bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of presence or absence of exercise and/or physical activity with non-restorative sleep by gender and age: a cross-sectional study
Authors: Hidaka Tomoo , Endo Shota , Kasuga Hideaki , Masuishi Yusuke , Kakamu Takeyasu , Kumagai Tomohiro , Fukushima Tetsuhito 
Published: May 2019

ObjectivesNon-restorative sleep (NRS) is related to qualitative aspects of sleep. The associations of NRS with exercise (EX; a planned and purposeful activity) and physical activity (PA; daily bodily movement) by gender and age have not yet been clarified. We investigated the associations of EX and/or PA with NRS by gender and age.DesignA cross-sectional study.SettingThe data on gender, age, presence of NRS and engagement in EX and/or PA were obtained from database and questionnaire of specified medical check-ups in FY 2013 in Japan. The analysis was conducted in 2017.ParticipantsThe subjects comprised 90 122 residents (38 603 males and 51 519 females), aged 40–74 years, who had completed the specified medical check-ups.Outcome measureThe presence of NRS was assessed using a question asking whether or not the subjects usually got enough sleep. NRS was considered to be present when the subjects answered ‘No’. Binary logistic regression analysis was used to assess the associations of presence or absence of EX and/or PA with NRS. The OR and 95% CI of NRS prevalence were calculated and compared between those engaged in both EX and PA and the others.ResultsExcept for 40s and 70s among males and 40s and 50s among females, the absence of EX or PA was associated with higher ORs of NRS than referent. ORs were more than twice compared with the referents in males in their 50s (OR 2.030(95% CI 1.675 to 2.459)) and 60s (OR 2.148(95% CI 1.970 to 2.343)) and females in their 60s (OR 2.142(95% CI 1.994 to 2.302)) when they engaged in neither EX nor PA.ConclusionsHealthcare providers must take into account the similarities and differences in the associations of EX and/or PA with NRS by gender and age when they support people with NRS.
Effectiveness and cost-effectiveness of a virtual multidisciplinary stroke care clinic for community-dwelling stroke survivors and caregivers: a randomised controlled trial protocol
Authors: Chau Janita Pak Chun , Lo Suzanne Hoi Shan , Lee Vivian Wing Yan , Choi Kai Chow , Shum Edward Wai Ching , Hung Zevari Sheung Sheung , Mok Vincent Chung Tong , Siow Elaine Kee Chen , Ching Jessica Yuet Ling , Lam Simon Kwun Yu , Yeung Jonas Hon Ming , Li Siu Hung , Lau Alexander Yuk Lun 
Published: May 2019

IntroductionThe virtual multidisciplinary stroke care clinic (VMSCC) is the first nurse-led clinic developed to offer support to community-dwelling stroke survivors and caregivers, and to promote poststroke recovery. This two-arm randomised controlled trial will evaluate its effectiveness on survivors’ self-efficacy (SE), survivors’ and caregivers’ health-related quality of life (HRQoL) and cost-effectiveness on emergency admissions and length of readmission hospital stay.Methods and analysisA consecutive sample of 384 stroke survivor–caregiver dyads will be recruited from four hospitals. An online platform that embraces readily accessible and reliable information will be developed. Participants randomly assigned to the intervention group will receive usual care plus the VMSCC service. The service includes access to a tablet containing 30 videos demonstrating appropriate self-care strategies, communication with a registered nurse monthly through video and telephone calls and regular blood pressure monitoring. Primary outcomes include survivors’ SE in self-management and survivors’ and caregivers’ HRQoL. Secondary outcomes include survivors’ performance of self-management behaviours, depression and social participation; and caregivers’ coping strategies, satisfaction with caring and depression. Data will be collected at baseline, and at 3 and 6 months after commencing the intervention. Survivors’ and caregivers’ satisfaction with the service will be assessed at 6-month follow-up. Multivariable regressions and generalised estimating equations model will be conducted. Survivors’ emergency admissions and length of hospital stay will be evaluated during the 6-month follow-up period. Cost-effectiveness analysis will be performed on the average total cost incurred.DiscussionThe results will inform stakeholders about incorporating the VMSCC service into current stroke rehabilitation service.Ethics and disseminationThis protocol was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2017.660). All participants will provide written informed consent. Results will be disseminated through scientific publications, and presentations at local and international conferences.Trial registration numberChiCTR1800016101; Pre-results.
Factors associated with adverse drug reaction occurrence and prognosis, and their economic impacts in older inpatients in Taiwan: a nested case–control study
Authors: Liao Pei-Ju , Mao Chien-Tai , Chen Tun-Liang , Deng Shin-Tarng , Hsu Kuang-Hung 
Published: May 2019

ObjectiveOlder patients are likely to have higher disease complexity and more drug prescriptions of which are associated with a higher incidence of adverse drug reactions (ADR). This study aimed to investigate factors associated with ADR occurrence, prognosis and medical expenses in older inpatients.DesignA nested case–control study.SettingA medical centre located in north Taiwan.Participants539 reported ADR cases from a patient cohort containing 108 548 older inpatients were collected from 2006 to 2012. There were 1854 non-ADR matched controls; a maximum of 1:5 matched by age, sex and principal diagnosis were collected.ExposurePolypharmacy, the number of drugs prescribed, comorbidities and the admission department were factors associated with ADRs, as well as subsequent poor prognosis, length of stay and medical expenses.Primary and secondary outcome measuresADR occurrence and poor prognosis (mortality, discharge against medical advice in critical conditions, or admitted to intensive care unit) were the primary outcomes. Additional medical expenses and the length of hospital stay were the secondary outcomes.ResultsThe admission department, number of comorbidities and number of drug prescriptions before ADRs were associated with ADR occurrence among older inpatients. ADR severity was a significant prognostic factor among ADR cases. The multivariate-adjusted OR of 1.63 (95% CI 1.36 to 1.95) for poor prognosis was found as the number of comorbidities increased. Patients prescribed ≥11 drugs including psychoactive drugs showed 2.45-fold (95% CI 1.40 to 4.28) poorer prognosis than other patients. ADRs caused the addition of US$1803.8, US$360.8 and 5.6 days in total medical expenses, drug expenses and length of stay among affected older inpatients, respectively.ConclusionsThe number of comorbidities and polypharmacy including the use of psychoactive drugs has significant impacts on ADR occurrence and prognosis among older inpatients. The findings provide clues for future prescription modification and patient’s safety improvement in geriatric care.
Determinants of cigarette smoking status in a national cohort of black and white adult ever smokers in the USA: a cross-sectional analysis of the REGARDS study
Authors: Parekh Trisha M , Wu Chengyi , McClure Leslie A , Howard Virginia J , Cushman Mary , Malek Angela M , Harrington Kathleen F , Cherrington Andrea L , Dransfield Mark T , Bhatia Smita 
Published: May 2019

ObjectivesWhile awareness of cigarette smoking’s harmful effects has increased, determinants associated with smoking status remain understudied, including potential racial differences. We aim to examine factors associated with former versus current smoking status and assess whether these associations differed by race.SettingWe performed a cross-sectional analysis using the population-based Reasons for Geographic and Racial Differences in Stroke(REGARDS)study.Outcome measuresLogistic regression was used to calculate the OR of former smoking status compared with current smoking status with risk factors of interest. Race interactions were tested using multiplicative interaction terms.Results16 463 participants reported smoking at least 100 cigarettes in their lifetime. Seventy-three per cent (n=12 067) self-reported former-smoker status. Physical activity (reference (REF) <3×/week; >3×/week: OR=1.26, 95% CI 1.11 to 1.43), adherence to Mediterranean diet (REF: low; medium: OR=1.46, 95% CI 1.27 to 1.67; high: OR=2.20, 95% CI 1.84 to 2.64), daily television viewing time (REF: >4 hours; <1 hour: OR=1.32, 95% CI 1.10 to 1.60) and abstinence from alcohol use (REF: heavy; none: OR=1.50, 95% CI 1.18 to 1.91) were associated with former-smoker status. Male sex, higher education and income $35 000–$74 000 (REF: <$20 000) were also associated with former-smoker status. Factors associated with lower odds of reporting former-smoker status were younger age (REF: ≥65 years; 45–64 years: OR=0.34, 95% CI 0.29 to 0.39), black race (OR=0.62, 95% CI 0.53 to 0.72) and single marital status (REF: married status; OR=0.66, 95% CI 0.51 to 0.87), being divorced (OR=0.60, 95% CI 0.50 to 0.72) or widowed (OR=0.70, 95% CI 0.57 to 0.85). Significant interactions were observed between race and alcohol use and dyslipidaemia, such that black participants had higher odds of reporting former-smoker status if they were abstinent from alcohol (OR=2.32, 95% CI 1.47 to 3.68) or had a history of dyslipidaemia (OR=1.31, 95% CI 1.06 to 1.62), whereas these relationships were not statistically significant in white participants.ConclusionEfforts to promote tobacco cessation should consist of targeted behavioural interventions that incorporate racial differences.
Levels of Lipoprotein (a) in patients with coronary artery disease with and without inflammatory rheumatic disease: a cross-sectional study
Authors: Holm Sverre , Oma Ingvild , Hagve Tor-Arne , Saatvedt Kjell , Brosstad Frank , Mikkelsen Knut , Rydningen Hans , Risnes Ivar , Almdahl Sven Martin , Ueland Thor , Aukrust Pål , Halvorsen Bente , Hollan Ivana 
Published: May 2019

ObjectivesPatients with various inflammatory rheumatic diseases (IRDs) have increased risk of atherothrombotic disease. Lipoprotein (a) (Lp(a)) is a risk factor for atherosclerosis but its role in IRD with accompanying coronary artery disease (CAD) is still unclear. We aimed to examine if serum Lp(a) levels differed between CAD patients with and without accompanying IRD.DesignA cross-sectional observational, patient-based cohort study.SettingReferred centre for coronary artery bypass grafting in the South Eastern part of Norway.Participants67 CAD patients with IRD (CAD/IRD) and 52 CAD patients without IRD (CAD/non-IRD). All patients were Caucasians, aged >18 years, without any clinically significant infection or malignancy.MethodsLp(a) levels in serum were analysed by particle enhanced immunoturbidimetric assay, and Lp(a) levels were related to clinical and biochemical characteristics of the patient population.ResultsWe found no differences in serum levels of Lp(a) between CAD patients with and without IRD. In general, we found that Lp(a) correlated poorly with clinical and biochemical parameters including C reactive protein with the same pattern in the CAD/non-IRD and CAD/IRD groups.ConclusionsOur data do not support a link between inflammation and Lp(a) levels in CAD and in general Lp(a) levels were not correlated with other risk factors for cardiovascular disease.
Clinical implications of early caudate dysfunction in Parkinson’s disease
Authors: Pasquini Jacopo , Durcan Rory , Wiblin Louise , Gersel Stokholm Morten , Rochester Lynn , Brooks David James , Burn David , Pavese Nicola 
Published: May 2019

ObjectiveAlthough not typical of Parkinson’s disease (PD), caudate dopaminergic dysfunction can occur in early stages of the disease. However, its frequency and longitudinal implications in large cohorts of recently diagnosed patients remain to be established. We investigated the occurrence of caudate dopaminergic dysfunction in the very early phases of PD (<2 years from diagnosis) using123I-FP-CIT single photon emission CT and determined whether it was associated with the presence or subsequent development of cognitive impairment, depression, sleep and gait problems.MethodsPatients with PD and healthy controls were identified from the Parkinson’s Progression Markers Initiative (PPMI) database. We defined a clinically significant caudate dysfunction as123I-FP-CIT binding <–2 SDs compared with the controls’ mean and categorised three groups accordingly (no reduction, unilateral reduction, bilateral reduction). All statistical analyses were adjusted for mean putamen binding.ResultsAt baseline, 51.6% of 397 patients had normal caudate dopamine transporter binding, 26.0% had unilateral caudate involvement, 22.4% had bilaterally impaired caudate.Compared with those with a baseline normal caudate function, at the4-year follow-up patients with a baseline bilateral caudate involvement showed a higher frequency of cognitive impairment (p<0.001) and depression (p<0.001), and worse cognitive (p<0.001), depression (<0.05) and gait (<0.001) ratings. Significant caudate involvement was observed in 83.9% of the population after 4 years (unilateral 22.5%, bilateral 61.4%).ConclusionsEarly significant caudate dopaminergic denervation was found in half of the cases in the PPMI series. Baseline bilateral caudate involvement was associated with increased risk of developing cognitive impairment, depression and gait problems over the next 4 years.
Cognitive functional therapy (CFT)-based rehabilitation improves clinical outcomes in UK military personnel with persistent low back pain
Authors: Conway Dean , Ladlow P , Ferreira J , Mani-Babu S , Bennett A N 
Published: May 2019

IntroductionLow back pain (LBP) has been reported as the most common reason for presentation to the Medical Centre in the British Military, and the most common re-referral for the same condition. In 2015, the UK Defence Medical Rehabilitation Centre (DMRC) adopted a cognitive functional therapy (CFT) approach to spinal rehabilitation in line with National Institute for Health and Care Excellence and military best practice guidelines. The aim of this study is to evaluate the functional and psychosocial outcomes of all patients with chronic LBP treated with CFT-based multidisciplinary rehabilitation at DMRC, Headley Court.MethodsA prospective observational service evaluation of British Military patients (n=238) with LBP who attended 3 weeks of inpatient multidisciplinary CFT-based programme from 2015 to the end of 2017 at DMRC was analysed. Functional outcomes include: multistage locomotion test (MSLT) and sit and reach test. Psychosocial outcomes include: Tampa Scale of Kinesiophobia, Oswestry Disability Index, Brief Pain Inventory (BPI), General Anxiety Disorder-7 and Patient Health Questionnaire-9.ResultsThere were significant improvements in endurance (MSLT), range of motion, kinesiophobia, pain-related lifestyle interference (BPI-Lifestyle), anxiety and depression (p≤0.001). However, no improvements in pain intensity (BPI-Intensity) were demonstrated (p>0.05).ConclusionAfter 3 weeks of CFT-based multidisciplinary rehabilitation, function and psychosocial health improved with symptoms of pain being less obtrusive to activities of daily activity. There were however no patient-reported reductions in pain intensity. The improvements demonstrated are indicative of outcomes that facilitate greater integration back to work or into society.
Strategic timing and rate of sulphur fertilization improves sulphur use efficiency in subirrigated greenhouse-grown chrysanthemums
Authors: Sutton William J. , Bozzo Gale G. , Carlow Chevonne , MacDonald William N. , Shelp Barry J. 
Published: May 2019

Industry standards for nutrient delivery to greenhouse-grown ornamentals are typically in excess of the plant’s needs and can be reduced without causing adverse effects. Previous studies have reduced the level of specific nutrients or suite of nutrients over the entire crop cycle or at the onset of reproductive growth. Here, two split-plot experiments (four blocks each) were conducted with subirrigated, potted, disbudded chrysanthemums (Chrysanthemum morifolium Ramat.) grown under greenhouse conditions with sulphate treatment (2.25 mmol L−1 S supplied continuously over the crop cycle in experiment 2 only and 2.25, 1.125, or 0.5625 mmol L−1 S interrupted at inflorescence emergence) as the main plot and cultivar (‘Olympia’ and ‘Covington’) as the sub-plot. Morphological characteristics of plants with fully-expanded inflorescences were unaffected by decreasing S delivery over the crop cycle. Dry mass (DM) yields and S budgets revealed that supply-based S use and S uptake efficiencies increased markedly in both cultivars with decreasing S delivery. Minor amounts of reduced-S, rather than sulphate, were lost from leaves of ‘Covington’ during inflorescence development. High quality chrysanthemums had sufficient leaf-S (0.17%–0.23% DM) at inflorescence emergence even with the lowest S supply, which would deliver an approximate 87.5% reduction in S over the crop cycle compared with industry standards. The primary mechanism to obtain sufficient S for the growth of chrysanthemums in these studies was increased uptake efficiency.
TIM-3 Dictates Functional Orientation of the Immune Infiltrate in Ovarian Cancer
Authors: Fucikova Jitka , Rakova Jana , Hensler Michal , Kasikova Lenka , Belicova Lucie , Hladikova Kamila , Truxova Iva , Skapa Petr , Laco Jan , Pecen Ladislav , Praznovec Ivan , Halaska Michael J. , Brtnicky Tomas , Kodet Roman , Fialova Anna , Pineau Josephine , Gey Alain , Tartour Eric , Ryska Ales , Galluzzi Lorenzo , Spisek Radek 
Published: May 2019

Abstract

Purpose:
In multiple oncological settings, expression of the coinhibitory ligand PD-L1 by malignant cells and tumor infiltration by immune cells expressing coinhibitory receptors such as PD-1, CTLA4, LAG-3, or TIM-3 conveys prognostic or predictive information. Conversely, the impact of these features of the tumor microenvironment on disease outcome among high-grade serous carcinoma (HGSC) patients remains controversial.

Experimental Design:
We harnessed a retrospective cohort of 80 chemotherapy-naïve HGSC patients to investigate PD-L1 expression and tumor infiltration by CD8+ T cells, CD20+ B cells, DC-LAMP+ dendritic cells as well as by PD-1+, CTLA4+, LAG-3+, and TIM-3+ cells in relation with prognosis and function orientation of the tumor microenvironment. IHC data were complemented with transcriptomic and functional studies on a second prospective cohort of freshly resected HGSC samples. In silico analysis of publicly available RNA expression data from 308 HGSC samples was used as a confirmatory approach.

Results:
High levels of PD-L1 and high densities of PD-1+ cells in the microenvironment of HGSCs were strongly associated with an immune contexture characterized by a robust TH1 polarization and cytotoxic orientation that enabled superior clinical benefits. Moreover, PD-1+TIM-3+CD8+ T cells presented all features of functional exhaustion and correlated with poor disease outcome. However, although PD-L1 levels and tumor infiltration by TIM-3+ cells improved patient stratification based on the intratumoral abundance of CD8+ T cells, the amount of PD-1+ cells failed to do so.

Conclusions:
Our data indicate that PD-L1 and TIM-3 constitute prognostically relevant biomarkers of active and suppressed immune responses against HGSC, respectively.
Abstract SY34-02: The impact of O2 availability on human cancer
Authors: Simon M. Celeste 
Published: May 2019

Abstract
During the past century, it has been established that regions within solid tumours experience mild to severe O2 deprivation owing to aberrant vascular function. These hypoxic regions are associated with altered cellular metabolism, as well as increased resistance to radiation and chemotherapy. As discussed in this Timeline, over the past decade work from many laboratories has elucidated the mechanisms by which hypoxia-inducible factors (HIFs) modulate tumour cell metabolism, angiogenesis, growth and metastasis. The central role played by intra-tumoural hypoxia and HIF in these processes has made them attractive therapeutic targets in the treatment of multiple human malignancies.
Citation Format: M. Celeste Simon. The impact of O2 availability on human cancer [abstract]. In: Proceedings of the AACR 101st Annual Meeting 2010; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr SY34-02
Abstract 2097: Gemini vitamin D analogs inhibit estrogen receptor positive and estrogen receptor negative mammary tumorigenesis without hypercalcemic toxicity
Authors: Lee Hong Jin , Paul Shiby , Ji Yan , Atalla Nadi , Thomas Paul E , Maehr Hubert , Uskokovic Milan , Suh Nanjoo 
Published: May 2019

Abstract
Numerous preclinical, epidemiological and clinical studies with vitamin D and analogs have suggested the benefits of vitamin D and analogs for prevention and treatment of cancer. However, the hypercalcemic effects have limited the use of 1α,25(OH)2D3, the hormonally active form of vitamin D, and many of its classical synthetic analogs as potent agents for cancer prevention and treatment. To identify vitamin D analogs with better efficacy and low toxicity, we have tested more than 60 novel Gemini vitamin D analogs, which have a unique structure of two six-carbon chains with a C-20-normal and a C-20-epi side chain. Our initial studies found that some Gemini analogs are many-fold more active than 1α,25(OH)2D3 in growth inhibition assay. We further examined the inhibitory effect of selected Gemini vitamin D analogs against mammary carcinogenesis in vivo by using N-methyl-N-nitrosourea (NMU)-induced mammary tumor model which is ER-positive. Among Gemini vitamin D analogs we tested, Gemini 0072 and Gemini 0097 treated groups showed approximately 60% suppressive activity in NMU-induced mammary tumor growth compared to the control group. In a dose dependent experiment, Gemini 0097 significantly reduced the average tumor burden per rat without affecting the body weight. At all doses tested, Gemini 0097 did not exert any calcemic toxicity. In addition, we determined the inhibitory effect of Gemini 0097 in MCF10DCIS xenograft model of ER-negative mammary tumors. Gemini 0097 significantly inhibited MCF10DCIS xenograft tumor growth without calcemic toxicity. We analyzed the tumor samples and found that the inhibitory effect of Gemini 0097 in vivo was through (a) increasing cyclin dependent kinase inhibitor, p21 and (b) inducing insulin-like growth factor binding protein 3 (IGFBP3) in both ER-positive and ER-negative mammary tumors. Our results suggest that Gemini vitamin D analogs may be potent agents for the prevention and treatment of both ER positive and ER negative breast cancer without calcemic toxicity.