bluuebunny/crossref_metadata_2025_split huggingface dataset:
INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn (INCARO): a multicentre, open-label, randomised controlled trial - study protocol
Authors: Räty Panu , Mentula Panu , Lampela Hanna , Nykänen Taina , Helanterä Ilkka , Haapio Mikko , Lehtimäki Tiina , Skrifvars Markus B , Vaara Suvi T , Leppäniemi Ari , Sallinen Ville 
Published: October 2020

IntroductionCT is the primary imaging option for acute abdominal pain in adults. Intravenous (IV) contrast media use improves CT quality but may cause post-contrast acute kidney injury (PC-AKI). Retrospective studies show no association between reduced baseline renal function and IV contrast CT, but, to our knowledge, no data from randomised controlled trials exist.Methods and analysisThe INCARO (INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn) trial is a multicentre, open-label, parallel group, superiority, individually randomised controlled trial comparing IV contrast-enhanced CT to native CT in patients requiring emergency abdominal or body CT with impaired renal function defined as an estimated glomerular filtration rate (eGFR) of 15 to 45 mL/min/1.73 m2. The primary outcome is a composite of all-cause mortality or renal replacement therapy (RRT) within 90 days from CT. Secondary outcomes are AKI measured by KDIGO (The Kidney Disease: Improving Global Outcomes) criteria within 72 hours from CT, organ dysfunction defined by mSOFA (modified Sequential Organ Failure Assessment) criteria after 48 hours from CT, alive and hospital-free days within 90 days after CT, and time from imaging to definitive treatment. All-cause mortality, need for RRT and renal transplant in long-term follow-up are also measured. The calculated sample size is 994 patients. Patient recruitment is estimated to take 3 years.Ethics and disseminationThe Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT04196244
Assessing the hospital volume-outcome relationship in surgery: a scoping review protocol
Authors: Levaillant Mathieu , Marcilly Romaric , Levaillant Lucie , Vallet Benoît , Lamer Antoine 
Published: October 2020

IntroductionEven if a positive volume-outcome correlation in surgery is mostly admitted in many surgical fields, the various ways to assess this relationship make it difficult for researchers and policymakers to use it. Our aim is therefore to provide an overview of the way hospital volume-outcome relationship was assessed. Through this overview, our goal is to identify potential gaps in the assessment of this relationship, to help researchers who want to pursue work in this field and, ultimately, to help policy makers interpret such analyses.Methods and analysisThis review will be conducted using the six stages of the scoping review method: identifying the research question, searching for relevant studies, selecting studies, data extraction, collating, summarising and reporting the results and concluding. This review will address all the key questions used to assess the volume-outcome relationship in surgery.Primary research papers investigating the hospital volume-outcome relationship from 2009 will be included. Studies only looking at surgeons’ volume-outcome relationship or studies were the volume variable is not individualisable will be excluded.Both MEDLINE and Scopus will be searched along with grey literature. Two researchers will perform all the stages of the review: screen the titles and abstracts, review the full text of selected articles to determine final inclusions and extract the data. The results will be summarised quantitatively using numerical counts.Ethical considerations and disseminationReviews of published articles are considered secondary analysis and do not need ethical approval. The findings will be disseminated through multiple channels like conferences and peer-reviewed journals.
Association of tea consumption and the risk of gastric cancer in Japanese adults: the Japan Collaborative Cohort Study
Authors: Sheerah Haytham , Keyang Liu , Eshak Ehab Salah , Cui Renzhe , Shirai Kokoro , Muraki Isao , Iso Hiroyasu , Tamakoshi Akiko 
Published: October 2020

ObjectiveTo examine the possible relationship between tea consumption and risk of gastric cancer (GC) among Japanese men and women included in a large Japanese population-based study titled the Japan Collaborative Cohort (JACC) Study.DesignProspective cohort study.SettingA population-based cohort included subjects who were recruited from 24 areas of JACC Study, in which data regarding the incidence of cancer were available.Participants63 848 participants (26 025 men and 37 823 women), aged 40–79, were included in the analyses and underwent follow-up (median 13.3 years) prospectively in research on cancer incidence.Primary and secondary outcome measuresThe primary outcome variable was the risk of GC according to the frequency intakes of total tea, green tea, black tea and oolong tea. The adjusted HRs for the risk of GC associated with tea consumption were calculated using the Cox proportional hazards model.Results1494 cases of GC were detected (960 men and 534 women) during the follow-up period. The multivariable-adjusted HRs for the risk of GC in the highest versus lowest quintiles of total tea intake were 1.05 (0.83–1.33); p trend=0.50 in men, and 0.82 (0.60–1.12); p trend=0.45 in women. There was no association found between the consumption of green tea, black tea or oolong tea with the risk for GC in either gender.ConclusionsIn this large community-based prospective cohort study, tea consumption was not associated with the risk of GC in either gender.
Cohort profile: the eLIXIR Partnership—a maternity–child data linkage for life course research in South London, UK
Authors: Carson Lauren E , Azmi Borscha , Jewell Amelia , Taylor Clare L , Flynn Angela , Gill Carolyn , Broadbent Matthew , Howard Louise , Stewart Robert , Poston Lucilla 
Published: October 2020

PurposeLinked maternity, neonatal and maternal mental health records were created to support research into the early life origins of physical and mental health, in mothers and children. The Early Life Cross Linkage in Research (eLIXIR) Partnership was developed in 2018, generating a repository of real-time, pseudonymised, structured data derived from the electronic health record systems of two acute and one Mental Health Care National Health Service (NHS) Provider in South London. We present early descriptive data for the linkage database and the robust data security and governance structures, and describe the intended expansion of the database from its original development. Additionally, we report details of the accompanying eLIXIR Research Tissue Bank of maternal and neonatal blood samples.ParticipantsDescriptive data were generated from the eLIXIR database from 1 October 2018 to 30 June 2019. Over 17 000 electronic patient records were included.Findings to date10 207 women accessed antenatal care from the 2 NHS maternity services, with 8405 deliveries (8772 infants). This diverse, inner-city maternity service population was born in over 170 countries with an ethnic profile of 46.1% white, 19.1% black, 7.0% Asian, 4.1% mixed and 4.1% other. Of the 10 207 women, 11.6% had a clinical record in mental health services with 3.0% being treated during their pregnancy. This first data extract included 947 infants treated in the neonatal intensive care unit, of whom 19.1% were postnatal transfers from external healthcare providers.Future plansElectronic health records provide potentially transformative information for life course research, integrating physical and mental health disorders and outcomes in routine clinical care. The eLIXIR database will grow by ~14 000 new maternity cases annually, in addition to providing child follow-up data. Additional datasets will supplement the current linkage from other local and national resources, including primary care and hospital inpatient data for mothers and their children.
Appropriate CT cervical spine utilisation in the emergency department
Authors: Baker Mark , Jaeger Cassie , Hafley Carol , Waymack James 
Published: October 2020

IntroductionOver 40 000 CT scans are performed in our emergency department (ED) annually and utilisation is over 80% capacity. Improving medical appropriateness of CT scans may reduce total number of scans, time, cost and radiation exposure.MethodsLean Six Sigma methodology was used to improve the process. A National Emergency X-Radiography Utilisation Study (NEXUS)-based PowerForm was implemented in the electronic health record and providers were educated on the criteria.ResultsThe rate of potentially medically inappropriate CT C-spine scans decreased from 45% (19/42) to 22% (90/403) (two-proportion test, p=0.002). After the intervention, there was no longer a difference between midlevel providers and physicians in the rate of medically inappropriate orders (19% vs 22%) (two-proportion test, p=0.850) compared with that before the intervention (56% vs 31%) (two-proportion test, p<0.01). Overall rates of CT C-spine scans ordered decreased from 69.3 to 62.6/week (t-test, p=0.019).ConclusionA validated clinical decision-making tool implemented into the medical record can improve quality of care. This study lays a foundation for other imaging studies with validated support tools with similar potential improvements.
Evaluation of a novel strategy to implement exercise evidence into clinical practice in breast cancer care: protocol for the NEXT-BRCA randomised controlled trial
Authors: Smith-Turchyn Jenna , Mukherjee Som , Richardson Julie , Ball Elizabeth , Bordeleau Louise , Neil-Sztramko Sarah , Levine Oren , Thabane Lehana , Sathiyapalan Arani , Sabiston Catherine 
Published: October 2020

IntroductionThe burden of breast cancer in Canada is steadily growing. More women are surviving breast cancer, yet, survivors live with side effects for years after treatments have ended. The benefits of exercise for women with breast cancer are well established and include improvement in treatment-related physical and emotional side effects. Despite these benefits, few survivors meet exercise guidelines. Exercise programmes are needed within the cancer institution in Canada to bridge the current knowledge to practice gap. The purpose of this study is to test the effects of a novel implementation strategy that includes institution-based exercise plus self-management (SM) or SM alone versus usual care in improving exercise level, quality of life, aerobic capacity, muscle strength and use of healthcare services over 12 months for women with breast cancer receiving chemotherapy.Methods and analysisParticipants:Women with stages I–III breast cancer undergoing chemotherapy.Intervention:Group 1: institution-based exercise and SM (8 exercise sessions plus 8 SM modules); Group 2: SM alone; Group 3: usual care.Outcomes:The primary effectiveness outcome is minutes per week of moderate to vigorous physical activity. Secondary outcomes include quality of life, aerobic capacity, muscle strength, and use of healthcare services.Randomisation: Participants will be randomised (1:1:1) to one of the three groups by a blinded statistician and will be stratified based on age of participant (<40, 40–60, and >60 years).Statistical analysis: Outcomes will be measured at baseline, post-intervention, 6-month and 12-month follow-up using an analysis of covariance to test changes between groups over time adjusted for age.Ethics and DisseminationThis study addresses a long-standing need to help women with breast cancer undergoing chemotherapybecome and staymore active by implementing novel rehabilitation strategies into real-world practice. This is vital in order for this population to minimise the lingering side effects of treatment, improve function and quality of life and prevent cancer recurrence.Trial registration numberThe study protocol (v1: July 2020) has been registered on ClinicalTrials.gov (NCT04109274).
Utilisation of artificial intelligence for the development of an EUS-convolutional neural network model trained to enhance the diagnosis of autoimmune pancreatitis
Authors: Marya Neil B , Powers Patrick D , Chari Suresh T , Gleeson Ferga C , Leggett Cadman L , Abu Dayyeh Barham K , Chandrasekhara Vinay , Iyer Prasad G , Majumder Shounak , Pearson Randall K , Petersen Bret T , Rajan Elizabeth , Sawas Tarek , Storm Andrew C , Vege Santhi S , Chen Shigao , Long Zaiyang , Hough David M , Mara Kristin , Levy Michael J 
Published: October 2020

ObjectiveThe diagnosis of autoimmune pancreatitis (AIP) is challenging. Sonographic and cross-sectional imaging findings of AIP closely mimic pancreatic ductal adenocarcinoma (PDAC) and techniques for tissue sampling of AIP are suboptimal. These limitations often result in delayed or failed diagnosis, which negatively impact patient management and outcomes. This study aimed to create an endoscopic ultrasound (EUS)-based convolutional neural network (CNN) model trained to differentiate AIP from PDAC, chronic pancreatitis (CP) and normal pancreas (NP), with sufficient performance to analyse EUS video in real time.DesignA database of still image and video data obtained from EUS examinations of cases of AIP, PDAC, CP and NP was used to develop a CNN. Occlusion heatmap analysis was used to identify sonographic features the CNN valued when differentiating AIP from PDAC.ResultsFrom 583 patients (146 AIP, 292 PDAC, 72 CP and 73 NP), a total of 1 174 461 unique EUS images were extracted. For video data, the CNN processed 955 EUS frames per second and was: 99% sensitive, 98% specific for distinguishing AIP from NP; 94% sensitive, 71% specific for distinguishing AIP from CP; 90% sensitive, 93% specific for distinguishing AIP from PDAC; and 90% sensitive, 85% specific for distinguishing AIP from all studied conditions (ie, PDAC, CP and NP).ConclusionThe developed EUS-CNN model accurately differentiated AIP from PDAC and benign pancreatic conditions, thereby offering the capability of earlier and more accurate diagnosis. Use of this model offers the potential for more timely and appropriate patient care and improved outcome.
More expansive horizons: a review of endovascular therapy for patients with low NIHSS scores
Authors: McCarthy David J , Tonetti Daniel A , Stone Jeremy , Starke Robert M , Narayanan Sandra , Lang Michael J , Jadhav Ashutosh P , Gross Bradley A 
Published: October 2020

While the landmark 2015 stroke trials demonstrated that endovascular therapy (EVT) was superior to medical management for the treatment of acute ischemic stroke due to large vessel occlusion, the efficacy of EVT for patients presenting with a low NIHSS score remains undetermined. We conducted a review of the EVT low National Institutes of Health Stroke Scale (NIHSS) stroke literature, identifying 24 quantitative and six qualitative publications. Details of study designs and outcome were extracted and critically discussed.All identified qualitative studies were retrospective. There was significant study design heterogeneity, with 18 unique study designs between the 24 identified quantitative manuscripts. Study investigations included low NIHSS EVT feasibility (n=6), EVT versus best medical management (BMM; n=10), EVT versus intravenous therapy (IVT, n=3), and low NIHSS score versus high NIHSS score (n=3). From single-arm EVT feasibility studies, the reported ranges of modified Thrombolysis in Cerebral Infarction and symptomatic intracranial hemorrhage were 78–97% and 0–10%, respectively. The EVT versus BMM literature had heterogeneous results with 40% reporting benefit with EVT and 60% reporting neutral findings. None of the studies comparing EVT with IVT reported a difference between the two revascularization therapies. The four identified meta-analyses had incongruent inclusion criteria and conflicting results. Two randomized trials are currently investigating EVT in patients with a low NIHSS score. Selected meta-analyses do suggest a potential benefit of EVT over BMM; however, current and future randomized clinical trials will better elucidate the efficacy of EVT in this patient population.
Changes in selected haematological parameters associated with JAK1/JAK2 inhibition observed in patients with rheumatoid arthritis treated with baricitinib
Authors: Kay Jonathan , Harigai Masayoshi , Rancourt Josh , Dickson Christina , Melby Thomas , Issa Maher , de la Torre Inmaculada , Isaka Yoshitaka , Cardoso Anabela , Saifan Chadi , Keystone Edward C , van Vollenhoven Ronald F , Giles Jon T , Huizinga Tom WJ , Kremer Joel M 
Published: October 2020

ObjectiveTo characterise changes in selected haematological parameters following once-daily oral baricitinib dosing.MethodsData were pooled from eight randomised clinical trials (four phase 3, three phase 2, one phase 1b) and one long-term extension. Changes in haematological parameters were evaluated up to 128 weeks (N=2387); overall safety of baricitinib was assessed up to 6 years (N=3492).ResultsMean absolute neutrophil counts decreased (−1.36×109/L) within 1 month, followed by stabilisation within the normal reference range through week 128. The incidence of serious infections was not elevated in patients with neutropenia during the 24-week placebo-controlled period. Mean lymphocyte counts increased (+0.30×109/L) within 1 month, then decreased to baseline (weeks 12–24). Mean platelet counts increased at week 2 (+51×109/L), then decreased towards baseline. Overall, mean haemoglobin concentrations decreased (−0.12 mmol/L), then returned to baseline; however, reduced baseline haemoglobin concentrations observed in the highest baseline high-sensitivity C reactive protein quartile increased over time. Permanent drug discontinuation occurred due to laboratory abnormalities related to neutrophil count in 8 (0.2%), lymphocyte counts in 6 (0.2%), platelet counts in 8 (0.2%), and haemoglobin levels in 16 (0.5%) of all baricitinib-treated patients (N=3492 with 7993 total person-years of exposure).ConclusionsModerate decreases in neutrophils were seen during baricitinib treatment; however, serious infection was uncommon in patients with neutropenia. Transient increases were observed in lymphocytes and platelets, which returned to baseline over time. Changes in haemoglobin concentration were generally small. Haematological abnormalities seldom led to drug discontinuation.
Experimental study of an innovative driven and grouted soil nail (x-Nail)
Authors: Bhuiyan Mohammad Zahidul I. , Wang Shanyong , Carter John P. 
Published: October 2020

This paper describes an experimental investigation of a newly developed driven and grouted soil nail (x-Nail), which combines the capabilities of a purely frictional driven nail and a compaction-grouted nail. The innovative design allows the x-Nail to be driven into the ground with a latex balloon attached that is subsequently used for compaction grouting. A grout bulb is thus formed at the driven end of the nail to improve its pull-out resistance. For compaction grouting, a special type of additive−mixed cement grout was used in this investigation because of its zero bleeding and high bond strength. A series of pullout model tests was conducted to examine the performance of the x-Nail compared to a purely frictional soil nail. It was found that more than 90% of the pullout force of the x-Nail was resisted by the expanded grout bulb and the end bearing resistance of the grout bulb increased with the increment of the injected grout volumes. The experimental results revealed that the pullout force of the x-Nail increased approximately 1800%, 1550%, 1200%, and 900% compared to the purely frictional soil nail for the injected grout volumes of about 350, 270, 220, and 170 mL, respectively.
Proteomics of host–bacterial interactions: new insights from dual perspectives
Authors: Sukumaran Arjun , Woroszchuk Elizabeth , Ross Taylor , Geddes-McAlister Jennifer 
Published: October 2020

Mass-spectrometry (MS)-based proteomics is a powerful and robust platform for studying the interactions between biological systems during health and disease. Bacterial infections represent a significant threat to global health and drive the pursuit of novel therapeutic strategies to combat emerging and resistant pathogens. During infection, the interplay between a host and pathogen determines the ability of the microbe to survive in a hostile environment and promotes an immune response by the host as a protective measure. It is the protein-level changes from either biological system that define the outcome of infection, and MS-based proteomics provides a rapid and effective platform to identify such changes. In particular, proteomics detects alterations in protein abundance, quantifies protein secretion and (or) release, measures an array of post-translational modifications that influence signaling cascades, and profiles protein–protein interactions through protein complex and (or) network formation. Such information provides new insight into the role of known and novel bacterial effectors, as well as the outcome of host cell activation. In this Review, we highlight the diverse applications of MS-based proteomics in profiling the relationship between bacterial pathogens and the host. Our work identifies a plethora of strategies for exploring mechanisms of infection from dual perspectives (i.e., host and pathogen), and we suggest opportunities to extrapolate the current knowledgebase to other biological systems for applications in therapeutic discovery.
Prospects for direct searches for light Higgs bosons at the ILC with 250 GeV
Authors: Drechsel P. , Moortgat-Pick G. , Weiglein G. 
Published: October 2020

AbstractThe particle discovered in the Higgs boson searches at the LHC with a mass of about 125 GeV is compatible within the present uncertainties with the Higgs boson predicted in the Standard Model (SM), but it could also be identified with one of the neutral Higgs bosons in a variety of beyond the SM (BSM) theories with an extended Higgs sector. The possibility that an additional Higgs boson (or even more than one) could be lighter than the state that has been detected at 125 GeV occurs generically in many BSM models and has some support from slight excesses that were observed above the background expectations in Higgs searches at LEP and at the LHC. The couplings between additional Higgs fields and the electroweak gauge bosons in BSM theories could be probed by model-independent Higgs searches at lepton colliders. We present a generator-level extrapolation of the limits obtained at LEP to the case of a future$$e^+e^-$$e+e-collider, both for the search where the light Higgs boson decays into a pair of bottom quarks and for the decay-mode-independent search utilising the recoil method. We find that at the ILC with a centre-of-mass energy of 250 GeV, an integrated luminosity of 500 fb$$^{-1}$$-1and polarised beams, the sensitivity to a light Higgs boson with reduced couplings to gauge bosons is improved by more than an order of magnitude compared to the LEP limits and goes much beyond the projected indirect sensitivity of the HL-LHC with 3000 fb$$^{-1}$$-1from the rate measurements of the detected state at 125 GeV.