{"component": "clause", "props": {"groups": [{"snippet_links": [{"key": "objective-of-the-study", "type": "clause", "offset": [6, 28]}, {"key": "adverse-events", "type": "clause", "offset": [75, 89]}], "samples": [{"hash": "j7aQc2GbJQ8", "uri": "/contracts/j7aQc2GbJQ8#study-objective", "label": "Clinical Investigational Plan", "score": 24.5578718888, "published": true}, {"hash": "6Do3KDP0v5h", "uri": "/contracts/6Do3KDP0v5h#study-objective", "label": "Clinical Investigational Plan", "score": 24.1704312115, "published": true}], "size": 2, "snippet": "\u200c The objective of the study will be to evaluate lung function changes and adverse events after BLVR using the Pulmonx EBV.", "hash": "37d93b67f479f6997442199b19a1e7ec", "id": 1}, {"snippet_links": [{"key": "treatment-of", "type": "clause", "offset": [77, 89]}, {"key": "the-study", "type": "definition", "offset": [193, 202]}, {"key": "approval-of-the-product", "type": "clause", "offset": [257, 280]}, {"key": "following-completion", "type": "clause", "offset": [281, 301]}], "samples": [{"hash": "jz4Qu2HdASY", "uri": "/contracts/jz4Qu2HdASY#study-objective", "label": "Exclusive License Agreement (Novogen LTD)", "score": 28.8138261465, "published": true}], "size": 1, "snippet": "This study is intended to demonstrate\u2019safety and efficacy of GDC-0084 in the treatment of glioblastoma multiforme (GBM) in the adjuvant setting, following surgical, resection and radiotherapy. The study is designed to maximise the potential for accelerated approval of the product following completion.", "hash": "f1864636b44ae16aa155a79eed37b1f4", "id": 2}, {"snippet_links": [{"key": "body-of-evidence", "type": "definition", "offset": [10, 26]}, {"key": "adjacent-to", "type": "definition", "offset": [78, 89]}, {"key": "coal-ash", "type": "definition", "offset": [90, 98]}, {"key": "public-health", "type": "definition", "offset": [219, 232]}, {"key": "a-great-deal", "type": "definition", "offset": [307, 319]}, {"key": "health-and", "type": "clause", "offset": [391, 401]}, {"key": "power-plants", "type": "definition", "offset": [444, 456]}, {"key": "the-association", "type": "clause", "offset": [500, 515]}, {"key": "ground-water-contamination", "type": "definition", "offset": [550, 576]}, {"key": "in-\u2587", "type": "clause", "offset": [741, 745]}], "samples": [{"hash": "gyQcdoT0DrG", "uri": "/contracts/gyQcdoT0DrG#study-objective", "label": "Distribution Agreement", "score": 32.6069850469, "published": true}], "size": 1, "snippet": "A growing body of evidence has highlighted the unique threat that communities adjacent to coal ash impoundments, like \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, face. The metal composition of coal ash and its permeability into groundwater is an urgent public health concern, especially for communities that rely on private \u2587\u2587\u2587\u2587\u2587 for water. A great deal of research has been done to understand how exposure to metals impacts health and the dangers of emissions from coal- fired power plants. However, few investigations have explored the association between coal ash impoundments and ground water contamination, and even fewer have sought to understand well contamination near coal ash impoundments. This study will first seek to understand the extent to which private \u2587\u2587\u2587\u2587\u2587 in \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, GA are contaminated with metals. This will be followed by an examination of whether spatial factors, including distance and elevation, are contributing to well contamination.", "hash": "3c7cfd21a614334390fb4a1696a2c00e", "id": 3}, {"snippet_links": [{"key": "the-cost", "type": "clause", "offset": [13, 21]}, {"key": "effectiveness-of-the", "type": "clause", "offset": [22, 42]}], "samples": [{"hash": "lfGX8aj2Exg", "uri": "/contracts/lfGX8aj2Exg#study-objective", "label": "Computer Matching Agreement", "score": 22.3086926762, "published": true}], "size": 1, "snippet": "To determine the cost-effectiveness of the SSA/IRS computer matching operation.", "hash": "d2318ffbdb341ca8b2e115088561810d", "id": 4}, {"snippet_links": [{"key": "the-primary", "type": "clause", "offset": [0, 11]}, {"key": "the-study", "type": "definition", "offset": [19, 28]}, {"key": "the-risk", "type": "definition", "offset": [44, 52]}, {"key": "associated-with", "type": "definition", "offset": [63, 78]}, {"key": "duration-1", "type": "clause", "offset": [169, 179]}, {"key": "types-of", "type": "clause", "offset": [364, 372]}, {"key": "cancer-risk", "type": "definition", "offset": [435, 446]}, {"key": "over-time", "type": "clause", "offset": [504, 513]}, {"key": "clinical-practice", "type": "clause", "offset": [582, 599]}, {"key": "the-association", "type": "clause", "offset": [654, 669]}, {"key": "risk-in", "type": "clause", "offset": [720, 727]}, {"key": "adjustment-for", "type": "clause", "offset": [794, 808]}, {"key": "information-on", "type": "clause", "offset": [858, 872]}, {"key": "to-develop", "type": "definition", "offset": [896, 906]}, {"key": "high-risk", "type": "clause", "offset": [952, 961]}, {"key": "risk-factors", "type": "definition", "offset": [1016, 1028]}], "samples": [{"hash": "5VNes2ELvGq", "uri": "/contracts/5VNes2ELvGq#study-objective", "label": "Research Protocol", "score": 22.2168997778, "published": true}], "size": 1, "snippet": "The primary aim of the study is to quantify the risk of cancer associated with the (long- term) use of insulin and insulin analogues1 by studying the effects of dosage, duration 1 Insulin and insulin analogues together are often referred to as \u2018insulins\u2019 in this protocol. and/or intensity of insulin treatment on the likelihood of developing cancer and different types of cancer. Secondary aims are: \u25cf to study the hazard patterns of cancer risk associated with the use of insulin and insulin analogues over time, to test plausible biological mechanisms of initiation/promotion in clinical practice. \u25cf to study the influence of potential confounders on the association between insulin (type, dose, duration) and cancer risk in observational studies, and to use or develop methods for external adjustment for unmeasured confounders in databases with missing information on certain confounders. \u25cf to develop methods for screening/predicting patients at high risk of developing cancer by identification of predictors (risk factors) for developing cancer in patients with diabetes mellitus treated with insulins. \u25cf to develop methods to combine various pharmacoepidemiological databases with long- term follow-up.", "hash": "14f49338f467f05649178169e42dccf6", "id": 5}, {"snippet_links": [{"key": "the-objective", "type": "clause", "offset": [2, 15]}, {"key": "and-safety", "type": "clause", "offset": [57, 67]}, {"key": "control-device", "type": "definition", "offset": [114, 128]}, {"key": "repair-of", "type": "clause", "offset": [234, 243]}, {"key": "closure-of-the", "type": "clause", "offset": [300, 314]}], "samples": [{"hash": "kqRV33W1cOQ", "uri": "/contracts/kqRV33W1cOQ#study-objective", "label": "Investigator's Agreement", "score": 29.6918707431, "published": true}], "size": 1, "snippet": "\u200c The objective of this study is to compare the efficacy and safety of the LiquiBand FIX8\u00ae device to a tack-based control device (AbsorbaTack\u2122) for the TEP (totally extraperitoneal) or \u2587\u2587\u2587\u2587 (transabdominal preperitoneal) laparoscopic repair of groin (femoral or inguinal) hernia by mesh fixation and closure of the peritoneum (\u2587\u2587\u2587\u2587 patients only).", "hash": "f692d890eeecefe811422564a539d002", "id": 6}, {"snippet_links": [{"key": "system-reliability", "type": "clause", "offset": [63, 81]}, {"key": "enter-into-agreements", "type": "clause", "offset": [119, 140]}, {"key": "market-participants", "type": "definition", "offset": [146, 165]}, {"key": "own-or-operate", "type": "definition", "offset": [176, 190]}, {"key": "generation-resources", "type": "definition", "offset": [191, 211]}, {"key": "to-maintain", "type": "clause", "offset": [316, 327]}, {"key": "the-principal", "type": "definition", "offset": [348, 361]}, {"key": "to-determine", "type": "definition", "offset": [400, 412]}, {"key": "change-in-status", "type": "clause", "offset": [440, 456]}, {"key": "necessary-for", "type": "definition", "offset": [470, 483]}, {"key": "based-on", "type": "clause", "offset": [503, 511]}, {"key": "the-criteria", "type": "clause", "offset": [512, 524]}, {"key": "business-practices", "type": "definition", "offset": [547, 565]}, {"key": "the-study", "type": "definition", "offset": [575, 584]}, {"key": "work-included", "type": "definition", "offset": [585, 598]}, {"key": "state-branch", "type": "definition", "offset": [637, 649]}, {"key": "transmission-facilities", "type": "clause", "offset": [672, 695]}, {"key": "the-relevant", "type": "clause", "offset": [757, 769]}, {"key": "reliability-criteria", "type": "clause", "offset": [813, 833]}, {"key": "purpose-of-this", "type": "clause", "offset": [879, 894]}, {"key": "suspension-of", "type": "clause", "offset": [947, 960]}, {"key": "located-in", "type": "definition", "offset": [981, 991]}, {"key": "effective-september", "type": "clause", "offset": [1003, 1022]}], "samples": [{"hash": "en4IfHfGtfR", "uri": "/contracts/en4IfHfGtfR#study-objective", "label": "System Support Resource Agreement", "score": 33.6165271769, "published": true}], "size": 1, "snippet": "Under Section 38.2.7 of MISO\u2019s Tariff, SSR procedures maintain system reliability by providing a mechanism for MISO to enter into agreements with Market Participants (MP) that own or operate Generation Resources or Synchronous Condenser Units (SCUs) that have requested to either Retire or Suspend, but are required to maintain system reliability. The principal objective of an Attachment Y study is to determine if the unit(s) for which a change in status requested is necessary for system reliability based on the criteria set forth in the MISO Business Practices Manuals. The study work included monitoring and identifying the steady state branch/voltage violations on transmission facilities due to the unavailability of the Generation Resource or SCU. The relevant MISO Transmission Owner(s) and/or regional reliability criteria are used for monitoring such violations. The purpose of this study is to assess the reliability impacts from the suspension of Rush Island 1 and 2 located in Festus, MO effective September 1, 2022. 2022WP_RUSH_ISLAND_OFF Winter Peak 2022 OFF SCED P1,P2,P4,P5,P7, Selected P3, P6 2022WP_RUSH_ISLAND_ON Winter Peak 2022 ON SCED + Scale P1,P2,P4,P5,P7, Selected P3, P6", "hash": "abb92abc6348df0dca7a894a398ee9c8", "id": 7}, {"snippet_links": [{"key": "healthcare-professionals", "type": "definition", "offset": [143, 167]}, {"key": "in-particular", "type": "clause", "offset": [169, 182]}, {"key": "given-that", "type": "clause", "offset": [229, 239]}, {"key": "review-of", "type": "clause", "offset": [243, 252]}, {"key": "physical-therapy", "type": "definition", "offset": [263, 279]}, {"key": "educational-requirements", "type": "definition", "offset": [449, 473]}, {"key": "in-the-united-states", "type": "clause", "offset": [491, 511]}, {"key": "the-purpose", "type": "clause", "offset": [513, 524]}, {"key": "program-director", "type": 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"definition", "offset": [2359, 2370]}, {"key": "musculoskeletal-system", "type": "definition", "offset": [2456, 2478]}, {"key": "the-profession", "type": "definition", "offset": [2545, 2559]}, {"key": "reduction-of", "type": "clause", "offset": [2620, 2632]}, {"key": "the-study", "type": "definition", "offset": [2751, 2760]}, {"key": "to-the-public", "type": "definition", "offset": [2801, 2814]}, {"key": "recognition-of", "type": "clause", "offset": [2853, 2867]}, {"key": "incorporation-of", "type": "clause", "offset": [3010, 3026]}, {"key": "plan-of-care", "type": "definition", "offset": [3066, 3078]}, {"key": "addition-of", "type": "clause", "offset": [3129, 3140]}, {"key": "care-needs", "type": "definition", "offset": [3356, 3366]}, {"key": "appropriate-healthcare", "type": "definition", "offset": [3421, 3443]}, {"key": "physical-activity", "type": "clause", "offset": [3546, 3563]}, {"key": "primary-prevention", "type": "definition", "offset": [3567, 3585]}, {"key": "type-2-diabetes", "type": "definition", "offset": [3792, 3807]}, {"key": "cardiovascular-disease", "type": "definition", "offset": [3809, 3831]}, {"key": "these-conditions", "type": "clause", "offset": [3958, 3974]}, {"key": "affected-by", "type": "definition", "offset": [3979, 3990]}, {"key": "the-balance", "type": "clause", "offset": [4131, 4142]}, {"key": "and-exercise", "type": "clause", "offset": [4176, 4188]}, {"key": "lack-of", "type": "clause", "offset": [4222, 4229]}, {"key": "the-primary", "type": "clause", "offset": [4236, 4247]}, {"key": "an-individual", "type": "clause", "offset": [4328, 4341]}, {"key": "prevention-act", "type": "definition", "offset": [4572, 4586]}, {"key": "vo2-max", "type": "definition", "offset": [4736, 4743]}, {"key": "strongly-recommended", "type": "clause", "offset": [4944, 4964]}, {"key": "for-example", "type": "definition", "offset": [4966, 4977]}, {"key": "cardiac-rehabilitation", "type": "definition", "offset": [5009, 5031]}, {"key": "health-issues", "type": "clause", "offset": [5152, 5165]}, {"key": "in-order-to", "type": "clause", "offset": [5241, 5252]}, {"key": "health-and", "type": "clause", "offset": [5435, 5445]}, {"key": "high-risk", "type": "clause", "offset": [5535, 5544]}, {"key": "physical-fitness", "type": "definition", "offset": [5671, 5687]}, {"key": "benefits-of", "type": "clause", "offset": [5786, 5797]}, {"key": "short-term", "type": "clause", "offset": [5822, 5832]}, {"key": "benefits-include", "type": "clause", "offset": [5833, 5849]}, {"key": "long-term", "type": "clause", "offset": [5907, 5916]}, {"key": "fall-prevention", "type": "clause", "offset": [5968, 5983]}, {"key": "older-adults", "type": "definition", "offset": [5987, 5999]}, {"key": "reduction-in", "type": "definition", "offset": [6026, 6038]}, {"key": "according-to", "type": "definition", "offset": [6146, 6158]}, {"key": "loss-of", "type": "definition", "offset": [6307, 6314]}, {"key": "body-weight", "type": "definition", "offset": [6324, 6335]}, {"key": "appropriate-amount", "type": "definition", "offset": [6424, 6442]}, {"key": "weekly-basis", "type": "definition", "offset": [6465, 6477]}, {"key": "evidence-supporting", "type": "clause", "offset": [6691, 6710]}, {"key": "in-combination", "type": "definition", "offset": [6741, 6755]}, {"key": "medical-treatment", "type": "definition", "offset": [6782, 6799]}, {"key": "wide-body", "type": "clause", "offset": [6806, 6815]}, {"key": "medical-practice", "type": "definition", "offset": [6921, 6937]}, {"key": "effects-of-exercise", "type": "clause", "offset": [6978, 6997]}, {"key": "directly-affect", "type": "definition", "offset": [7014, 7029]}, {"key": "quality-of-life", "type": "clause", "offset": [7147, 7162]}, {"key": "impaired-glucose-tolerance", "type": "definition", "offset": [7418, 7444]}, {"key": "following-groups", "type": "definition", "offset": [7454, 7470]}, {"key": "the-risk", "type": "definition", "offset": [7548, 7556]}, {"key": "general-recommendations", "type": "clause", "offset": [7894, 7917]}, {"key": "further-evidence", "type": "clause", "offset": [7979, 7995]}, {"key": "change-of", "type": "definition", "offset": [8013, 8022]}, {"key": "individual-consultation", "type": "clause", "offset": [8260, 8283]}, {"key": "six-months", "type": "definition", "offset": [8384, 8394]}, {"key": "types-and-amounts", "type": "clause", "offset": [8741, 8758]}, {"key": "effect-of-exercise", "type": "clause", "offset": [8958, 8976]}, {"key": "blood-pressure", "type": "definition", "offset": [9044, 9058]}, {"key": "further-reductions", "type": "clause", "offset": [9381, 9399]}, {"key": "study-groups", "type": "clause", "offset": [9452, 9464]}, {"key": "risk-factors", "type": "definition", "offset": [9701, 9713]}, {"key": "existing-evidence", "type": "clause", "offset": [10093, 10110]}, {"key": "having-a", "type": "definition", "offset": [10299, 10307]}, {"key": "causal-link", "type": "clause", "offset": [10681, 10692]}, {"key": "healthy-lifestyle", "type": "clause", "offset": [10750, 10767]}, {"key": "health-benefits", "type": "definition", "offset": [10902, 10917]}, {"key": "multiple-sclerosis", "type": "clause", "offset": [11005, 11023]}], "samples": [{"hash": "icpRy9kGrKB", "uri": "/contracts/icpRy9kGrKB#study-objective", "label": "Distribution Agreement", "score": 33.2232343798, "published": true}], "size": 1, "snippet": "Considering the motivation and drive in healthcare to better assess, manage, and treat physical inactivity, it is imperative to understand how healthcare professionals, in particular PTs, are educated on this topic. Furthermore, given that no review of Doctor of Physical Therapy (DPT) educational curricula in regard to PA has been completed, this leaves a literature gap that we are seeking to fill. This study is intended to better understand PA educational requirements in DPT curricula in the United States. The purpose is to evaluate program director perspectives on DPT curricula pertaining to three large components of PA: benefits, assessment, and prescription. Secondary factors being evaluated include health promotion within curricula, behavioral change factors, and perceptions of PA including opinion, confidence and practice of healthy lifestyles. The question purportedly to be answered through this academic endeavor is: Is PA, from a public health perspective, included and taught in United States DPT programs, and if so, to what extent? Further, we hope to explore the perception of PA held by academic directors of these institutions. The potential significance of this study is to identify PA training\u2014 either gaps or strengths \u2014 with a secondary significance of redirecting long-term educative focuses on PA and sustainability of patient health. The results of this study will highlight training gaps to subsequently be filled through curricular development of PA benefits, assessment, prescription in entry-level DPT programs across the United States. Should study results reveal otherwise, it will serve as a demonstration of the knowledge PTs possess, with which they may use to identify at- risk patients, and treat physically inactive patients, along the continuum of targeting the growing burden of NCDs in the United States. While programs and research exist addressing PA across other healthcare settings, the significance of understanding current education levels specific to DPT curricula will better guide program and curricular development. PTs are experts in the science of human movement and have a unique ability to be primary providers of preventative health for PA assessment, prescription, and referral in an overall effort to reduce the burden of chronic diseases. This may also act as an avenue to advocate to other health care professions of the expertise PTs possess relative to PA and its interaction with the musculoskeletal system. Furthermore, assessing PT education can facilitate growth within the profession to better fill the health care need of health promotion for reduction of physical inactivity \u2014 a sentiment that holds great implications for the health of the public. Ultimately, the goal of the study is to understand where PT lies relative to the public health impact of physical inactivity: recognition of the PT role is crucial, considering their expertise in human movement science and rehabilitation. Given the multitude of diagnoses PTs treat, incorporation of PA and movement is key to a successful plan of care and achievement of positive patient outcomes. The addition of PTs to identify physical inactivity will assist in combating chronic disease and physical inactivity and highlight the many ways in which PTs can build upon their existing expertise to better address current health care needs across the United States, all in an effort to utilize appropriate healthcare professionals to combat chronic disease and physical inactivity. Extensive evidence exists supporting physical activity as primary prevention to chronic disease, and physical inactivity as a cause of major chronic disease. Physical inactivity initiates pathological processes resulting in clinical conditions including obesity, insulin resistance, type 2 diabetes, cardiovascular disease, cognitive disease, and bone and connective tissue disorders, among many others. Functional capabilities of individuals which these conditions are affected by progression of pathological processes, in which every cell, organ, and system in the body is affected. Literature by \u2587\u2587\u2587\u2587\u2587, et al. outlines the balance between PA and inactivity, as PA and exercise prevent chronic disease, whereas lack of PA is the primary factor leading to chronic disease. The greatest benefit pertaining to health of an individual and population, to prevent chronic disease, lies with regular PA, which can be modulated and explored through various components of fitness (power, strength, flexibility, maximal oxygen consumption etc.).28 Secondary and tertiary prevention act first to detect symptoms, and second to slow symptom progression. The Dallas Bed Rest Study identified a 27% decrease in maximal oxygen consumption (VO2 max) in healthy, young males after 20 days on continuous bed rest, demonstrating the aerobic losses of physical inactivity.29 Re-incorporation of PA after diagnosis of a chronic disease is prescribed and strongly recommended. For example, after a cardiovascular event, cardiac rehabilitation is a service often sought after. Per the CDC, chronic diseases are among the most costly, common yet preventable of all health issues in the United States.30 Therefore, conclusions were identified as follows: in order to maximize health, prevent chronic disease, and extend lifespan, PA is a required behavior and the only approach to combat sedentary lifestyles.28 Exercise or PA imperatively enhances health and well-being, as well as in prevention of disease onset.31 Inactivity places patients at a high risk of developing cardiovascular disease, cancer, and diabetes, and is the fourth leading risk factor for global mortality.32 Low physical fitness as a risk factor for all-cause mortality can be mitigated through regular PA. Short and long-term benefits of PA are well documented: short term benefits include improved cognitive ability and anxiety reduction whereas long term benefits include strengthening of bone and muscle, fall prevention in older adults, increased longevity, and reduction in risk of NCDs including stroke and colon cancer.33 Physical inactivity is also correlated with obesity, and according to the WHO 34.9% of United States adults are overweight or obese. While obesity is a major risk factor for cardiovascular disease, a 5% or more weight loss of baseline body weight is effective in reducing risk of CVD and diabetes. Various recommendations exist on the appropriate amount of PA to achieve on a weekly basis yet behavior among United States adults is not reflecting an appropriately proportionate change, as only 21% of United States adults meet the 2008 guidelines.34,35,36 Evidence from a 2006 meta-analysis highlights evidence supporting exercise therapy as effective in combination with, and exclusive from, medical treatment. This wide body of accumulated knowledge is so extensive that PA counseling and prescription must implemented in regular medical practice and should have been decades ago. These effects of exercise therapy, or PA, directly affect disease pathogenesis by improving dominant symptoms of underlying disease, enhancing physical fitness, strength, and quality of life \u2014 all of which is supported by the strongest evidence reviewed in this meta-analysis.37 Different disease processes and conditions were reviewed, relative to the influence of exercise and PA. For example, a Chinese study by \u2587\u2587\u2587 et al. divided groups with impaired glucose tolerance into the following groups: diet alone, exercise alone, diet and exercise, and control. They found that the risk of diabetes was greatest in exercise group (46% reduction P <0.0005).38 An extensive amount of literature exists in support of this concept, with successful reproduction of similar findings in Finland and the United States.39,40 Prescription of PA for patients with insulin resistance needs to be highly individualized yet should follow general recommendations reported by regulating bodies such as the CDC, WHO and ACSM. Further evidence explore behavior change of patients with type 2 diabetes, reporting that patients can be motivated to change their PA habits with consultation of exercise.41 Another study by \u2587\u2587\u2587\u2587\u2587\u2587 and \u2587\u2587\u2587\u2587\u2587\u2587 randomized inactive individuals to either no consultation or 30-minute individual consultation on PA, basing their intervention on the transtheoretical model. It was found that overall PA levels six months post intervention were higher in the consultation group, as well as significant reductions in SBP and HbA1c.42 \u2587\u2587\u2587\u2587 and \u2587\u2587\u2587\u2587\u2587\u2587\u2587 performed a meta-analysis in 2001 assessing aerobic exercise training of moderate to hard intensity, and the effects on lipid profiles of participants. A dose-response could not be calculated considering the different types and amounts of exercises, however mean 4.6% increase in HDL (P<0.05), 3.7% decrease in triglyceride concentration (P<0.05) and a 5% decrease in LDL (P <0.05) were identified. These results indicate the positive effect of exercise training on lipid profiles of participants.43 The effects of PA on blood pressure, whether normotensive or hypertensive, have been well documented for the past few decades. \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 and \u2587\u2587\u2587\u2587\u2587\u2587 completed a meta-analysis in 2005 which included 72 trials and nearly 4,000 participants, assessing these effects. They found that endurance training led to significant net reductions of blood pressure, with further reductions in blood pressure identified in the 30 hypertensive study groups. Other positive effects of endurance identified included decrease in body weight (1.2 kg, P<0.001), decrease in waist circumference by 2.8 cm (P <0.001), and an increase in HDL cholesterol by 0.032 mmol/L(-1) (P<0.05). All of the above risk factors (blood pressure, body weight, waist circumference, and HDL levels) are assessed when a patient\u2019s risk of, or progression of, chronic disease is evaluated by a physician.44 While the above evidence is strong and supportive of exercise addressing chronic disease and associated risk factors, it is older evidence that was specifically chosen to demonstrate the historical depth of existing evidence supporting exercise as a therapeutic and preventative tool in fighting chronic disease. In 2006, \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 and \u2587\u2587\u2587\u2587\u2587\u2587 published updated results to this meta- analysis, identifying exercise having a \u201crole as medicine\u201d to be prescribed as first-line treatment for diseases chronic in nature. This update extended the disease systems that were reviewed, including psychiatric, neurological, cardiovascular, pulmonary, and musculoskeletal diseases. This update extended to psychiatric diseases including depression, anxiety, and stress, yet could not conclusively identify a causal link between PA and exercise. They considered PA as part of a healthy lifestyle that may, through multifactorial involvement, influence these diseases.45,46,47 Evidence exists demonstrating association of positive health benefits from PA for various neurological disorders, such as Dementia, Alzheimer\u2019s disease, and Multiple Sclerosis (MS). 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