bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group sequential designs for stepped-wedge cluster randomised trials
Authors: Grayling Michael J , Wason James MS , Mander Adrian P 
Published: June 2017

Background/Aims: The stepped-wedge cluster randomised trial design has received substantial attention in recent years. Although various extensions to the original design have been proposed, no guidance is available on the design of stepped-wedge cluster randomised trials with interim analyses. In an individually randomised trial setting, group sequential methods can provide notable efficiency gains and ethical benefits. We address this by discussing how established group sequential methodology can be adapted for stepped-wedge designs. Methods: Utilising the error spending approach to group sequential trial design, we detail the assumptions required for the determination of stepped-wedge cluster randomised trials with interim analyses. We consider early stopping for efficacy, futility, or efficacy and futility. We describe first how this can be done for any specified linear mixed model for data analysis. We then focus on one particular commonly utilised model and, using a recently completed stepped-wedge cluster randomised trial, compare the performance of several designs with interim analyses to the classical stepped-wedge design. Finally, the performance of a quantile substitution procedure for dealing with the case of unknown variance is explored. Results: We demonstrate that the incorporation of early stopping in stepped-wedge cluster randomised trial designs could reduce the expected sample size under the null and alternative hypotheses by up to 31% and 22%, respectively, with no cost to the trial’s type-I and type-II error rates. The use of restricted error maximum likelihood estimation was found to be more important than quantile substitution for controlling the type-I error rate. Conclusion: The addition of interim analyses into stepped-wedge cluster randomised trials could help guard against time-consuming trials conducted on poor performing treatments and also help expedite the implementation of efficacious treatments. In future, trialists should consider incorporating early stopping of some kind into stepped-wedge cluster randomised trials according to the needs of the particular trial.
Cyclic Testing of 3 Medial Patellofemoral Ligament Reconstruction Techniques
Authors: Mehta Vishal , Mandala Cassie , Akhter Ahmed 
Published: June 2017

Background: Several techniques are available to secure the graft to the patella during medial patellofemoral ligament (MPFL) reconstruction. The biomechanical properties of these techniques remain unknown. Purpose: To compare the biomechanical properties of 3 MPFL patellar fixation techniques: bone tunnels (BT), PushLock anchors (PL), and tenodesis screws (TS). Study Design: Controlled laboratory study. Methods: Forty-five MPFL reconstructions were performed using 3 different reconstruction techniques (BT, PL, and TS). The specimens were randomly assigned, with 15 specimens in each of the 3 groups. Cyclic loading (500 cycles) and load-to-failure testing were performed. Gap formation after 100 and 500 cycles, ultimate load to failure, and stiffness were measured. Results: Six constructs failed during cyclic loading, 5 in the PL group (33%) and 1 in the TS group (6.7%). After 100 cycles, differences in gap formation were found between the PL and BT groups (4.48 vs 3.62 mm, P < .03) and between the PL and TS groups (4.48 vs 2.28 mm, P < .0001). After 500 cycles, differences in gap formation were found between the BT and TS groups (6.63 vs 4.16 mm, P < .002) and between the PL and TS groups (7.89 vs 4.16 mm, P < .005). The PL group was found to have a lower ultimate load to failure when compared with the BT group (161.4 vs 258.3 N, P = .019) and the TS group (161.4 vs 237.1 N, P = .009). Group differences in stiffness did not reach statistical significance among the 3 groups (PL, 33.72 N/mm; BT, 37.50 N/mm; TS, 43.00 N/mm). Conclusion: The TS and BT groups have more ideal biomechanical properties than the PL group, as demonstrated by less displacement during cyclic loading and a higher load to failure. Clinical Relevance: Fixation of the patellar limbs during MPFL reconstruction may be optimized with the use of TS or BT over a PL technique.
Treatment Efficacy, Adherence, and Quality of Life Among Women Younger Than 35 Years in the International Breast Cancer Study Group TEXT and SOFT Adjuvant Endocrine Therapy Trials
Authors: Saha Poornima , Regan Meredith M. , Pagani Olivia , Francis Prudence A. , Walley Barbara A. , Ribi Karin , Bernhard Jürg , Luo Weixiu , Gómez Henry L. , Burstein Harold J. , Parmar Vani , Torres Roberto , Stewart Josephine , Bellet Meritxell , Perelló Antonia , Dane Faysal , Moreira Antonio , Vorobiof Daniel , Nottage Michelle , Price Karen N. , Coates Alan S. , Goldhirsch Aron , Gelber Richard D. , Colleoni Marco , Fleming Gini F. ,   for the SOFT,   TEXT Investigators,   the International Breast Cancer Study Group
Published: June 2017

Purpose To describe benefits and toxicities of adjuvant endocrine therapies in women younger than 35 years with breast cancer (n = 582) enrolled in the Suppression of Ovarian Function Trial (SOFT) and Tamoxifen and Exemestane Trial (TEXT). Methods In SOFT, women still premenopausal after surgery with or without chemotherapy were randomly assigned to tamoxifen alone, tamoxifen plus ovarian function suppression (OFS), or exemestane plus OFS. In TEXT, all received OFS with or without concomitant chemotherapy and were randomly assigned to exemestane plus OFS or tamoxifen plus OFS. We summarize treatment efficacy, quality of life, and adherence of the cohort of women younger than 35 years in SOFT and TEXT, alongside data from the cohort of older premenopausal women. Results For 240 human epidermal growth factor receptor 2–negative patients younger than 35 years enrolled in SOFT after receiving chemotherapy, the 5-year breast cancer–free interval (BCFI) was 67.1% (95% CI, 54.6% to 76.9%) with tamoxifen alone, 75.9% with tamoxifen plus OFS (95% CI, 64.0% to 84.4%), and 83.2% with exemestane plus OFS (95% CI, 72.7% to 90.0%). For 145 human epidermal growth factor receptor 2–negative patients younger than 35 years in TEXT, 5-year BCFI was 79.2% (95% CI, 66.2% to 87.7%) with tamoxifen plus OFS and 81.6% (95% CI, 69.8% to 89.2%) with exemestane plus OFS. The most prominent quality of life symptom for patients younger than 35 years receiving OFS was vasomotor symptoms, with the greatest worsening from baseline at 6 months (on the order of 30 to 40 points), but loss of sexual interest and difficulties in becoming aroused were also clinically meaningful (≥ 8-point change). The level of symptom burden was similar in older premenopausal women. A total of 19.8% of women younger than 35 years stopped all protocol-assigned endocrine therapy early. Conclusion In women younger than 35 years with hormone receptor–positive breast cancer, adjuvant OFS combined with tamoxifen or exemestane produces large improvements in BCFI compared with tamoxifen alone. Menopausal symptoms are significant but are not worse than those seen in older premenopausal women.
Educar en el mundo antiguo: El Pedagogo de Clemente de Alejandría y las reglas de urbanidad
Authors: Soaje de Elías Raquel 
Published: July 2017

Many ancient authors wrote about the concern of the elite for educational matters and recorded the most widely accepted rules on how to behave in society. First the Greeks and then Roman writers shed light on the concern about this type of norms, and how they related to the ideals of life peculiar to each of these eras. Among these authors, Clement, Bishop of Alexandria between the second and third centuries of our era, stands out. This influential Greek author wrote The Pedagogue, a fundamental text in the history of education in Antiquity. Based on a hermeneutical study of this work and its context, we set out to determine how it helped to restore the Classical standards of civility, and a related code of social behaviour that served to lay the foundations of Christian pedagogy. This analysis enables us to see how the clerics’ concern for social behaviour paved the way for an integrational type of formation that encompassed all the different aspects of the life of man. Based not only on their intellectual, physical and moral education, but also their emotional development, this paideutic model sought to regulate all manifestations of civilians’ daily behaviour, and their relationship with the society in which they were immersed.
The Effect of Hip Joint Angle on Isometric Midthigh Pull Kinetics
Authors: Dos'Santos Thomas , Thomas Christopher , Jones Paul A. , McMahon John J. , Comfort Paul 
Published: June 2017

Abstract
Dos'Santos, T, Thomas, C, Jones, PA, McMahon, JJ, and Comfort, P. The effect of hip joint angle on isometric midthigh pull kinetics. J Strength Cond Res 31(10): 2748–2757, 2017—The aim of this study were to compare isometric midthigh pull (IMTP) peak force (PF), time-specific force values (100-, 150-, and 200 ms), rate of force development (RFD) at predetermined time bands (0–100, 0–150, and 0–200 ms) and net forces between 2 commonly adopted hip joint angles (145°[hip145] and 175°[hip175]) with a 145° standardized knee angle. Twenty-eight collegiate athletes (age: 21.7 ± 1.5 years, height: 1.75 ± 0.08 m, mass: 81.5 ± 8.4 kg) performed 2 IMTP trials at each hip joint angle in a randomized counterbalanced order. A subgroup (n = 10) performed the IMTP testing 7 days later to establish the between-session reliability. Intraclass correlation coefficients (ICCs) and coefficient of variation (CV) demonstrated high within-session reliability and acceptable variability for all IMTP kinetics at each posture (ICC ≥ 0.86, CV ≤ 13.7%), excluding hip175 RFD 0–100 ms and net force at 100 ms which demonstrated greater variability (CV = 18.1–18.5%). High between-session reliability and acceptable variability were observed for all IMTP kinetics at each posture (ICC = 0.72–0.97, CV = 4.5–12.8%), excluding RFD 0–100 ms which demonstrated greater variability for both postures. Hip145 produced significantly greater time-specific force values (p ≤ 0.025, g = 0.25–0.28), RFD at predetermined time bands (p ≤ 0.001, g = 0.59–0.78), and net forces (p ≤ 0.001, g = 0.57–0.74) compared with hip175. Trivial nonsignificant differences were demonstrated between postures for PF and force at 100 ms (p > 0.05, g ≤ 0.14). Significantly greater body weights (weighing period force) were observed with hip175 compared with hip145 (p < 0.001, g = 0.74). Coaches should consider administering a hip145 for IMTP testing as greater IMTP kinetics and lower levels of pretension during the weighing period are achieved with this posture.
On the growth of a class of Dirichlet series absolutely convergent in half-plane
Authors: Kulyavetc' L.V. , Mulyava O.M. 
Published: July 2017

In terms of generalized orders it is investigated a relation between the growth of a Dirichlet series $F(s)=\sum\limits_{n=1}^{\infty}a_n\exp\{s\lambda_n\}$ with the abscissa of asolute convergence $A\in (-\infty,+\infty)$ and the growth of Dirichlet series $F_j(s)=\sum\limits_{n=1}^{\infty}a_{n,j}\exp\{s\lambda_n\}$, $1\le j\le 2$, with the same abscissa of absolute convergence, if the coefficients $a_n$ are connected with the coefficients $a_{n,j}$ by correlation $$ \beta\left(\frac{\lambda_n}{\ln\,\left(|a_n|e^{A\lambda_n}\right)}\right)=(1+o(1)) \prod\limits_{j=1}^{m}\beta\left(\frac{\lambda_n} {\ln\,\left(|a_{n,j}|e^{A\lambda_n}\right)}\right)^{\omega_j},\ n\to\infty, $$ where $\omega_j>0$ $(1\le j\le m)$, $\sum\limits_{j=1}^{m}\omega_j=1$, and $\alpha$ is a positive slowly increasing function on $[x_0, +\infty)$.
FlyExpress 7: An Integrated Discovery Platform To Study Coexpressed Genes Usingin SituHybridization Images inDrosophila
Authors: Kumar Sudhir , Konikoff Charlotte , Sanderford Maxwell , Liu Li , Newfeld Stuart , Ye Jieping , Kulathinal Rob J 
Published: July 2017

AbstractGene expression patterns assayed across development can offer key clues about a gene’s function and regulatory role. Drosophila melanogaster is ideal for such investigations as multiple individual and high-throughput efforts have captured the spatiotemporal patterns of thousands of embryonic expressed genes in the form of in situ images. FlyExpress (www.flyexpress.net), a knowledgebase based on a massive and unique digital library of standardized images and a simple search engine to find coexpressed genes, was created to facilitate the analytical and visual mining of these patterns. Here, we introduce the next generation of FlyExpress resources to facilitate the integrative analysis of sequence data and spatiotemporal patterns of expression from images. FlyExpress 7 now includes over 100,000 standardized in situ images and implements a more efficient, user-defined search algorithm to identify coexpressed genes via Genomewide Expression Maps (GEMs). Shared motifs found in the upstream 5′ regions of any pair of coexpressed genes can be visualized in an interactive dotplot. Additional webtools and link-outs to assist in the downstream validation of candidate motifs are also provided. Together, FlyExpress 7 represents our largest effort yet to accelerate discovery via the development and dispersal of new webtools that allow researchers to perform data-driven analyses of coexpression (image) and genomic (sequence) data.
A színész mint szimulált páciens az oktatásban a Pécsi Tudományegyetemen
Authors: Koppán Ágnes , Eklicsné Lepenye Katalin , Halász Renáta , Sebők Judit , Szemán Eszter , Németh Zsuzsanna , Rendeki Szilárd 
Published: June 2017

Abstract: Introduction: Medical training in the 21st century faces simulation-based education as one of the challenges that efficiently contributes to clinical skills development while moderating the burden on the clinicians and patients alike. Aim: The University of Pécs, Medical School has launched a simulation program in the MediSkillsLab based on history taking with actors to improve patient interviewing communication skills. Method: This new program was inspired by experiences gathered in previous medical language teaching and integrates the method of the “Standardized Patient Program”. The method has been applied in America since the 1960s. Results: This is the first time the program has been introduced in Hungary and implemented in an interdisciplinary design, where medical specialists, linguists, actor-patients and medical students collaborate to improve professional, language and communicative competence of the students. Conclusion: A course like this has its pivotal role in the medical training, and as a result more efficient and patient-oriented communication may take place at the clinical setting. Orv Hetil. 2017; 158(26): 1022–1027.
Néhány florisztikai adat Kötcse környékéről II. (Dél-Dunántúl, Nyugat-Külső-Somogy)
Authors: Nagy Tímea 
Published: July 2017

Munkámban 73 faj, nagyrészt 2016-ban gyűjtött előfordulási adatát közlöm Nyugat-Külső-Somogy északkeleti szegletéből. A kézirat Külső-Somogyból eddig nem ismert fajok (például Peucedanum arenarium) előfordulási adatait, a Dél-Dunántúlon vagy az egész országban ritkának vagy szórványosnak tekinthető fajok (például Menyanthes trifoliata, Veronica scardica) újabb lelőhelyeit, valamint néhány kultúrszökevény (például Narcissus poëticus, Helleborus purpurascens) előfordulási adatait tartalmazza.
Apró közlemények
Authors: Horváth Dénes , Hődör István , Gulyás Gergely , Magos Gábor , Horváth Zoltán , Kozma-Bognár Tamás , Balogh Gábor , Sallainé Kapocsi Judit , Bota Viktória , Heilig Dávid , Bodorik Janka , Toldi Miklós 
Published: July 2017

1. A Schoenoplectus mucronatus (L.) Palla újabb előfordulásai az Észak-Alföldön
2. Királyharaszt (Osmunda regalis L.) újabb állományának megkerülése Belső-Somogyban
3. Új védett növényfaj, a poloskaszagú kosbor (Orchis coriophora L.) a Dél-Tiszántúlon
4. Karcsú sisakvirág (Aconitum variegatum subsp. gracile (Rchb.) Gáyer) előfordulása Göcsejben
5. A Cephalanthera damasonium (Mill.) Druce újabb előfordulása a Nyugat-Dráva síkon
Felföldy Lajos és a vízminőség-védelemben vele töltött néhány év
Authors: Csányi Béla 
Published: July 2017

Munkakapcsolatunk látszólag igen rövid ideig tartott. Az ő 15 éves, vízügynél befutott pályája és az én vele egy munkahelyen töltött három évem (csak 1977 októbere és 1980 szeptembere között dolgoztunk együtt) nevetségesen csekély idő-átfedés. Ennek ellenére – pláne mai szemmel nézve – ez igen-igen speciális időszak volt, amikor még kézzel írtuk a jelentéseinket, valamint írógéppel, megfelelő határozókönyvek híján, számítógép nélkül dolgoztunk, nekem tereptapasztalataim még egyáltalán nem voltak, vizeink élővilágát csekély módon ismertem csak, s a környezetszennyezés durvábbnál durvább eseteivel sem igen találkoztam. Egy mérnöki szemlélet által uralt kutatóintézeti közegben kezdtem a munkát, a hazai vizek átfogó feltárásáról még nem esett sok szó, és meg lehet említeni – az akkori KGST-kapcsolatok ellenére – a bizonyos fokú nemzetközi elszigeteltségünket is. Felföldy Lajossal ekkor találkozhattam és dolgozhattam együtt. Ő volt az a kutató, akitől kollegáimmal elsajátíthattuk a hidrobiológiai szemléletmódot, a környezet- és természetvédelem szeretetét és ápolását, a magas fokú szakmaiságot...
Identifying barriers to accessing family planning contraceptives among women aged 15-49 years in Maprik District, East Sepik Province, Papua New Guinea, 2014.
Authors: Flint James , Morisause Margaret 
Published: July 2017

<p><strong>Introduction</strong></p><p>Family Planning is central to the empowerment of women and a key factor reducing poverty. However, millions of women around the world are not accessing safe and effective family planning methods. This study determined contraceptive prevalence and identified barriers to using modern contraception in the Maprik district of East Sepik Province, Papua New Guinea.</p><p><strong> </strong></p><p><strong>Methods</strong></p><p>Data from the National Health Information System (NHIS) and a survey of women presenting to outpatient clinics was used to estimate contraceptive prevalence. The in-person interviews, which also sought to understand barriers to using modern contraceptives, included women aged 15-49 years from three different health facility catchments. A population based awareness campaign promoting family planning was undertaken through mass media (local radio) and targeted information sessions.</p><p><strong> </strong></p><p><strong>Findings</strong></p><p>The retrospective review of NHIS data indicated a contraceptive prevalence of 38% while the survey indicated a prevalence of 30%. Of the women interviewed, 46% indicated having an unintended pregnancy and 16% had sought to end a pregnancy. Of those women who were not using modern contraceptives, 19% lacked knowledge on methods to avoid pregnancy and 13% were concerned about side effects from using modern contraceptives. A family planning awareness program resulted in a notable increase in the number of men having a vasectomy.</p><p><strong> </strong></p><p><strong>Conclusion</strong></p><p>This study confirmed low contraceptive prevalence estimates in Maprik District and identified the key barriers to contraceptive use that can be effectively addressed. Continued awareness campaigns are necessary to address key knowledge gaps and alleviate fears about the side effects of contraceptive use. </p>
From zero to 60: Building belief, capacity and community in Street Law instructors in one weekend
Authors: Arthurs Seán , Cooperman Melinda , Gallagher Jessica , Grealy Freda , Lunney John , Marrs Rob , Roe Richard 
Published: July 2017

Street Law, where law students or lawyers teach about the law in local school, correctional, and community settings, is the fastest growing and most popular type of experiential legal education in the world—and with good reason. The Street Law methodology helps make the law more relevant, more accessible, and more understandable to both participants in the program and lawyers and law students delivering the programming. Despite Street Law’s prevalence and popularity, there is scant guidance for how to best introduce and implement a program, little research support explaining why Street Law works, and even less empirical justification proving that the program works. This paper makes three significant and unique contributions to the emerging field of Street Law scholarship and research. First, we provide an in-depth explanation of the principles and learner-centered practices that make Street Law such a powerful tool for legal education. Second, we ground these principles and practices in a robust body of research, the first such effort in the field. Third, we offer an annotated step-by-step outline of a unique weekend orientation program developed and field-tested by the seminal Georgetown Street Law program and delivered in partnership with the Law Societies of Ireland and Scotland. It is our hope that this paper will offer practitioners both a series of best practices to draw upon and a reason to do so. A second paper, that will shortly follow this one, will share and discuss quantitative and qualitative data evidencing the powerful outcomes that this weekend orientation can effect in participants.
Punção Aspirativa de Nódulos da Tiroide: Vale a Pena Repetir?
Authors: Fernandes Vera , Pereira Tânia , Eloy Catarina 
Published: July 2017

Introdução: A punção aspirativa por agulha fina tem um papel relevante na avaliação do risco de malignidade de nódulos da tiroide. Persistem dúvidas quanto ao valor da repetição da punção aspirativa por agulha fina em nódulos com resultado benigno. Este trabalho pretende avaliar a concordância de resultados em punções aspirativas por agulha fina consecutivas e estudar a pertinência da repetição nos resultados benignos.Material e Métodos: Estudo retrospetivo dos resultados das 4800 punções aspirativas por agulha fina da tiroide realizadas no Instituto de Patologia e Imunologia Molecular da Universidade do Porto entre 1 de janeiro de 2014 e 2 de maio de 2016. Da amostra inicial, selecionaram-se as punções aspirativas por agulha fina repetidas no mesmo nódulo.Resultados: O resultado da primeira punção aspirativa por agulha fina dos 309 nódulos submetidos a reavaliação foi não diagnóstico em 103 (33,3%), benigno em 120 (38,8%) e atipia/lesão folicular de significado indeterminado em 86 (27,8%). A concordância entre a primeira e segunda punção aspirativa por agulha fina foi significativamente mais elevada nos casos com resultado inicial benigno (benigno: 85,8%, não diagnóstico: 27,2% e atipia/lesão folicular de significado indeterminado: 17,4%, p < 0,005). Os motivos de repetição da punção aspirativa por agulha fina em resultados inicialmente benignos (n = 78) foram a sugestão de repetição em 58, crescimento do nódulo em 17 e características ecográficas suspeitas de malignidade em três.Discussão: A repetição da punção aspirativa por agulha fina em nódulos com resultado inicial não diagnóstico e atipia/lesão folicular de significado indeterminado alterou o diagnóstico inicial numa proporção significativa de doentes, modificando a sua orientação terapêutica. A elevada concordância de resultados em casos inicialmente benignos torna a repetição da punção aspirativa por agulha fina não custo-efetiva na maioria dos casos.Conclusão: A repetição da punção aspirativa por agulha fina deve ser realizada quando o resultado citológico inicial é não diagnóstico ou atipia/lesão folicular de significado indeterminado.