Moderators of Exercise Effects on Cancer-related Fatigue:A Meta-analysis of Individual Patient Data

PURPOSE: Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. METHODS: We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. RESULTS: Exercise interventions had statistically significant beneficial effects on fatigue (β = -0.17; 95% confidence interval [CI], -0.22 to -0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = -0.29; 95% CI, -0.39 to -0.20) than supervised interventions with a longer duration. CONCLUSIONS: In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Das Klassikerwörterbuch : Begründung und Erläuterung eines digitalen Wörterbuchprojekts zum differenten Wortschatz in der klassischen Literatur

This article is a delineation of the "Projekt Klassikerwortschatz" that collects and processes those words in german literature between ca. 1750 and 1900 which are semantically different in today’s german due to language change. It is the aim of the project to publish a dictionary in print, on CD-ROM as well as on the internet that explains these words in order to help to understand the literary language of the german "classic period". The dictionary will therefore be a beginning of an attempt to fill the gap between Reichmann’s FWB, the DWB and the DWDS which curiously coincides with this important period of german literature. The article focuses on the survey phase, when voluntary readers marked those words that made it difficult for them to understand a passage, the digitalization and the processing within the computerized environment. The main focus is on the digital editorial system „Paula“ which has been developped specifically for the "Klassikerwörterbuch" and enables the lexicographer to focus exclusively on the content of the article rather than its format