bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exercise training intensity determination in cardiovascular rehabilitation: Should the guidelines be reconsidered?
Authors: Hansen Dominique , Bonné Kim , Alders Toon , Hermans Ann , Copermans Katrien , Swinnen Hans , Maris Vincent , Jansegers Thomas , Mathijs Wout , Haenen Laura , Vaes Johan , Govaerts Emmanuela , Reenaers Veerle , Frederix Ines , Dendale Paul 
Published: June 2019

Aims In the rehabilitation of cardiovascular disease patients a correct determination of the endurance-type exercise intensity is important to generate health benefits and preserve medical safety. It remains to be assessed whether the guideline-based exercise intensity domains are internally consistent and agree with physiological responses to exercise in cardiovascular disease patients. Methods A total of 272 cardiovascular disease patients without pacemaker executed a maximal cardiopulmonary exercise test on bike (peak respiratory gas exchange ratio >1.09), to assess peak heart rate (HRpeak), oxygen uptake (VO2peak) and cycling power output (Wpeak). The first and second ventilatory threshold (VT1 and VT2, respectively) was determined and extrapolated to %VO2peak, %HRpeak, %heart rate reserve (%HRR) and %Wpeak for comparison with guideline-based exercise intensity domains. Results VT1 was noted at 62 ± 10% VO2peak, 75 ± 10% HRpeak, 42 ± 14% HRR and 47 ± 11% Wpeak, corresponding to the high intensity exercise domain (for %VO2peak and %HRpeak) or low intensity exercise domain (for %Wpeak and %HRR). VT2 was noted at 84 ± 9% VO2peak, 88 ± 8% HRpeak, 74 ± 15% HRR and 76 ± 11% Wpeak, corresponding to the high intensity exercise domain (for %HRR and %Wpeak) or very hard exercise domain (for %HRpeak and %VO2peak). At best (when using %Wpeak) in only 63% and 72% of all patients VT1 and VT2, respectively, corresponded to the same guideline-based exercise intensity domain, but this dropped to about 48% and 52% at worst (when using %HRR and %HRpeak, respectively). In particular, the patient’s VO2peak related to differently elicited guideline-based exercise intensity domains ( P < 0.05). Conclusion The guideline-based exercise intensity domains for cardiovascular disease patients seem inconsistent, thus reiterating the need for adjustment.
King's Brief Interstitial Lung Disease questionnaire: responsiveness and minimum clinically important difference
Authors: Nolan Claire M. , Birring Surinder S. , Maddocks Matthew , Maher Toby M. , Patel Suhani , Barker Ruth E. , Jones Sarah E. , Walsh Jessica A. , Wynne Stephanie C. , George Peter M. , Man William D-C. 
Published: June 2019

Health status is increasingly used in clinical practice to quantify symptom burden and as a clinical trial end-point in patients with interstitial lung disease (ILD). The King's Brief Interstitial Lung Disease (KBILD) questionnaire is a brief, validated 15-item, disease-specific, health-related quality of life questionnaire that is increasingly used in clinical trials, but little data exist regarding the minimum clinically important difference (MCID). Using pulmonary rehabilitation as a model, we aimed to determine the responsiveness of KBILD and provide estimates of the MCID.KBILD scores, Chronic Respiratory Questionnaire (CRQ) scores, Medical Research Council (MRC) Dyspnoea score and incremental shuttle walk test (ISWT) distance were measured in 209 patients with ILD (105 with idiopathic pulmonary fibrosis (IPF)) before and after an outpatient pulmonary rehabilitation programme. Changes with intervention and Cohen's effect size were calculated. Anchor-based (linear regression and receiver operating characteristic plots) or distribution-based approaches (0.5sdand standard error of measurement) were used to estimate the MCID of KBILD domain and total scores.KBILD, CRQ, MRC Dyspnoea and ISWT improved with intervention, and the effect sizes of KBILD domain and total scores ranged from 0.28 to 0.38. Using anchor-based estimates, the MCID estimates for KBILD-Psychological, KBILD-Breathlessness and activities, and KBILD-Total were 5.4, 4.4 and 3.9 points, respectively. Using distribution-based methods, the MCID estimate for KBILD-Chest symptoms was 9.8 points. The MCID estimates for KBILD in IPF patients were similar.In patients with ILD and IPF, KBILD is responsive to intervention with an estimated MCID of 3.9 points for the total score.
The global prevalence of latent tuberculosis: a systematic review and meta-analysis
Authors: Cohen Adam , Mathiasen Victor Dahl , Schön Thomas , Wejse Christian 
Published: June 2019

In 1999, the World Health Organization (WHO) estimated that one-third of the world's population had latent tuberculosis infection (LTBI), which was recently updated to one-fourth. However, this is still based on controversial assumptions in combination with tuberculin skin test (TST) surveys. Interferon-γ release assays (IGRAs) with a higher specificity than TST have since been widely implemented, but never used to estimate the global LTBI prevalence.We conducted a systematic review and meta-analysis of LTBI estimates based on both IGRA and TST results published between 2005 and 2018. Regional and global estimates of LTBI prevalence were calculated. Stratification was performed for low, intermediate and high TB incidence countries and a pooled estimate for each area was calculated using a random effects model.Among 3280 studies screened, we included 88 studies from 36 countries with 41 IGRA (n=67 167) and 67 TST estimates (n=284 644). The global prevalence of LTBI was 24.8% (95% CI 19.7–30.0%) and 21.2% (95% CI 17.9–24.4%), based on IGRA and a 10-mm TST cut-off, respectively. The prevalence estimates correlated well to WHO incidence rates (Rs=0.70, p<0.001).In the first study of the global prevalence of LTBI derived from both IGRA and TST surveys, we found that one-fourth of the world's population is infected. This is of relevance, as both tests, although imperfect, are used to identify individuals eligible for preventive therapy. Enhanced efforts are needed targeting the large pool of latently infected individuals, as this constitutes an enormous source of potential active tuberculosis.
Systematic evaluation of the QualityRights programme in public mental health facilities in Gujarat, India
Authors: Pathare Soumitra , Funk Michelle , Drew Bold Natalie , Chauhan Ajay , Kalha Jasmine , Krishnamoorthy Sadhvi , Sapag Jaime C. , Bobbili Sireesha J. , Kawade Rama , Shah Sandeep , Mehta Ritambhara , Patel Animesh , Gandhi Upendra , Tilwani Mahesh , Shah Rakesh , Sheth Hitesh , Vankar Ganpat , Parikh Minakshi , Parikh Indravadan , Rangaswamy Thara , Bakshy Amritkumar , Khenti Akwatu 
Published: June 2019

BackgroundRecognising the significant extent of poor-quality care and human rights issues in mental health, the World Health Organization launched the QualityRights initiative in 2013 as a practical tool for implementing human rights standards including the United Nations Convention on Rights of Persons with Disabilities (CRPD) at the ground level.AimsTo describe the first large-scale implementation and evaluation of QualityRights as a scalable human rights-based approach in public mental health services in Gujarat, India.MethodThis is a pragmatic trial involving implementation of QualityRights at six public mental health services chosen by the Government of Gujarat. For comparison, we identified three other public mental health services in Gujarat that did not receive the QualityRights intervention.ResultsOver a 12-month period, the quality of services provided by those services receiving the QualityRights intervention improved significantly. Staff in these services showed substantially improved attitudes towards service users (effect sizes 0.50–0.17), and service users reported feeling significantly more empowered (effect size 0.07) and satisfied with the services offered (effect size 0.09). Caregivers at the intervention services also reported a moderately reduced burden of care (effect size 0.15).ConclusionsTo date, some countries are hesitant to reforming mental health services in line with the CRPD, which is partially attributable to a lack of knowledge and understanding about how this can be achieved. This evaluation shows that QualityRights can be effectively implemented even in resource-constrained settings and has a significant impact on the quality of mental health services.
Ectodysplasin-A signaling is a key integrator in the lacrimal gland–cornea feedback loop
Authors: Kuony Alison , Ikkala Kaisa , Kalha Solja , Magalhães Ana Cathia , Pirttiniemi Anniina , Michon Frederic 
Published: June 2019

ABSTRACT
A lack of ectodysplasin-A (Eda) signaling leads to dry eye symptoms, which have so far only been associated with altered Meibomian glands. Here, we used loss-of-function (Eda−/−) mutant mice to unravel the impact of Eda signaling on lacrimal gland formation, maturation and subsequent physiological function. Our study demonstrates that Eda activity is dispensable during lacrimal gland embryonic development. However, using a transcriptomic approach, we show that the Eda pathway is necessary for proper cell terminal differentiation in lacrimal gland epithelium and correlated with modified expression of secreted factors commonly found in the tear film. Finally, we discovered that lacrimal glands present a bilateral reduction of Eda signaling activity in response to unilateral corneal injury. This observation hints towards a role for the Eda pathway in controlling the switch from basal to reflex tears, to support corneal wound healing. Collectively, our data suggest a crucial implication of Eda signaling in the cornea–lacrimal gland feedback loop, both in physiological and pathophysiological conditions. Our findings demonstrate that Eda downstream targets could help alleviate dry eye symptoms.
Modulation of gold nanoparticle mediated radiation dose enhancement through synchronization of breast tumor cell population
Authors: Rieck Kristy , Bromma Kyle , Sung Wonmo , Bannister Aaron , Schuemann Jan , Chithrani Devika Basnagge 
Published: June 2019

Objective:
The incorporation of high atomic number materials such as gold nanoparticles (GNPs) into tumor cells is being tested to enhance the local radiotherapy (RT) dose. It is also known that the radiosensitivity of tumor cells depends on the phase of their cell cycle. Triple combination of GNPs, phase of tumor cell population, and RT for improved outcomes in cancer treatment.

Methods:
We used a double-thymidine block method for synchronization of the tumor cell population. GNPs of diameters 17 and 46 nm were used to capture the size dependent effects. A radiation dose of 2 Gy with 6 MV linear accelerator was used to assess the efficacy of this proposed combined treatment. A triple negative breast cancer cell line, MDA-MB-231 was chosen as the model cell line. Monte Carlo (MC) calculations were done to predict the GNP-mediated cell death using the experimental GNP uptake data.

Results:
There was a 1.5- and 2- fold increase in uptake of 17 and 46 nm GNPs in the synchronized cell population, respectively. A radiation dose of 2 Gy with clinically relevant 6 MV photons resulted in a 62 and 38 % enhancement in cell death in the synchronized cell population with the incorporation of 17 and 46 nm GNPs, respectively. MC data supported the experimental data, but to a lesser extent.

Conclusion:
A triple combination of GNPs, cell cycle synchronization, and RT could pave the way to enhance the local radiation dose while minimizing side effects to the surrounding healthy tissue.

Advances in knowledge:
This is the first study to show that the combined use of GNPs, phase of tumor cell population, and RT could enhance tumor cell death.
Improving the evidence for integrated family planning and economic growth programming: a synthesis of the evidence
Authors: Marcus Rachel , Bercu Chiara , Norton Maureen , Mutunga Clive 
Published: June 2019

Background:Integrated family planning and economic growth programming has the potential to be more equitable and cost-effective, to garner high levels of support from communities, and to support countries on their journey to self-reliance. The available evidence is limited, but demonstrates that such integrated programming can catalyze improved outcomes in both sectors. We reviewed available program evidence to explore what information is available to implementers regarding potential best practices.Methods:Economic growth is a broad sector; we focused specifically on the need for evidence related to integration of family planning with microfinance and livelihood programs. We conducted an extensive literature search and reviewed both published and gray literature according to two criteria: whether the papers explicitly focused on FP/EG integration and whether they included program descriptions, including discussions of what specific interventions were implemented.Results:We find that only limited information exists regarding how best to design and implement such programs for FP/RH and economic growth. We provide ideas drawn from the identified program evidence about potential best practices for FP/RH and economic growth integrated programs, and find an increasing need for tools and resources on related best practices.Conclusions:Both family planning and economic growth programs should consider strengthening linkages between the two sectors, to accelerate the achievement of global family planning goals as well as to improve economic growth outcomes. We call for additional research and improved documentation to clarify the apparent contributions and effectiveness of FP/EG integration, as well as to confirm promising practices. The integration of family planning and economic growth sectors is particularly important as the global community works toward achieving broader global and country-level development goals.
Conditional Life Cycle: An Examination of Operating Performance for Leaders and Laggards
Authors: Cantrell Brett W. , Dickinson Victoria 
Published: June 2019

The economics and management literature provides theoretical support for both leader and laggard firms to earn higher future operating returns. However, prior empirical research lacks a generalizable proxy to capture leader versus laggard behavior, thus limiting prior findings to specific contexts. This study utilizes a combination of firm-specific and industry life cycle identification to categorize leaders and laggards and validates the designation against constructs established in prior literature. Additionally, we examine each strategy’s effect on future performance, finding that, in general, laggards earn greater operating returns. Laggards gain their advantage through product differentiation—specifically, through marketing/advertising expenditures. Leaders are, on average, unable to convert their first movers’ advantage into sustainable future profitability once we control for other determinants of profitability. The leader/laggard classification using financial statement information has useful applications in analysis, forecasting, and valuation. This paper was accepted by Suraj Srinivasan, accounting.
Ultrasonic cement removal in cement-in-cement revision total hip arthroplasty
Authors: Liddle A. , Webb M. , Clement N. , Green S. , Liddle J. , German M. , Holland J. 
Published: June 2019

Objectives Previous studies have evidenced cement-in-cement techniques as reliable in revision arthroplasty. Commonly, the original cement mantle is reshaped, aiding accurate placement of the new stem. Ultrasonic devices selectively remove cement, preserve host bone, and have lower cortical perforation rates than other techniques. As far as the authors are aware, the impact of ultrasonic devices on final cement-in-cement bonds has not been investigated. This study assessed the impact of cement removal using the Orthosonics System for Cemented Arthroplasty Revision (OSCAR; Orthosonics) on final cement-in-cement bonds. Methods A total of 24 specimens were manufactured by pouring cement (Simplex P Bone Cement; Stryker) into stainless steel moulds, with a central rod polished to Stryker Exeter V40 specifications. After cement curing, the rods were removed and eight specimens were allocated to each of three internal surface preparation groups: 1) burr; 2) OSCAR; and 3) no treatment. Internal holes were recemented, and each specimen was cut into 5 mm discs. Shear testing of discs was completed by a technician blinded to the original grouping, recording ultimate shear strengths. Scanning electron microscopy (SEM) was completed, inspecting surfaces of shear-tested specimens. Results The mean shear strength for OSCAR-prepared specimens (33.6 MPa) was significantly lower than for the control (46.3 MPa) and burr (45.8 MPa) groups (p < 0.001; one-way analysis of variance (ANOVA) with Tukey’s post hoc analysis). There was no significant difference in shear strengths between control and burr groups (p = 0.57). Scanning electron microscopy of OSCAR specimens revealed evidence of porosity undiscovered in previous studies. Conclusion Results show that the cement removal technique impacts on final cement-in-cement bonds. This in vitro study demonstrates significantly weaker bonds when using OSCAR prior to recementation into an old cement mantle compared with cement prepared with a burr or no treatment. This infers that care must be taken in surgical decision-making regarding cement removal techniques used during cement-in-cement revision arthroplasty, suggesting that the risks and benefits of ultrasonic cement removal need consideration. Cite this article: A. Liddle, M. Webb, N. Clement, S. Green, J. Liddle, M. German, J. Holland. Ultrasonic cement removal in cement-in-cement revision total hip arthroplasty: What is the effect on the final cement-in-cement bond? Bone Joint Res 2019;8:246–252. DOI: 10.1302/2046-3758.86.BJR-2018-0313.R1.
The effect of Oncotype DX® on adjuvant chemotherapy treatment decisions in early breast cancer
Authors: Rabie MA , Rankin A , Burger A , Youssef MMG 
Published: June 2019

Introduction The aim of this study was to objectively establish the value of the Oncotype DX® (ODX) gene assay in adjuvant treatment decisions for intermediate risk patients with early, oestrogen receptor positive, human epidermal growth factor receptor 2 negative, lymph node negative breast cancer at a district general hospital. Methods All patients who underwent surgery for breast cancer between January 2015 and December 2017 at Queen Elizabeth Hospital in King’s Lynn were considered for inclusion in the study. Those who did not meet the criteria for ODX referral were excluded. Patients were divided into two cohorts based on whether they were treated before or after the introduction of ODX testing in this hospital (June 2016): the pre-ODX and post-ODX groups. The primary outcome was the percentage of patients for whom adjuvant chemotherapy (AC) was recommended in each group. Results Of the 462 patients who underwent surgery during the study period, 43 met the eligibility criteria for ODX testing: 18 in the pre-ODX group and 25 in the post-ODX group. AC was recommended and given to 11 (61%) of the patients in the pre-ODX group. In the post-ODX group, AC was recommended for seven patients with an ODX Recurrence Score® (RS) of >25; this was given to six patients (24%). One patient (with a RS of 26) declined AC. ODX testing led to a significant reduction in the proportion of patients who received AC (p=0.015). Conclusions In intermediate risk patients with breast cancer, the results of the ODX gene assay may change the decision for adjuvant treatment. It represents a valuable tool to assist patients’ and clinicians’ decision making regarding adjuvant chemotherapy.
PERANCANGAN SISTEM KONTROL NAVIGASI BEARING PADA QUADCOPTER DENGAN METODE PID (PROPORTIONAL, INTEGRAL, DERIVATIVE) SELF TUNING PSO (PARTICLE SWARM OPTIMIZATION)
Authors: Sulila Muhammad Surya , Sumardi Sumardi , Riyadi Munawar Agus 
Published: June 2019

Unmanned Aerial Vehicle (UAV) adalah pesawat tanpa awak yang dapat dikendalikan secara manual ataupun otomatis dari jarak jauh. Sistem navigasi UAV quadcopter salah satunya adalah membuat sistem kontrol quadcopter agar dapat stabil menghadap ke arah koordinat yang dituju dengan mengatur sudut putar sumbu vertikal (yaw) atau disebut navigasi bearing sehingga pada Penelitian ini dirancang sistem kontrol Proportional Integral Derivative self tuning Particle Swarm Optimization. Perancangan sistem navigasi bearing digunakan input berupa Global Position System untuk mengetahui koordinat quadcopter, sedangkan sensor kompas HMC5883L digunakan untuk mengetahui kondisi aktual sudut arah hadap quadcopter. Berdasarkan hasil pengujian respon sistem quadcopter, untuk dapat mengarah ke koordinat yang dituju dengan koordinat quadcopter tetap, settling time dicapai pada detik ke 6,4 dan error setelah settling time sebesar 5,4⁰. Berdasarkan pengujian dengan perubahan koordinat, didapatkan error rata-rata sebesar 7,9⁰. Berdasarkan pengujian dengan diberi gangguan didapatkan error offset rata-rata sebesar 1,89⁰ dan mencapai settling time pada detik ke 4,1. Batasan nilai self tuning PSO yang terbaik didapat pada nilai Kp = 0,15 sampai 0,3, Ki = 0,06 sampai 0,6, dan Kd = 0,005 sampai Kd = 0,1. Nilai koefisien PSO yang digunakan adalah C1 = 1,5, C2 = 2 dan bobot inersia dari 0,7 sampai 1,2.
STUDI UNJUK KERJA LIGHTNING AIR TERMINAL PROTECTION DITINJAU DARI JENIS BAHAN
Authors: Napitupulu Anastasia Br , Nugroho Agung , Syakur Abdul 
Published: June 2019

Lightning air terminal merupakan bagian utama dari sistem proteksi petir eksternal. Parameter yang menentukan baik buruknya kinerja lightning air terminal franklin ialah level tegangan tembus. Pada penelitian ini membahas lightning air terminal yang ditinjau dari jenis bahan. Penelitian ini dilakukan dengan skala laboratorium dengan 6 kali percobaan pada 4 jenis bahan yang berbeda. Standard mengacu pada International Electrotechnical Commision (IEC) 62305. Metode penelitian menggunakan tegangan tinggi DC polaritas negatif dengan mengatur jarak sela kemudian dilakukan pemetaan distribusi tegangan dan medan listrik dengan metode FEM (Finite Element Method) menggunakan software Matlab R2008. Variabel yang dicari berupa tegangan tembus, resistansi, distribusi tegangan dan medan listrik dari masing-masing lightning air terminal. Hasil penelitian menunjukan bahwa jenis bahan mempengaruhi kemampuan menyalurkan arus petir sampai ke ground. Dengan jarak sela yang sama, dihasilkan tegangan tembus yang berbeda. Probabilitas pegujian tegangan tembus pada jenis bahan tembaga, alumunium, besi galvanis, dan besi sebesar 100 % , 100 %, 96,67 % dan 100 % dengan resistansi 0,06 Ω, 0,08 Ω, 0,10 Ω, dan 0,11 Ω .Distribusi tegangan dan medan listrik tidak merata untuk keempat lightning air terminal.
PERANCANGAN ZERO VOLTAGE SWITCHING BUCK CONVERTER DENGAN BEBAN RESISTIF BERVARIASI DAN SEBAGAI CATU DAYA UNTUK MOTOR ARUS SEARAH
Authors: Arief Rahman Zya Jamaluddin Al-Rasyid , Windarta Jaka , Hermawan Hermawan 
Published: June 2019

Penggunaan konverter arus searah sebagai penghasil tegangan arus searah sudah mengalami perkembangan. Rangkaian konverter arus searah diatur dengan menggunakan rangkaian kontrol Pulse Width Modulation (PWM) yang digunakan sebagai pengendali saklar. Proses ketika saklar mengalami kondisi nyala dan mati mengakibatkan terjadinya rugi-rugi pensaklaran. Masalah tersebut dapat diatasi dengan menggunakan metode soft-switching. Salah satu metode soft-switching yang digunakan adalah Zero Voltage Switching (ZVS). Teknik pensaklaran ZVS dapat membuat saklar bekerja ketika tegangan bernilai nol. Teknik pensaklaran tegangan nol ini dapat mengurangi rugi - rugi pensaklaran yang terjadi, sehingga dapat meningkatkan efisiensi konverter arus searah yang digunakan sebagai catu daya motor arus searah. Berdasarkan hasil pengujian, rangkaian konverter arus searah tipe ZVS buck converter dapat menghasilkan daya keluaran sebesar 103,77 watt dengan nilai efisiensi sebesar 94,83%. Nilai efisiensi tertinggi terjadi ketika diberi beban statis berupa resistor 500 Ω sebesar 99,77%.