bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic plasticity mediates differential responses to spring and autumn migrations: Evidence from gene expression patterns in migratory buntings
Authors: Sharma Aakansha , Kumar Vinod 
Published: October 2019

New Findings
What is the central question of this study?
What are the molecular underpinnings of seasonal metabolic plasticity during spring and autumn migrations in songbirds?

What is the main finding and its importance?
We report differences in mRNA levels of genes involved in the regulation of glucose and fat metabolism between photoinduced non‐migratory and migratory states and between the spring and autumn migratory states. Higher expression of genes associated with fat mobilization and energy generation in the spring than in the autumn migration suggests differential activation of the metabolic pathways or alteration in the efficiency of existing functional machinery during annual journeys between nearly fixed destinations.

AbstractThe molecular underpinnings of metabolic plasticity underlying differential responses to spring and autumn migrations are not well understood. We investigated this by examining the differences in mRNA levels of metabolic genes in the liver, muscle and adipose tissues of night‐migratory red‐headed buntings between photostimulated non‐migratory and migratory states and between spring and autumn migratory states. Buntings accumulated more subcutaneous fat and hepatic lipid, had higher body mass, larger adipose cells and higher circulating triglyceride and free fatty acid levels and exhibited more intense Zugunruhe in the spring migratory state than in the autumn migratory state. More importantly, we found differences in the hepatic expression of pdc and pdk genes, indicating a differential acetyl‐CoA requirement, and of the mdh and ogdh genes, suggesting differential oxidative phosphorylation between the non‐migratory and migratory states and between the spring and autumn migratory states. Differences in fasn, bmal1 and glut1 mRNA levels were consistent with this and suggested seasonal differences in lipogenesis and/or glucose uptake. Likewise, differences in mRNA levels of genes coding for lipases (atgl and lpl) suggested that adipose triglycerides and free fatty acids serve largely as the metabolic substrate. Furthermore, changes in mRNA levels of genes coding for the fatty acid binding protein (fabp3) and fatty acid translocases (cd36) were consistent with differential fat fuel supply (via circulating free fatty acids) to aerobically exercising flight muscles between the spring and autumn migrations. These results show seasonal adaptation of genetic pathway(s) underlying seasonal metabolic plasticity that seems to mediate differential responses to spring and autumn migrations in latitudinal migratory songbirds.
Integrating Blended Learning Within Sport Event Management Curriculum
Authors: Lower-Hoppe Leeann M. , Wanless Liz A. , Aldridge Sarah M. , Jones Daniel W. 
Published: October 2019

Experiential learning is a critical component of sport management education and industry preparation; however, the inclusion of time-intensive experiential projects can displace content learning. Blended learning integrates face-to-face and online instruction to enable the space to maximize multiple learning types. This article proposes an innovative experiential project that integrates blended learning—implemented in a sport event management course—with reflection and scholarship supporting the pedagogical strategies. The article concludes with implications to optimize blended learning (e.g., multimedia, pedagogical workshops, course evaluation), enhance communication (e.g., office hours, discussion forum, orientation video), and expand student learning outcomes (e.g., reading outlines, video lectures, student assessment).
Validation of electronic visual acuity (EVA) measurement against standardised ETDRS charts in patients with visual field loss from inherited retinal degenerations
Authors: Jolly Jasleen K , Juenemann Kristin , Boagey Heather , Nadsady Marie , Bridge Holly , Maclaren Robert E 
Published: October 2019

BackgroundWith the increase in clinical trials testing therapy for retinal disease, there is a need to ensure that outcome measures are both accurate and standardised. The US Food and Drug Administration favours the use of visual acuity measured using ETDRS logMAR charts. The loss of visual field can interfere with visual tracking across the charts, leading to increased variability of measurements. Electronic visual acuity (EVA) presents the optotype on the centre of a screen, thereby removing the tracking element of the task, and may provide a more precise measurement.MethodsVisual acuity was measured twice using ETDRS charts, EVA automated single letter (E-ETDRS) and EVA single line (EVA-SL) presentation (EMMES). Patients underwent microperimetry (MAIA; Centervue) to determine visual field. We tested 65 patients with rod-cone dystrophies and 41 healthy volunteers.ResultsBoth participant groups read 2–3 letters more on average on the electronic charts compared with ETDRS. Limits of agreement using a modified Bland-Altman analysis account for replicates were wider in eyes with foveal defects (−9 to 18) compared with eyes without foveal defects (−11 to 15). Electronic charts in the presence of foveal defects reduced the range (−11 to 13).ConclusionEVA may provide more accurate measures of visual acuity than traditional ETDRS charts in patients when the visual field loss encroached on the central vision. Electronic presentation with a single line of letters was the favoured style reported by patients and should be considered in future interventional clinical trials.
Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal
Authors: Bellou Vanesa , Belbasis Lazaros , Konstantinidis Athanasios K , Tzoulaki Ioanna , Evangelou Evangelos 
Published: October 2019

Abstract

Objective
To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD).

Design
Systematic review.

Data sources
PubMed until November 2018 and hand searched references from eligible articles.

Eligibility criteria for study selection
Studies developing, validating, or updating a prediction model in COPD patients and focusing on any potential clinical outcome.

Results
The systematic search yielded 228 eligible articles, describing the development of 408 prognostic models, the external validation of 38 models, and the validation of 20 prognostic models derived for diseases other than COPD. The 408 prognostic models were developed in three clinical settings: outpatients (n=239; 59%), patients admitted to hospital (n=155; 38%), and patients attending the emergency department (n=14; 3%). Among the 408 prognostic models, the most prevalent endpoints were mortality (n=209; 51%), risk for acute exacerbation of COPD (n=42; 10%), and risk for readmission after the index hospital admission (n=36; 9%). Overall, the most commonly used predictors were age (n=166; 41%), forced expiratory volume in one second (n=85; 21%), sex (n=74; 18%), body mass index (n=66; 16%), and smoking (n=65; 16%). Of the 408 prognostic models, 100 (25%) were internally validated and 91 (23%) examined the calibration of the developed model. For 286 (70%) models a model presentation was not available, and only 56 (14%) models were presented through the full equation. Model discrimination using the C statistic was available for 311 (76%) models. 38 models were externally validated, but in only 12 of these was the validation performed by a fully independent team. Only seven prognostic models with an overall low risk of bias according to PROBAST were identified. These models were ADO, B-AE-D, B-AE-D-C, extended ADO, updated ADO, updated BODE, and a model developed by Bertens et al. A meta-analysis of C statistics was performed for 12 prognostic models, and the summary estimates ranged from 0.611 to 0.769.

Conclusions
This study constitutes a detailed mapping and assessment of the prognostic models for outcome prediction in COPD patients. The findings indicate several methodological pitfalls in their development and a low rate of external validation. Future research should focus on the improvement of existing models through update and external validation, as well as the assessment of the safety, clinical effectiveness, and cost effectiveness of the application of these prognostic models in clinical practice through impact studies.

Systematic review registration
PROSPERO CRD42017069247
Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries
Authors: Sania Ayesha , Sudfeld Christopher R , Danaei Goodarz , Fink Günther , McCoy Dana C , Zhu Zhaozhong , Fawzi Mary C Smith , Akman Mehmet , Arifeen Shams E , Barros Aluisio J D , Bellinger David , Black Maureen M , Bogale Alemtsehay , Braun Joseph M , van den Broek Nynke , Carrara Verena , Duazo Paulita , Duggan Christopher , Fernald Lia C H , Gladstone Melissa , Hamadani Jena , Handal Alexis J , Harlow Siobán , Hidrobo Melissa , Kuzawa Chris , Kvestad Ingrid , Locks Lindsey , Manji Karim , Masanja Honorati , Matijasevich Alicia , McDonald Christine , McGready Rose , Rizvi Arjumand , Santos Darci , Santos Leticia , Save Dilsad , Shapiro Roger , Stoecker Barbara , Strand Tor A , Taneja Sunita , Tellez-Rojo Martha-Maria , Tofail Fahmida , Yousafzai Aisha K , Ezzati Majid , Fawzi Wafaie 
Published: October 2019

ObjectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).DesignMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sourcesWe searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.Eligibility criteria for selecting studiesStudies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study.AnalysesLinear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.ResultsWe retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (–0.24 to –0.05) and 0.23 SD (–0.42 to –0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from −0.18 to −0.10 SDs.ConclusionsDifferential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.
Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review
Authors: Zhou Yin , van Melle Marije , Singh Hardeep , Hamilton Willie , Lyratzopoulos Georgios , Walter Fiona M 
Published: October 2019

ObjectivesIn urological cancers, sex disparity exists for survival, with women doing worse than men. Suboptimal evaluation of presenting symptoms may contribute.DesignWe performed a systematic review examining factors affecting the quality of the diagnostic process of patients presenting with symptoms of bladder or kidney cancer.Data sourcesWe searched Medline, Embase and the Cochrane Library from 1 January 2000 to 13 June 2019.Eligible criteriaWe focused on one of the six domains of quality of healthcare: timeliness, and examined the quality of the diagnostic process more broadly, by assessing whether guideline-concordant history, examination, tests and referrals were performed. Studies describing the factors that affect the timeliness or quality of the assessment of urinary tract infections, haematuria and lower urinary tract symptoms in the context of bladder or kidney cancer, were included.Data extraction and synthesisData extraction and quality assessment were independently performed by two authors. Due to the heterogeneity of study design and outcomes, the results could not be pooled. A narrative synthesis was performed.Results28 studies met review criteria, representing 583 636 people from 9 high-income countries. Studies were based in primary care (n=8), specialty care (n=12), or both (n=8). Up to two-thirds of patients with haematuria received no further evaluation in the 6 months after their initial visit. Urinary tract infections, nephrolithiasis and benign prostatic conditions before cancer diagnosis were associated with diagnostic delay. Women were more likely to experience diagnostic delay than men. Patients who first saw a urologist were less likely to experience delayed evaluation and cancer diagnosis.ConclusionsWomen, and patients with non-cancerous urological diagnoses just prior to their cancer diagnosis, were more likely to experience lower quality diagnostic processes. Risk prediction tools, and improving guideline ambiguity, may improve outcomes and reduce sex disparity in survival for these cancers.
Management of erectile dysfunction after prostate cancer treatment: cross-sectional surveys of the perceptions and experiences of patients and healthcare professionals in the UK
Authors: Dyer Amy , Kirby Mike , White Isabel D , Cooper Alison Michelle 
Published: October 2019

ObjectivesErectile dysfunction (ED) is known to be a common consequence of radical treatment for prostate cancer (PCa) but is often under-reported and undertreated. This study aimed to explore how ED in patients with PCa is managed in real-life clinical practice, from the perspective of patients and healthcare professionals (HCPs).Design and settingThis is a UK-wide cross-sectional survey of men with ED after treatment for PCa which covered assessment and discussion of erectile function, provision of supportive care and satisfaction with management. Parallel surveys of primary and secondary HCPs were also conducted.ResultsResponses were received from 546 men with ED after PCa treatment, 167 primary (general practitioners and practice nurses) and 94 secondary care HCPs (urologists and urology clinical nurse specialists). Survey findings revealed inadequate management of ED in primary care, particularly underprescribing of effective management options. A fifth of men (21%) were not offered any ED management, and a similar proportion (23%) were not satisfied with the way HCPs addressed their ED concerns. There was poor communication between HCPs and men, including failure to initiate discussions about ED and/or involve partners, with 12% of men not told that ED was a risk factor of PCa treatment. These issues seemed to reflect poor access to effective ED management or services and lack of primary HCP confidence in managing ED, as well as confusion over the roles and responsibilities among both HCPs and men.ConclusionsThis study confirms the need for better support for men from HCPs and more tailored and timely access to effective ED management after treatment for PCa. A clearly defined pathway is required for the discussion and management of ED, starting from the planning stage of PCa treatment. Improved adherence to ED management guidelines and better education and training for primary care HCPs are areas of priority.
Predictors of return to work after kidney transplantation: a 12-month cohort of the Japan Academic Consortium of Kidney Transplantation study
Authors: Miyake Katsunori , Endo Motoki , Okumi Masayoshi , Unagami Kohei , Kakuta Yoichi , Furusawa Miyuki , Shimizu Tomokazu , Omoto Kazuya , Shirakawa Hiroki , Ishida Hideki , Tanabe Kazunari 
Published: October 2019

ObjectivesTo investigate the cumulative return-to-work (RTW) rate and to identify predictors of employment after kidney transplantation (KT).DesignRetrospective, outpatient-based cohort study.SettingThis was a single-centre study of the largest Japanese kidney transplant centre.ParticipantsWe selected Japanese kidney transplant recipients aged 20–64 years who were employed in paid jobs at the time of transplantation and who visited an outpatient clinic from December 2017 to March 2018. From 797 patients, we evaluated 515 in this study.InterventionsWe interviewed patients at an outpatient clinic and investigated the timing and predictors of RTW using logistic regression models.Primary and secondary outcome measuresThe primary outcome was the cumulative RTW rate, and the secondary outcome was to investigate the predictors of RTW after KT.ResultsAmong the 515 included recipients, the cumulative overall partial/full RTW rates at 2, 4, 6 and 12 months were 22.3%, 59.0%, 77.1% and 85.0%, respectively. The median duration from transplantation to RTW was 4 months. Regarding partial/full RTW, according to the multivariable analysis including all variables, male sex was a greater predictor for RTW than female sex (OR 2.05, 95% CI 1.32 to 3.20), and a managerial position was a greater predictor than a non-managerial position (OR 2.23, 95% CI 1.42 to 3.52). Regarding full RTW, male sex (OR 1.95, 95% CI 1.25 to 3.06) and managerial position (OR 1.95, 95% CI 1.25 to 3.06) were also good predictors.ConclusionsThe cumulative RTW rate was 85.0% 1-year post-transplantation. Given that cumulative RTW rates varied by sex and position, transplant and occupational physicians should support kidney transplant recipients in the aspect of returning to work.Trial registration numberUMIN000033449
Diagnosing and treating haemothorax in dogs and cats
Authors: Allerton Fergus 
Published: October 2019

Background: Cases of haemothorax are seen in primary practice. Given the range of potential aetiologies, a structured approach to diagnosis is important.Aim of the article: This article reviews the causes of haemothorax and outlines the approach to diagnosing this condition in practice, as well as how to treat cases.
Effect of procedural refinement of transfemoral transcatheter aortic valve implantation on outcomes and costs: a single-centre retrospective study
Authors: Sangaraju Sivasankar , Cox Ian , Dalrymple-Hay Malcolm , Lloyd Clinton , Suresh Venkatesan , Riches Tania , Melhuish Samantha , Asopa Sanjay , Newcombe Samantha , Deutsch Cornelia , Bramlage Peter 
Published: October 2019

ObjectivesTo determine the effect of introducing several procedural refinements of transfemoral transcatheter aortic valve implantation (TAVI) on clinical outcomes and costs.DesignRetrospective analysis comparing two consecutive 1-year periods, before and after the introduction of procedural refinements.SettingTertiary hospital aortic valve programme.ParticipantsConsecutive patients undergoing transfemoral TAVI treated between April 2014 and August 2015 using the initial setup (n=70; control group) or between September 2015 and August 2016 after the introduction of procedural refinements (n=89).InterventionsIntroduction of conscious sedation, percutaneous access and closure, omission of transoesophageal echocardiography during the procedure, and an early discharge procedure.Outcome measuresProcedural characteristics, complications and outcomes; length of stay in intensive care unit (ICU) and hospital; hospital-related direct costs associated with TAVI.ResultsThere were no statistically significant differences in the incidence of complications or mortality between the two groups. The mean length of stay in the ICU was significantly shorter in the procedural-refinement group compared with the control group (5.1 vs 57.2 hours, p<0.001), as was the mean length of hospital stay (4.7 vs 6.6 days, p<0.001). The total cost per TAVI procedure was significantly lower, by £3580, in the procedural-refinement group (p<0.001). This was largely driven by lower ICU costs.ConclusionsAmong patients undergoing transfemoral TAVI, procedural refinement facilitated a shorter stay in ICU and earlier discharge from hospital and was cost saving compared with the previous setup.
Impact of pulmonary hypertension on outcome in patients with moderate or severe tricuspid regurgitation
Authors: Saeed Sahrai , Smith Jenna , Grigoryan Karine , Urheim Stig , Chambers John B , Rajani Ronak 
Published: October 2019

ObjectivesThe true prevalence and disease burden of moderate or severe (significant) tricuspid regurgitation (TR) in patients undergoing routine echocardiography remains unknown. Our aim was to explore the prevalence of significant TR and the impact of pulmonary hypertension (PH) on outcome in a less selected cohort of patients referred to echocardiography.MethodsFrom 12 791 echocardiograms performed between January and December 2010, a total of 209 (1.6%) patients (72±14 years, 56% men) were identified with significant TR; 123 (0.96%) with moderate and 86 (0.67%) with severe TR. Median follow-up time was 80 months (mean 70±33 months). Systolic pulmonary artery pressure was derived from peak velocity of tricuspid regurgitant jet plus the right atrial pressure and considered elevated if ≥40 mm Hg (PH).ResultsDuring follow-up there were 123 (59%) deaths with no difference in mortality between moderate and severe TR (p=0.456). The death rates were 93 (67%) in patients with PH versus 30 (42%) without PH (p<0.001). PH was associated with lower event-free survival in moderate (log-rank, p<0.001), but not in severe TR (log-rank, p=0.133). In a multivariate Cox regression analysis adjusted for age, smoking, coronary artery disease, reduced right ventricle S′, lower left ventricular ejection fraction at baseline, right atrium size and mitral valve replacement, PH remained a significant predictor of all-cause mortality (HR 2.22; 95% CI 1.41 to 3.47, p=0.001).ConclusionsModerate or severe TR was found in 1.6% of patients attending for routine echocardiograms. PH identified a high-risk subset of patients with moderate TR but not with severe TR.