to document their advance care preferences with decision-making capacity in order to avoid futile care. Healthcare providers should strive to provide optimum care to the patients in their best interest and ensure not to provide treatment that is not desired by the patients.Level of evidenceLevel IV.
Various dark energy models for variables G and Λ in f(R, T) modified theory
Authors: Aktaş Can 
Published: March 2019

In this paper, we have researched tachyon field, k-essence and quintessence dark energy (DE) models for Friedmann–Robertson–Walker (FRW) universe with varying G and [Formula: see text] in f(R, T) gravitation theory. The theory of f(R, T) is proposed by Harko et al. [Phys. Rev. D 84, 024020, 2011]. In this theory, R is the Ricci scalar and T is the trace of energy–momentum tensor. For the solutions of field equations, we have used linearly varying deceleration parameter (LVDP), the equation of state (EoS) and the ratio between [Formula: see text] and Hubble parameter. Also, we have discussed some physical behavior of the models with various graphics.
Pondering variables and direct instruction
Authors: Hill Robin K. , Guzdial Mark 
Published: March 2019

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Robin K. Hill considers the nature of variables, while Mark Guzdial reflects on renewed interest in the "direct instruction model."
Portal milieu and the interplay of multiple antidiabetic effects after gastric bypass surgery
Authors: Pal Atanu , Rhoads David B. , Tavakkoli Ali 
Published: March 2019

Diabetes is a worldwide health problem. Roux-en-Y gastric bypass (RYGB) leads to rapid resolution of type 2 diabetes (T2D). Decreased hepatic insulin resistance is key, but underlying mechanisms are poorly understood. We hypothesized that changes in intestinal function and subsequent changes in portal venous milieu drive some of these postoperative benefits. We therefore aimed to evaluate postoperative changes in portal milieu. Two rat strains, healthy [Sprague-Dawley (SD)] and obese diabetic [Zucker diabetic fatty (ZDF)] rats, underwent RYGB or control surgery. After 4 wk, portal and systemic blood was sampled before and during an intestinal glucose bolus to investigate changes in intestinal glucose absorption (Gabsorp) and utilization (Gutil), and intestinal secretion of incretins and glucagon-like peptide-2 (GLP-2). Hepatic activity of dipeptidyl peptidase-4 (DPP4), which degrades incretins, was also measured. RYGB decreased Gabsorp in both rat strains. Gutil increased in SD rats and decreased in ZDF rats. In both strains, there was increased expression of intestinal hexokinase and gluconeogenesis enzymes. Systemic incretin and GLP-2 levels also increased after RYGB. This occurred without an increase in secretion. Hepatic DPP4 activity and expression were unchanged. RYGB perturbs multiple intestinal pathways, leading to decreased intestinal glucose absorption and increased incretin levels in both healthy and diabetic animals. In diabetic rats, intestinal glucose balance shifts toward glucose release. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to rapid changes in hepatic glucose and hormone handling. This fresh insight into the surgical physiology of RYGB raises the hope of less invasive alternatives. NEW & NOTEWORTHY Portal milieu after gastric bypass surgery is an underinvestigated area. Roux-en-Y gastric bypass perturbs multiple intestinal pathways, reducing intestinal glucose absorption and increasing incretin levels. In diabetic rats, the intestine becomes a net releaser of glucose, increasing portal glucose levels. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to changes in hepatic glucose handling. This fresh insight raises the hope of less invasive alternatives.
Impact of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profile
Authors: Costa Ricardo J. S. , Camões-Costa Vera , Snipe Rhiannon M. J. , Dixon David , Russo Isabella , Huschtscha Zoya 
Published: March 2019

It is commonly believed that gastrointestinal issues during exercise are exacerbated by hypohydration. This study aimed to determine the effect of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profiles. In a randomized crossover design, male endurance runners ( n = 11) performed 2 h of running at 70% of maximum oxygen uptake in 25°C ambient temperature with water provision [euhydration (EuH)] and total water restriction [hypohydration (HypoH)] during running, which accounted for 0.6 ± 0.6% and 3.1 ± 0.7% body mass loss, respectively. Blood and fecal samples were collected before and after exercise. Breath samples (H2 determination) were collected and gastrointestinal symptoms (GIS) recorded before, during, and after exercise. HypoH resulted in a higher, yet insignificant, ∆ preexercise to postexercise plasma cortisol concentration (+286 nmol/l vs. +176 nmol/l; P = 0.098) but significantly higher intestinal fatty acid-binding protein (I-FABP) (+539 pg/ml vs. +371 pg/ml; P = 0.047) concentration compared with EuH. A greater breath H2 response ( P = 0.026) was observed on HypoH (1,188 ppm/3 h, peak +12 ppm) vs. EuH (579 ppm/3 h, peak +6 ppm). Despite greater GIS incidence on HypoH (82%) vs. EuH (64%), GIS severity scores were not significant between trials. Exercise-induced leukocytosis (overall pre- to postexercise: 5.9 × 109/l to 12.1 × 109/l) was similar on both trials. Depressed in vitro neutrophil function was observed during recovery on HypoH (−36%) but not on EUH (+6%). A pre- to postexercise increase ( P < 0.05) was observed for circulating cytokine concentrations but not endotoxin values. Hypohydration during 2 h of running modestly perturbs gastrointestinal integrity and function and increases GIS incidence but does not affect systemic endotoxemia and cytokinemia. NEW & NOTEWORTHY Despite anecdotal beliefs that exercise-induced hypohydration exacerbates perturbations to gastrointestinal status, the present study reports only modest perturbations in gastrointestinal integrity, function, and symptoms compared with euhydration maintenance. Exercise-induced hypohydration does not exacerbate systemic endotoxemia and cytokinemia compared with euhydration maintenance. Programmed water intake to maintain euhydration results in gastrointestinal symptom severity similar to exercise-induced hypohydration. Maintaining euhydration during exertional stress prevents the exercise-associated depression in bacterially stimulated neutrophil function.
Genome-Wide Interrogation of Human Cancers Identifies EGLN1 Dependency in Clear Cell Ovarian Cancers
Authors: Price Colles , Gill Stanley , Ho Zandra V. , Davidson Shawn M. , Merkel Erin , McFarland James M. , Leung Lisa , Tang Andrew , Kost-Alimova Maria , Tsherniak Aviad , Jonas Oliver , Vazquez Francisca , Hahn William C. 
Published: March 2019

Abstract

We hypothesized that candidate dependencies for which there are small molecules that are either approved or in advanced development for a nononcology indication may represent potential therapeutic targets. To test this hypothesis, we performed genome-scale loss-of-function screens in hundreds of cancer cell lines. We found that knockout of EGLN1, which encodes prolyl hydroxylase domain-containing protein 2 (PHD2), reduced the proliferation of a subset of clear cell ovarian cancer cell lines in vitro. EGLN1-dependent cells exhibited sensitivity to the pan-EGLN inhibitor FG-4592. The response to FG-4592 was reversed by deletion of HIF1A, demonstrating that EGLN1 dependency was related to negative regulation of HIF1A. We also found that ovarian clear cell tumors susceptible to both genetic and pharmacologic inhibition of EGLN1 required intact HIF1A. Collectively, these observations identify EGLN1 as a cancer target with therapeutic potential.

Significance:
These findings reveal a differential dependency of clear cell ovarian cancers on EGLN1, thus identifying EGLN1 as a potential therapeutic target in clear cell ovarian cancer patients.
Predictable Value of Functional Independence Measure Differs between Anterior and Posterior Circulation Ischemic Strokes
Authors: Kawano Hiroyuki , Johno Takashi , Torii Masataka , Kamiyama Hiroshi , Amano Tatsuo , Honda Yuko , Okano Haruko , Unno Yoshiko , Yamada Shin , Okajima Yasutomo , Shiokawa Yoshiaki , Hirano Teruyuki 
Published: March 2019

<b><i>Background:</i></b> The functional independence measure (FIM) is a standard tool to provide a detailed evaluation of ADL of patients with disabilities. This study aimed to show the differences in FIM scores as an outcome predictor between patients with anterior circulation (AC) and posterior circulation (PC) strokes. <b><i>Methods:</i></b> Consecutive patients with acute ischemic stroke hospitalized within 7 days after onset were investigated. Baseline NIHSS scores, 1st-FIM (&#x3c; 72 h after ­admission to stroke unit), 2nd-FIM (&#x3c; 72 h before discharge), and modified Rankin Scale (mRS) scores were collected. Logistic regression analyses were used to identify predictors of a favorable outcome (mRS 0–2) at 3-month after stroke. <b><i>Results:</i></b> Three hundred eighty-five patients (median age, 78 years; male, 59%; median length of stroke unit stay, 20 days) were included. The median baseline NIHSS, 1st- and 2nd-FIM scores were 4 (interquartile range 2–9), 65 (33–91), and 98 (54–122) respectively. Baseline NIHSS (3 vs. 4, <i>p</i> = 0.01) and mRS score at 3-month (1 vs. 2, <i>p</i> = 0.01) were lower, and 1st-FIM (75 vs. 64, <i>p</i> &#x3c; 0.01) and 2nd-FIM (113 vs. 95, <i>p</i> = 0.01) were higher in 82 patients with PC than 303 patients with AC strokes. On multivariate logistic regression analysis, 2nd-FIM score was an independent predictor of favorable outcomes in both PC (OR 1.18, 95% CI 1.04–1.48, <i>p</i> &#x3c; 0.01) and AC (OR 1.12, 95% CI 1.06–1.20, <i>p</i> &#x3c; 0.01) strokes. The optimal cutoff scores of 2nd-FIM for predicting favorable outcome were 104 for PC (sensitivity 0.82, specificity 0.88) and 93 for AC (0.88–0.90) strokes. <b><i>Conclusions:</i></b> The differences in outcome predictability by FIM score between AC and PC strokes should be considered, although FIM scores at discharge from stroke unit were useful to predict a favorable outcome.
Risk Factors for Stroke in Patients With Sepsis and Bloodstream Infections
Authors: Shao Iris Yuefan , Elkind Mitchell S.V. , Boehme Amelia K. 
Published: March 2019

Background and Purpose—
Sepsis has been identified as a trigger for stroke, but the underlying mechanisms and risk factors that predispose patients with sepsis to increased stroke risk remain unclear. We sought to identify predictors of stroke after sepsis and bloodstream infections.

Methods—

The 2007–2009 California State Inpatient Database from the Health Care Utilization Project was used to identify patients over the age of 18 years and hospitalized with sepsis or bloodstream infection defined by
International Classification of Diseases, Ninth Revision
codes. Patients who died during their sepsis hospitalization were excluded. The primary outcome was a primary diagnosis of ischemic or hemorrhagic stroke on a subsequent hospitalization within 1 year. Associations between risk factors, also defined by
International Classification of Diseases, Ninth Revision
codes, and stroke were analyzed using multivariable logistic regression. A composite risk score was generated to predict stroke risk.

Results—
Of 121 947 patients with sepsis, 0.5% (n=613) had a primary diagnosis of stroke within a year of their sepsis hospitalization. Significant predictors for stroke were identified. A score was generated from these risk factors with points assigned based on regression coefficients: valvular heart diseases (1 point), congestive heart failure (1), renal failure (1), lymphoma (2), peripheral vascular diseases (2), pulmonary circulation disorders (2), and coagulopathy (3). The C statistic for the receiver operating characteristic curve for the score was 0.68. The risk of stroke increased 43% (odds ratio, 1.43; 95% CI, 1.37–1.48) per-point increase in the score. The effect of increase in score was greater among younger patients.

Conclusions—
Risk factors and a composite risk score for stroke may help identify a subpopulation of sepsis patients that could be targeted to reduce the short-term risk of stroke after serious infections.
Home-Time Is a Feasible and Valid Stroke Outcome Measure in National Datasets
Authors: McDermid Iain , Barber Mark , Dennis Martin , Langhorne Peter , Macleod Mary J. , McAlpine Christine H. , Quinn Terence J. 
Published: March 2019

Background and Purpose—
Home-time (HT) is a stroke outcome measure based on time spent at home after stroke. We hypothesized that HT assessment would be feasible and valid using national data.

Methods—
We linked the Scottish Stroke Care Audit to routine healthcare data and calculated 90-day HT for all strokes, 2005 to 2017. We described prognostic validity (Spearman rank correlation) of HT to baseline factors.

Results—
We were able to calculate HT for 101 969 strokes (99.3% of total Scottish strokes). Mean HT was 46 days (95% CI, 45.8–46.2; range, 0–90). HT showed consistent correlation with our prespecified prognostic factors: age: ρ, −0.35 (95% CI, −0.35 to −0.36); National Institutes of Health Stroke Scale score, −0.54 (95% CI, −0.52 to −0.55); and 6 simple variables (ordinal), −0.61 (95% CI, −0.61 to −0.62).

Conclusions—
HT can be derived at scale using routine clinical data and appears to be a valid proxy measure of functional recovery. Other national databases could use HT as a time and cost efficient measure of medium and longer-term outcomes.
Response of the Sea Breeze to Urbanization in the Pearl River Delta Region
Authors: You Cheng , Chi-Hung Fung Jimmy , Tse Wai Po 
Published: March 2019

AbstractThe Pearl River delta (PRD) region has undergone rapid urbanization since the 1980s, which has had significant effects on the sea-breeze circulation in this region. Because the sea breeze plays an important role in pollutant transportation and convective initiation in the PRD region, it is meaningful to study the effects of urbanization on the sea breeze. In this study, three numerical experiments were conducted from 2 June to 31 August 2010 with land-use data from 1988, 1999, and 2010. For each simulation, characteristics of the sea breeze such as the start time, end time, intensity, height, pumping ability, and inland penetration distance were quantified. By comparing the characteristics of the sea breeze in these simulations, its response to urbanization was quantified. The results show that urbanization enhances the duration, height, and intensity of the sea breeze but blocks its inland penetration. One physical mechanism is proposed to dynamically elucidate the response of the sea breeze to urbanization. Because the urban area in the PRD region is concentrated near the coast, urbanization imposes a positive heating gradient on the coastal region and a negative heating gradient on the region farther inland. The positive heating gradient may intensify the sea breeze, and the negative heating gradient may prevent the sea breeze from propagating farther inland.