bluuebunny/crossref_metadata_2025_split huggingface dataset:
Athletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patterns
Authors: Franklyn-Miller A , Richter C , King E , Gore S , Moran K , Strike S , Falvey E C 
Published: October 2016

BackgroundAthletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation.AimThe primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy.Methods322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering.ResultsThree subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain.ConclusionsWe identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms.Trial registration numberNCT02437942, pre results.
Interventions to reduce sedentary behaviour in 0–5-year-olds: a systematic review and meta-analysis of randomised controlled trials
Authors: Downing Katherine L , Hnatiuk Jill A , Hinkley Trina , Salmon Jo , Hesketh Kylie D 
Published: October 2016

Aim or objectiveTo evaluate the effectiveness of behavioural interventions that report sedentary behaviour outcomes during early childhood.DesignSystematic review and meta-analysis.Data sourcesAcademic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with Full Text and EMBASE electronic databases were searched in March 2016.Eligibility criteria for selecting studiesInclusion criteria were: (1) published in a peer-reviewed English language journal; (2) sedentary behaviour outcomes reported; (3) randomised controlled trial (RCT) study design; and (4) participants were children with a mean age of ≤5.9 years and not yet attending primary/elementary school at postintervention.Results31 studies were included in the systematic review and 17 studies in the meta-analysis. The overall mean difference in screen time outcomes between groups was −17.12 (95% CI −28.82 to −5.42) min/day with a significant overall intervention effect (Z=2.87, p=0.004). The overall mean difference in sedentary time between groups was −18.91 (95% CI −33.31 to −4.51) min/day with a significant overall intervention effect (Z=2.57, p=0.01). Subgroup analyses suggest that for screen time, interventions of ≥6 months duration and those conducted in a community-based setting are most effective. For sedentary time, interventions targeting physical activity (and reporting changes in sedentary time) are more effective than those directly targeting sedentary time.Summary/conclusionsDespite heterogeneity in study methods and results, overall interventions to reduce sedentary behaviour in early childhood show significant reductions, suggesting that this may be an opportune time to intervene.Trial registration numberCRD42015017090.
Diagnostic rules and algorithms for the diagnosis of non-acute heart failure in patients 80 years of age and older: a diagnostic accuracy and validation study
Authors: Smeets Miek , Degryse Jan , Janssens Stefan , Matheï Catharina , Wallemacq Pierre , Vanoverschelde Jean-Louis , Aertgeerts Bert , Vaes Bert 
Published: October 2016

ObjectivesDifferent diagnostic algorithms for non-acute heart failure (HF) exist. Our aim was to compare the ability of these algorithms to identify HF in symptomatic patients aged 80 years and older and identify those patients at highest risk for mortality.DesignDiagnostic accuracy and validation study.SettingGeneral practice, Belgium.Participants365 patients with HF symptoms aged 80 years and older (BELFRAIL cohort). Participants underwent a full clinical assessment, including a detailed echocardiographic examination at home.Outcome measuresThe diagnostic accuracy of 4 different algorithms was compared using an intention-to-diagnose analysis. The European Society of Cardiology (ESC) definition of HF was used as the reference standard for HF diagnosis. Kaplan-Meier curves for 5-year all-cause mortality were plotted and HRs and corresponding 95% CIs were calculated to compare the mortality risk predicting abilities of the different algorithms. Net reclassification improvement (NRI) was calculated.ResultsThe prevalence of HF was 20% (n=74). The 2012 ESC algorithm yielded the highest sensitivity (92%, 95% CI 83% to 97%) as well as the highest referral rate (71%, n=259), whereas the Oudejans algorithm yielded the highest specificity (73%, 95% CI 68% to 78%) and the lowest referral rate (36%, n=133). These differences could be ascribed to differences inN-terminal probrain natriuretic peptide cut-off values (125 vs 400 pg/mL). The Kelder and Oudejans algorithms exhibited NRIs of 12% (95% CI 0.7% to 22%, p=0.04) and 22% (95% CI 9% to 32%, p<0.001), respectively, compared with the ESC algorithm. All algorithms detected patients at high risk for mortality (HR 1.9, 95% CI 1.4 to 2.5; Kelder) to 2.3 (95% CI 1.7 to 3.1; Oudejans). No significant differences were observed among the algorithms with respect to mortality risk predicting abilities.ConclusionsChoosing a diagnostic algorithm for non-acute HF in elderly patients represents a trade-off between sensitivity and specificity, mainly depending on differences between cut-off values for natriuretic peptides.
mTORC2 Signaling Drives the Development and Progression of Pancreatic Cancer
Authors: Driscoll David R. , Karim Saadia A , Sano Makoto , Gay David M. , Jacob Wright , Yu Jun , Mizukami Yusuke , Gopinathan Aarthi , Jodrell Duncan I. , Evans T.R. Jeffry , Bardeesy Nabeel , Hall Michael N. , Quattrochi Brian J. , Klimstra David S. , Barry Simon T. , Sansom Owen J. , Lewis Brian C. , Morton Jennifer P. 
Published: October 2016

Abstract
mTOR signaling controls several critical cellular functions and is deregulated in many cancers, including pancreatic cancer. To date, most efforts have focused on inhibiting the mTORC1 complex. However, clinical trials of mTORC1 inhibitors in pancreatic cancer have failed, raising questions about this therapeutic approach. We employed a genetic approach to delete the obligate mTORC2 subunit Rictor and identified the critical times during which tumorigenesis requires mTORC2 signaling. Rictor deletion resulted in profoundly delayed tumorigenesis. Whereas previous studies showed most pancreatic tumors were insensitive to rapamycin, treatment with a dual mTORC1/2 inhibitor strongly suppressed tumorigenesis. In late-stage tumor-bearing mice, combined mTORC1/2 and PI3K inhibition significantly increased survival. Thus, targeting mTOR may be a potential therapeutic strategy in pancreatic cancer. Cancer Res; 76(23); 6911–23. ©2016 AACR.
Fzd7 (Frizzled-7) Expressed by Endothelial Cells Controls Blood Vessel Formation Through Wnt/β-Catenin Canonical Signaling
Authors: Peghaire Claire , Bats Marie Lise , Sewduth Raj , Jeanningros Sylvie , Jaspard Beatrice , Couffinhal Thierry , Duplàa Cécile , Dufourcq Pascale 
Published: October 2016

Objective—
Vessel formation requires precise orchestration of a series of morphometric and molecular events controlled by a multitude of angiogenic factors and morphogens. Wnt/frizzled signaling is required for proper vascular formation. In this study, we investigated the role of the Fzd7 (frizzled-7) receptor in retinal vascular development and its relationship with the Wnt/β-catenin canonical pathway and Notch signaling.

Approach and Results—

Using transgenic mice, we demonstrated that Fzd7 is required for postnatal vascular formation. Endothelial cell (EC) deletion of
fzd7
(
fzd7
ECKO
) delayed retinal plexus formation because of an impairment in tip cell phenotype and a decrease in stalk cell proliferation. Dvl (dishevelled) proteins are a main component of Wnt signaling and play a functionally redundant role. We found that
Dvl3
depletion in
dvl1
−/−
mice mimicked the
fzd7
ECKO
vascular phenotype and demonstrated that Fzd7 acted via β-catenin activation by showing that LiCl treatment rescued impairment in tip and stalk cell phenotypes induced in
fzd7
mutants. Deletion of
fzd7
or
Dvl1/3
induced a strong decrease in Wnt canonical genes and Notch partners’ expression. Genetic and pharmacological rescue strategies demonstrated that Fzd7 acted via β-catenin activation, upstream of Notch signaling to control Dll4 and Jagged1 EC expression.

Conclusions—
Fzd7 expressed by EC drives postnatal angiogenesis via activation of Dvl/β-catenin signaling and can control the integrative interaction of Wnt and Notch signaling during postnatal angiogenesis.
Small GTPase ARF6 Regulates Endocytic Pathway Leading to Degradation of ATP-Binding Cassette Transporter A1
Authors: Mukhamedova Nigora , Hoang Anh , Cui Huanhuan L. , Carmichael Irena , Fu Ying , Bukrinsky Michael , Sviridov Dmitri 
Published: October 2016

Objective—
ABCA1 (ATP-binding cassette transporter A1) is the principal protein responsible for cellular cholesterol efflux. Abundance and functionality of ABCA1 is regulated both transcriptionally and post-translationally, with endocytosis of ABCA1 being an important element of post-translational regulation. Functional ABCA1 resides on the plasma membrane but can be internalized and either degraded or recycled back to the plasma membrane. The interaction between the degradative and recycling pathways determines the abundance of ABCA1 and may contribute to the efflux of intracellular cholesterol.

Approach and Results—
Here, we show that the principal pathway responsible for the internalization of ABCA1 leading to its degradation in macrophages is ARF6-dependent endocytic pathway. This pathway was predominant in the regulation of ABCA1 abundance and efflux of plasma membrane cholesterol. Conversely, the efflux of intracellular cholesterol was predominantly controlled by ARF6-independent pathways, and inhibition of ARF6 shifted ABCA1 into recycling endosomes enhancing efflux of intracellular cholesterol.

Conclusions—
We conclude that ARF6-dependent pathway is the predominant route responsible for the ABCA1 internalization and degradation, whereas ARF6-independent endocytic pathways may contribute to ABCA1 recycling and efflux of intracellular cholesterol.
Temporal Trends in Care and Outcomes of Patients Receiving Fibrinolytic Therapy Compared to Primary Percutaneous Coronary Intervention: Insights From the Get With The Guidelines Coronary Artery Disease (GWTG‐CAD) Registry
Authors: Hira Ravi S. , Bhatt Deepak L. , Fonarow Gregg C. , Heidenreich Paul A. , Ju Christine , Virani Salim S. , Bozkurt Biykem , Petersen Laura A. , Hernandez Adrian F. , Schwamm Lee H. , Eapen Zubin J. , Albert Michelle A. , Liang Li , Matsouaka Roland A. , Peterson Eric D. , Jneid Hani 
Published: October 2016

Background

Timely reperfusion after ST‐elevation myocardial infarction (
STEMI
) improves survival. Guidelines recommend primary percutaneous coronary intervention (
PPCI
) within 90 minutes of arrival at a
PCI
‐capable hospital. The alternative is fibrinolysis within 30 minutes for those in those for whom timely transfer to a
PCI
‐capable hospital is not feasible.

Methods and Results

We identified
STEMI
patients receiving reperfusion therapy at 229 hospitals participating in the
Get With the Guidelines—Coronary Artery Disease
(
GWTG
‐
CAD
) database (January 1, 2003 through December 31, 2008). Temporal trends in the use of fibrinolysis and
PPCI
, its timeliness, and in‐hospital mortality outcomes were assessed. We also assessed predictors of fibrinolysis versus
PPCI
and compliance with performance measures. Defect‐free care was defined as 100% compliance with all performance measures. We identified 29 190
STEMI
patients, of whom 2441 (8.4%) received fibrinolysis; 38.2% of these patients achieved door‐to‐needle times ≤30 minutes. Median door‐to‐needle times increased from 36 to 60 minutes (
P
=0.005) over the study period. Among
PPCI
patients, median door‐to‐balloon times decreased from 94 to 64 minutes (
P
<0.0001) over the same period. In‐hospital mortality was higher with fibrinolysis than with
PPCI
(4.6% vs 3.3%,
P
=0.001) and did not change significantly over time. Patients receiving fibrinolysis were less likely to receive defect‐free care compared with their
PPCI
counterparts.

Conclusions

Use of fibrinolysis for
STEMI
has decreased over time with concomitant worsening of door‐to‐needle times. Over the same time period, use of
PPCI
increased with improvement in door‐to‐balloon times. In‐hospital mortality was higher with fibrinolysis than with
PPCI
. As reperfusion for
STEMI
continues to shift from fibrinolysis to
PPCI
, it will be critical to ensure that door‐to‐needle times and outcomes do not worsen.
Cardiac Vulnerability to Cerebrogenic Stress as a Possible Cause of Troponin Elevation in Stroke
Authors: Ahn Sung‐Ho , Kim Young‐Hak , Shin Chol‐Ho , Lee Ji‐Sung , Kim Bum‐Joon , Kim Yeon‐Jung , Noh Sang‐Mi , Kim Seung‐Min , Kang Hyun‐Goo , Kang Dong‐Wha , Kim Jong S. , Kwon Sun U. 
Published: October 2016

Background
Troponin elevation with electrocardiography changes is not uncommon in patients with acute ischemic stroke; however, it is still unclear whether the mechanism of these changes is due to cardiac problems or neurally mediated myocytic damage. Thus, we investigated cardiac and neurological predictors of troponin elevation in those patients.

Methods and Results

We retrospectively analyzed medical data of the prospectively registered ischemic stroke patients on stroke registry who were admitted and underwent a serum cardiac troponin I and 12‐lead electrocardiography within 24 hours of symptom onset. However, patients with well‐known troponin‐elevating comorbidities were excluded from the analysis. Among 1404 ischemic stroke patients, 121 (8.7%) had elevated troponin, which was defined as more than 0.04 mg/mL. Multivariable analysis identified electrocardiography abnormalities such as
QT
c‐prolongation (odds ratio [
OR
]: 1.52, 95%
CI
: 1.02–2.28), left ventricular hypertrophy (
OR
: 2.14, 95%
CI
1.43–3.19), Q‐wave (
OR
: 2.53, 95%
CI
: 1.48–4.32), and
ST
elevation (
OR
: 2.74, 95%
CI
: 1.12–6.72) as cardiac variables associated with troponin elevation, and higher National Institutes of Health Stroke Scale score (
OR
: 1.04, 95%
CI
: 1.01–1.07) and insular cortical lesions (
OR
: 2.78, 95%
CI
: 1.85–4.19) as neurological variables associated with troponin elevation. Incidence of troponin elevation as well as
QT
c‐prolongation was increased further in combination with cardiac and neurological factors.

Conclusions
Certain cardiac and neurological conditions in acute ischemic stroke may contribute to troponin elevation. The proposed concept of cardiac vulnerability to cerebrogenic stress can be a practical interpretation of troponin elevation and electrocardiography abnormalities in stroke patients.
Uric Acid Therapy Prevents Early Ischemic Stroke Progression
Authors: Amaro Sergio , Laredo Carlos , Renú Arturo , Llull Laura , Rudilosso Salvatore , Obach Víctor , Urra Xabier , Planas Anna M. , Chamorro Ángel 
Published: October 2016

Background and Purpose—
Identification of neuroprotective therapies in acute ischemic stroke is imperative. We report a predefined analysis of the URICO-ICTUS trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) assessing the efficacy of uric acid (UA) compared with placebo to prevent early ischemic worsening (EIW) and the relevance of collateral circulation.

Methods—
URICO-ICTUS was a double-blind, placebo-controlled, phase 2b trial where a total of 411 patients treated with alteplase within 4.5 hours of stroke onset were randomized (1:1) to receive UA 1000 mg (n=211) or placebo (n=200) before the end of alteplase infusion. EIW defined an increment ≥4 points in the National Institutes of Health Stroke Scale score within 72 hours of treatment in the absence of hemorrhage or recurrent stroke. Logistic regression models assessed the interaction between therapy and the collateral circulation in 112 patients who had a pretreatment computed tomographic angiography.

Results—

EIW occurred in 2 of 149 (1%) patients with good outcome and 23 of 262 (9%) patients with poor outcome (χ
2
;
P
=0.002). EIW occurred in 7 of 204 (3%) patients treated with UA and in 18 of 200 (9%) patients treated with placebo (χ
2
;
P
=0.01). There was a significant interaction between the efficacy of UA to prevent EIW and collaterals (
P
=0.029), with lower incidence in patients with good collaterals treated with UA compared with placebo (2% versus 15%, respectively;
P
=0.048).

Conclusions—
UA therapy may prevent EIW after acute stroke in thrombolysed patients. Optimal access of UA to its molecular targets through appropriate collaterals may modify the magnitude of the neuroprotective effect.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00860366.
Ominous Swans in Philostratus’ Life of Apollonius (1.5)
Authors: Miles Graeme 
Published: October 2016

AbstractThe opening chapters of Philostratus’Life of Apollonius of Tyanapresent readers with a series of signs foreshadowing the future character of the text’s protagonist. This article addresses a little discussed omen at Apollonius’ birth: the appearance of swans who set up a chorus around the future philosopher’s mother, startling her and bringing on his birth, before departing, apparently on their annual migration. This curious avian episode is, on closer inspection, laden with evocations, which have so far been only partially explored: of the god Apollo, and of the philosophers Pythagoras, Plato and Socrates, specifically as Apollonian philosophers.
Suppression of Baroclinic Instabilities in Buoyancy-Driven Flow over Sloping Bathymetry
Authors: Hetland Robert D. 
Published: October 2016

AbstractBaroclinic instabilities are ubiquitous in many types of geostrophic flow; however, they are seldom observed in river plumes despite strong lateral density gradients within the plume front. Supported by results from a realistic numerical simulation of the Mississippi–Atchafalaya River plume, idealized numerical simulations of buoyancy-driven flow are used to investigate baroclinic instabilities in buoyancy-driven flow over a sloping bottom. The parameter space is defined by the slope Burger number S = Nf−1α, where N is the buoyancy frequency, f is the Coriolis parameter, and α is the bottom slope, and the Richardson number Ri = N2f2M−4, where M2 = |∇Hb| is the magnitude of the lateral buoyancy gradients. Instabilities only form in a subset of the simulations, with the criterion that SH ≡ SRi−1/2 = Uf−1W−1 = M2f−2α 0.2, where U is a horizontal velocity scale and SH is a new parameter named the horizontal slope Burger number. Suppression of instability formation for certain flow conditions contrasts linear stability theory, which predicts that all flow configurations will be subject to instabilities. The instability growth rate estimated in the nonlinear 3D model is proportional to ωImaxS−1/2, where ωImax is the dimensional growth rate predicted by linear instability theory, indicating that bottom slope inhibits instability growth beyond that predicted by linear theory. The constraint SH 0.2 implies a relationship between the inertial radius Li = Uf−1 and the plume width W. Instabilities may not form when 5Li > W; that is, the plume is too narrow for the eddies to fit.
An Efficient Way to Account for Observation Error Correlations in the Assimilation of Data from the Future SWOT High-Resolution Altimeter Mission
Authors: Ruggiero Giovanni Abdelnur , Cosme Emmanuel , Brankart Jean-Michel , Le Sommer Julien , Ubelmann Clement 
Published: October 2016

AbstractMost data assimilation algorithms require the inverse of the covariance matrix of the observation errors. In practical applications, the cost of computing this inverse matrix with spatially correlated observation errors is prohibitive. Common practices are therefore to subsample or combine the observations so that the errors of the assimilated observations can be considered uncorrelated. As a consequence, a large fraction of the available observational information is not used in practical applications. In this study, a method is developed to account for the correlations of the errors that will be present in the wide-swath sea surface height measurements, for example, the Surface Water and Ocean Topography (SWOT) mission. It basically consists of the transformation of the observation vector so that the inverse of the corresponding covariance matrix can be replaced by a diagonal matrix, thus allowing to genuinely take into account errors that are spatially correlated in physical space. Numerical experiments of ensemble Kalman filter analysis of SWOT-like observations are conducted with three different observation error covariance matrices. Results suggest that the proposed method provides an effective way to account for error correlations in the assimilation of the future SWOT data. The transformation of the observation vector proposed herein yields both a significant reduction of the root-mean-square errors and a good consistency between the filter analysis error statistics and the true error statistics.
Viability of Cloud Computing for Real-Time Numerical Weather Prediction
Authors: Siuta David , West Gregory , Modzelewski Henryk , Schigas Roland , Stull Roland 
Published: October 2016

Abstract
As cloud-service providers like Google, Amazon, and Microsoft decrease costs and increase performance, numerical weather prediction (NWP) in the cloud will become a reality not only for research use but for real-time use as well. The performance of the Weather Research and Forecasting (WRF) Model on the Google Cloud Platform is tested and configurations and optimizations of virtual machines that meet two main requirements of real-time NWP are found: 1) fast forecast completion (timeliness) and 2) economic cost effectiveness when compared with traditional on-premise high-performance computing hardware. Optimum performance was found by using the Intel compiler collection with no more than eight virtual CPUs per virtual machine. Using these configurations, real-time NWP on the Google Cloud Platform is found to be economically competitive when compared with the purchase of local high-performance computing hardware for NWP needs. Cloud-computing services are becoming viable alternatives to on-premise compute clusters for some applications.