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Articles 4381 - 4410 of 6784
Full-Text Articles in Medicine and Health Sciences
The Digital Migration Of Research Dissemination In Aviation Psychology Disciplines, Brent D. Bowen, Erin E. Bowen, Henry R. Lehrer, John H. Mott, Charles T. Watkinson, Mark P. Newton, Jennifer Kirschner
The Digital Migration Of Research Dissemination In Aviation Psychology Disciplines, Brent D. Bowen, Erin E. Bowen, Henry R. Lehrer, John H. Mott, Charles T. Watkinson, Mark P. Newton, Jennifer Kirschner
International Symposium on Aviation Psychology - 2011
Innovations in research dissemination have emerged over the last decade in the movement toward on-line digital materials and distribution by increasingly environmentally-friendly processes. The access to scholarship has often been limited to major research organizations capable of funding subscriptions, the costs of which have escalated to prohibitive values. Demonstrated herein is a model for world-wide open access to the latest contributions to the foundations of our discipline. The development of a systemic process to cross boundaries so that overall progress can result through the integration of research and industry practice at the individual level is provided. The foundational relationships and …
2011 Annual Report, Center For Applied Research On Substance Use And Health Disparities
2011 Annual Report, Center For Applied Research On Substance Use And Health Disparities
Center for Applied Research on Substance Use and Health Disparities Annual Reports
No abstract provided.
L-Arginine Is Essential For Pancreatic B-Cell Functional Integrity, Metabolism And Defense From Inflammatory Challenge, Mauricio S. Krause, Neville H. Mcclenaghan, Peter R. Flatt, Paulo I Homem De Bittencourt, Colin Murphy, Philip Newsholme
L-Arginine Is Essential For Pancreatic B-Cell Functional Integrity, Metabolism And Defense From Inflammatory Challenge, Mauricio S. Krause, Neville H. Mcclenaghan, Peter R. Flatt, Paulo I Homem De Bittencourt, Colin Murphy, Philip Newsholme
Articles
In this work, our aim was to determine whether L-arginine (a known insulinotropic amino acid) can promote a shift of b-cell intermediary metabolism favoring glutathione (GSH) and glutathione disulfide (GSSG) antioxidant responses, stimulus–secretion coupling and functional integrity. Clonal BRIN-BD11 b-cells and mouse islets were cultured for 24 h at various L-arginine concentrations (0–1.15 mmol/l) in the absence or presence of a proinflammatory cytokine cocktail (interleukin 1b, tumour necrosis factor a and interferon g). Cells were assessed for viability, insulin secretion, GSH, GSSG, glutamate, nitric oxide (NO), superoxide, urea, lactate and for the consumption of glucose and glutamine. Protein levels of …
Anti-Amyloid-Β Single-Chain Antibody Brain Delivery Via Aav Reduces Amyloid Load But May Increase Cerebral Hemorrhages In An Alzheimer's Disease Mouse Model, Jinghong Kou, Hong-Duck Kim, Hiroaki Taguchi, Sudhir Paul, Selvarangan Ponnazhagan, Ken-Ichiro Fukuchi
Anti-Amyloid-Β Single-Chain Antibody Brain Delivery Via Aav Reduces Amyloid Load But May Increase Cerebral Hemorrhages In An Alzheimer's Disease Mouse Model, Jinghong Kou, Hong-Duck Kim, Hiroaki Taguchi, Sudhir Paul, Selvarangan Ponnazhagan, Ken-Ichiro Fukuchi
NYMC Faculty Publications
Accumulation of amyloid-β protein (Aβ) in the brain is thought to be a causal event in Alzheimer's disease (AD). Immunotherapy targeting Aβ holds great promise for reducing Aβ in the brain. Here, we evaluated the efficacy and safety of anti-Aβ single-chain antibody (scFv59) delivery via recombinant adeno-associated virus (rAAV) on reducing Aβ deposits in an AD mouse model (TgAβPPswe/PS1dE9). First, delivery of scFv59 to the brain was optimized by injecting rAAV serotypes 1, 2, and 5 into the right lateral ventricle. Symmetrical high expression of scFv59 was found throughout the hippocampus and partly in the neocortex in both hemispheres via …
Sleep Estimates In Children: Parental Versus Actigraphic Assessments, Ehab A. Dayyat, Karen Spruyt, Dennis L. Molfese, David Gozal
Sleep Estimates In Children: Parental Versus Actigraphic Assessments, Ehab A. Dayyat, Karen Spruyt, Dennis L. Molfese, David Gozal
Center for Brain, Biology, and Behavior: Faculty Publications
Background: In the context of increasing awareness about the need for assessment of sleep duration in community and clinical settings, the use of questionnaire-based tools may be fraught with reporter bias. Conversely, actigraphy provides objective assessments of sleep patterns. In this study, we aimed to determine the potential discrepancies between parentally-based sleep logs and concurrent actigraphic recordings in children over a one-week period.
Methods: We studied 327 children aged 3–10 years, and included otherwise healthy, nonsnoring children from the community who were reported by their parents to be nonsnorers and had normal polysomnography, habitually-snoring children from the community …
Minimal Information For Neural Electromagnetic Ontologies (Minemo): A Standards-Compliant Method For Analysis And Integration Of Event-Related Potentials (Erp) Data, Gwen Frishkoff, Jason Sydes, Kurt Mueller, Tim Curran, John F. Connolly, Kerry Kilborn, Dennis L. Molfese, Charles Perfetti, Allen D. Malony
Minimal Information For Neural Electromagnetic Ontologies (Minemo): A Standards-Compliant Method For Analysis And Integration Of Event-Related Potentials (Erp) Data, Gwen Frishkoff, Jason Sydes, Kurt Mueller, Tim Curran, John F. Connolly, Kerry Kilborn, Dennis L. Molfese, Charles Perfetti, Allen D. Malony
Center for Brain, Biology, and Behavior: Faculty Publications
We present MINEMO (Minimal Information for Neural ElectroMagnetic Ontologies), a checklist for the description of event-related potentials (ERP) studies. MINEMO extends MINI (Minimal Information for Neuroscience Investigations)to the ERP domain. Checklist terms are explicated in NEMO, a formal ontology that is designed to support ERP data sharing and integration. MINEMO is also linked to an ERP database and web application (the NEMO portal). Users upload their data and enter MINEMO information through the portal. The database then stores these entries in RDF (Resource Description Framework), along with summary metrics, i.e., spatial and temporal metadata. Together these spatial, temporal, and functional …
How Loss Of Neurofibromin In Oligodendrocytes Affects The Brain, Debra A. Mayes, Tilat A. Rizvi, Nathan T. Kolasinski, S. Miller, Nancy Ratner
How Loss Of Neurofibromin In Oligodendrocytes Affects The Brain, Debra A. Mayes, Tilat A. Rizvi, Nathan T. Kolasinski, S. Miller, Nancy Ratner
Neuroscience, Cell Biology & Physiology Faculty Publications
Neurofibromatosis type 1 patients are predisposed to central nervous system (CNS) phenotypes including enlarged brains, delayed acquisition of motor skills, brain tumors, and cognitive deficits. Imaging and pathologic analysis suggest that changes in white matter myelination may underlie both the enlargement of white matter tracts that contributes to megancephaly, and/or hyper-intense signals visualized on MRI. To study the role(s) of Nf1 and HRasin oligodendrocytes, we examined the optic nerve and corpus callosum,myelinated fiber tracts.We studiedNf1heterozygous mice,tamoxifen-induced Nf1 loss in mature oligodendrocytes (Plp-CreERT), and a new transgenic model in which the CNPase promoter drives expression of HRasG12V. Activated HRas and loss …
Assessment And Management Of Adult Obesity In A Primary Care Practice, Sherry M. Adkins
Assessment And Management Of Adult Obesity In A Primary Care Practice, Sherry M. Adkins
Master of Public Health Program Student Publications
Purpose: The purpose of this project was to describe primary care physician adherence to National Heart Lung and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998) and to explore patient characteristics associated with physician assessment and management behaviors. Patient characteristics included age, sex, race, BMI, associated disease risk, and Medicaid coverage.
Methods: A chart abstraction of 99 randomly selected adult patients with at least one visit to a particular primary care practice during a 12-month period was completed. Patients were not pregnant during the year of review, and had a …
Graduate Medical Education 2010 Annual Report, Children's Mercy Hospital
Graduate Medical Education 2010 Annual Report, Children's Mercy Hospital
GME Annual Reports
Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.
The Internship Application Process: Advice You Might Not Have Heard (Student Forum), David K. Dilillo, Thad R. Leffingwell
The Internship Application Process: Advice You Might Not Have Heard (Student Forum), David K. Dilillo, Thad R. Leffingwell
Department of Psychology: Faculty Publications
Offers advice about the mastering the application process for a psychology clinical training internship, including: making your dissertation sound interesting, interviewing effectively, and tips for writing engaging essays.
Treatment Effects For Common Outcomes Of Child Sexual Abuse: A Current Meta-Analysis, Emily V. Trask, Kate Walsh, David Dilillo
Treatment Effects For Common Outcomes Of Child Sexual Abuse: A Current Meta-Analysis, Emily V. Trask, Kate Walsh, David Dilillo
Department of Psychology: Faculty Publications
The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, and inclusion of caregiver) and participant (e.g., age, gender, …
The Lli Chronicle Volume 2 Number 9, Nova Southeastern University
The Lli Chronicle Volume 2 Number 9, Nova Southeastern University
Lifelong Learning Institute Newsletters
No abstract provided.
Assessing Human Immunodeficiency Virus Testing Attitudes Among African Immigrants, Hazel Namona Nachembe
Assessing Human Immunodeficiency Virus Testing Attitudes Among African Immigrants, Hazel Namona Nachembe
Theses Digitization Project
This study attempted to assess and explore the attitudes of African immigrants towards HIV testing and seeking HIV services in the U.S. The pool of HIV/AIDS cases among blacks at risk in the United States does not clearly distinguish between African Americans and Black African immigrants in regard to attitudes on HIV testing. A closer exploration of African immigrants as specific black sub-groups within the larger group of blacks or African Americans infected with HIV may help distinguish and explain the increase in incidents and high risk behaviors among blacks.
The Effects Of Childhood Sexual Abuse On Women In Recovery For Substance Abuse, Barbara Eileen Egan
The Effects Of Childhood Sexual Abuse On Women In Recovery For Substance Abuse, Barbara Eileen Egan
Theses Digitization Project
This study assessed if women who are survivors of Childhood Sexual Abuse and receive treatment for this issue, when they were in treatment for substance abuse, stayed sober longer and thus experienced a healthier and happier recovery. The benefit of this research is two-fold as it not only leads to better treatment programs for women who have this co-occurring condition, it also allows for better treatment outcomes and as a result is more cost effective for treatment agencies. The data was collected confidentially through surveys that were distributed at 10 local Alcoholic's Anonymous meetings in the Inland Empire area.
Cefuroxime Pharmacokinetics In Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass, Chad A. Knoderer, Sarah A. Saft, Scott G. Walker, Markl D. Rodefeld, Mark W. Turrentine, John W. Brown, Daniel P. Healy, Kevin M. Sowinski
Cefuroxime Pharmacokinetics In Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass, Chad A. Knoderer, Sarah A. Saft, Scott G. Walker, Markl D. Rodefeld, Mark W. Turrentine, John W. Brown, Daniel P. Healy, Kevin M. Sowinski
Scholarship and Professional Work – COPHS
Objectives
The objective of this study was to determine the pharmacokinetics of cefuroxime in children undergoing cardiopulmonary bypass (CPB) for cardiovascular surgery.
Design
A prospective study.
Setting
A tertiary pediatric teaching hospital.
Participants
Infants and children undergoing CPB were enrolled in the study.
Intervention
An initial dose (mean, 24.2 ± 1.6 mg/kg) of cefuroxime was administered before surgical incision, and a second dose (mean, 14.4 ± 7.9 mg/kg) was administered in the CPB prime solution. Serial blood samples were obtained before, during, and after the CPB process. Samples were shipped on dry ice to the analytic laboratory and concentrations determined …
Assessment Of The Validity Of Reported Antibiotic Allergic Reactions In Pediatric Patients, Lauren E. Miller, Chad A. Knoderer, Elaine G. Cox, Martin B. Kleinman
Assessment Of The Validity Of Reported Antibiotic Allergic Reactions In Pediatric Patients, Lauren E. Miller, Chad A. Knoderer, Elaine G. Cox, Martin B. Kleinman
Scholarship and Professional Work – COPHS
Study Objective. To determine whether a reported antibiotic allergy was likely to have been immunologically mediated.
Design. Questionnaire-based study.
Setting. Tertiary care, freestanding children's hospital.
Patients. One hundred patients aged 1 month-18 years for whom guardians reported an allergy to an antibiotic at the time of hospital admission between October 2009 and March 2010.
Intervention. Guardians of the patients were interviewed by using a standardized allergy assessment questionnaire.
Measurements and Main Results. Based on answers to the questionnaire, the reported allergic reactions were categorized to determine if they were true allergies or adverse reactions. Among the 100 patients, reported allergies …
Cefepime Neurotoxicity In An Adolescent Cystic Fibrosis Patient With Aminoglycoside-Induced Acute Kidney Injury, Kristen R. Nichols, Danielle M. Brown, Chad A. Knoderer, Sharon P. Andreoli
Cefepime Neurotoxicity In An Adolescent Cystic Fibrosis Patient With Aminoglycoside-Induced Acute Kidney Injury, Kristen R. Nichols, Danielle M. Brown, Chad A. Knoderer, Sharon P. Andreoli
Scholarship and Professional Work – COPHS
Objective: To describe a case of cefepime neurotoxicity in an adolescent with cystic fibrosis and aminoglycoside-associated acute kidney injury (AKI).
Case Summary: A 15-year-old, 46-kg male with cystic fibrosis (CF) and chronic sinusitis was admitted to the hospital for CF exacerbation. The patient was subsequently discharged to complete home antibiotic therapy with intravenous gentamicin and cefepime. Thirteen days after discharge, while still receiving intravenous antibiotics, the patient presented to an outside hospital complaining of vomiting, fatigue, decreased appetite, and decreased urine output. The patient was diagnosed with AKI and was transferred to our institution, where he displayed signs and symptoms …
Assessment Of Web-Based Training (Wbt) Modules On Learning Facilitation For Advanced Pharmacy Practice Experiences (Appe) In Pediatrics, Jennifer L. Morris, Chad A. Knoderer
Assessment Of Web-Based Training (Wbt) Modules On Learning Facilitation For Advanced Pharmacy Practice Experiences (Appe) In Pediatrics, Jennifer L. Morris, Chad A. Knoderer
Scholarship and Professional Work – COPHS
OBJECTIVES: To assess the effectiveness of web-based training (WBT) modules to enhance and facilitate student pharmacists’ learning and their ability to provide pharmaceutical care to children during a pediatric advanced pharmacy practice experience (APPE).
METHODS: Pediatric-specific WBT modules were developed for completion by APPE students during a 4- week rotation. Pediatric modules covered developmental pharmacology; antimicrobial use and monitoring; fluids, electrolytes, and dehydration; and drug information. Students were responsible for completing all modules within the first week of the APPE. Preassessments and postassessments consisted of 8 to 10 multiple-choice questions, with scores ranging from 0 to 100 points. Data were …
Hyperphosphatemia In Pediatric Oncology Patients Receiving Liposomal Amphotericin B, Chad A. Knoderer, Holly M. Knoderer
Hyperphosphatemia In Pediatric Oncology Patients Receiving Liposomal Amphotericin B, Chad A. Knoderer, Holly M. Knoderer
Scholarship and Professional Work – COPHS
OBJECTIVE: After transitioning our front-line amphotericin product to the liposomal formulation, we observed an increased incidence of hyperphosphatemia. We aimed to determine the incidence of hyperphosphatemia in children with oncologic disorders receiving an amphotericin B product and to establish whether the incidence varies depending on amphotericin formulation.
METHODS: This retrospective review of the medical record was conducted at a tertiary, free standing children’s hospital. Pharmacy data revealed 159 patients receiving an amphotericin product between November 2006 and December 2008. Doses of amphotericin, serum phosphorous, calcium and creatinine concentrations were recorded at daily time points during the 10 days following both …
Pharmacotherapy And Pregnancy: Highlights From The Third International Conference For Individualized Pharmacotherapy In Pregnancy, David M. Haas, Beverly Gallauresi, Kristine Shields, Deborah S. Zeitlin, Shannon M. Clark, Mary F. Herbert, Zhaoxia Ren, Srikanth C. Nallani, Eric M. Meslin, Karen B. Feibus, Gideon Koren, W. Scott Goebel, Thomas Easterling, Scott C. Denne, David A. Flockhart, Jamie L. Renbarger
Pharmacotherapy And Pregnancy: Highlights From The Third International Conference For Individualized Pharmacotherapy In Pregnancy, David M. Haas, Beverly Gallauresi, Kristine Shields, Deborah S. Zeitlin, Shannon M. Clark, Mary F. Herbert, Zhaoxia Ren, Srikanth C. Nallani, Eric M. Meslin, Karen B. Feibus, Gideon Koren, W. Scott Goebel, Thomas Easterling, Scott C. Denne, David A. Flockhart, Jamie L. Renbarger
Scholarship and Professional Work – COPHS
To address provider struggles to provide evidence-based, rational drug therapy to pregnant women, this third Conference was convened to highlight the current progress and research in the field. Speakers from academic centers, industry, and governmental institutions spoke about: the Food and Drug Administration’s role in pregnancy pharmacology and the new labeling initiative; drug registries in pregnancy; the pharmacist’s role in medication use in pregnancy; therapeutic areas such as preterm labor, gestational diabetes, nausea and vomiting in pregnancy, and hypertension; breast-feeding and medications; ethical challenges for consent in pregnancy drug studies; the potential for cord blood banks; and concerns about the …
Synchronization Analysis Of Voltage-Sensitive Dye Imaging During Focal Seizures In The Rat Neocortex, Sonya Bahar, Daisuke Takeshita
Synchronization Analysis Of Voltage-Sensitive Dye Imaging During Focal Seizures In The Rat Neocortex, Sonya Bahar, Daisuke Takeshita
Physics Faculty Works
Seizures are often assumed to result from an excess of synchronized neural activity. However, various recent studies have suggested that this is not necessarily the case. We investigate synchronization during focal neocortical seizures induced by injection of 4-aminopyridine (4AP) in the rat neocortex in vivo. Neocortical activity is monitored by field potential recording and by the fluorescence of the voltage-sensitive dye RH-1691. After removal of artifacts, the voltage-sensitive dye (VSD) signal is analyzed using the nonlinear dynamics-based technique of stochastic phase synchronization in order to determine the degree of synchronization within the neocortex during the development and spread of each …
Baseball Media Guide 2011, Indiana State University
Baseball Media Guide 2011, Indiana State University
Intercollegiate Athletics
No abstract provided.
Football Yearbook 2011, Indiana State University
Football Yearbook 2011, Indiana State University
Intercollegiate Athletics
No abstract provided.
Kcumb Communicator, Winter 2011: Serving Up A Personal Touch, Kansas City University Of Medicine And Biosciences
Kcumb Communicator, Winter 2011: Serving Up A Personal Touch, Kansas City University Of Medicine And Biosciences
Communicator (1991-2012)
Contents: Climbing the Ladder to Success: Nii-Daako Darko, D.O. (COM '06) -- From the President -- Collaboration, Compassion and One Alum's Work on HIV -- Concierge Medicine: Perspectives on a Trend -- The Fitness Guru -- KCUMB Lends a Hand Following Joplin Tornado -- 2012 Homecoming -- Alumni News -- Campus News -- Class Notes -- Passages -- Last Look.
Perinatal Or Adult Nf1 Inactivation Using Tamoxifen-Inducible Plpcre Each Cause Neurofibroma Formation, Debra A. Mayes, Tilat A. Rizvi, Jose A. Cancelas, Nathan T. Kolasinski, Georgianne M. Ciraolo, Anat O. Stemmer-Rachamimov, Nancy Ratner
Perinatal Or Adult Nf1 Inactivation Using Tamoxifen-Inducible Plpcre Each Cause Neurofibroma Formation, Debra A. Mayes, Tilat A. Rizvi, Jose A. Cancelas, Nathan T. Kolasinski, Georgianne M. Ciraolo, Anat O. Stemmer-Rachamimov, Nancy Ratner
Neuroscience, Cell Biology & Physiology Faculty Publications
OBJECTIVES
Neurofibromas are tumors initiated by biallelic mutation of the NF1 tumor suppressor gene in the Schwann cell lineage. One idea within the field suggests that Nf1loss must occur within progenitor cells present within a critical window during Schwann cell development in order for neurofibromas to form. To test this hypothesis and to examine whethermyelinating Schwann cells can serve as aneurofibroma cell of origin, Nf1 loss was induced at perinatal or adult timepoints using a tamoxifen-inducible Plp-CreERT driver.
RESULTS
Perinatal loss of Nf1 resulted in small neurofibromas late in life, while adult loss caused large neurofibromas and morbidity beginning …
The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley
The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley
Master of Public Health Program Student Publications
The prevalence of childhood overweight and obesity in the United States has prompted researchers to examine the factors that contribute to children’s food choices and consumption. Schools provide ample opportunities to teach children healthy eating habits, as well as create eating environments that are conducive to healthy eating behaviors. The National School Lunch Program (NSLP) provides federally assisted meals to millions of children every day and the assessment of the NSLP provides an opportunity to examine the school-eating environment. Hierarchical and logistic modeling of the SNDA-III, the USDA assessment of the NSLP, was conducted to determine relationships between environmental factors …
Research Annual Report 2010, Children's Mercy Hospital
Research Annual Report 2010, Children's Mercy Hospital
Research Annual Reports
Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.
Graduate Medical Education 2010-2011 Annual Report, Children's Mercy Hospital
Graduate Medical Education 2010-2011 Annual Report, Children's Mercy Hospital
GME Annual Reports
Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.
Electronic Cigarettes: A New ‘Tobacco’ Industry?, Jonathan K. Noel, Vaughan W. Rees, Gregory N. Connolly
Electronic Cigarettes: A New ‘Tobacco’ Industry?, Jonathan K. Noel, Vaughan W. Rees, Gregory N. Connolly
Health & Wellness Department Faculty Publications and Research
No abstract provided.
Reduction Of Exacerbations By The Pde4 Inhibitor Roflumilast--The Importance Of Defining Different Subsets Of Patients With Copd, Stephen I. Rennard, Peter M.A. Calverley, Udo M. Goehring, Dirk Bredenbröker, Fernando J. Martinez
Reduction Of Exacerbations By The Pde4 Inhibitor Roflumilast--The Importance Of Defining Different Subsets Of Patients With Copd, Stephen I. Rennard, Peter M.A. Calverley, Udo M. Goehring, Dirk Bredenbröker, Fernando J. Martinez
Journal Articles: Pulmonary & Critical Care Med
BACKGROUND: As chronic obstructive pulmonary disease (COPD) is a heterogeneous disease it is unlikely that all patients will benefit equally from a given therapy. Roflumilast, an oral, once-daily phosphodiesterase 4 inhibitor, has been shown to improve lung function in moderate and severe COPD but its effect on exacerbations in unselected populations was inconclusive. This led to the question of whether a responsive subset existed that could be investigated further.
METHODS: The datasets of two previous replicate, randomized, double-blind, placebo-controlled, parallel-group studies (oral roflumilast 500 μg or placebo once daily for 52 weeks) that were inconclusive regarding exacerbations were combined in …