Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: The schedule of benefits: Physician services under the Act, July 2, 2021 (effective October 1, 2021). 20. Division. Virtual care billing information manual, version 2. 0, (2021, accessed 28 June 2021). 21. . Temporary OHIP physician services funding is being extended and enhanced. INFOBulletin #210304. Ottawa, ON: Ministry of Health, (2021, accessed 29 July 2021). 22. Branch. Virtual care services require modality indicators. INFOBulletin #210904. Ottawa, ON: Ministry of Health, (2021, accessed 9 January 2022). 23. Access to cancer surgery in a universal health care system during the COVID-19 pandemic. 2021; 4: e211104. Crossref24. Incident cancer detection during the COVID-19 pandemic. online ahead of print 1 February 2022. Crossref25. COVID-19 Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 2021; 398: 1700–1712. CrossrefPubMed26. The telehealth ten: A guide for a patient-assisted virtual physical examination. Med 2021; 134: 48–51. CrossrefPubMed27. Medical Association. of of Canada, College of Physicians and Surgeons of Canada. Virtual care guide for patients, (2020, accessed 9 February 2022). 28. Ministry of Infrastructure. Ontario bringing high-speed internet access to more communities across the province. Ontario Newsroom, (2021, accessed 9 February 2022). 29. Rural use of health service and telemedicine during COVID-19: The role of access and eHealth literacy. J 2021; 27: 1–15. 30. Office of the Premier. Ontario temporarily moving to modified step two of the roadmap to reopen. Ontario Newsroom, (2022, accessed 4 January 2022). 31. Knudsen LR, de Thurah A, Lomborg K. telehealth followup in patients With rheumatoid arthritis: A qualitative interview study. Res (Hoboken) 2018; 70: 1366–1372. CrossrefPubMed32. Telemedicine experiences and perspectives of healthcare providers in long-term care: A scoping review.

Output: contrast


Input: Claim: Bioengineered yeast can produce biofuels from sugars. [SEP] Text: : Sean Garcia, in St. for Alongside this important discovery, one additional aspect of the electron uptake process needed additional clarification – this time, concerning the link between electron uptake and CO2 fixation within the microbes. In this crucial stage of the microbial electrosynthesis process, the carbon contained in CO2 is converted into larger, more complex organic molecules, which are used as precursors for microbial metabolism and growth. However, after cytochrome-initiated electron capture by TIE-1, the mechanisms by which electrons are transferred to CO2, triggering the fixation process, were still poorly understood. In a further 2019 study, and her team again used Rhodopseudomonas palustris TIE-1 contained in a microbial electrochemical cell to show how this electron transport is strongly correlated with the highly reducing, or electron-depleting nature of redox reactions within the microbial cell. They discovered that the process is driven by a particular CO2-fixing enzyme named ruBisCO. This enzyme is part of the well-studied ‘Calvin-Benson-Bassham’ cycle. This pathway allows the fixation of CO2 into more useful organic compounds. The researchers clearly proved the importance of the process by deleting the genes that encode the ruBisCO enzyme – reducing TIE-1’s ability to take up electrons by as much as 90%. With this discovery, and her team now had a far more complete picture of how photoferroautotrophic microbes use their surrounding environments to survive. Having studied these biomechanisms in a suitable level of detail, the team could now turn their attention to exploring their potential real-world applications. Among these is the production of bioplastics named ‘polyhydroxybutyrates’ (PHBs). This family of biodegradable polyesters can be produced naturally inside several different types of bacteria. In an additional 2019 study, and her team assessed the ability of Rhodopseudomonas palustris TIE-1 to produce PHBs under various conditions including the use of a microbial electrochemical cell. In the experiments, various tests were performed, to obtain PHB as a product of CO2 fixation.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: In a large randomized controlled trial, Kraus et al42 examined the effects of different amounts and intensities of aerobic exercise on blood lipids. They randomized 111 men and women with mild-to-moderate dyslipidemia to 8 months of either a high amount (jogging approximately 32 km/week) of high-intensity exercise (65%–85% of peak oxygen consumption); a low amount (jogging approximately 19. 2 km/week) of high-intensity exercise; a low amount of moderate-intensity exercise (40%–55% of peak oxygen consumption); or 6-month control. The high-high group exhibited a significant improvement in the levels of HDL cholesterol (+0. 11378 mmol/l) and triglycerides (–0. 7344 mg/dl), but no significant change in LDL cholesterol levels, compared with lesser intensity amount of exercise. Still, O’Donovan et al43 observed a significant reduction in LDL cholesterol levels following 24 weeks of high-intensity (80% of aerobic capacity), but not lower-intensity (60% of aerobic capacity) aerobic exercise in previously sedentary but otherwise healthy men. A more recent meta-analysis41 indicates that high-intensity aerobic interval training, (ie, periods of high-intensity exercise interspersed with periods of active passive recovery) is more effective at raising HDL cholesterol levels than moderate-intensity continuous exercise, independent of dietary or pharmaceutical interventions, for subclinical or clinical populations (eg, healthy or obese individuals taking usual medications). In contrast, exercise interventions40 that examined the effectiveness of resistance exercise (ie, strength-developing exercises using body weight or external resistance) on lipid profiles have found significant reductions in LDL cholesterol and triglycerides levels with greater volume of exercise (eg, more sets and repetitions), but not necessarily greater intensity (eg, higher loads). Mechanisms of actionWhile the mechanisms explaining the beneficial effects of exercise on the lipid profile have not been entirely elucidated, it is clear that exercise improves the ability of the skeletal muscle to use lipids as the primary food substrate, resulting in a reduction in plasma lipid levels. 44 This may be accomplished, in part, through the upregulation of lecithin cholesterol acyltransferase, the enzyme involved in HDL cholesterol formation and, in turn, reverse cholesterol transport or through the upregulation of lipoprotein lipase, which hydrolyzes triglycerides into free fatty acids and promotes the cellular uptake of TRL remnants.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: 2020;48(4):643-652. doi:10. 1177/1073110520979371PubMed7. Turner K, M, Naso C, et al. Health care providers’ and professionals’ experiences with telehealth oncology implementation during the COVID-19 pandemic: a qualitative study.  J Res. 2022;24(1):e29635. doi:10. 2196/29635PubMed8. Knudsen KE, Willman C, Winn R. Optimizing the use of telemedicine in oncology care: postpandemic opportunities.  Res. 2021;27(4):933-936. doi:10. 1158/1078-0432. CCR-20-37589. Lau J, Knudsen J, Jackson H, et al. Staying connected in the COVID-19 pandemic: telehealth at the largest safety-net system in the United States.  (Millwood). 2020;39(8):1437-1442. doi:10. 1377/hlthaff. 2020. 0090310. US Agency. Greenhouse gas emissions from a passenger vehicle. 1, 2021. M. tmap: in R.  J Stat Softw. 2018;84(6). doi:10. 18637/jss. v084. i0612. US Agency (EPA). Equivalencies Calculator. 1, 2021. T. Public Transportation's Role in Responding to Climate Change. US Department of of Budget and Policy. 2010. 15, 2022. AB, Irwin CA, Cranford CO, Denny GS. The impact of telemedicine on patients’ cost savings: some preliminary findings.  E Health. 2003;9(4):361-367. doi:10. 1089/153056203772744680PubMed15. Dorrian C, Ferguson J, Ah-See K, et al. Head and neck cancer assessment by flexible endoscopy and telemedicine.

Output: contrast


Input: Claim: Bioengineered yeast can produce biofuels from sugars. [SEP] Text: The researchers found that although TIE-1’s ability to produce PHB varied in different conditions, electron capture (from iron or poised electrodes) through photoferroautotrophy was among the most effective processes available for PHB production. Through further studies of TIE-1’s gene expression, they suggest a future possibility to fine-tune and enhance PHB production by this microbe. These discoveries paved the way for additional studies of how sustainable bioplastics could be produced using widely available resources, including light, electricity, iron, and CO2. : Sean Garcia, in St. bioplastics can be manufactured on industrial scales, researchers will still need to address limitations in electron uptake in the specific context of PHB production within microbial electrochemical cells. In their latest study from 2020, and her team explored potential improvements to electron uptake, through modifications to the cell’s cathode. In their design, conductive materials were developed from a combination of nanop4. 2 times more PHB than an electrochemical cell with an unmodified carbon felt electrode; and up to 20 times as much as the yields achieved in previous studies, using standard graphite electrodes. The success of the experiment now presents clear routes to the industrial-scale production of sustainable PHB. This creates a pathway for sustainable bioplastic production that bypasses the need for the crude oil required for conventional plastic manufacturing. their use in plastic production, organic molecules are also highly desired for the energy they release when combusted. In previous studies, researchers have explored the use of microbes such as cyanobacteria to produce sustainable biofuels. However, these organisms produce oxygen during photosynthesis. Biofuel synthesis can have limited efficiency when pathways involve oxygen-sensitive enzymes. In a further 2020 study, and her team studied how TIE-1 could be exploited to produce a biofuel named n-butanol. As a fuel, n-butanol is particularly desirable for its high energy content and low tendency to vaporise or dissolve in water without combusting, compared with ethanol, a commonly used biofuel. During their experiments, and her team constructed a mutant form of TIE-1 that could not fix nitrogen. This mutant is unable to grow when nitrogen gas is the only nitrogen source.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Previous data45 in well-trained men suggest that an energy expenditure threshold (ie, approximately 1000 kcal) must be achieved to elicit an increased lipoprotein lipase activity. This threshold is likely to vary depending on an individual’s previous exercise history, disease status (healthy vs hypercholesterolemic), intensity of exercise, age, sex, and exercise modality. While exercise-induced changes in the levels of LDL cholesterol and triglycerides appear less consistently across exercise training studies than improvement in HDL cholesterol levels and may require higher intensities of aerobic exercise to achieve, it appears that activity-induced improvements in HDL cholesterol can offset any increases in LDL cholesterol and triglycerides. High blood pressureHypertension tends to coexist with hypercholesterolemia. 46 The higher shear forces against the endothelial wall associated with chronically elevated blood pressure result in endothelial damage, making vessels more vulnerable to the incursion of LDLs to the subendothelial space. It is also believed that vascular structural and functional abnormalities (eg, endothelial dysfunction, vascular remodeling) precede clinically diagnosed hypertension. Thus, hypertension may act as an atherogenic stimulus as well as contribute to atherosclerosis progression. Moreover, chronically high blood pressure has significant consequences for the heart. 47 Cardiac myocytes grow larger in order to offset the increased arterial pressure; however, this increased growth is associated with an increased deposition of surrounding collagen that requires greater blood supply and results in decreased ventricular compliance. Eventually, the compensatory hypertrophy of the heart leads to subendocardial ischemia and heart failure. Since mean arterial pressure is the product of cardiac output and peripheral vascular resistance, a reduction in one or both factors would, in theory, help to reduce the CVD risk. The case for exerciseAerobic exercise is recommended by the Association of Cardiology,17 the of Hypertension of Cardiology,48 and the Education Program49 as a first-line treatment for the prevention, treatment, and control of elevated blood pressure or hypertension. This recommendation is bolstered by numerous randomized controlled trials that report a mean reduction of blood pressure of 5 to 7 mm Hg following aerobic exercise programs. 50There is general agreement across these governing bodies that exercise should be performed on most, if not all, days of the week.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text:  J Telemed Telecare. 2009;15(3):118-121. doi:10. 1258/jtt. 2009. 003004PubMed16. Thota R, Gill DM, Brant JL, Yeatman TJ, Haslem DS. Telehealth is a sustainable population health strategy to lower costs and increase quality of health care in rural Utah.  JCO Oncol Pract. 2020;16(7):e557-e562. doi:10. 1200/JOP. 19. 00764PubMed17. Sellars H, Ramsay G, Sunny A, Gunner CK, Oliphant R, Watson AJM. Video consultation for new colorectal patients.  Colorectal Dis. 2020;22(9):1015-1021. doi:10. 1111/codi. 15239PubMed18. Houts PS, Lipton A, Harvey HA, et al. Nonmedical costs to patients and their families associated with outpatient chemotherapy.  Cancer. 1984;53(11):2388-2392. doi:10. 1002/1097-0142(19840601)53:11<2388::AID-CNCR2820531103>3. 0. CO;2-APubMed19. Kangovi S, Barg FK, Carter T, Long JA, Shannon R, Grande D. Understanding why patients of low socioeconomic status prefer hospitals over ambulatory care.  (Millwood). 2013;32(7):1196-1203. doi:10. 1377/hlthaff. 2012. 0825PubMed20. Salloum RG, Smith TJ, Jensen GA, Lafata JE. Factors associated with adherence to chemotherapy guidelines in patients with non-small cell lung cancer.  Lung Cancer. 2012;75(2):255-260. doi:10. 1016/j. lungcan. 2011. 07. 005PubMed21.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: Park, Hwang, and Yang: Relationship between growth velocity and change of levels of insulin-like growth factor-1, insulin-like growth factor binding protein-3 and, IGFBP-3 promoter polymorphism during GnRH agonist treatment Original 239. Published online: July 30, 2020 DOI: Relationship between growth velocity and change of levels of insulin-like growth factor-1, insulin-like growth factor binding protein-3 and, IGFBP-3 promoter polymorphism during GnRH agonist treatment Jun-Hong Park, MD1, Il-1, 2 1Department of 2Department of for correspondence: of Pediatrics, Guri Hospital, 153, Gyeongchun-ro, Guri 11923, Korea Tel: +82-31-560-2251 Fax: +82-31-560-2786 E-mail: jxisfriend@gmail. com 23, 2020 26, 2020 20, 2020 © 2020 Annals of & is an 4. 0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. This study aims to investigate the effect of gonadotropin-releasing hormone agonist (GnRHa) on the growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis and to evaluate whether -202 A/C IGF binding protein-3 (IGFBP-3) promoter polymorphism affects growth velocity in females with central precocious puberty (CPP) during treatment. was collected from 97 females younger than 9 years, diagnosed with precocious puberty and treated with GnRHa for at least 1 year at from 2014 to 2015. Their body height, weight, change in height standard deviation score (∆SDS), serum IGF-1, serum IGFBP-3, bone age, and -202 A/-3 promoter polymorphism were measured before and after GnRHa treatment. The interrelationships between the variables were calculated. treatment, height -1 -3 SDS, and IGF-1/IGFBP-3 ratio significantly decreased. A significant correlation was observed between ∆IGF-1 SDS and ∆height SDS (r=0. 405, P<0. 001). The presence of the C allele was significantly correlated with IGF-1 SDS after treatment (P=0.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: This is based on evidence of an immediate reduction in blood pressure following a single, acute bout of aerobic exercise; a phenomenon referred to as postexercise hypotension. 51 This reduction in blood pressure can be sustained for 24 hours after exercise. 52 Importantly, the magnitude of reduction appears to be dose-dependent, as illustrated by Eicher et al,53 who measured ambulatory blood pressure in 45 pre- stage 1 hypertensive men after they completed low-intensity (40% of peak oxygen consumption), moderate-intensity (60% of peak oxygen consumption), and high-intensity (100% of peak oxygen consumption) exercise on a bicycle ergometer. The high intensity elicited the largest reduction in blood pressure (11. 7/4. 9 mm Hg), followed by moderate intensity (5. 4/2. 0 mm Hg) and low intensity (2. 8/1. 5 mm Hg). Moreover, a significant reduction in ambulatory blood pressure (6/3 mm Hg) was observed among a group of adults with resistant hypertension (eg, blood pressure above 140/90 mm Hg despite using 3 antihypertensive agents) who exercised at a moderate intensity, 3 days per week for 8 to 12 weeks. 54 Also, in a study55 of 17 prehypertensive men and women who underwent blood pressure assessment before and after acute exercise and following 8 weeks of aerobic exercise training, it was reported that the magnitude of reduction in blood pressure following acute exercise was associated with the magnitude of decline in resting blood pressure after chronic training. Finally, Moraes et al56 reported significant reductions in resting blood pressure (–16/–12 mm Hg) among middle-aged hypertensive patients who were deprived of antihypertensive medications, following 12 weeks of moderate-intensity resistance training. Together, these data suggest the following: 1) a dose-response relationship exists between aerobic exercise intensity and improved blood pressure; although 2) lower intensities of exercise can be used to achieve clinically significant reductions in blood pressure among individuals with established hypertension but resistant to drug therapy; 3) blood pressure responses to acute exercise can be used to predict the magnitude of response following chronic training; and 4) reductions in blood pressure are observed across different exercise modalities. 52Mechanisms of actionCardiac output and total peripheral resistance contribute to mean arterial pressure and hence provide targets for antihypertensive therapies.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Consortium on Climate & Health. About. 1, 2021. J. Medical groups call climate change a ‘health emergency. ’ blog. June 25, 2019. 1, 2021. I, Roschnik S, Ashby B, et al. Health care’s response to climate change: a carbon footprint assessment of the NHS in England.  Health. 2021;5(2):e84-e92. doi:10. 1016/S2542-5196(20)30271-0PubMed32. UK Service. Delivering a ‘Net Zero’ Service. Published 2020. 1, 2021. order on catalyzing clean energy industries and jobs through federal sustainability. Executive order No. 14057. Fed Regist. 2021;86(236):70935-70943. 34. Transportation Association. . 15, 2022. Association. . 15, 2022. —Telemedicine’s Role in 31, 2023 Matthew W. ; Amy M. J. O’Shea, PhD; Charlie M. and Up for on your JAMA Network experience by selecting one or more topics from the list below. and or Art and Images in and Caring for the in Climate and of Complementary and Coronavirus (COVID-19) and of and and and to Statistics and of in in and is and Education and Journals and and and and and and Pharmacy and and -being and and the Future of and and and Art of and and e-Trauma and ' Guide to the 's and the latest research based on your areas of interest. 3788. doi:10. 1001/jamanetworkopen. 2022. 53788 Manage 3788. doi:10. 1001/jamanetworkopen. 2022. 53788 visual abstract icon editorial comment icon related 2021. For patients living within a driving distance of 60 minutes from the cancer center, an estimated 424 471 kg carbon dioxide (CO2) emissions were saved (per-visit mean savings of 19. 8 kg CO2 emissions) due to telemedicine, the equivalent of 91. 5 passenger vehicles driven for 1 year. For patients whose driving distance was greater than 60 minutes, 2 744 248 kg CO2 emissions were saved (per-visit mean savings of 98.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: 049) and with IGFBP-3 SDS before and after treatment (P=0. 012 and P=0. 001), but not with ∆IGF-1 SDS, ∆IGFBP-3 SDS, ∆IGF-1/IGFBP-3 ratio, or ∆height SDS. velocity during GnRHa treatment is related to ∆IGF-1 SDS, indicating the apparent impact of GnRHa on the GH-IGF-1 axis. The -202 A/-3 promoter polymorphism does not affect the growth velocity of GnRHa in CPP girls. Keywords: Precocious puberty, Growth velocity, Insulin-like growth factor-1, Insulin-like growth factor binding protein-3, -202 A/-3, Promoter regions females and males younger than 8 and 9 years, respectively, undergo secondary sexual changes caused by stimulation of the hypothalamic-pituitary-gonadal axis, they are diagnosed with central precocious puberty (CPP) [1]. A recent study reported an increasing number of CPP patients in from 2008 to 2014 [2]. Concerns regarding the negative effects of CPP are increasing, one of which includes reduced stature caused by accelerated early growth and bone maturation [3]. Gonadotropin-releasing hormone agonist (GnRHa) is the treatment of choice in CPP patients because it increases final adult height by reducing progression of bone age (BA) and extending the duration of growth [4]. GnRHa induces downregulation of the hormonal axis and decreases the production of luteinizing hormone (LH) and follicle-stimulating hormone, resulting in gonadal suppression. These sex hormones are responsible for early bone maturation and pubertal growth spurts. Therefore, gonadal suppression delays bone maturation and growth velocity to those of prepuberty levels [5]. Multiple factors such as initial chronological age (CA), initial height, target height, and BA advancement affect the treatment response and final height [6-8]. GnRHa treatment increases serum growth hormone-binding protein concentration and decreases serum IGF-I and IGFBP-3 concentrations [9]. However, predicting final height remains a challenge due to the variable factors affecting the treatment outcome and the course of precocious puberty.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Yet, a major benefit of exercise training is an increase in cardiac output at rest. Thus, the principle means through which exercise is believed to maintain or lower blood pressure is through the reduction in total peripheral resistance. A number of exercise-induced vascular and autonomic adaptations have been proposed that potentially provide major contributions to blood pressure control. 57 These adaptations are briefly discussed below. Firstly, hypertensive patients exhibit heightened sympathetic control, which results in increased total peripheral resistance via vasoconstriction of arterial beds. 58 This may be the result of increased sensitivity of baroreceptors,55 located in the aortic arch and carotid sinus, that are responsible for monitoring changes in blood pressure. There is evidence that baroreceptor sensitivity is influenced by exercise. 59 For example, in a group of hypertensive patients, blood pressure and muscle sympathetic nerve activity declined following 4 months of cycle exercise (3 times per week at 70% of maximum capacity), and these changes corresponded with improvements in baroreflex control such that the levels of sensitivity were reset to the levels observed in normotensives. 60Secondly, exercise enhances vascular function through its effects on the local vascular control mechanisms. Specifically, exercise increases the bioavailability of nitric oxide,61 a potent vasodilator, and decreases the bioavailability of endothelin-1, a vasoconstrictor,62 both of which are secreted by the endothelial cells. This improvement in the nitric oxide vasodilator system with exercise training is seen consistently among groups of patients with CVD and risk factors and this is manifested as an improvement in endothelial function. 63 In a recent trial, Pedralli et al64 observed similar improvements in endothelial function among patients with prehypertension or hypertension who engaged in 8 weeks of aerobic, resistance, or combined exercise. Importantly, all groups experienced improvements in ambulatory blood pressure. Previously, Maeda et al65 found that endothelin-1 concentrations in previously sedentary normotensive older women (aged 61–69 years) were higher than in younger women (21–28 years). However, the concentrations were reduced significantly following 3 months (5 days per week) of cycling exercise and were accompanied by reductions in blood pressure. Thirdly, in addition to improved endothelial function, exercise training leads to increased vessel size in the conduit arteries that feed active muscle beds.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: 6 kg CO2 emissions), the equivalent of 591 passenger vehicles driven for 1 year. results highlight the carbon emissions savings that could be gained with the increased use of telemedicine in oncology. This has important implications in reducing health care–related carbon footprint. While the health care community advocates broadly for climate change policy, medical professionals can look within care practices to assess their contribution to carbon dioxide (CO2) emissions, and provide solutions wherever possible. Telemedicine can help in mitigating climate change by providing care from a distance. assess the carbon savings achieved from telemedicine visits. Design, Setting, and cross-sectional study of telemedicine visits was conducted at a single-institution Institute (NCI)-designated comprehensive cancer center. Eligible patients were aged 18 years and above, completed telemedicine visits from April 1, 2020, to June 20, 2021, and had a Florida mailing address documented in their electronic medical record. Groups were divided between those within driving time of 60 minutes (1-way) to the cancer center vs those living beyond 60 minutes of drive time. Data were analyzed between April 2020 and June 2021. emission savings from telemedicine, measured in total and average per-visit savings. total 49 329 telemedicine visits with 23 228 patients were conducted from April 1, 2020, to June 30, 2021. A total 21 489 visits were for patients with driving time of 60 minutes or less (median [IQR] age, 62. 0 [52. 0-71. 0] years; 12 334 [57. 4%] female; 1685 [7. 8%] Black, 1500 [7. 0%] Hispanic, 16 010 [74. 5%] non-Hispanic White), while 27 840 visits were for patients with driving time greater than 60 minutes (median [IQR] age, 67. 0 [57. 0-74. 0] years; 14 372 [51. 6%] female; 1056 [3. 8%] Black, 1364 [5. 0%] Hispanic, 22 457 [80. 7%] non-Hispanic White). For patients living within a driving time of 60 minutes from the cancer center, 424 471 kg CO2 emissions were saved (mean [SD] emissions savings, 19. 8 [9. 4] kg CO2 per visit) due to telemedicine—equivalent to 91.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: Other genetic components are presumed to influence the competence of GnRHa. Specifically, -202 A/-3 promoter polymorphism is associated with increased IGFBP-3 level and growth velocity during growth hormone (GH) treatment for prepubertal GH deficiency [10,11]. Another study revealed the effect of -202 A/-3 promoter polymorphism on the physical development of Korean females. However, its effect was unclear [12]. The present study was performed to clarify the effect of GnRHa on the GH-IGF-1 axis and to evaluate the predictive role of -202 A/-3 promoter polymorphism on growth velocity during GnRHa administration in females diagnosed with CPP. Materials and methods 1. study enrolled 97 young female subjects between the ages of 6 and 8 years who were diagnosed with CPP and administered GnRHa at from January 2014 to January 2015. The subjects were diagnosed with CPP when they presented with breast budding above Tanner stage B2 before 8 years of CA, revealed BA advancement of more than one year compared to CA, and had 5 IU/L or greater peak LH level after the gonadotropin releasing hormone stimulation test. In total, 22 subjects who were diagnosed with hypothyroidism, GH deficiency, or congenital adrenal hyperplasia or who underwent previous GH treatment or were born small for gestational age were excluded. GnRHa was injected every 4 weeks. Children weighing more than 30 kg were injected with 3. 75 mg of GnRHa, compared to 2. 5 mg for those below 30 kg. 2. height and weight, serum IGF-1 and IGFBP-3 concentrations, and the BA of patients were measured before and one year after GnRHa treatment. A (Holtain Ltd. , Pembs. UK) was used to approximate height to the closest 0. 1. Thereafter, body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared. Midparental height (MPH) was calculated by adding the height of the parents, subtracting 13, and dividing by 2. An IGF-1-D-RIA-CT kit (Biosource, Nivelles, Belgium) was utilized to measure serum IGF-1 concentration through the radioimmune method, whereas an immunoradiometric assay with -3 kit (Immunotech, Marseile, France) was used to evaluate the serum IGFBP-3 concentration.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: 66 This adaptation serves to normalize the increases in shear stress associated with repetitive exercise bouts. 67 Indeed, 6 months of resistance training that involved mostly upper body movement led to improved vasodilatory function and brachial artery remodeling, while 6 months of aerobic exercise involving the legs led to improved vasodilatory function and size of the femoral artery. 68Lastly, there are some data suggesting that exercise increases the compliance of large elastic arteries (eg, the aorta and carotids) which buffer the fluctuations in pressure with each beat of the heart. When arterial compliance is reduced, ventricular afterload is increased, resulting in left ventricular hypertrophy. Tanaka et al69 reported an improvement in arterial compliance of the carotid artery among middle- to older-aged sedentary normotensive men (mean age, 53 years) following 3 months of aerobic exercise training (4 to 6 days per week at 70%–75% of the maximum capacity). In contrast, systemic arterial compliance was unaltered in adults with isolated systolic hypertension after 8 weeks (3 days per week) of moderate-intensity (65% of the maximum capacity) cycling. 70 Similarly, 20 weeks (3 days per week) of moderate-intensity (70% of the maximum capacity) aerobic exercise failed to alter carotid arterial stiffness in a group of older hypertensives (mean age, 68 years). 71 Finally, Stewart et al72 found that while diastolic blood pressure improved following 6 months of combined aerobic and resistance exercise in a group of older (55–75 years) hypertensive patients, no changes in systolic blood pressure or aortic stiffness were observed. These conflicting data suggest age- and hypertension-related structural changes of elastic vessels resulting in the fact that effect compliance may not be modified with exercise training. Chronic inflammationWhile the entrance of LDLs into the subendothelial space is arguably the initial event in the atherosclerotic process, inflammatory cells play a major role in every stage of its development. 33,73 LDLs are oxidized by reactive oxygen species which upregulate adhesion molecules (eg, VCAM-1, intercellular adhesion molecule-1 [ICAM-1], E-selectin, and P-selectin), ultimately leading to the recruitment of monocytes and T lymphocytes to the site of the lesion.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: 5 passenger vehicles driven for 1 year. For patients whose driving distance was greater than 60 minutes, 2 744 248 kg CO2 emissions were saved (mean emissions savings, 98. 6 [54. 8] kg CO2 per visit)—equivalent to 591 passenger vehicles driven for 1 year. Conclusions and a large data set, this cross-sectional analysis highlighted the carbon emissions savings due to telemedicine in oncology. This has important implications in reducing health care–related carbon footprint. 2020, global carbon dioxide (CO2) emissions fell by 6. 4%, or 2. 3 billion tons, as an unintended effect of the COVID-19 pandemic’s restrictions. 1 The US led the reduction in emissions with a nearly 13% decrease; this was mostly due to decreases in transportation,1 which is currently the largest source of greenhouse gas (GHG) emissions in the US after having surpassed electricity generation in 2016. 2 From 2008 to 2018, US health care sector GHG emissions rose by 6%, approximately 553 metric tons of CO2 equivalent emissions, or 8. 5% of domestic GHG emissions. 3 Per capita CO2 equivalent emissions were 1693 kg, the highest among industrialized nations. Recently, more than 200 leading health journals published a joint commentary on the current climate emergency, with a call for urgent action to reduce the impact of climate change on health. 4 This statement was published in anticipation of the 26th Conference of the Parties. While the health care community advocates for climate change policy, we must also look within care practices and assess our contribution to the CO2 emissions and provide solutions wherever possible. 5,6 While previous studies have focused on smaller patient populations in the prepandemic era, telemedicine was rapidly adopted during the COVID-19 pandemic to improve widespread access to health care. 7 Not only does telemedicine provide substantial cost benefits and improve access, but it can also help in mitigating climate change by providing care from distance. 8,9 In this study, we used a large oncology patient data set to estimate the CO2 emission savings from implementing telemedicine at Center (MCC), a Institute (NCI)-designated cancer center. was a retrospective study of patients seen at MCC, an NCI-designated comprehensive cancer center in Florida. Due to the COVID-19 pandemic, implementation of telemedicine at MCC was accelerated in March 2020.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: BA was based on left hand anteroposterior radiographs, and the measurements were performed in accordance with the Greulich and [13]. 3. Molecular study Genomic DNA was extracted from patient blood samples. The target IGFBP-3 gene containing -202 A/C polymorphic sites of 459 base pairs (bp) at the promoter region was amplified using corresponding sense and antisense primers. The polymerase chain reaction (PCR) product was sheared using the Alw21I restriction enzyme () to verify the allele types through restriction fragment length polymorphism and agarose gel electrophoresis. The PCR product was digested into 242-bp and 162-bp fragments containing an A allele and into 288-bp and 162-bp fragments when a C allele was present [14]. 4. Statistical analysis The definition of age-adjusted height velocity was established according to the difference between initial height SDS and final height SDS to minimize the confounding effect of age. Height SDS was calculated using Cole's modified least mean squares (LMS) algorithm [15]. The LMS values were provided by the 2007 version of for Children and Adolescents [16]. For IGF-I and IGFBP-3 SDSs, the LevenbergMarquardt algorithm was used to estimate the parameters from percentile values in Korean females [16,17]. Changes of IGF-1 and IGFBP-3 SDSs after GnRHa treatment were calculated and expressed as ∆SDS. The molar ratio of IGF-1 and IGFBP-3 was calculated, and the ratio of IGF-1/IGFBP-3 after treatment over the initial value was calculated and expressed as ∆IGF-1/IGFBP-3 ratio. The mean, SDS, minimum, and maximum values of the continuous data were obtained by descriptive statistics and compared for statistical significance using paired t-test before and after treatment. Pearson correlation analysis evaluated the association between ∆height SDS and parameters of BMI, initial height advancement, and ∆IGF-1 SDS, ∆IGFBP-3 SDS, and ∆IGF-1/IGFBP-3 ratio.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: 74 These, in turn, express a family of chemoattractant cytokines (eg, interferon γ, tumor necrosis factor-α [TNF-α], and interleukin-6), which cause smooth muscle cells to impede into the subendothelial space, eventually forming a fibrous cap. 75 Vascular endothelial growth factor (VEGF) is produced by inflammatory cells in the atherosclerotic plaque. VEGF stimulates microvessel growth (along with endothelial progenitor cells [EPCs]) that is needed to supply the plaque with nutrition, but plaque rupture can lead to hemorrhage and thrombosis. 76 Also, levels of C-reactive protein (CRP), which is produced in the liver, start to rise in response to the inflammatory process, which exacerbates endothelial dysfunction. 74 As the vessel thickens at the point of the lesion, blood flow is impeded, causing ischemia. Following the plaque rupture, the subendothelial factors that are exposed stimulate platelet activation and aggregation leading to thrombus formation and potentially triggering a stroke or myocardial infarction. 73 Accordingly, treatments aimed toward lowering the factors associated with inflammation (or raising EPC expression) could affect atherosclerosis progression, enhance endothelial function, and decrease cardiovascular risk. The case for exerciseThere is strong evidence that exercise has positive effects on several, but not all, of the above factors involved in the atherosclerosis process. These data have been summarized and evaluated in a recent review. 73 For instance, Schumacher et al,77 observed an inverse relation between the amount of physical work (ie, kilojoules minute × minutes of exercise) performed during an exercise test following 6 months of aerobic exercise training and levels of TNF-α, VCAM-1, and CRP (see below) among patients with established CAD. In a group of patients with breast cancer, Pakiz et al78 reported an association between the number of hours engaged in moderate-to-vigorous exercise over a 16-week weight loss program that included dietary counseling and favorable changes in TNF-α levels. For those with chronic heart failure,79 12 weeks of aerobic exercise led to significant reductions in ICAM and VCAM. Moreover, the improvement in aerobic fitness was correlated with the magnitude of reduction in these adhesion molecules.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Telemedicine was defined as real-time care delivered through a synchronous videoconferencing. Starting in April 2020, MCC instituted a synchronous video platform (Zoom Meetings) for telemedicine visits. All telemedicine visits with a mailing address listed in the electronic medical record within the State of Florida from April 1, 2020, to June 30, 2021, were included in the study. All patients were offered telemedicine if deemed appropriate by the clinical team. Telemedicine visits were not offered to patients who needed physical examinations beyond what can be assessed during a telemedicine visit. This study was deemed exempt from review by the MCC institutional review board with a waiver of informed consent from patients due to low risk. Baseline demographics data including age, sex, insurance, race and ethnicity were abstracted from electronic health record. the Reporting of in Epidemiology () reporting guideline for cross-sectional study was used as a reference to report study design and findings. All patients with addresses within the State of Florida were assumed to travel round-trip via an automobile from the home address listed in the electronic medical record to MCC as a final destination. For patients with a post office box as their mailing address, their zip code’s centroid was used as driving departure point. All patients included in the study had addresses on record. Driving distance traveled in miles was calculated in October 2021 by an analytics organization (Buxton Company) that uses Alteryx’s analytic platform to provide geospatial data. Briefly, the locations were geocoded, and the distance between the 2 geocoded locations was calculated by finding the route that resulted in the least amount of drive time. CO2 emissions saved for vehicle travel were calculated using EPA emissions calculator, which estimates 411 g of CO2 emissions per vehicle per mile traveled. 10 Analyses were completed and maps were generated using the tmap11 package in R version 4. 2. 0 (R Project for Statistical Computing). CO2 emissions equivalencies were determined using EPA equivalencies calculator. 12 April 1, 2020, to June 30, 2021, 49 329 telemedicine visits (23 228 patients) were for patients residing within the same state as MCC (Florida). The majority of the patients coming to MCC were within 60 minutes of 1-way driving time (eFigure 1 in Supplement 1).

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: Univariate and multivariate regression analyses were performed to investigate the effects of ∆IGF-1 SDS, ∆IGFBP-3 SDS, and ∆IGF-1/IGFBP-3 ratio on ∆Height SDS. All covariates associated with the height velocity from the Pearson correlation analysis adjusted for initial height SDS, ∆IGF-1 SDS, ∆IGFBP-3 SDS, and ∆IGF-1/IGFBP-3 ratio. The target patients were arranged into 2 subgroups based on the allele of -202 A/-3 promoter polymorphism. Independent t-test was performed between the 2 subgroups for SDS values of height, IGF-1, IGFBP-3, and IGF-1/IGFBP-3 before and after treatment. ∆IGF-1 SDS, ∆IGFBP-3 SDS, ∆IGF-1/IGFBP-3 ratio, and ∆height SDS were compared between the 2 subgroups. The differences of IGF-1 SDS and IGFBP-3 SDS before and after GnRHa treatment within the subgroups were confirmed by paired t-test. All statistical analyses were performed with ver. 26. 0 (IBM Co. , ). A value of P<0. 05 was considered statistically significant. values of height SDS, and BMI before treatment were 8. 5±0. 5 years, 10. 5±0. 6 years, 160. 0±3. 2 cm, 1. 2±0. 8, and 18. 2±2. 4, respectively. The SDSs for serum IGF-1 and IGFBP-3 concentrations were 0. 8±1. 0 and 3. 3±1. 1, respectively, and the IGF-1/IGFBP-3 ratio was 60. 7±16. 3. Subsequently, the mean BA value after one year of treatment was 10. 9±0. 6 years. The difference between BA and CA was significantly reduced from 2. 0±0. 6 to 1. 3±0. 6 (P<0. 001) and the height SDS to 1. 1±0. 8 (P<0. 001) after GnRHa. SDSs of serum IGF-1 and IGFBP-3 concentrations significantly decreased to 0. 5±0.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Similarly, VEGF levels decreased by 9% and myocardial blood flow increased by 33% in post–myocardial infarction patients after 3 months of exercise training. 80There is also evidence that both aerobic77,81 and resistance exercise82 reduces the levels of CRP. In addition to the abovementioned findings from Schumacher et al,77 et al81 found that CAD patients who underwent 4 months of aerobic exercise (60-min sessions 3 times per week) of moderate-to-high intensity exhibited a decreased CRP level in response to an acute bout of exercise. Also, Olson et al82 randomized young (25–44 years), overweight women free from CVD to a resistance training program (twice weekly) or a control condition. They found significant reductions in CRP levels, but not in the levels of adhesion molecules, following 1 year of training. Finally, some data suggest that exercise increases the levels of EPC. For example, Schlager et al83 showed that levels of EPC and maximal walking distance increased in patients with peripheral artery disease following 6 months of aerobic exercise (eg, walking intermittently to claudication). Moreover, for older patients who underwent cardiac surgery, levels of EPCs increased following just 15 days of cardiac rehabilitation that consisted of moderate aerobic exercise, but only among patients who improved the 6-minute walking distance by at least 23% from baseline. 84The above data suggest that there is a strong link between the magnitude of improvement in various factors involved in chronic inflammation and levels of fitness achieved through exercise training, implying a dose-response relationship. Also, in contrast to what has been previously discussed regarding the effects of exercise on blood pressure (ie, older adults with established hypertension may be resistant to exercise-induced improvements in blood pressure), the exercise-mediated effects on inflammatory markers are observed in those who have developed CVD (eg, peripheral vascular disease and coronary artery disease), thus highlighting the importance of exercise as a tool for secondary prevention. Insulin resistanceInsulin resistance is associated with the cluster of atherosclerosis risk factors described above (ie, hypercholesterolemia, hypertension, and chronic inflammation) and is thus a strong predictor of CVD in patients with type 2 diabetes. 85 In insulin-resistant states, including obesity, glucose metabolism is impaired, resulting in augmented secretion of insulin by the β cells of the pancreas.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Telemedicine can help address diagnostic and treatment delays and improve access to high-quality care,18-23 as seen during COVID-19 pandemic. Telemedicine also provides significant advantages for patients who live farther away from treatment centers by improving access to care, reducing financial toxic effects, and subsequently reducing CO2 emissions. 14-17 There has been a reduction in the number of rural hospitals over the previous decade, consequently almost doubling the number of people who live outside a 60-minute driving range of a major hospital. 24 As a result of rural hospital closures, patients are driving longer distances and contributing more to CO2 emissions while simultaneously experiencing decreased access to high-quality care. Continued expansion and coverage of telemedicine, along with improved broadband access for rural communities under recently passed legislation in US,25 will be critical for telemedicine’s continued success and implementation. In addition, at MCC the Department was established to provide clinical and administrative support to patients prior to the telemedicine appointments and developing patient facing and clinician facing educational materials. 7 Increased CO2 emissions are both direct and indirect factors affecting the health of the population. Regarding the direct health implications of climate change, the total disease burden from US health care pollution resulted in a loss of approximately 388 000 disability-adjusted life-years in 2018. 3 Cancer patients are particularly prone to the direct effects of pollution and particulate matter. 26 Climate change also results in increased extreme weather events, which affects health care delivery and access to care. 26 These can result in shifts in care due to diagnostic and treatment delays, lack of access to high-quality care centers, and supply chain disruptions that result in critical shortages of medical supplies and medications. 26 These factors have been shown time and again to be associated with the survival of cancer patients and increase secondary use of health care resources. 26 A study modeling the showed that, if implemented, it would result in significant annual reduction deaths related to pollution, diet, and physical inactivity 2040. 27 Without Harm28 and members of the Consortium on Climate and Health29 partnered together to highlight climate change as a health emergency and to call for policymakers to take steps to address it. 30 For example, the UK’s Service has implemented a mandated government-sponsored carbon reduction initiative for its health system through the Unit, which tracks GHG progress over time (albeit without including patient travel).

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: 9 (P<0. 001) and 2. 3±0. 9 (P<0. 001), respectively. However, there was no significant change in IGF-1/IGFBP-3 ratio after treatment (P=0. 887) (Table 1). ∆IGF-1 SDS (r=0. 405, P<0. 001), ∆IGFBP-3 SDS (r=0. 228, P=0. 025), and ∆serum IGF-1/IGFBP-3 ratio (r=0. 204, P=0. 045) showed significant positive correlations with ∆height SDS. On the other hand, initial height SDS was negatively correlated with ∆height SDS (r=-0. 307, P=0. 002). Correlation analysis between ∆and BA advancement showed no statistical significance (Table 2). Only ∆IGF-1 SDS was significantly related to ∆height SDS on multivariate regression analysis after adjusting for covariates of ∆IGF-1 SDS, ∆IGFBP-3 SDS, ∆IGF-1/IGFBP-3 ratio, and initial height SDS (β=0. 110, P≤0. 001) (Table 3). According to the -202 A/-3 promoter polymorphism analyses, 72 AA genotypes (74. 2%), 22 AC genotypes (22. 7%), and 3 CC genotypes (3. 1%) were present. allele frequency accounted for 14. 4% of the study population. These genotypes were divided into 2 subgroups based on C allele presence. No significant difference was observed in IGF-1 SDS before treatment between the 2 subgroups (P=0. 421). However, the group with the C allele exhibited notably lower IGF-1 SDS after treatment (P=0. 049). IGFBP-3 SDS was lower in the C allele groups both before and after GnRHa treatment (P=0. 012 and P=0. 001, respectively). -1/IGFBP-3 ratio, ∆IGF-1 SDS, ∆IGFBP-3 SDS, ∆IGF-1/IGFBP-3 ratio, and ∆height SDS between the 2 subgroups exhibited no significant differences before and after treatment (1).

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: 86 At high levels, insulin stimulates the growth and proliferation of vascular smooth muscle cells,87 it activates inflammatory pathways,88 results in a deficiency in nitric oxide and stimulation of endothelin-1 production,89 thus promoting vasoconstriction and atherogenesis. Since suboptimal diets act as the primary lifestyle factor that triggers insulin resistance, exercise may not be sufficient as a solitary treatment. However, there is evidence of significant impact of exercise, independent of dietary change or weight loss, on the insulin-resistant state. The case for exerciseA series of reports provide strong evidence for the importance of exercise in the treatment of type 2 diabetes. Boule et al90 reviewed 7 randomized controlled trials that compared the effects of aerobic exercise interventions (a mean of 3 sessions per week, at 50 minutes per session for 20 weeks) compared with nonexercise controls in patients with type 2 diabetes. As expected, the exercise interventions led to an approximate 12% increase in aerobic fitness compared with no change in the controls. Interventions that employed greater exercise intensities produced greater improvements in aerobic fitness and blood glucose control, as defined by reductions in glycated hemoglobin (HbA1c). The total exercise volume expressed as total weekly energy expenditure was not an important predictor of the change in either aerobic capacity or HbA1c. However, the same authors91 later suggested that a threshold of 150 minutes of weekly structured exercise per week must be achieved for significant reductions in HbA1c to occur. In this way, in an updated analysis92 of 26 randomized controlled trials that included aerobic, resistance, or combined exercise of at least 12 weeks in duration, it was reported that patients with a higher level of HbA1c at the beginning of an intervention experienced greater reductions in HbA1c and that the volume of weekly aerobic or combined exercise was associated with HbA1c level reductions. Neither the volume nor intensity of resistance exercise (when performed as the sole modality) explained the subsequent change in HbA1c. However, Church et al93 demonstrated in a group of patients with type 2 diabetes with HbA1c levels above 6. 5% that adding resistance exercise performed twice weekly to a moderate-intensity aerobic exercise program (ie, 150 min/week at 50%–80% of the maximum intensity), was superior after 9 months with regard to decreasing HbA1c than engaging in aerobic or resistance training alone.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: 31,32 A similar US program under the supervision of Department of Health and may initially help in tracking health care–related GHG emissions and eventually help in reducing them. 3 A 2021 US order required federal facilities, notably Administration and Agency hospitals and medical facilities, to reduce GHG emissions—certainly a step in the right direction given the large negotiating power the federal government wields. 33 As our results indicate, telemedicine can help in reducing CO2 emissions. Continued support and implementation of telemedicine may assist in meeting these reduction targets. are important study limitations that need to be considered. Carbon emissions savings reported in this study are likely to be on the upper end of the estimates. Notably, we assumed all patients traveled via personal automobile to MCC—personal automobiles are known to be higher generators of CO2 emissions compared with other modes of public transportation. 13 public transit ridership data analysis showed that at the start of the study period (April 1, 2020) public transit ridership was 31% and at the end of the study period (Jun 30, 2021) ridership was 64% of prepandemic levels (eFigure 3 in Supplement 1). 34 This was consistent with public transit ridership nationally. 35 Furthermore, given that social isolation protocols were recommended for high-risk patients with active or a history of cancer, comorbidities, and advanced age, it is conceivable that the use of public transportation to attend their oncologic appointments would be even lower. Thus, it stands to reason that the telemedicine visits described in this study were largely shifted from in-person visits that would have been attended using a personal vehicle. While beyond the scope of the study to examine the factors contributing to successful completion of telemedicine vs in-person visits, it is conceivable that not all patients seen by telemedicine would otherwise attend an in-person appointment. In-person cancellation and no-show rates between prepandemic and study period were similar, and so were the in-person and telemedicine cancellation and no-show rates during the study period (eTable 2 in Supplement 1). Thus, the difference in the estimated carbon emission savings is likely to be small in the data set. It is important to note that findings from this study have to be taken in the context of health system and region characteristics and the demographics of their patients.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: There were significant changes of IGF-1 SDS after GnRHa treatment within both subgroups (P=0. 005 and P<0. 001, respectively) (Fig. 1A). IGFBP-3 SDS also significantly decreased in both subgroups (P<0. 001 and P<0. 001, respectively) (Fig. 1B). GH-IGF axis directly or indirectly influences skeletal development, especially during puberty. However, the mechanism of IGF-1 or IGFBP-3 action during puberty and how the hormones interact with each other remain unclear. Juul et al. [18] discovered that the increase of free IGF-1 in puberty is not directly influenced by IGFBP-3 proteolysis. Verrotti et al. [19] compared the IGF-1 and IGFBP-3 concentrations between the 2 treatment regimens of GnRHa with or without cyproterone acetate and concluded that IGF-1 and IGFBP-3 are regulated by different metabolic pathways. Despite continuous attempts to effectively understand GnRHa action upon the GH-IGF-1 axis, studies have reported disparate results. Numerous previous studies have presented trivial changes in serum IGF-1 or IGFBP-3 level during GnRHa treatment in CPP patients [20-23], in contrast to other studies where IGF-1 concentration decreased [9,18]. The present study aimed for a well-controlled project design to revise the GnRHa effect on the GH-IGF-1 axis and its relationship with height change. IGF-1 SDS and IGFBP-3 SDS decreased after 1 year of GnRHa treatment. However, after analyzing ∆IGF-1 SDS, ∆IGFBP-3 SDS, and ∆IGF-1/IGFBP-3 ratio with ∆Height SDS, only ∆IGF-1 SDS was significantly related. This result supports that IGF-1 plays a major role in pubertal height gain, and that a decrease in IGF-1 during GnRHa treatment restores the growth velocity to that before puberty. Among the numerous characteristics that increase final adult height in treated CPP patients, other than the GH-IFG-1 axis [6-8], we reevaluated BA advancement, initial height and MPH to determine whether they influenced growth velocity during GnRHa treatment.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Together, these data suggest that for exercise to have a significant effect on the insulin-resistant state, a minimum dose of approximately 150 minutes of accumulated exercise over the course of a week may be required. Additional beneficial effects may be achieved by increasing the intensity of aerobic exercise and resistance training may be most impactful when practiced in combination with an aerobic exercise intervention. Finally, those with better glycemic control and short diabetes duration may respond most favorably to exercise. Mechanisms of actionThe mechanisms through which exercise can ameliorate diabetes have been well studied. 94 Evidence from experimental studies suggest a myriad redundant pathways that impact the delivery, transport of glucose across the muscle cell surface, and metabolism of glucose in the muscle cell. It should be also stated that insulin sensitivity is increased for 48 hours after the completion of 60 minutes of moderate-intensity cycling in healthy but untrained men. 95 While patients with type 2 diabetes also experience improved insulin sensitivity following exercise, the effect does not appear to be as long-lasting (eg, >15 h post exercise). 96 Briefly, regarding glucose transport, increased glucose delivery to active muscles occurs as a result of increased blood flow that is proportional to exercise intensity, and increased glucose uptake is linked to increased levels of skeletal muscle perfusion. 97 Furthermore, it has been reported98 that glucose transporter-4 (GLUT-4) concentrations are increased by approximately 70% compared with baseline in both apparently healthy individuals and patients with type 2 diabetes following just 1 bout of cycling exercise (ie, 45–60 min at 60%–70% of the maximum effort). GLUT-4 is the glucose transporter that permits the facilitated diffusion of plasma glucose into the muscle and fat cells. Finally, GLUT-4 activity is intricately linked to glucose metabolism within the cell. While glycogen is the preferred energy source during exercise, as exercise is prolonged and glycogen stores become depleted, the muscle permeability to glucose is increased and there is a gradual shift from glycogen to blood glucose to generate the adenosine triphosphate required for exercise. 94 Altogether, by simultaneously enhancing the factors that improve the delivery, transport, and metabolism of glucose, as well as enhancing insulin sensitivity, exercise provides a powerful treatment for CVD. ConclusionCardiovascular disease remains the leading cause of death in the industrialized world. Luckily, increasing levels of exercise and improved aerobic fitness can dramatically reduce CVD risk.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Lastly, we did not account for carbon emissions generated by clinicians commuting to and from work, and we did not factor in electricity used during telemedicine visits. More generally, while we demonstrate in this study that there are carbon emission savings from telemedicine, further data are needed to examine if long-term oncologic outcomes with telemedicine visits are equivalent to those seen in person. Additionally, the field of telemedicine is in its nascent stages and data are not mature to assess if in-person evaluations can be avoided to truly reduce the carbon emissions. Future studies should assess this specific question of quality provided by telemedicine consultation to better triage the need for in-person evaluation. cross-sectional study highlighted the important benefits of telemedicine and advocate for further implementation of telemedicine in oncology. Telemedicine can help in reducing health care–related carbon emissions. Back to top 2022. Published: January 31, 2023. doi:10. 1001/jamanetworkopen. 2022. 53788Open Access: This is an open access 2. Meeting Presentation: Part of the manuscript was presented at the Association 2022; May 1-3, 2022; Boston, Massachusetts. Additional Contributions: The authors would like to acknowledge the members of Center’s Planning & from Department of Operations for their help with data curation and analysis and April Manna, MS, for administrative assistance. Editorial assistance was provided by the Center’s Office of by Daley Drucker, BA, and Gerard Hebert, MA. No compensation was given beyond their regular salaries. We would also like to thank donors to the COVID-19 Fund at Center for their generous support, which helped to fund research to improve the quality and cost savings offered through Virtual Health. 1. Liu Z, Ciais P, Deng Z, et al. Near-real-time monitoring of global CO2 emissions reveals the effects of the COVID-19 pandemic.  Nat Commun. 2020;11(1):5172. doi:10. 1038/s41467-020-18922-7PubMed2. Department of Transportation. 2020. December 1, 2020. 5, 2022.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: However, none were statistically associated with ∆Height SDS, suggesting that it is inappropriate to predict final adult height in CPP females based on BA, body figure, or parental height. The -202 A/-3 promoter polymorphism has been suggested to be a potential genetic determinant that alters the GH-IGF-1 axis. Studies have reported that the presence of the C allele genotype is associated with low serum IGFBP level [24-26]. has a role in pubertal growth, there is a potential for -202 A/-3 promoter polymorphism to affect growth velocity and final adult height. Nevertheless, it was difficult to confirm a concrete correlation due to the discrete results. According to Miletta et al. [27] the IGFBP-3 genotype had no effect on final height after GH treatment in severe GHD patients. In contrast, Costalonga et al. [10] implied that the -202 A allele polymorphism of the IGFBP-3 promoter region was associated with not only higher IGFBP-3 levels, but also increased growth during recombinant human GH treatment in prepubertal GHD children. This study focused on the effect of the -202 A/-3 promoter polymorphism on the GH-IGF-1 axis as well as the growth velocity in CPP females undergoing GnRHa treatment for at least 1 year. We compared SDS of IGF-1 and IGFBP-3 between the 2 subgroups before and after GnRHa treatment. The results showed that IGF-1 SDS was not statistically different before treatment, but the group with the C allele after treatment demonstrated lower IGF-1 SDS than the AA subgroup. -3 SDS was lower in the C allele subgroup both before and after GnRHa treatment. However, change of IGF-1 -3 SDS, or IGF-1/IGFBP-3 during treatment exhibited no significant difference between the 2 subgroups. Divergence of age-adjusted height velocity between the 2 allele groups was trivial. The effect of GnRHa on IGF-1 SDS or IGFBP-3 SDS was noted in both subgroups, regardless of allele. This suggests that -202 A/-3 promoter polymorphism does not significantly affect the therapeutic effect of GnRHa in CPP females. Our study was carefully designed with a uniform diagnosis and treatment protocol in which GnRHa was administered every 4 weeks to all enrolled CPP patients.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Evidence from randomized controlled trials and experimental studies suggest that structured exercise confers cardioprotection, in part, by targeting the intermediary mechanisms involved in the atherosclerotic process; namely, hypercholesterolemia, hypertension, chronic inflammation, and insulin resistance. The efficacy of exercise for improving the lipid profile, reducing blood pressure and certain markers of inflammation, and improving blood glucose control in diabetes is well supported by the literature. A summary of the benefits and limitations of exercise training on atherosclerotic stimuli is provided in Table 1. A general understanding of these effects can be used to help support physical activity and exercise promotion efforts in health care settings. Table 1. The benefits and limitations of exercise training on atherosclerotic stimuliAtherosclerotic stimuliBenefitsLimitationsCholesterolModerate vigorous AE is associated with an increase in HDL-C levels (4.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Staying connected in the COVID-19 pandemic: telehealth at the largest safety-net system in the United States.  (Millwood). 2020;39(8):1437-1442. doi:10. 1377/hlthaff. 2020. 0090310. US Agency. Greenhouse gas emissions from a passenger vehicle. 1, 2021. M. tmap: in R.  J Stat Softw. 2018;84(6). doi:10. 18637/jss. v084. i0612. US Agency (EPA). Equivalencies Calculator. 1, 2021. T. Public Transportation's Role in Responding to Climate Change. US Department of of Budget and Policy. 2010. 15, 2022. AB, Irwin CA, Cranford CO, Denny GS. The impact of telemedicine on patients’ cost savings: some preliminary findings.  E Health. 2003;9(4):361-367. doi:10. 1089/153056203772744680PubMed15. Dorrian C, Ferguson J, Ah-See K, et al. Head and neck cancer assessment by flexible endoscopy and telemedicine.  J Telemed Telecare. 2009;15(3):118-121. doi:10. 1258/jtt. 2009. 003004PubMed16. Thota R, Gill DM, Brant JL, Yeatman TJ, Haslem DS. Telehealth is a sustainable population health strategy to lower costs and increase quality of health care in rural Utah.  JCO Oncol Pract. 2020;16(7):e557-e562. doi:10. 1200/JOP. 19. 00764PubMed17. Sellars H, Ramsay G, Sunny A, Gunner CK, Oliphant R, Watson AJM. Video consultation for new colorectal patients.  Colorectal Dis. 2020;22(9):1015-1021. doi:10. 1111/codi.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: Target patients with the C allele alone could not substantially contribute to a definitive conclusion due to the small number. Therefore, children with CC and AC genotypes of -202 A/-3 promoter polymorphism were pooled into a single subgroup. This is due to a racial characteristic that the Korean population has a higher proportion of the A allele compared to other populations [12,25,28]. Another limitation of our study is that free IGF-1 level was estimated using the IGF-1/IGFBP-3 ratio. This estimation, however, is based on a previous study conducted by Juul et al. [18] showing that free IGF-1 concentration significantly correlates with the molar ratio of IGF-1 and IGFBP-3. In conclusion, growth velocity during GnRHa treatment is related to ∆IGF-1 SDS, and GnRHa seems to have an impact on the GH-IGF-1 axis. allele in the -202 A/-3 promoter regions was not associated with the growth rate during GnRHa treatment in CPP girls and did not affect the reduction of IGF-1 SDS or IGFBP-3 SDS during treatment. statement The study was approved by the Board of (approval number: 2014-02-003). Informed consent was obtained from the parents or legal guardians of the children. Conflicts of interest No potential conflict of interest relevant to this 10. 6065/apem. 2040020. 010 apem-2040020-010-suppl. pdf Fig. 1. The graphs resemble the differences of IGF-1 SDS (A) and IGFBP-3 SDS (B) before and after GnRHa treatment within the two allele subgroups. GnRHa, gonadotropin-releasing hormone agonist; SDS, standard deviation score; IGF-1, insulin like growth factor 1; IGFBP-3, insulin-like growth factor binding protein 3. Table 1. Characteristics of the 97 girls treated with GnRAt diagnosis After a year Post-Pre P-value* CA (yr) 8. 5±0. 5 9. 6±0. 5 - - BA (yr) 10. 5±0. 6 10. 9±0. 6 0. 4±0. 4 <0. 001 BA–CA (yr) 2. 0±0. 6 1. 3±0. 6 -0.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: 6%)Independent of changes in fitness body composition dietHIIT may be required for clinical populationsRE volume more important than intensityLDL-C and triglyceride levels not altered with AEAE of higher intensities may be requiredBlood pressureAE is associated with a decrease in BP (approximately 5–6 mm Hg)Dose response: the higher the AE intensity, the greater the decrease in BPLower AE intensity may lead to a decrease in BP among patients with hypertensionBP is responsive to REOlder patients with hypertension may be resistant to exercise adaptationsChronic inflammationIncreased AE volume is associated with decreased levels of TNF-α, VCAM-1, and CRPDose response: markers improve as the level of fitness increasesRE reduces CRP levelsAE increases EPC levels in clinical populationsAE or RE do not alter IL-8, SDF-1, or E-selectinInflammatory markers not altered in healthy populationsInsulin resistanceIncreased AE intensity is associated with a decrease in HbA1c150 min/week of structured exercise needed for positive changeCombined exercise (AE + RE) is associated with a greater decrease in HbA1c than AE or ER alonePatients with poor glycemic control or long diabetes duration may not be responsive to AE or REAbbreviations: AE, aerobic exercise; BP, blood pressure; CRP, C-reactive protein; EPC, endothelial progenitor cell; HbA1c, glycated hemoglobin; HDL-C, high-density lipoprotein cholesterol; HIIT, high-intensity interval training; IL-8, interleukin-8; LDL-C, low-density lipoprotein cholesterol; RE, resistance exercise; SDF-1, stromal cell-derived factor 1; TNF-α, tumor necrosis factor-alpha; VCAM-1, vascular cell adhesion moledule-12021. Revision acceptedSeptember 27, 2021. Published onlineOctober 27, 2021. Conflict of interestNone declared. How to citeDobrosielski DA. How can exercise reduce cardiovascular disease risk? A primer for the clinician. Intern Med. 2021; 131: 16122. doi:10. 20452/pamw. 161221. . Advances in the prevention and treatment of cardiovascular disease. (Millwood). 2007; 26: 25-37. Crossref2. .

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: . org 2024 in to your account Login or this option if you have an account on informs. org or if you want to become an member Combine personal and institutional access with an Informs PubsOnline account using main navigation14, 2020 in in a Clinic utilizes management and systems engineering to optimize delivery of medical services during the pandemic. (Amy) Donahoe-R. : Share onShare on PRINT 10. 1287/orms. 2020. 06. 03 Mayo Clinic’s Department of and Consulting (ME&C) was engaged to assist with the exponential increase of video visits during the COVID-19 pandemic. The potential and reach of telemedicine was highlighted on many fronts, especially for patient engagement during the pandemic. This resulted in the need for significant business consulting and engineering guidance to successfully operationalize telemedicine in an ever-changing environment. Staffing to workload, piloting process improvements, creating information resources and monitoring staff proficiency amidst other interventions were needed to navigate the demands on telehealth services in an agile way and ensure high patient satisfaction. As a result of the deep collaboration between ME&C engineers and various multidisciplinary subject matter experts, hundreds of staff were trained and daily patient video visits were increased by hundreds and thousands per day as compared to pre-COVID levels, enabling virtual care for patients in need of medical attention across the nation. Need for year, more than 1 million domestic and international patients seek care at Mayo Clinic. In 2020, this abruptly changed in a matter weeks. COVID-19 led to broad lockdowns on local, state and international travel. However, the need for medical care was not reduced by the global pandemic. Although telehealth patient visits had been growing in both popularity and availability in the years leading up to the pandemic, large-scale adoption and utilization were constrained by licensing, reimbursement, technical and logistical barriers. COVID-19 became the catalyst for licensing and reimbursement reforms, allowing for rapid and widespread adoption of virtual care by the healthcare industry. Video-enabled virtual appointments (“video visits”) are one of the cornerstones of telemedicine. Video visits provide a bridge for patients and providers to continue receiving and delivering care in a safe and convenient manner using video technology.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: 6±0. 4 <0. 001 Height SDS 1. 2±0. 8 1. 1±0. 8 -0. 1±0. 2 <0. 001 BMI 18. 2±2. 4 19. 3±2. 7 1. 1±0. 9 <0. 001 IGF-1 SDS 0. 8±1. 0 0. 5±0. 9 -0. 3±0. 7 <0. 001 IGFBP-3 SDS 3. 3±1. 1 2. 3±0. 9 -1. 0±1. 0 <0. 001 IGF-1/IGFBP-3 60. 7±16. 3 60. 5±16. 8 -0. 2±14. 4 0. 887 Midparental height (cm) 160. 0±3. 2 - - - Values are presented as mean±standard deviation. GnRHa, gonadotropin-releasing hormone agonist; CA, chronological age; BA, bone age; SDS, standard deviation score; BMI, body mass index; IGF-1, insulin like growth factor 1; IGFBP-3, insulinlike growth factor binding protein 3. * P<0. 05 compared before and after the treatment. Table 2. Pearson correlation analysis Variable ∆Height SDS Body mass index 0. 035 (0. 736) Initial height SDS -0. 307* (0. 002) Midparental height -0. 109 (0. 288) BA advancement -0. 017 (0. 871) ∆IGF-1 SDS 0. 405* (<0. 001) ∆IGFBP-3 SDS 0. 228* (0. 025) ∆IGF-1/IGFBP-3 ratio 0. 204* (0. 045) Values are presented as correlation coefficient r (P-value). SDS, standard deviation score; BA, bone age; IGF-1, insulin like growth factor 1; IGFBP-3, insulin-like growth factor binding protein 3. * P<0. 05. Table 3. Univariate and multivariate regression model to find factors associated with Δheight SDS Variable ΔHeight SDS Univariate analysis Multivariate analysis β±SE P-value* β±SE P-value* ∆IGF-1 SDS 0. 110±0. 025 <0.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Waging war on modern chronic diseases: primary prevention through exercise biology. J Appl Physiol. 2000; 88: 774-778. Crossref3. Coronary heart-disease and physical activity of work. Lancet. 1953; 262: 1111-1120. Crossref4. . Characteristics of longshoremen related fatal coronary heart disease and stroke. Public Health. 1971; 61: 1362-1370. Crossref5. . Physical fitness and cardiovascular disease mortality. The US Railroad Study. Epidemiol. 1988; 127: 571-580. Crossref6. . Healthy hearts – and the universal benefits of being physically active: physical activity and health. Ann Epidemiol. 2009; 19: 253-256. Crossref7. 3rd, Barlow CE, et al. Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA. 1995; 273: 1093-1098. Crossref8. Nocon M, Hiemann T, Muller-Riemenschneider F, et al. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Rehabil. 2008; 15: 239-246. Crossref9. Physical activity, all-cause and cardiovascular mortality, and cardiovascular disease. Sports Exerc. 2019; 51: 1270-1281. Crossref10. Physical activity to prevent and treat hypertension: a systematic review. Sports Exerc. 2019; 51: 1314-1323. Crossref11. Cardiorespiratory fitness and cardiovascular disease – the past, present, and future. Dis. 2019; 62: 86-93. Crossref12. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. J Med. 2002; 347: 716-725. Crossref13. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007; 116: 2110-2118. Crossref14. Saint-. , et al. Association of daily step count and step intensity with mortality among US adults. JAMA. 2020; 323: 1151-1160. Crossref15. Sedentary behavior, exercise, and cardiovascular health. Circ Res. 2019; 124: 799-815. Crossref16. Physical activity and public health.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: -19-related impacts grew during the spring of 2020, scaled up to quickly expand the use of video visits as part of the transitional care plan for patients still requiring care from clinical/hospital departments across multiple U. S. states and nations. and May, daily video visit volumes grew 8,650% from pre-COVID volumes. Staffing volumes grew in alignment with the growth from just a few staff to more than 200 full-time equivalents to keep up with demand. This required immediate staffing changes, reengineering of processes and augmentation of technology resources. To help address these demands, the telehealth group engaged health systems engineers from ME&C department. ME&C’s role in partnership with multidisciplinary teams was to engage in extensive capacity planning, optimize staff-to-patient ratios, deploy both a centralized and decentralized staffing model across the enterprise, enable agile and iterative improvement cycles, efficiently leverage video technology and facilitate innovative remote training of staff and patients. Methods and changing landscape of COVID-19 meant had to quickly adapt to the demand for video visits across the organization, which outpaced staff’s capacity to intake and room patients for these visits. The modeling and analysis of the demand led to the utilization of virtual patient check-in and rooming to provide a higher quality video visit experience. For many patients, this video visit was their first time using telehealth, and technical difficulties were proactively anticipated. To ensure patient satisfaction, Specialist (DOS) staff guided each patient through their video visit, assisting with technical issues prior to transitioning the patient to their care team. DOS staff leveraged best practices from their current roles and blended in the changes needed to effectively room patients in a virtual setting to include: validating demographic and insurance information, completing pre-visit questionnaires, assisting with check-in elements unique to video visits, ensuring patients were on the correct visit and understood how to use the technology, and assuring they had functioning video/audio capabilities. Although not typically top-of-mind when one thinks of a clinical visit, the investment of these additional few minutes by nonlicensed staff was pivotal in ensuring a seamless experience for patients and saved valuable time for the care team. During the initial planning and ramp-up, service improvements to workflow design were achieved through agile cycles of forecasting staffing ratios, cross-training, service design optimization and change management strategies. This ensured a reliable, consistent and repeatable positive patient experience.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: 001 0. 110±0. 025 <0. 001 ∆IGFBP-3 SDS 0. 041±0. 018 0. 025 - 0. 429 ∆IGF-1/IGFBP-3 ratio 0. 147±0. 072 0. 045 - 0. 271 Initial height SDS -0. 069±0. 022 0. 002 - 0. 099 Values are presented as regression coefficient (β)±standard error (SE). SDS, standard deviation score; IGF-1, insulin like growth factor 1; IGFBP-3, insulin-like growth factor binding protein 3. * P<0. 05. 1. . . Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier Saunders. 2019;pp 2899–912. 2. Incidence and prevalence of central precocious puberty in Korea: an epidemiologic study based on a national database. J Pediatr 2019;208:221–8. 3. . Precocious puberty and statural growth. Update 2004;10:135–47. 4. . Factors predicting adult height in girls with idiopathic central precocious puberty: implications for treatment. 2002;56:297–302. 5. . The pubertal growth spurt in eight patients with true precocious puberty and growth hormone deficiency: evidence for a direct role of sex steroids. J Metab 1990;71:975–83. 6. . Long-term effect of gonadotropin-releasing hormone agonist therapy on final and near-final height in 26 children with true precocious puberty treated at a median age of less than 5 years. J Metab 1995;80:546–51. 7. Allali S, Lemaire P, Couto-. Predicting the adult height of girls with central precocious puberty. Monit 2011;17:PH41–8. 8. . Final height of girls with central precocious puberty, untreated versus treated with cyproterone acetate or GnRH analogue. A comparative study with re-evaluation of predictions by the Bayley-Pinneau method. 1997;47:54–61. 9. Antoniazzi F, Bertoldo F, Z amboni Bone mineral metabolism in girls with precocious puberty during gonadotrophinreleasing hormone agonist treatment. Endocrinol 1995;133:412–7.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Effects of the amount and intensity of exercise on plasma lipoproteins. N Med. 2002; 347: 1483-1492. Crossref43. O’ Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J (1985). 2005; 98: 1619-1625. Crossref44. Horowitz JF, Klein S. Lipid metabolism during endurance exercise. Clin Nutr. 2000; 72: 558S-563S. Crossref45. Effects of four different single exercise sessions on lipids, lipoproteins, and lipoprotein lipase. J (1985). 1998; 85: 1169-1174. Crossref46. . Pathogenesis of hypertension. Med. 2003; 139: 761-776. Crossref47. . Essential hypertension: the heart and hypertension. Heart. 2001; 86: 467-475. Crossref48. 2013 ESH/ESC practice guidelines for the management of arterial hypertension. Blood Press. 2014; 23: 3-16. Crossref49. The 2014 recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Cardiol. 2014; 30: 485-501. 50. Methodological quality of meta-analyses on the blood pressure response to exercise: a review. J Hypertens. 2014; 32: 706-723. Crossref51. . Postexercise hypotension. Key features, mechanisms, and clinical significance. Hypertension. 1993; 22: 653-664. Crossref52. . Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Rep. 2015; 17: 87. Crossref53. The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension. J. 2010; 160: 513-520. Crossref54. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension. 2012; 60: 653-658. Crossref55. Blood pressure responses to acute and chronic exercise are related in prehypertension. Sports Exerc. 2012; 44: 1644-1652. Crossref56. Chronic conventional resistance exercise reduces blood pressure in stage 1 hypertensive men. J Res. 2012; 26: 1122-1129. Crossref57. .

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: The ongoing collaboration between the team comprised of various leadership, clinical and technical staff was invaluable for strategy development and implementation. rates and productivity were closely monitored and shared with key stakeholders to ensure optimal staff-to-patient ratios to manage daily volume fluctuations and maintain efficiency. Regular communications to internal and external stakeholders were crucial to rapidly establishing, diffusing and coordinating video visit technologies across multidisciplinary care providers. As face-to-face visits continued to be reduced in response to the pandemic, temporarily displaced staff were redeployed to assist with video visits. Although these staff were effectively leveraged for this new work, a significant challenge emerged with the need to rapidly onboard the ever-growing staff pool. At the outset, the general training time for an inexperienced staff member to reach competency was 5-10 days. To overcome this potential training barrier related to timeliness, remote training was developed leveraging a mix of both asynchronous/self-guided materials (e. g. , videos, training modules and quick reference guides), a mentor model and a reference web page made available for staff. Identifying and onboarding staff at the pace of growth remained an ever-present challenge. To address staffing constraints, the team increased its focus on improving staff efficiency. To meet demand, staff needed to reach a higher daily staff-to-patient ratio. To accomplish this goal, ME&C collaborated with operational partners to identify improvement opportunities and experiment with multiple process enhancement pilots. The pilots included a time study of staff check-in and rooming processes by segmenting the overall processes into subprocesses that could be individually and more accurately timed. Comparison to baseline times was used to validate the efficiency of the process and identify potential improvements. Due to COVID-19, the time study was conducted in person following social distancing guidelines and self-reporting by staff. Based on the learnings, small but significant changes were simultaneously implemented in isolated work groups, allowing for rapid iterations and fast learning cycles. The changes were measured using self-reported trackers and electronic health record (EHR) generated reports. ME&C applied analytics tools to study data from the trackers and reports to determine the efficacy of the changes and those that could be integrated into the standard workflow. Another strategy for managing staffing levels was the integration of the core telehealth staff team and the temporarily displaced labor pool. The integration provided relief to the strained staffing capabilities of the core telehealth team.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: 10. -. The -202 A allele of insulinlike growth factor binding protein-3 (IGFBP3) promoter polymorphism is associated with higher IGFBP-3 serum levels and better growth response to growth hormone treatment in patients with severe growth hormone deficiency. J Metab 2009;94:588–95. 11. Growth hormone pharmacogenetics: the interactive effect of a microsatellite in the IGF1 promoter region with the GHR-exon 3 and -202 A/3 variants on treatment outcomes of children with severe GH deficiency. 2012;12:439–45. 12. . Influence of the -202 A/ C insulin-like growth factor-binding protein-3 promoter polymorphism on individual variation in height in Korean girls. 2017;22:36–42. 13. . Radiographic atlas of skeletal development of the hand and wrist. 2nd ed. California: Press. 1959;pp 256. 14. Novel promoter polymorphism in insulin-like growth factor-binding protein-3: correlation with serum levels and interaction with known regulators. J Metab 2001;86:1274–80. 15. Cole TJ. The LMS method for constructing normalized growth standards. 1990;44:45–60. 16. 2007 Growth Charts: review of developmental process and an outlook. Pediatr 2008;51:1–25. 17. Reference values for serum levels of insulin-like growth factor-I and insulin-like growth factor binding protein-3 in Korean children and adolescents. 2012;45:16–21. 18. . Serum concentrations of free and total insulin-like growth factor-I, IGF binding proteins -1 and -3 and IGFBP-3 protease activity in boys with normal or precocious puberty. 1996;44:515–23. 19. . Serum insulin-like growth factor-I (IGF-I) and IGF binding protein-3 levels in children with precocious puberty treated with gonadotropin-releasing hormone analog without or in combination with cyproterone acetate. 1997;11:243–50. 20. . Insulin-like growth factor-I and IGF binding protein-3 remain high after GnRH analogue therapy in girls with central precocious puberty. 1996;45:7–12. 21. .

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Exercise and hypertension: uncovering the mechanisms of vascular control. Dis. 2016; 59: 226-234. Crossref58. . The sympathetic nervous system and blood pressure in humans: implications for hypertension. J Hum Hypertens. 2012; 26: 463-475. Crossref59. . Human investigations into the arterial and cardiopulmonary baroreflexes during exercise. Exp Physiol. 2012; 97: 39-50. Crossref60. Laterza MC, de Exercise training restores baroreflex sensitivity in never-treated hypertensive patients. Hypertension. 2007; 49: 1298-1306. Crossref61. ’Driscoll G, Taylor R. Effect of exercise training on endothelium-derived nitric oxide function in humans. J Physiol. 2004; 561: 1-25. Crossref62. Endothelin-1 vasoconstrictor tone increases with age in healthy men but can be reduced by regular aerobic exercise. Hypertension. 2007; 50: 403-409. Crossref63. Maiorana A, O’. Exercise and the nitric oxide vasodilator system. Sports Med. 2003; 33: 1013-1035. Crossref64. Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: a randomized clinical trial exercise, endothelium and blood pressure. Sci Rep. 2020; 10: 7628. Crossref65. Aerobic exercise training reduces plasma endothelin-1 concentration in older women. J (1985). 2003; 95: 336-341. Crossref66. Time course of change in vasodilator function and capacity in response to exercise training in humans. J Physiol. 2008; 586: 5003-5012. Crossref67. Shear stress mediates endothelial adaptations to exercise training in humans. Hypertension. 2010; 55: 312-318. Crossref68. . A prospective randomized longitudinal study involving 6 months of endurance or resistance exercise. Conduit artery adaptation in humans. J Physiol. 2013; 591: 1265-1275. Crossref69. Aging, habitual exercise, and dynamic arterial compliance. Circulation. 2000; 102: 1270-1275. Crossref70.

Output: corroborate


Input: Claim: Telemedicine eliminates the need for in-person visits entirely. [SEP] Text: Various oversight, planning and monitoring structures were needed to ensure daily efficiency targets were met. To support the expanded staffing, various functions and documents were created, including day-to-day visit volume tracking, volume forecasts for upcoming days/weeks, work breakdown structure, staff attendance tracker and staff productivity reports. The creation of staffing-to-workload models was the result of these efforts. High-level weekly metrics were captured for all staff. As part of a formal change management plan, staff was made aware of proficiencies and given additional resources and training opportunities to accomplish the needed work ratios. Early morning and late afternoon daily standup meetings were conducted for the first six months with various leadership stakeholders to enhance communications and ensure the entire telehealth video visit process functioned smoothly each day. the onsite clinical practice began to ramp up during summer and fall of 2020, additional layers of complexity were added to the video visit process and the engagement of the ME&C engineers was extended. While daily video visits slowly decreased to a relatively stable level – about 3,400% above the pre-COVID rate – the corresponding practice reactivation resulted in the recall of temporary staff to their prior roles. To capitalize on this distribution of knowledge and skills, efforts were taken to actively “decentralize” video visit support by directly integrating the functions into more than 100 departments, clinics and hospitals throughout locations across the United States. The staffing plans and staffing-to-workload tools that were developed enabled practice areas to manage surges in video visits in a contextual way. The decentralized approach led to a hybrid approach with centralized and decentralized models being tested and refined to meet the individual department, clinic and hospital needs for patient-centered video visits. The ability to scale and sustain serving thousands of patients per day across the country via video visits during a prolonged pandemic is indicative of the success of this intervention. However, success is best represented by the experience and voice of our patients: Parent of a pediatric neurology patient: “I just want to know what’s going on with my baby and I thought, now of all times, we weren’t going to be able to get an answer [without these visits]. ” A cancer patient during her first video visit: “You’re the first face I’ve seen in six weeks! I can’t believe I get to talk to someone. . . anyone. . . like this.

Output: contrast


Input: Claim: Bacteria can be engineered to produce pharmaceuticals like insulin. [SEP] Text: Suppression of the pituitary-gonadal axis in children with central precocious puberty: effects on growth, growth hormone, insulin-like growth factor-I, and prolactin secretion. J Metab 1991;73:734–8. 22. The acid-labile subunit of human ternary insulin-like growth factor-binding protein complex in girls with central precocious puberty before and during gonadotropin-releasing hormone analog therapy. J Metab 2002;87:4629–33. 23. . Relationship between serum insulin-like growth factor-1, IGF binding protein-3 levels and body height before and after gonadotropin-releasing hormone agonist therapy. 2014;19:208–13. 24. van der de Kort SW, et al. Genetic and epigenetic variability in the gene for IGFBP-3 (IGFBP3): correlation with serum IGFBP-3 levels and growth in short children born small for gestational age. 2009;19:198–205. 25. . Influence of IGFBP3 gene polymorphisms on IGFBP3 serum levels and the risk of prostate cancer in low-risk Korean men. Urology 2010;75:1516. e1-7. 26. . Relationship of insulin-like growth factor (IGF) binding protein-3 (IGFBP-3) gene polymorphism with the susceptibility to development of prostate cancer and influence on serum levels of IGF-I, and IGFBP-3. 2011;21:146–54. 27. Association of the (CA)n repeat polymorphism of insulin-like growth factor-I and -202 A/C IGF-binding protein-3 promoter polymorphism with adult height in patients with severe growth hormone deficiency. 2012;76:683–90. 28. Single nucleotide polymorphisms of IGFBP-3 gene and lung cancer risk in a Korean population. 2008;62:152–61.

Output: pass


Input: Claim: Exercise can lower the risk of heart disease and stroke. [SEP] Text: Exercise training increases endothelial progenitor cells and decreases asymmetric dimethylarginine in peripheral arterial disease: a randomized controlled trial. Atherosclerosis. 2011; 217: 240-248. Crossref84. Relationship between exercise capacity, endothelial progenitor cells and cytochemokines in patients undergoing cardiac rehabilitation. Thromb Haemost. 2009; 101: 521-526. Crossref85. Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis. PLoS One. 2012; 7: e52036. Crossref86. Determinants of glucose tolerance in impaired glucose tolerance at baseline in the for Prevention of Diabetes () study. Diabetologia. 2010; 53: 435-445. Crossref87. . Critical nodes in signalling pathways: insights into insulin action. Biol. 2006; 7: 85-96. Crossref88. A central role for JNK in obesity and insulin resistance. Nature. 2002; 420: 333-336. Crossref89. . Chronic endothelin-1 treatment leads to insulin resistance in vivo. Diabetes. 2003; 52: 1904-1909. Crossref90. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in type 2 diabetes mellitus. Diabetologia. 2003; 46: 1071-1081. Crossref91. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011; 305: 1790-1799. Crossref92. . Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia. 2013; 56: 242-251. Crossref93. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2010; 304: 2253-2262. Crossref94. . Exercise-stimulated glucose uptake - regulation and implications for glycaemic control. Endocrinol. 2017; 13: 133-148. Crossref95. Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Physiol. 1988; 254: E248-E259. Crossref96. .

Output: corroborate