bluuebunny/crossref_metadata_2025_split huggingface dataset:
The benefit of adding a physiotherapy or occupational therapy intervention programme to a standardized group-based interdisciplinary rehabilitation programme for patients with chronic widespread pain: a randomized active-controlled non-blinded trial
Authors: Amris Kirstine , Bülow Cecilie von , Christensen Robin , Bandak Elisabeth , Rasmussen Marianne Uggen , Danneskiold-Samsøe Bente , Wæhrens Eva E 
Published: April 2019

Objective: To evaluate the benefit of adding occupational therapy or physiotherapy interventions to a standard rehabilitation programme targeted for chronic widespread pain. Design: Randomized active-controlled non-blinded trial. Subjects: Women with chronic widespread pain recruited in a tertiary outpatient clinic. Methods: Participants were randomized to a two-week, group-based standard rehabilitation programme followed by 16 weeks of group-based occupational therapy (Group BOT, n = 43) or 16 weeks of group-based physiotherapy (Group BPT, n = 42). Group A only received the two-week rehabilitation programme acting as comparator ( n = 96). Outcomes: Primary outcomes were the Assessment of Motor and Process Skills and Short Form-36 (SF36) Mental Component Summary score. Results: Mean changes in motor and process ability measures were clinically and statistically insignificant and without differences across the three groups assessed 88 weeks from baseline. Motor ability measures: −0.006 (95% confidence interval (CI): −0.244 to 0.233) in Group BOT; −0.045 (95% CI: −0.291 to 0.202) in Group BPT; and −0.017 (95% CI: −0.248 to 0.213) in Group A, P = 0.903. Process ability measures: 0.087 (95% CI: −0.056 to 0.231) in Group BOT; 0.075 (95% CI: −0.075 to 0.226) in Group BPT; and 0.072 (95% CI: −0.067 to 0.211) in Group A, P = 0.924. Mean changes in patient-reported outcomes were likewise small; clinically and statistically insignificant; and independent of group allocation, except for the SF36 mental component summary score in the BPT group: 8.58 (95% CI: 1.75 to 15.41). Conclusion: Participants were on average stable in observation-based measures of functional ability and patient-reported outcomes, except in overall mental well-being, favouring the enhanced intervention. Efficacy of additional interventions on functional ability remains uncertain.
The effect of peripheral blood eosinophilia on inflammatory markers in asthmatic patients with lower respiratory tract infections
Authors: Cag Yakup , Pacal Yakup , Gunduz Mehmet , Isik Sakine , Kertmen Birgul Altinsoy , Toprak Necmettin , Ozaydin Sadik Erhan , Ozcetin Mustafa , Kut Arif 
Published: April 2019

Background To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections. Methods This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils). Results A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR ( r = −0.34) and CRP ( r = −0.20). Conclusion The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.
Empathizing and systemizing profiles of Brazilian and Portuguese nursing undergraduates
Authors: Souza Mirella Castelhano , Mendes Isabel Amélia Costa , Martins José Carlos Amado , de Godoy Simone , Souza-Junior Valtuir Duarte , Trevizan Maria Auxiliadora , Santos Sara Soares dos , de Oliveira Luís Miguel Nunes , Ventura Maria Clara Amado Apóstolo , Ventura Carla Aparecida Arena 
Published: April 2019

Aim: To analyze the empathizing and systemizing profiles of Brazilian and Portuguese nursing undergraduates. Background: Empathy is a fundamental skill for nursing practice and should be analyzed during the student’s education. Methods: Descriptive study with cross-sectional design. Participants were 968 undergraduate students, including 215 (22.2%) Brazilians from a university in the state of São Paulo and 753 (77.8%) Portuguese students from a higher education institution in central Portugal. The Portuguese and Brazilian versions of the Empathizing/Systemizing Quotient have good internal consistency and reliability. Ethical considerations: In Brazil, approval for the study was obtained from the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing (protocol 191/2016) and in Portugal, from the Ethics Committee of the Health Sciences Research Unit: Nursing, Coimbra Higher School of Nursing (protocol P362-09/2016). Results: Most (86%) participants were female and aged between 20 and 24 years. In the general profile analysis between both groups, the domains “Social Skills,” “Contents,” and “Processes” scored higher. Gender differences exist for the feeling of empathy and systemizing, as women scored better on the short version of the Empathy Quotient and men on the Systemizing Quotient. Conclusion: As demonstrated in the domain scores for “Social Skills,” “Contents,” and “Processes,” the undergraduate nursing students analyzed have the ability to deal intuitively and spontaneously with social situations; they are also characterized as methodical people, who like to follow rules, and experience practice better than theory, and the women have a higher empathetic level than men, who in turn are more systemizing.
Does Hazardous Alcohol Use Impact Individual and Relational Functioning Among Couples Seeking Couples Therapy?
Authors: Patton Rikki , Goerke Jennifer , Fye Janelle , Katafiasz Heather 
Published: April 2019

Objective: The effects of alcohol use on the couple unit are largely under studied, especially among distressed couples. To address this gap, this study explored groups differences between couples presenting to couples therapy based on hazardous alcohol use in both individual and relational functioning. Method: Secondary data collected from 75 couples presenting for couple therapy were used to address the research question. Participants completed self-report measures to assess demographics, hazardous alcohol use, individual functioning, and relational functioning. Results: Two separate repeated measures ANOVAs were conducted to compare (1) the effect of male individual functioning on female individual functioning and (2) the effect of male relational functioning on female relational functioning in the alcohol use versus nonuse conditions. Findings indicated a statistically significant difference between the means of male and female relational functioning scores based on use versus nonuse groups: F(1, 73) = 5.512, p = .02. Differences between the means of male and female individual functioning scores between the use and nonuse groups were not statistically significant: F(1, 73) = 3.588, p = .06. Conclusions: There is a potential intersection between alcohol use, individual functioning, and relational functioning among distressed couples. Future research is needed to identify other factors that likely interact with alcohol use, as a better understanding of alcohol use within the couple context may lead to improved treatment protocols.
Hip Arthroscopy: extra-articular Procedures
Authors: Perets Itay , Rybalko Danil , Mu Brian H , Friedman Adi , Morgenstern David R , Domb Benjamin G 
Published: April 2019

Hip preservation is one of the fastest growing fields in orthopaedics and indications of intra-articular procedures are well established. In the last decade, extra-articular procedures have gained momentum and arthroscopic solutions to peri-articular hip pathologies have been offered. It should be noted that many of these pathologies are well-treated conservatively and only those who fail conservative management should be treated operatively. These indications can be divided into 5 categories: greater trochanteric pain syndrome; internal hip snapping; anterior inferior iliac spine/sub-spine impingement; sciatic nerve entrapment; and proximal hamstring injuries. This article reviews the anatomy, patient history and physical examination, imaging, non-operative treatment, endoscopic operative treatment and outcomes of each category. While indications for hip arthroscopy, specifically extra-articular procedures, are rising steadily, there is not enough data to support its superiority over open procedures. Current literature consists of case studies, case reports, and expert opinions and lacks large, randomised control studies.
The Delta of Correction: a novel, more reliable variable than limb-length discrepancy at predicting outcome after total hip arthroplasty
Authors: Reina Nicolas , Hourtal Jonathan , Salib Christopher G , Gracia Gauthier , Cavaignac Etienne , Chiron Philippe 
Published: April 2019

Background: Leg-length discrepancy (LLD) is a frequent and recurring issue after total hip arthroplasty (THA). It can lead to discomfort and litigation due to the patient’s perception of this inequality. Purpose: The aim of this study was to evaluate the functional impact of postoperative LLD and length correction in patients after primary THA. We hypothesised that clinical outcomes are inversely correlated to length correction and residual discrepancy. Methods: In a prospective cohort, we included 121 patients undergoing unilateral primary THA. Patients were categorised into 3 groups based on their residual LLD using routine EOS imaging; Shorter (<-5 mm); Equal (-5 mm to +5 mm); and Longer (>+5 mm). Delta of Correction (DC) was defined as the difference between pre- and postoperative discrepancy measured on EOS imaging. Functional scores (HHS, Postel Merle d’Aubigné, and WOMAC) were measured preoperatively and at last follow-up. The average follow-up was 24 months. We evaluated the clinical and radiographic outcomes regarding the residual LLD and DC. Results: All patients had improvement in their functional scores at last follow-up. There was no difference in clinical outcomes, regardless of preoperative or residual LLD. The highest scores were found in the population with the smallest variations (DC -5 to +5 mm, HHS 96). Conversely, poorer results were found in shortened patients (DC <-5 mm), HHS 86, and lengthened patients, corrected by > 15 mm, with HHS of 83, p < 0.005. Patient perception of postoperative LLD correlated with the DC ( p = 0.004). Conclusion: The DC measurement is a more effective assessment than arthroplasty.
Low skeletal muscle mass is associated with the risk of all-cause mortality in patients with type 2 diabetes mellitus
Authors: Miyake Hitomi , Kanazawa Ippei , Tanaka Ken-ichiro , Sugimoto Toshitsugu 
Published: April 2019

Background: Patients with type 2 diabetes mellitus (T2DM) have an increased risk of muscle mass reduction. However, the association between muscle mass and mortality in T2DM remains unknown. Methods: This was a historical cohort study with the endpoint of all-cause mortality. This study included 163 Japanese men and 141 postmenopausal women with T2DM whose body compositions were evaluated using dual-energy X-ray absorptiometry. Low muscle mass was defined as a skeletal muscle mass index (SMI) of <7.0 kg/m2 for men and <5.4 kg/m2 for women. Results: During the 6-year follow-up period, 32 men and 14 women died. In a Cox regression analysis adjusted for age, T2DM duration, glycated hemoglobin, serum creatinine, fasting C-peptide, body mass index, and lean body mass were associated with the risk of mortality in men [hazard ratio (HR) = 1.81, 95% confidence interval (CI) = 1.00–3.28 per standard deviation (SD) decrease, p = 0.049] and women (HR = 4.53, 95% CI = 1.14–17.96 per SD decrease, p = 0.032). Neither fat mass nor bone mineral content was associated with mortality. Low SMI was associated with increased mortality in women (HR = 5.97, 95% CI = 1.04–34.37, p = 0.045), while the association between low SMI and mortality was marginal in men (HR = 2.38, 95% CI = 0.92–6.14, p = 0.074). Conclusions: Low muscle mass was independently associated with all-cause mortality in patients with T2DM. The preservation of skeletal muscle mass is important to protect patients with T2DM from increased mortality risk.
Bioethical Issues in Biostatistical Consulting Study: Additional Findings and Concerns
Authors: Wang M.Q. , Fan A.Y. , Katz R.V. 
Published: April 2019

Objectives: To determine the frequency and severity of 17 requests for inappropriate analysis and reporting of data that biostatisticians received from researchers in statistical consultations, as indirectly experienced (i.e., either heard about or observed being asked of other biostatisticians). Methods: A randomly drawn sample of 522 members of the American Statistical Association who self-identified as consulting biostatisticians were selected to participate in an online survey with the Bioethical Issues in Biostatistical Consulting Questionnaire, specifically developed for this study. Results: Of the 522 consulting biostatisticians contacted, 390 (74.7%) completed the survey. The top 4 most frequently reported indirectly experienced inappropriate requests rated as “high severity” by at least 50% of the respondents were as follows: 1) proposing a study with a flawed design, including insufficient power; 2) setting aside values when the outcome turns on a few outliers; 3) reporting results of data analysis from only subsets of the data; and 4) overstating the statistical findings well beyond what the data support so that readers are misled. Conclusions: This article is a follow-up report to our recently published article on 18 directly experienced inappropriate and/or unethical requests by biomedical researchers of their consulting biostatisticians. These additional survey findings from the Bioethical Issues in Biostatistical Consulting Questionnaire on 17 indirectly experienced inappropriate requests show the following: 1) the widespread nature of inappropriate, if not, frankly unethical requests made by biomedical researchers of their consulting biostatisticians and 2) the urgent need to develop and offer educational programs for biomedical researchers in training to correct these behaviors—be they intentional or accidental. This report speaks to the urgency for developing training programs for new and existing researchers to reduce the frequency of these inappropriate bioethical requests during biostatistical consultations. Knowledge Transfer Statement: The findings from this U.S. national survey of biostatisticians on inappropriate requests for data analyses by biomedical researchers strongly suggest a need for remedial actions, including 1) new educational modules for in-development and currently employed biomedical researchers, 2) improved institutional environments by research universities and companies regarding job and publication pressures, and 3) inclusion of a collaborating biostatistician as a working research team member from the early planning stages of all biomedical studies.
Reprogramming identifies functionally distinct stages of clonal evolution in myelodysplastic syndromes
Authors: Hsu Jasper , Reilly Andreea , Hayes Brian J. , Clough Courtnee A. , Konnick Eric Q. , Torok-Storb Beverly , Gulsuner Suleyman , Wu David , Becker Pamela S. , Keel Siobán B. , Abkowitz Janis L. , Doulatov Sergei 
Published: April 2019

Abstract
Myeloid neoplasms, including myelodysplastic syndromes (MDS), are genetically heterogeneous disorders driven by clonal acquisition of somatic mutations in hematopoietic stem and progenitor cells (HPCs). The order of premalignant mutations and their impact on HPC self-renewal and differentiation remain poorly understood. We show that episomal reprogramming of MDS patient samples generates induced pluripotent stem cells from single premalignant cells with a partial complement of mutations, directly informing the temporal order of mutations in the individual patient. Reprogramming preferentially captured early subclones with fewer mutations, which were rare among single patient cells. To evaluate the functional impact of clonal evolution in individual patients, we differentiated isogenic MDS induced pluripotent stem cells harboring up to 4 successive clonal abnormalities recapitulating a progressive decrease in hematopoietic differentiation potential. SF3B1, in concert with epigenetic mutations, perturbed mitochondrial function leading to accumulation of damaged mitochondria during disease progression, resulting in apoptosis and ineffective erythropoiesis. Reprogramming also informed the order of premalignant mutations in patients with complex karyotype and identified 5q deletion as an early cytogenetic anomaly. The loss of chromosome 5q cooperated with TP53 mutations to perturb genome stability, promoting acquisition of structural and karyotypic abnormalities. Reprogramming thus enables molecular and functional interrogation of preleukemic clonal evolution, identifying mitochondrial function and chromosome stability as key pathways affected by acquisition of somatic mutations in MDS.
Natural Language Processing for Automated Quantification of Brain Metastases Reported in Free-Text Radiology Reports
Authors: Senders Joeky T. , Karhade Aditya V. , Cote David J. , Mehrtash Alireza , Lamba Nayan , DiRisio Aislyn , Muskens Ivo S. , Gormley William B. , Smith Timothy R. , Broekman Marike L.D. , Arnaout Omar 
Published: April 2019

PURPOSE Although the bulk of patient-generated health data are increasing exponentially, their use is impeded because most data come in unstructured format, namely as free-text clinical reports. A variety of natural language processing (NLP) methods have emerged to automate the processing of free text ranging from statistical to deep learning–based models; however, the optimal approach for medical text analysis remains to be determined. The aim of this study was to provide a head-to-head comparison of novel NLP techniques and inform future studies about their utility for automated medical text analysis. PATIENTS AND METHODS Magnetic resonance imaging reports of patients with brain metastases treated in two tertiary centers were retrieved and manually annotated using a binary classification (single metastasis v two or more metastases). Multiple bag-of-words and sequence-based NLP models were developed and compared after randomly splitting the annotated reports into training and test sets in an 80:20 ratio. RESULTS A total of 1,479 radiology reports of patients diagnosed with brain metastases were retrieved. The least absolute shrinkage and selection operator (LASSO) regression model demonstrated the best overall performance on the hold-out test set with an area under the receiver operating characteristic curve of 0.92 (95% CI, 0.89 to 0.94), accuracy of 83% (95% CI, 80% to 87%), calibration intercept of –0.06 (95% CI, –0.14 to 0.01), and calibration slope of 1.06 (95% CI, 0.95 to 1.17). CONCLUSION Among various NLP techniques, the bag-of-words approach combined with a LASSO regression model demonstrated the best overall performance in extracting binary outcomes from free-text clinical reports. This study provides a framework for the development of machine learning-based NLP models as well as a clinical vignette of patients diagnosed with brain metastases.
Examining Arm Vascular Function and Blood Flow Regulation in Row-trained Males
Authors: GARTEN RYAN S. , HOGWOOD AUSTIN C. , WEGGEN JENNIFER , DECKER KEVIN , DARLING ASHLEY , MANIYAR RUHI , MICHAEL AUSTIN 
Published: April 2019

ABSTRACT
Vascular function and blood flow responses to upper limb exercise are differentially altered in response to different exercise training modalities. Rowing is a unique exercise modality that incorporates the upper limbs and can significantly augment upper limb endurance, strength, and power capacity.

Purpose
This study sought to determine whether vascular function and blood flow regulation during handgrip exercise are altered in row-trained males.

Methods
Nine young row-trained males (ROW, 20 ± 1 yr; V˙O2peak = 51 ± 2 mL·kg−1·min−1) and 14 recreationally active male controls (C: 22 ± 1 yr; V˙O2peak = 37 ± 2 mL·kg−1·min−1) were recruited for this study. Subjects performed multiple bouts of progressive rhythmic handgrip exercise. Brachial artery (BA) diameter, blood flow, shear rate, and mean arterial pressure were measured at rest and during the last minute of each exercise workload.

Results
Resting values for BA diameter, blood flow, shear rate, and mean arterial pressure were not different between groups. During handgrip exercise, the ROW group reported significantly lower BA blood flow (ROW vs C: 4 kg [146 ± 21 vs 243 ± 13 mL·min−1], 8 kg [248 ± 29 vs 375 ± 17 mL·min−1], 12 kg [352 ± 43 vs 490 ± 22 mL·min−1]) across all workloads when compared with controls. The examination of BA dilation, when controlled for the shear rate stimulus and evaluated across all workloads, was revealed to be significantly greater in ROW group versus controls.

Conclusion
This study revealed that vascular function and blood flow regulation were significantly different in row-trained males when compared with untrained controls evidenced by greater shear-induced BA dilation and lower arm blood flow during progressive handgrip exercise.
Dermal Calcium Loss Is Not the Primary Determinant of Parathyroid Hormone Secretion during Exercise
Authors: KOHRT WENDY M. , WOLFE PAMELA , SHERK VANESSA D. , WHERRY SARAH J. , WELLINGTON TOBY , MELANSON EDWARD L. , SWANSON CHRISTINE M. , WEAVER CONNIE M. , BOXER REBECCA S. 
Published: April 2019

ABSTRACTIntroductionExercise can cause a decrease in serum ionized calcium (iCa) concentration, which stimulates parathyroid hormone (PTH) secretion and activates bone resorption. We postulated that dermal Ca loss during cycling exercise is the major determinant of the serum iCa, PTH, and bone resorption (C-terminal telopeptide of type 1 collagen [CTX]) responses.MethodsTo investigate this, women (n= 13) and men (n= 12) age 18 to 45 yr performed the same exercise bout under cool (18°C) and warm (26°C) conditions. Exercise was 60 min of cycling at ~75% of peak aerobic power. Sweat samples were obtained during exercise using a skin patch method, and blood samples were obtained before and during exercise and during 60 min of recovery.ResultsSweat volume and estimated sweat Ca loss were 50% higher for the warm condition than the cool condition. Despite this, there were no differences between thermal conditions in the changes (mean, 95% confidence interval [95% CI]) in iCa (cool, −0.07 mg·dL−1; 95% CI, −0.16 to 0.03); warm, −0.07 mg·dL−1; 95% CI, −0.20 to 0.05), PTH (cool, 34.4 pg·mL−1; 95% CI, 23.6–45.2; warm: 35.8 pg·mL−1; 95% CI, 22.4–49.1), or CTX (cool, 0.11 ng·mL−1; 95% CI, 0.08–0.13; warm, 0.15 ng·mL−1; 95% CI, 0.11–0.18). Adjusting for exercise-related shifts in plasma volume revealed a marked decline in vascular iCa content in the first 15 min of exercise (cool, −0.85 mg·dL−1; 95% CI, −1.01 to −0.68; warm, −0.85 mg·dL−1; 95% CI, −1.05 to −0.66), before substantial sweat Ca loss had occurred.ConclusionsThis indicates that dermal Ca loss was not the primary trigger for the increases in PTH and CTX during exercise. Further research is necessary to understand the causes and consequences of the disruption in Ca homeostasis during exercise and specifically the extravascular shift in iCa.