bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical and Psychological Health Outcomes of Qigong Exercise in Older Adults: A Systematic Review and Meta-Analysis
Authors: Chang Pei-Shiun , Knobf Tish , Oh Byeongsang , Funk Marjorie 
Published: March 2019

Physical limitations, depression and anxiety are prevalent among older adults. Mild to moderate exercise can promote physical and psychological health and reduce the risk of chronic diseases. Qigong, a type of Chinese traditional medicine exercise, has demonstrated beneficial effects on physical ability and mental health in adults with chronic conditions. The purpose of this review was to systematically assess the effects of Qigong exercise on physical and psychological health outcomes in older adults. A total of 1282 older adults aged 62 to 83 years with depressive symptoms, frailty or chronic medical illnesses were included in this review. The meta-analysis showed that Qigong exercise resulted in significantly improved physical ability compared with active control or usual care (standardized mean difference [SMD] [Formula: see text] 1.00 and 1.20, respectively). The pooled effects of studies with thrice weekly Qigong sessions had the greatest effect ([Formula: see text]) on physical ability in older adults. Lower quality studies demonstrated larger effect sizes than those of higher quality. Although Qigong exercise showed favorable effects on depression, balance and functioning, the overall effects did not reach statistical significance. No significant adverse events were reported. The findings suggest that the Qigong exercise may be an option for older adults to improve physical ability, functional ability, balance and to lessen depression and anxiety. However, the number of RCTs that enroll older adults is limited. More methodologically sound RCTs are needed to confirm the efficacy of Qigong exercise on physical and psychological health in older adults with chronic illnesses.
Provisioning and Performance Evaluation of Parallel Systems with Output Synchronization
Authors: KhudaBukhsh Wasiur R. , Kar Sounak , Rizk Amr , Koeppl Heinz 
Published: March 2019

Parallel server frameworks are widely deployed in modern large-data processing applications. Intuitively, splitting and parallel processing of the workload provides accelerated application response times and scaling flexibility. Examples of such frameworks include MapReduce, Hadoop, and Spark. For many applications, the dynamics of such systems are naturally captured by a Fork-Join (FJ) queuing model, where incoming jobs are split into tasks each of which is mapped to exactly one server. When all the tasks that belong to one job are executed, the job is reassembled and leaves the system. We consider this behavior at the output as a synchronization constraint.In this article, we study the performance of such parallel systems for different server properties, e.g., work-conservingness, phase-type behavior, and as suggested by recent evidence, for bursty input job arrivals. We establish a Large Deviations Principle for the steady-state job waiting times in an FJ system based on Markov-additive processes. Building on that, we present a performance analysis framework for FJ systems and provide computable bounds on the tail probabilities of the steady-state waiting times. We validate our bounds using estimates obtained through simulations. In addition, we define and analyze provisioning, a flexible division of jobs into tasks, in FJ systems. Finally, we use this framework together with real-world traces to show the benefits of an adaptive provisioning system that adjusts the service within an FJ system based on the arrival intensity.
Impact of the Built Environment on Physical Activity in Rural Cancer Survivors
Authors: Mama SK , Bhuiyan N , Lengerich EJ , Schmitz KH 
Published: March 2019

Abstract
Cancer survivors (CS) residing in rural areas are less likely to meet physical activity (PA) recommendations and are more likely to report poor health than those residing in urban areas. Ecologic models suggest that the built environment affects PA, thereby influencing cancer survivorship. The purpose of this study was to examine the impact of the home and neighborhood environment on PA in rural CS. Methods: CS were recruited to a cross-sectional study to explore factors related to PA in CS in central Pennsylvania. Participants completed questionnaires assessing sociodemographics, the home environment for exercise, perceived neighborhood environment, walkability, and PA. Logistic regression models were used to examine the associations between environmental correlates and the likelihood of meeting PA recommendations (≥150 minutes of moderate-to- vigorous intensity PA). Results: CS (n = 258) completed a brief demographic questionnaire, and 215 (83.3%) participants opted to complete a more in-depth questionnaire assessing the environment and PA. Nearly half of participants were prostate (21.9%) or breast (21.9%) CS, and 21.9% of participants reported multiple cancer diagnoses. Participants were mostly women (59.1%), in their mid-60s (M age = 64.7 ± 12.0 years), overweight (M BMI = 29.7 ± 6.8 kg/m2), and self-rated their health as good or better (84.3%). Over half (62.0%) of CS reported meeting PA recommendations. More equipment in the home for exercise (OR = 1.3, 95% CI: 1.1–1.6) and greater environmental support for PA (OR = 1.3, 95% CI: 1.1–1.6) were associated with a higher likelihood of meeting PA recommendations, after adjusting for age, gender, income, BMI, and cancer type. In the adjusted multivariate model, meeting PA recommendations was associated with lower street connectivity (OR = 0.5, 95% CI: 0.2–1.0), higher neighborhood aesthetics (OR = 2.8, 95% CI: 1.1–7.1), and the home environment (OR = 1.3, 95% CI: 1.1–1.6). Conclusions: Findings suggest that the home and neighborhood environment impact PA in rural CS and point to the need for interventions designed to meet the unique built environmental needs of rural CS in an effort to increase PA, improve cancer survivorship outcomes, and reduce cancer health disparities.
Trends in Breast MRI Use Among Women with BRCA Mutations: A National Claims Analysis 2006–2016
Authors: Wernli KJ , Callaway KA , Henderson LM , Kerlikowske K , Lee JM , Ross-Degnan D , Wallace JK , Wharam JF , Zhang F , Stout NK 
Published: March 2019

Abstract
Women with BRCA mutations are recommended to receive breast MRI as an adjunct to annual mammography for breast cancer screening however adoption of these guidelines is unclear. We estimated breast MRI use from 2006–2016 among insured US women to understand use over time. Methods: Using medical care claims, we conducted a cohort study of breast MRI use in commercially-insured women aged 20–64 years continuously enrolled for ≥1 year in a large national insurer between 2006–2016. Women were identified as BCRA mutation carriers without a personal history of breast cancer using ICD9/10 diagnosis codes. We used CPT codes to identify breast MRIs and developed claims-based algorithms to categorized MRI indication as: screening, diagnostic or other. We calculated annual age-specific and age-adjusted rates of use overall and by indication among BCRA mutation carrier women. We used autoregressive time series models to estimate the yearly trend. Results: We identified 12,457 women with BRCA mutations during the study period. Breast MRI use overall among BRCA+ women aged 20–64 was 47/1000 women in 2006 and increased on average by 11 MRIs per year to a rate of 174/1000 in 2016 (P &lt; 0.001). Across this time period, use for screening accounted for over 80% of breast MRIs and rates mirrored the overall trend with a 4.8-fold increase from 31/1000 in 2006 to 146/1000 women by 2016. Over the same time period, use of breast MRI for diagnostic workup or other indications remained stable. Use of screening breast MRI was highest among older women aged 50–64 compared with women &lt;40 and 40–49 years (in 2016, 189, 95, and 177/1000, respectively) Discussion: Breast MRI screening increased dramatically over the past decade in women with BRCA mutations concordant with clinical guidelines. Additional research is needed to understand use of breast imaging relative to health outcomes for this high-risk population.
Association Between Recent Ultraviolet Radiation Exposure and Cutaneous Beta Human Papillomavirus Infection
Authors: Zhao Y , Fenske N , Cherpelis B , Messina J , Giuliano AR , Mckay-Chopin S , Gheit T , Tommasino M , Rollison DE 
Published: March 2019

Abstract
Keratinocyte carcinoma (KC), comprised of squamous cell carcinoma and basal cell carcinoma, is the most common cancer in the United States. The effects of ultraviolet radiation (UVR), an established risk factor for KC, on cutaneous human papillomavirus (HPV) infection, a suggested risk factor currently under investigation, are not well established. We assessed cross sectional associations between UVR exposure and cutaneous beta HPV infection, using data obtained from the Viruses in Skin Cancer Study (VIRUSCAN), a prospective cohort study conducted at the Moffitt Cancer Center and the University of South Florida. Methods: Eyebrow hairs (EBH), skin swabs (SSW) and spectrophotometer-based measurements of recent UVR exposure were obtained from 1,179 skin cancer screening patients enrolled in the VIRUSCAN study. Viral DNA was measured using a multiplex PCR assay for 46 beta HPV types in both skin swab samples and eyebrow hair follicles. Logistic regression was used to examine the association between UVR exposure and cutaneous HPV infection in individual sites. Ordinal logistic regression was used to examine the effect of UVR exposure on the trend of having the same HPV infection across two sites, adjusted for age and sex. Results: Patients with higher UVR exposure were more likely to test positive for beta HPV 19, 47, 100 and 145 in EBH. In SSW, beta 38, 49, 76, 100, 124 were positively associated with UVR exposure. When considering viral infection across two sites, we found UVR exposure to be significantly associated with the odds of having infection in both EBH and SSW for beta HPV 19 (OR = 1.12, 95% CI: 1.03–1.23, p-trend = 0.04), 38 (OR = 1.08, 95% CI: 1.04–1.13, p-trend &lt; 0.01), 76 (OR = 1.06, 95% CI: 1.00–1.12, p-trend = 0.01), and 100 (OR = 1.10, 95% CI: 1.04–1.17, p-trend = 0.01). Conclusions: UVR exposure is positively associated with beta cutaneous HPV at the type level, in both individual sites and across skin swab and eyebrow hair. Future research is needed to better understand the biological mechanisms mediating the associations between UVR and cutaneous HPV infection.
Diagnostic Performance of Four Fecal Immunochemical Tests for Detecting Advanced Colorectal Neoplasia: Preliminary Results
Authors: Levy BT , Hoffman RM , Daly JM , Xu Y , Crockett SD , Shokar NK , Dawson JD , Reuland DS , Zuckerman MJ , Levin AD 
Published: March 2019

Abstract
Screening programs based on fecal blood testing have been shown in randomized controlled trials to reduce colorectal cancer incidence and mortality. Professional organizations highly recommend screening average-risk patients with fecal immunochemical testing (FIT). Many patients find these stool tests more acceptable than colonoscopy and stool testing may be the preferred option for areas with limited endoscopic resources. However, the diagnostic performance of FIT testing, particularly for CLIA-waived point-of-care (POC) tests, has not been well studied. Purpose: We are comparing the diagnostic accuracy of 4 FIT tests, one automated (AUTO) and 3 POC, for detecting advanced neoplasia (advanced adenomas and carcinomas) using colonoscopy as a gold standard. Methods. We are enrolling subjects ages 50 to 85 at 3 academic medical centers in Iowa, Texas, and North Carolina who were scheduled for a screening or surveillance colonoscopy. Each subject completed 4 different FIT tests on a single stool specimen. Based on colonoscopy results, we calculated sensitivity, specificity, and predictive values. We used PROC GLIMMIX models in SAS to compare sensitivity and specificity across the different tests, accounting for the within-patient correlation. Results: We currently have 641 subjects who completed FIT and colonoscopy. Mean age is 61.2 (±7.5) years, 63% women, 63% non-Hispanic white, and 31% Hispanic. We found advanced neoplasia, including 5 carcinomas, in 68 subjects. The sensitivities for detecting these neoplasia were 3%, 22%, 28%, and 16% (AUTO), respectively. Corresponding positive predictive values were 18%, 21%, 33%, and 24% (AUTO). Specificities were 97%, 89%, 90%, and 94% (AUTO), respectively, and corresponding negative predictive values were 89%, 91%, 92%, and 90% (AUTO). We found statistically significant differences in sensitivity (P &lt; 0.01) and specificity (P &lt; 0.01) across tests. Conclusions: Early data suggest that FIT products may vary in their sensitivity and specificity for detecting advanced colorectal neoplasia. This variability could have important impacts on the effectiveness of efforts to limit the burden of colorectal cancer by increasing population-based screening rates through fecal blood testing.
A Prospective Analysis of Red Blood Cell Trans Fatty Acid Levels and Risk of Non-Hodgkin Lymphoma
Authors: Ardisson Korat AV , Chiu YH , Bertrand KS , Zhang S , Laden F , Epstein MM , Rosner BA , Chiuve S , Campos H , Giovannucci EL , Chavarro JE , Birmann BM 
Published: March 2019

Abstract
To confirm previous reports of increased non-Hodgkin lymphoma (NHL) risk with higher intake of dietary trans fatty acids (TFA), we conducted the first prospective study of pre-diagnosis red blood cell (RBC) TFA levels and risk of NHL and common NHL histologic subtypes (diffuse large-B cell lymphoma (DLBCL), follicular lymphoma, chronic lymphocytic lymphoma/small lymphocytic leukemia, other B-cell NHL, T-cell NHL). Methods: We conducted a nested case-control study in Nurses' Health Study (NHS) and Health Professionals Follow-Up Study (HPFS) participants with archived RBC specimens and no history of cancer at sample collection (NHS: 1989–90; HPFS: 1994–5). We confirmed 583 NHL cases (332 women in NHS, 251 men in HPFS) and matched 583 controls by cohort (sex), age, race/ethnicity and blood draw date/time. We analyzed RBC TFAs using gas-liquid chromatography; individual TFA levels were expressed as a percentage of total fatty acids. We used unconditional logistic regression, adjusted for the matching factors, to estimate odds ratios (OR) and 95% confidence intervals (CI) for overall NHL risk per 1 standard deviation (SD) unit increase in TFA level. We fitted multivariate polytomous logistic regression models to assess associations for the specific subtypes listed above. Results: Total and individual RBC TFAs were not associated with overall NHL risk or risk of most histologic subtypes. However, we observed a positive association of total RBC TFA with DLBCL risk (n = 86 cases; OR [95% CI] per 1 SD: 1.29 [1.02, 1.64]), driven primarily by 18:1 TFAs (1.35 [1.07, 1.72]). Among 18:1 TFA isomers, we found a positive association for trans 18:1 n-9 (elaidic acid; 1.33 [1.05, 1.68]) but not for other isomers. Conclusions: We observed significant positive associations for RBC TFA levels with DLBCL risk. These findings are consistent with published studies of self-reported TFA intake; further, previous studies have shown that TFA levels – particularly trans 18:1n-9, which is industrially-derived – are positively correlated with biomarkers of inflammation and immune activation, supporting the biologic plausibility of our findings. Food industry and public health measures to diminish TFA intake may help to reduce risk of NHL, and particularly of DLBCL.
Results of a Randomized Pilot Trial of SHARE: A Self-Management Intervention for Head and Neck Cancer Patients Undergoing Radiotherapy and their Spousal Caregivers
Authors: Badr H , Chhabria K , Sandulache VC , Chiao E , Wagner T 
Published: March 2019

Abstract
Head and neck cancer (HNC) patients experience significant physical and psychological morbidity during radiotherapy (XRT) which contributes to treatment interruptions and poor quality of life. Although spouses/partners can help by encouraging patient self-management (e.g., self-care) during XRT, they often experience high psychological distress rates, lack basic healthcare knowledge/skills, and report increased marital conflict regarding patient self-management. This pilot study examined the feasibility and acceptability of a six-session telephone-based intervention called SHARE (Spouses coping with the Head And neck Radiation Experience), which teaches self-management, communication, and coping skills to HNC patients and their spouses. Treatment effects of SHARE relative to usual medical care (UMC) in controlling patient physical symptoms and improving patient/spouse psychological and marital functioning were also examined. METHODS: Thirty patients initiating XRT and their spouses (N = 60 participants; 40% racial/ethnic minorities) were randomized to SHARE or UMC, and pre- and post-intervention assessments were completed. RESULTS: Solid recruitment (70%) and low attrition rates (7%) demonstrated feasibility. Strong program evaluations and homework completion rates (72%) supported acceptability. Significant treatment effects (medium in magnitude) were observed for SHARE relative to UMC with regard to HNC-specific physical symptom burden (Cohen's d = −0.89) and symptom interference (d = −0.86). Medium-to-large effects favoring SHARE were also found for patient and spouse depressive symptoms (d = −0.84) and cancer-specific distress (d = −1.05). CONCLUSION: Findings support the feasibility, acceptability, and preliminary efficacy of SHARE. They also suggest that programs that empower HNC couples with the necessary skills to coordinate care and manage the challenges of XRT together hold great promise for controlling patient physical symptoms and improving both partners' psychological functioning.
A Comparison of Mortality-to-Incidence Ratio with Survival Analyses in Assessing Racial Breast Cancer Disparities Across South Carolina Counties
Authors: Babatunde O , Arp Adams S , Eberth JM , Zahnd WE , Felder TM , Moran R , Hebert JR 
Published: March 2019

Abstract
The mortality-to-incidence rate ratio (MIR) provides a population-based measure of survival which accounts for incidence. The use of MIR as a surveillance tool has shown that South Carolina (SC) exhibits more extreme racial differences in cancer incidence, mortality and MIR than other states or the nation. We assessed the effectiveness of MIR as a proxy for 5-year survival time (5YST) among breast cancer (BrCa) patients in South Carolina. Methods: The 5YST was computed from data on BrCA cases which were obtained retrospectively from the SC Central Cancer Registry from 2002 to 2010. The MIR was computed from Cancer incidence and mortality data which were obtained from the SC Community Access Network (SCAN). The underlying data for SCAN were generated from the SC Central Cancer Registry and SC DHEC Vital Records and used to construct MIRs. ArcGIS 10.2 was utilized to map BrCA MIRs by race for 46 counties within SC. Seven categories of MIR were derived using the national MIR for BrCA as reference. 5YST was computed for all BrCA cases in each county utilizing SAS software and this was mapped with MIR per county. Exploratory and geographically weighted regression analyses were conducted in ArcGIS to determine the relationship between MIR and MST. Results: A total of 2155 breast cancer patients (nWhites = 1557/72%; nBlacks = 598/28%) were reported in the study period. A visual inspection of the MIR maps by race showed that Blacks were in the highest MIR category while the MIR by 5YST map showed that higher MIR was likely associated with lower 5YST. By contrast, the MIRs for Whites were more evenly represented over the seven categories. Overall, the 5YST was 92.8% among blacks and 95.6% among whites. Assessment of MIR with MST in ArcGIS utilizing exploratory ArcGIS regression showed that there was statistically significant Global Moran's I p value indicative of clustering. Conclusions: The MIR proved useful for identifying disparities in BrCA incidence and mortality among Black and White women in SC. Cancer surveillance programs may use the MIR to monitor disparities across racial/ethnic groups and geographic regions going forward. MIRs have the potential to serve as an indicator of the long-term success of cancer surveillance programs.
Heart Failure With Preserved Ejection Fraction Infrequently Evolves Toward a Reduced Phenotype in Long-Term Survivors
Authors: Lupón Josep , Gavidia-Bovadilla Giovana , Ferrer Elena , de Antonio Marta , Perera-Lluna Alexandre , López-Ayerbe Jorge , Domingo Mar , Núñez Julio , Zamora Elisabet , Moliner Pedro , Santiago-Vacas Evelyn , Santesmases Javier , Bayés-Genis Antoni 
Published: March 2019

Background:
Long-term trajectories of left ventricular ejection fraction (LVEF) in heart failure (HF) patients with preserved EF (HFpEF) remain unclear. Our objective was to assess long-term longitudinal trajectories in consecutive HFpEF patients and the prognostic impact of LVEF dynamic changes over time.

Methods and Results:

Consecutive ambulatory HFpEF patients admitted to a multidisciplinary HF Unit were prospectively evaluated by 2-dimensional echocardiography at baseline and at 1, 3, 5, 7, 9, and 11 years of follow-up. Exclusion criteria were patients having a previous known LVEF <50%, patients undergoing only 1 echocardiogram study, and those with a diagnosis of dilated, noncompaction, alcoholic, or toxic cardiomyopathy. One hundred twenty-six patients (age, 71±13 years; 63% women) were included. The main pathogeneses were valvular disease (36%) and hypertension (28%). Atrial fibrillation was present in 67 patients (53%). The mean number of echocardiographies performed was 3±1.2 per patient. Locally weighted error sum of squares curves showed a smooth decrease of LVEF during the 11-year follow-up that was statistically significant in linear mixed-effects modeling (
P
=0.01). Ischemic patients showed a higher decrease than nonischemics. The great majority (88.9%) of patients remained in the HFpEF category during follow-up; 9.5% evolved toward HF with midrange LVEF, and only 1.6% dropped to HF with reduced LVEF. No significant relationship was found between LVEF dynamics in the immediate preceding period and mortality.

Conclusions:
LVEF remained ≥50% in the majority of patients with HFpEF for ≤11 years. Only 1.6% of patients evolved to HF with reduced LVEF. Dynamic LVEF changes were not associated with mortality.
New State Records for Mallochiola gagates (McAtee &amp; Malloch, 1924), a little-known microphysid in Eastern North America (Hemiptera: Heteroptera: Microphysidae)
Authors: BLINN ROBERT L. 
Published: March 2019

The Microphysidae is one of the smallest heteropteran families, comprised of 30 species and 10 extinct species in 5 genera (Henry 2009, Vinokurov et al. 2010). Only six species are known from Canada and the continental United States (Henry 1988, Schwartz 1989, Schwartz et al. 1991). Of these six species, only two, Chinaola quercicola Blatchley and Mallochiola gagates (McAtee and Malloch, 1924), are considered native to North America. The remaining four species are Palearctic in origin. Schuh and Slater (1995) presented an excellent review of the classification, morphology and natural history for the family. Microphysids are recognized by the presence of ocelli, a distinct cuneus, a single closed cell on the hemelytral membrane, and two-segmented tarsi.