bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disseminating Evidence-Based Physical Education Practices in Rural Schools: The San Luis Valley Physical Education Academy
Authors: Belansky Elaine S. , Cutforth Nick , Kern Ben , Scarbro Sharon 
Published: May 2016

Background:To address childhood obesity, strategies are needed to maximize physical activity during the school day. The San Luis Valley Physical Education Academy was a public health intervention designed to increase the quality of physical education and quantity of moderate to vigorous physical activity (MVPA) during physical education class.Methods:Elementary school physical education teachers from 17 schools participated in the intervention. They received SPARK curriculum and equipment, workshops, and site coordinator support for 2 years. A pre/post/post within physical education teacher design was used to measure intervention effectiveness. System for Observing Fitness Instruction Time (SOFIT) and a physical education teacher survey were collected 3 times.Results:MVPA increased from 51.1% to 67.3% over the 2-year intervention resulting in approximately 14.6 additional hours of physical activity over a school year and 4662 kcal or 1.33 lbs. of weight gain prevention. More time was spent on skill drills and less time on classroom management and free play.Conclusions:The San Luis Valley Physical Education Academy succeeded in increasing rural, low-income students’ physical activity. The multicomponent intervention contributed to the program’s success. However, cost-effective approaches are needed to disseminate and implement evidencebased practices aimed at increasing students’ physical activity during the school day.
The Invisible Employee: University Housekeeping Employees’ Perceptions of Physical Activity
Authors: Das Bhibha M. , Sartore-Baldwin Melanie , Mahar Matthew T. 
Published: May 2016

Background:A significant literature links race and socioeconomic status with physical inactivity and negative health outcomes. The aim of this study was to explore physical activity (PA) perceptions of an underserved, lower socioeconomic minority sector of the workforce.Methods:Two focus groups were conducted to examine university housekeepers’ perceptions of physical activity. Demographic and anthropometric data were also obtained.Results:Participants (N = 12; 100% female, 100% African-American) overwhelmingly associated PA with traditional exercise (eg, going to a gym). The most important barrier to PA was the perception of being active on the job, thus not needing to do leisure time PA. The most important perceived benefit to PA was improvement of physical and mental health. Employees perceived that a university investment in employees’ health might improve morale, especially within low-pay employee sectors where low levels of job satisfaction may be present.Conclusions:Although perceived benefits to PA in this population are consistent with other employee sectors, perceived barriers to PA may be unique to this sector of the workforce. PA promotion programs should focus on providing resources as well as guidelines that demonstrate the need for PA outside of the workplace setting. Such programs may improve employee health, morale, and productivity.
Association Between Neighborhood Social Environment and Children’s Independent Mobility
Authors: Wolfe Mary K. , McDonald Noreen C. 
Published: May 2016

Background:Independent travel among youth has diminished and rates of obesity have increased. It remains empirically unclear what factors influence the degree to which parents allow, or even enable, their children to be independently mobile. We analyze the association between parental perceptions of the social environment and the degree of independent mobility among children.Methods:Surveys were conducted with 305 parents of 10- to 14-year-olds in the Bay Area during 2006 and 2007. The social environment was measured with scales assessing parental perceptions of child-centered social control, intergenerational closure, social cohesion, and safety from crime and traffic. Independent mobility was measured as a composite variable reflecting the degree to which a child is allowed to do the following without adult accompaniment: travel to neighborhood destinations, walk around the neighborhood, cross main roads, and ride transit.Results:We find modest evidence of an association between parental perceptions of social cohesion and safety from traffic and independent mobility outcomes among children. Age is positively associated with increased independent mobility and Hispanic children experience greater restrictions on independent mobility.Conclusions:Interventions aimed at increasing physical activity among children through greater independent mobility should include neighborhood-level efforts to grow social cohesion and trust.
The Columbia River Basalt Group of western Idaho and eastern Washington—Dikes, vents, flows, and tectonics along the eastern margin of the flood basalt province
Authors: Reidel Stephen P. , Camp Victor E. , Martin Barton S. , Tolan Terry L. , Wolff John A. 
Published: May 2016

Abstract
The Middle Miocene Columbia River Basalt Group (CRBG) is the youngest and smallest continental flood basalt province on Earth, covering over 210,000 km2 of Oregon, Washington, and Idaho and having a volume of 210,000 km3. A well-established regional stratigraphic framework built upon seven formations, and using physical and compositional characteristics of the flows, has allowed the areal extent and volume of the individual flows and groups of flows to be calculated and correlated with their respective dikes and vents. CRBG flows can be subdivided into either compound flows or sheet flows, and are marked by a set of well-defined physical features that originated during their emplacement and solidification. This field trip focuses on the Lewiston Basin, in southeastern Washington, western Idaho, and northeastern Oregon, which contains the Chief Joseph dike swarm, where classic features of both flows and dikes can be easily observed, as well as tectonic features typical of those found elsewhere in the flood basalt province.
Gender-related affecting factors of prediabetes on its 10-year outcome
Authors: Song Xiaomin , Qiu Miaoyan , Zhang Xuan'e , Wang Haiyan , Tong Wenxin , Ju Liping , Gu Lei , Sun Siming , Zhang Hongli , Wang Weiqing , Tian Jingyan 
Published: May 2016

ObjectiveTo investigate the gender-related affecting factors of prediabetes on its 10-year outcome, in a longitudinal study.Methods and resultsThis longitudinal population-based study was performed in the Ping Liang community, Yangpu district, Shanghai, between November 2002 and October 2014. There were 334 participants with prediabetes enrolled in the final analysis. While a certain proportion of the prediabetic population progress to diabetes, the majority remain at the same level or even revert to normal glucose regulation. No gender difference was observed in the change of glucose regulation. However, results from an adjusted logistic regression analysis in males showed that physical activity was significantly associated with both elevated odds of reverting to normal glucose regulation (active vs inactive, OR 3.00, 95% CI 1.09 to 8.30) and developing diabetes (OR 0.34, 95% CI 0.13 to 0.92). Age, baseline 2 h glucose, triglycerides and smoking status were also risk factors significantly associated with diabetes development; while for females, waist circumference played a key role in the outcome. Every unit elevation of waist circumference was associated with lower odds of reverting to normal glucose regulation (OR, 0.94; 95% CI 0.89 to 0.98) and higher odds of progressing to diabetes (OR, 1.05; 95% CI 1.01 to 1.10). Baseline hypertension and family history of diabetes carried higher risk for developing diabetes as well.ConclusionsPhysical activity in males and waist circumference in females are important factors predicting both progression to diabetes and regression to normal glucose regulation, indicating that more exercise for males and lower waist circumference for females are beneficial for prediabetes to achieve reversion.
Survive On Call - A QI Project to Improve Access to Hospital Clinical Guidelines
Authors: Penders Robert , Mallet Mark 
Published: May 2016

Accessing clinical guidelines and telephone numbers can be time consuming for junior doctors, particularly during a busy on-call shift. Smartphones allow instant access to this information, without leaving a patient's bedside. This overcomes the relative paucity of fixed desktop computers available in most clinical areas. In this project, a trainee doctor developed a clinical smartphone app to improve the access of clinical and hospital-specific information.A representative sample of ten junior doctors were recruited to quantify the amount of time spent accessing guidelines using desktop computers, versus the App. The average time to access a common guideline (Hypokalaemia management) with the App was 12.4 seconds (95% CI 2.3), versus 76.8 seconds (95% CI 30.6) using a computer. A difference of 64.4 seconds (p < 0.001). The average time to access an Amiodarone prescribing guideline with the App was 25.9 seconds (95% CI 12.9), versus 142.0 seconds (95% CI 44.8) using a computer. A difference of 116.1 seconds (p < 0.001).User feedback was collected after each stage of release within the hospital. Following final release, users rated how much time they felt it saved them. 96.1% of respondents felt it either saved them time a ‘few times a week’ (53.85%) or ‘significantly saved time every day’ (42.31%).The project has significantly improved staff satisfaction with how easily they can access clinical guidelines and telephone numbers. They clearly feel it has improved their working efficiency. This has been supported by quantitative measures of actual time saved using the App. The ability to access such information in as little time as possible may be even more pertinent where decision-making is time-critical - for example in Anaesthesia and Emergency Medicine. Further study into these specialties is warranted to determine whether mobile information can impact upon patient safety and clinical outcomes.
Malignancy rates in patients with rheumatoid arthritis treated with tocilizumab
Authors: Rubbert-Roth Andrea , Sebba Anthony , Brockwell Laura , Kelman Ariella , Porter-Brown Benjamin , Pulley Jennifer , Napalkov Pavel , van Vollenhoven Ronald F 
Published: May 2016

ObjectiveTo analyse malignancy rates in patients with rheumatoid arthritis (RA) treated with tocilizumab.MethodsPatients who received tocilizumab or placebo+methotrexate/disease-modifying antirheumatic drugs in the double-blind phases of 5-phase three trials or who received at least 1 dose of tocilizumab in the long-term extension studies were analysed up to the 2 May 2012 cut-off date. Malignancies were monitored throughout the studies, analysed and adjudicated as malignant by medical review. Risk was compared with that in the general population using standardised incidence ratios (SIRs) based on data from the Surveillance Epidemiology and End Results SEER (US general population) and GLOBOCAN (non-US general population) databases.ResultsIn total, 4009 patients in the tocilizumab all-exposure population were included. Mean treatment duration was 4.0 years (mean 5.1 (range 0.0–6.8); total observation time was 16 120.1 patient-years (PY). The adjudicated malignancy rate (95% CI) was 1.26/100 PY (1.09 to 1.44) and remained constant over time. The SIR (95% CI) for all malignancies combined, excluding non-melanoma skin cancer, was 1.36 (1.01 to 1.80) for US and 1.81 (1.44 to 2.23) for non-US populations, driven primarily by higher rates in lung and bronchus (US/non-US) malignancies and prostate cancer and non-Hodgkin lymphoma (non-US), in contrast to those for the general populations; these higher rates are in line with those expected in patients with RA or in the geographic regions studied.ConclusionsMalignancy rates remained stable with long-term tocilizumab treatment, and malignancy types and rates were consistent with those expected in patients with RA.
TBCRC-010: Phase I/II Study of Dasatinib in Combination with Zoledronic Acid for the Treatment of Breast Cancer Bone Metastasis
Authors: Mitri Zahi , Nanda Rita , Blackwell Kimberly , Costelloe Colleen M. , Hood Ilona , Wei Caimiao , Brewster Abenaa M. , Ibrahim Nuhad K. , Koenig Kimberly B. , Hortobagyi Gabriel N. , Van Poznak Catherine , Rimawi Mothaffar F. , Moulder-Thompson Stacy 
Published: May 2016

Abstract
Purpose: Osteoclast-mediated bone resorption through src kinase releases growth factors, sustaining bone metastases. This trial determined the recommended phase II dose (RP2D) and clinical efficacy of the src kinase inhibitor dasatinib combined with zoledronic acid in bone predominant, HER2-negative breast cancer metastases.
Experimental Design: A 3+3 lead in phase I design confirmed the RP2D allowing activation of the single-arm, phase II trial. Zoledronic acid was administered intravenously on day 1, and dasatinib was given orally once daily for 28 days each cycle as twice daily administration caused dose-limiting toxicity (DLT). Response was assessed every three cycles. N-telopeptide (NTx) was serially measured.
Results: A total of 25 patients were enrolled. No DLTs were noted at the RP2D of dasatinib = 100 mg/d. Common adverse events were grade 1–2: rash (9/25, 36%), fatigue (9/25, 36%), pain (9/25, 36%), nausea (6/25, 20%). The objective response rate in bone was 5/22 (23%), all partial responses (PR). The clinical benefit rate [PRs + stable disease (SD) ≥ 6 months] in bone was 8/22 (36%). Median time to treatment failure was 2.70 months [95% confidence interval (CI), 1.84–5.72] in the general cohort, 3.65 months (95% CI, 1.97–7.33) in patients with hormone receptor (HR)-positive breast cancer and 0.70 months (95% CI, 0.30–NA) in those with HR-negative disease. Factors associated with response in bone included lower tumor grade, HR-positive status, and pretreatment high NTx levels.
Conclusions: Combination therapy was well tolerated and produced responses in bone in patients with HR-positive tumors. Clin Cancer Res; 22(23); 5706–12. ©2016 AACR.
Density, Distribution, and Composition of Immune Infiltrates Correlate with Survival in Merkel Cell Carcinoma
Authors: Feldmeyer Laurence , Hudgens Courtney W. , Ray-Lyons Genevieve , Nagarajan Priyadharsini , Aung Phyu P. , Curry Jonathan L. , Torres-Cabala Carlos A. , Mino Barbara , Rodriguez-Canales Jaime , Reuben Alexandre , Chen Pei-Ling , Ko Jennifer S. , Billings Steven D. , Bassett Roland L. , Wistuba Ignacio I. , Cooper Zachary A. , Prieto Victor G. , Wargo Jennifer A. , Tetzlaff Michael T. 
Published: May 2016

Abstract
Purpose: Merkel cell carcinoma (MCC) is an aggressive cancer with frequent metastasis and death with few effective therapies. Because programmed death ligand-1 (PD-L1) is frequently expressed in MCC, immune checkpoint blockade has been leveraged as treatment for metastatic disease. There is therefore a critical need to understand the relationships between MCPyV status, immune profiles, and patient outcomes.
Experimental Design: IHC for CD3, CD8, PD-1, PD-L1, and MCPyV T-antigen (to determine MCPyV status) was performed on 62 primary MCCs with annotated clinical outcomes. Automated image analysis quantified immune cell density (positive cells/mm2) at discrete geographic locations (tumor periphery, center, and hotspot). T-cell receptor sequencing (TCRseq) was performed in a subset of MCCs.
Results: No histopathologic variable associated with overall survival (OS) or disease-specific survival (DSS), whereas higher CD3+ (P = 0.004) and CD8+ (P = 0.037) T-cell density at the tumor periphery associated with improved OS. Higher CD8+ T-cell density at the tumor periphery associated with improved DSS (P = 0.049). Stratifying MCCs according to MCPyV status, higher CD3+ (P = 0.026) and CD8+ (P = 0.015) T-cell density at the tumor periphery associated with improved OS for MCPyV+ but not MCPyV− MCC. TCRseq revealed clonal overlap among MCPyV+ samples, suggesting an antigen-specific response against a unifying antigen.
Conclusions: These findings establish the tumor-associated immune infiltrate at the tumor periphery as a robust prognostic indicator in MCC and provide a mechanistic rationale to further examine whether the immune infiltrate at the tumor periphery is relevant as a biomarker for response in ongoing and future checkpoint inhibitor trials in MCC. Clin Cancer Res; 22(22); 5553–63. ©2016 AACR.
Early Stent Thrombosis and Mortality After Primary Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction
Authors: Dangas George D. , Schoos Mikkel M. , Steg Philippe Gabriel , Mehran Roxana , Clemmensen Peter , van ‘t Hof Arnoud , Prats Jayne , Bernstein Debra , Deliargyris Efthymios N. , Stone Gregg W. 
Published: May 2016

Background—
Early stent thrombosis (ST) within 30 days after primary percutaneous coronary intervention in ST-segment–elevation myocardial infarction is a serious event. We sought to determine the predictors of and risk of mortality after early ST according to procedural antithrombotic therapy.

Methods and Results—

In a patient-level pooled analysis from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) and European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trials, we examined 30-day outcomes in 4935 patients undergoing primary percutaneous coronary intervention with stent implantation at 188 international sites, randomized to either bivalirudin or heparin±a glycoprotein IIb/IIIa inhibitor (GPI). Early ST occurred in 100 patients (2.0%), 20 of whom (20.0%) died. Bivalirudin was associated with higher rates of early ST compared with heparin±GPI (2.5% versus 1.6%,
P
=0.04), because of more acute (≤24 h) ST (1.5% versus 0.2%,
P
<0.0001), with the risk limited to the first 4 hours after percutaneous coronary intervention. The rates of subacute (1–30 days) ST were similar with bivalirudin and heparin±GPI (1.0% versus 1.4%,
P
=0.24). Among patients with early ST, mortality within 30 days occurred in 4 of 60 (6.7%) bivalirudin-treated patients compared with 16 of 40 (40.0%) heparin±GPI–treated patients (adjusted hazard ratio, 0.12; 95% CI, 0.04–0.39;
P
=0.0004 and adjusted hazard ratio, 0.122; 95% CI, 0.04–0.39;
P
=0. 0004). Thus, 30-day mortality attributable to early ST occurred in 4 of 2479 (0.2%) bivalirudin-treated patients versus 16 of 2456 (0.7%) heparin±GPI–treated patients (
P
=0.007).

Conclusions—
In the present large-scale pooled analysis from 2 multicenter randomized trials, early ST was more frequent in patients treated with bivalirudin compared with heparin±GPI because of increased ST within 4 hours after primary percutaneous coronary intervention. However, the mortality attributable to early ST was significantly lower after bivalirudin than after heparin±GPI.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT00433966 (HORIZONS-AMI) and NCT01087723 (EUROMAX).
Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities
Authors: Audureau Etienne , Pouchot Jacques , Coste Joël 
Published: May 2016

Background—
Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities.

Methods and Results—
Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25–64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskeletal disorders, and asthma. After multiple linear regression, inverse associations were found between increasing body mass index category and physically oriented and most mentally oriented 36-item short-form health survey dimensions, with evidence of greater effects in women. Mediation analysis revealed that obesity effects were significantly mediated by several comorbidities, more apparently in men (eg, proportion of obesity class II total effect mediated via cardiometabolic factors: general health 27.0% [men] versus 13.6% [women]; proportion of obesity class II total effect mediated via total count of comorbidities: physical functioning 17.8% [men] versus 7.7% [women] and general health 37.1% [men] versus 20.3% [women]).

Conclusions—
Women have a greater overall impact of obesity on HRQoL, but with proportionally lower effects mediated by cardiometabolic and other obesity-related conditions, suggesting the possible role of other specific psychosocial processes.
Ideal Cardiovascular Health and Risk of Frailty in Older Adults
Authors: Graciani Auxiliadora , García-Esquinas Esther , López-García Esther , Banegas José R. , Rodríguez-Artalejo Fernando 
Published: May 2016

Background—
The major cardiovascular risk factors and existing cardiovascular disease have been linked to increased risk of the frailty syndrome. However, the association between ideal cardiovascular health and the risk of frailty in older adults is uncertain.

Methods and Results—

Prospective cohort study of 1745 individuals (≥60 years and free of cardiovascular disease) recruited during 2008 to 2010. Cardiovascular health was defined as having 7 ideal metrics: never smoking, physically active, healthy diet, body mass index <25 kg/m
2
, untreated serum cholesterol <200 mg/dL, untreated blood pressure <140/90 mm Hg, and untreated fasting serum glucose <100 mg/dL. Participants were followed-up through 2012 to assess incident frailty, defined as ≥3 of the 5 Fried criteria. Statistical analyses were performed with Cox regression and adjusted for main confounders. During a mean follow-up of 3.5 years, 117 cases of incident frailty were identified. Compared with meeting 0 to 1 ideal metrics, the hazard ratio (95% confidence interval) of frailty was 0.51 (0.30–0.84) for 2 metrics and 0.630 (0.39–0.99) for ≥3 metrics. Results were similar after excluding incident cases of cardiovascular disease. The number of ideal metrics showed a tendency to a reduced risk of all frailty criteria. The cardiovascular metrics associated with the greatest reduction of frailty risk were being physically active and ideal body mass index.

Conclusions—
Reaching old age in ideal cardiovascular health is associated with a reduced risk of frailty. This highlights the importance of a life-course approach for frailty prevention.