bluuebunny/crossref_metadata_2025_split huggingface dataset:
Underperformance of clinical risk scores in identifying vascular ultrasound-based high cardiovascular risk in systemic lupus erythematosus
Authors: Drosos George C , Konstantonis George , Sfikakis Petros P , Tektonidou Maria G 
Published: March 2020

Aims The aim of this study was to assess the performance of eight clinical risk prediction scores to identify individuals with systemic lupus erythematosus (SLE) at high cardiovascular disease (CVD) risk, as defined by the presence of atherosclerotic plaques. Methods CVD risk was estimated in 210 eligible SLE patients without prior CVD or diabetes mellitus (female: 93.3%, mean age: 44.8 ± 12 years) using five generic (Systematic Coronary Risk Evaluation (SCORE), Framingham Risk Score (FRS), Pooled Cohort Risk Equations (ASCVD), Globorisk, Prospective Cardiovascular Münster Study risk calculator (PROCAM)) and three ‘SLE-adapted’ (modified-SCORE, modified-FRS, QRESEARCH risk estimator, version 3 (QRISK3)) CVD risk scores, as well as ultrasound examination of the carotid and femoral arteries. Calibration, discrimination and classification measures to identify high CVD risk based on the presence of atherosclerotic plaques were assessed for all risk models. CVD risk reclassification was applied for all scores by incorporating ultrasound results. Results Moderate calibration ( p-value range from 0.38 to 0.63) and discrimination (area under the curve 0.73–0.84), and low-to-moderate sensitivity (8.3–71.4%) and classification ability (Matthews correlation coefficient (MCC) 0.25–0.47) were observed for all risk models to identify patients with plaques at any arterial site as high-risk. MCC was improved for modified-FRS versus FRS (0.43 vs 0.36), but not for modified-SCORE versus SCORE (0.25 vs 0.25). Based on plaque presence, CVD risk was upgraded to high-risk in 10%, 16.1%, 20.5%, 21.5%, 24%, 28.2% and 28.6% of cases classified as non-high-risk by QRISK3, modified-FRS, Globorisk, FRS/PROCAM, ASCVD, modified-SCORE and SCORE, respectively. Conclusions Most of the five generic and three ‘SLE-adapted’ clinical risk scores underestimated high CVD risk defined by atherosclerotic plaque presence in patients with SLE.
Association between insulin resistance and risk of atrial fibrillation in non-diabetics
Authors: Lee Yonggu , Cha Sung Joo , Park Jung-Hwan , Shin Jeong-Hun , Lim Young-Hyo , Park Hwan-Cheol , Shin Jinho , Kim Chun Ki , Park Jin-Kyu 
Published: March 2020

Aims
Previous studies from Western countries have been unable to demonstrate a relationship between insulin resistance and new-onset atrial fibrillation. We aimed to evaluate this relationship in the nondiabetic Asian population.

Methods
Between 2001–2003, 8175 adults (mean age 51.5 years, 53% women) without both existing atrial fibrillation and diabetes and with insulin resistance measures at baseline were enrolled and were followed by biennial electrocardiograms thereafter until 2014. We constructed multivariable-adjusted Cox proportional hazard models for risk of incident atrial fibrillation.

Results
Over a median follow-up of 12.3 years, 136 participants (1.89/1000 person-years) developed atrial fibrillation. Higher homeostasis model assessment of insulin resistance (HOMA-IR) was independently associated with newly developed atrial fibrillation (hazard ratio 1.61, 95% confidence interval 1.14–2.28). Atrial fibrillation development increased at the HOMA-IR levels approximately between 1–2.5, and then plateaued afterwards (p = 0.031).

Conclusion
There is a significant relationship between insulin resistance and atrial fibrillation development independent of other known risk factors, including obesity in a nondiabetic Asian population.
Comparison of facet joint violation in lumbar posterior spinal instrumentation using different techniques including cortical bone trajectory
Authors: To CY , Cheung P , Ng W , Mok WY 
Published: March 2020

Study background: A retrospective study to compare the rate of facet joint violation (FJV) in lumbar posterior spinal instrumentation using open pedicle screw, percutaneous pedicle screw, and cortical bone trajectory (CBT) technique. CBT is a new posterior spinal instrumentation technique in which a more caudal entry point can minimize iatrogenic damage to the cranial facet joint. Only one recent study reports incidence of FJV of 11%; however, no previous reports comment on radiological outcomes comparing to traditional open and percutaneous screws. Methods: We reviewed 90 patients who underwent lumbar posterior spinal instrumentation from January 2016 to June 2017. Postoperative computer tomography scans were performed to evaluate FJV. Incidence of FJV was graded by three reviewers according to Seo classification. Results: Totally, 446 screws (open 43.4%, percutaneous 37.8%, CBT 18.9%) were inserted. Among these, 6.3% (28/446) had screw head or rod in contact with facet joint and 0.9% (4/446) had screws directly invaded the facet joint. Overall, FJV was 7.2% (CTB = 3.4%, open = 10.4%, and percutaneous = 4.5%, p = 0.075). Conclusion: CBT technique has potential advantage in reducing FJV. It has a unique entry site at lateral aspect of pars interarticular with a caudomedial to craniolateral pathway. It is a reasonable alternative to open or percutaneous techniques in lumbar posterior spinal instrumentation.
Not for Adults Only: Toward a Child Lens in Migration Policies in Asia
Authors: Asis Maruja M. B. , Feranil Alan 
Published: March 2020

Executive Summary Having experienced substantial international migration since the 1970s, countries in East, South, and Southeast Asia have developed laws, institutions, policies, and programs to govern various aspects of international migration. Children, however, who comprise a significant share of the world’s international migrants, have not received as much policy attention as adults. Children are part of the region’s international migration experience (e.g., children left behind in the countries of origin when their parents migrate for work, children as migrants, and children as members of multicultural families). This article provides an overview of the challenges faced by children as migration actors, and the policy responses and programs that select countries in the region have developed to address children’s experiences and concerns. The Global Compact for Safe, Orderly and Regular Migration and the Global Compact on Refugees, which many Asian countries have endorsed, set forth objectives, commitments, and actions, informed by the principle of promoting the best interests of the child and child protection, which specifically address the needs of children. These include actions to promote universal birth registration, enhance access to education and health and social services regardless of migrant and legal status, and otherwise create inclusive and socially cohesive societies. Most countries in Asia have yet to meet these standards. Endorsing the two compacts was a first step. The good practices that have been implemented in a number of countries provide a template for how to translate these objectives into action and how to ensure that the full protection and best interests of migrant children, the left-behind children of migrant workers, and those who are part of multicultural families remain a priority.
Comparative Assessment of Widefield Fundus Autofluorescence Patterns in Retinoschisis and Retinal Detachment
Authors: Cao Jessica L. , Conti Thais F. , Hom Grant L. , Babiuch Amy S. , Greenlee Tyler , Ehlers Justis P. , Rachitskaya Aleksandra , Sharma Sumit , Yuan Alex , Kaiser Peter K. , Singh Rishi P. 
Published: March 2020

Purpose: This article characterizes widefield fundus autofluorescence (WF-FAF) patterns in retinoschisis (RS), retinal detachment (RD), and combined retinoschisis-detachment (RS/RD), and to correlate them with spectral-domain optical coherence tomography (SD-OCT) findings. Methods: A retrospective case series of 13 eyes with senile RS, RD, or RS/RD is presented. One eye underwent imaging of 2 areas within the retina, resulting in 14 data points. Independent, masked graders classified pathology on SD-OCT as RS, RD, or RS/RD and graded WF-FAF images for either hypoautofluorescent areas or mixed autofluorescence (AF) (hyper-AF, iso-AF, hyper-AF with hypo-AF, hyper-AF with iso-AF, or hypo-AF with iso-AF). Results: There was no statistically significant correlation between the autofluorescence pattern and the type of retinal abnormality ( P = .74). Conclusions: High variability was found in the characterization of WF-FAF in patients with RS and RD. SD-OCT remains the criterion-standard imaging modality in distinguishing RS from RD in clinically ambiguous cases.
Integrative analysis of the genomic and transcriptomic landscape of double-refractory multiple myeloma
Authors: Ziccheddu Bachisio , Biancon Giulia , Bagnoli Filippo , De Philippis Chiara , Maura Francesco , Rustad Even H. , Dugo Matteo , Devecchi Andrea , De Cecco Loris , Sensi Marialuisa , Terragna Carolina , Martello Marina , Bagratuni Tina , Kastritis Efstathios , Dimopoulos Meletios A. , Cavo Michele , Carniti Cristiana , Montefusco Vittorio , Corradini Paolo , Bolli Niccolo 
Published: March 2020

AbstractIn multiple myeloma, novel treatments with proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs) have prolonged survival but the disease remains incurable. At relapse, next-generation sequencing has shown occasional mutations of drug targets but has failed to identify unifying features that underlie chemotherapy resistance. We studied 42 patients refractory to both PIs and IMiDs. Whole-exome sequencing was performed in 40 patients, and RNA sequencing (RNA-seq) was performed in 27. We found more mutations than were reported at diagnosis and more subclonal mutations, which implies ongoing evolution of the genome of myeloma cells during treatment. The mutational landscape was different from that described in published studies on samples taken at diagnosis. The TP53 pathway was the most frequently inactivated (in 45% of patients). Conversely, point mutations of genes associated with resistance to IMiDs were rare and were always subclonal. Refractory patients were uniquely characterized by having a mutational signature linked to exposure to alkylating agents, whose role in chemotherapy resistance and disease progression remains to be elucidated. RNA-seq analysis showed that treatment or mutations had no influence on clustering, which was instead influenced by karyotypic events. We describe a cluster with both amp(1q) and del(13) characterized by CCND2 upregulation and also overexpression of MCL1, which represents a novel target for experimental treatments. Overall, high-risk features were found in 65% of patients. However, only amp(1q) predicted survival. Gene mutations of IMiD and PI targets are not a preferred mode of drug resistance in myeloma. Chemotherapy resistance of the bulk tumor population is likely attained through differential, yet converging evolution of subclones that are overall variable from patient to patient and within the same patient.
Impacts of increasing maximum truck weight – case Finland
Authors: Liimatainen Heikki , Pöllänen Markus , Nykänen Lasse 
Published: March 2020

AbstractFinnish government allowed in October 2013 operating high capacity vehicles (HCV) with a maximum weight limit of 76 t on Finnish roads. An analysis on how HCVs have affected the Finnish road freight transport sector is presented here based on a continuous time series data from 2013 to 2017. The analysis shows a significant increase in the average payload weight and a transition from 7-axle to 8- and 9-axle articulated vehicle combinations, which allow the higher weights. Truck mileage of 225 million km has been avoided from October 2013 until the end of 2017 and avoided mileage corresponded in 2017 to approximately 4% of total truck mileage in Finland. This equals around 126 million € cost savings in 2017 and 0.1 Mt of CO2 emissions reduction in road freight, even after taking into account that there has been some modal shift from rail to road.
Acceptance of mHealth among health professionals: a case study on anesthesia practitioners
Authors: Carvalho Hugo , Verdonck Michael , Forget Patrice , Poelaert Jan 
Published: March 2020

Abstract
Background
mHealth, the practice of medicine aided by mobile devices is a growing market. Although the offer on Anesthesia applications (Apps) is quite prolific, representative formal assessments on the views of anesthesia practitioners on its use and potential place in daily practice is lacking. This survey aimed thus to cross-assess the Belgian anesthesia population on the use of smartphone Apps and peripherals.

Methods
The survey was exclusively distributed as an online anonymous questionnaire. Sharing took place via hyperlink forwarding by the Belgian Society for Anesthesia and Reanimation (BSAR) and by the Belgian Association for Regional Anesthesia (BARA) to all registered members. The first answer took place on 5 September 2018, the last on 22 January 2019.

Results
Three hundred forty-nine answers were obtained (26.9% corresponding to trainees, 73.1% to specialists). Anesthesiologists were positively confident that Apps and peripherals could help improve anesthesia care (57.0 and 47.9%, respectively, scored 4 or 5, in a scale from 0 to 5). Trainees were significantly more confident than specialists on both mobile Apps (71.2% and 51.8%, respectively; p = 0.001) and peripherals (77.7% and 45.1%, respectively; p = 0.09).
The usefulness of Apps and Peripherals was rated 1 or below (on a 0 to 5 scale), respectively, by 9.5 and 14.6% of the total surveyed population, being specialists proportionally less confident in Smartphone peripherals than trainees (p = 0.008). Mobile apps are actively used by a significantly higher proportional number of trainees (67.0% vs. 37.3%, respectively; p = 0.000001).
The preferred category of mobile Apps was dose-calculating applications (39.15%), followed by digital books (21. 1%) and Apps for active perioperative monitoring (20.0%).

Conclusions
Belgian Anesthesia practitioners show a global positive attitude towards smartphone Apps and Peripherals, with trainees trending to be more confident than specialists.

Trial registration
ClinicalTrials.gov database Identifier: NCT03750084. Retrospectively registered on 21 November 2018.
Safety and efficacy of a standardized intracameral combination of mydriatics and anesthetic for cataract surgery in type-2 diabetic patients
Authors:   on behalf of the Intracameral Mydrane (ICMA), Ethics Group, Labetoulle Marc , Behndig Anders , Tassignon Marie-José , Nuijts Rudy , Mencucci Rita , Güell José Luis , Pleyer Uwe , Szaflik Jacek , Rosen Paul , Bérard Alain , Chiambaretta Frédéric , Cochener-Lamard Béatrice 
Published: March 2020

Abstract
Background
Cataract surgery in diabetics is more technically challenging due to a number of factors including poor intraoperative pupil dilation and a higher risk of vision threatening complications. This study evaluates the safety and efficacy of an intracameral combination of 2 mydriatics and 1 anesthetic (ICMA, Mydrane) for cataract surgery in patients with well-controlled type-2 diabetes.

Methods
Post-hoc subgroup analysis of a phase 3 randomized study, comparing ICMA to a conventional topical regimen. Data were collected from 68 centers in Europe and Algeria. Only well-controlled type-2 diabetics, free of pre-proliferative retinopathy, were included. The results for non-diabetics are also reported. The primary efficacy variable was successful capsulorhexis without additional mydriatic treatment. Postoperative safety included adverse events, endothelial cell density and vision.

Results
Among 591 randomized patients, 57 (9.6%) had controlled type 2 diabetes [24 (42.1%) in the ICMA Group and 33 (57.9%) in the Topical Group; intention-to-treat (ITT) set]. Among diabetics, capsulorhexis was successfully performed without additional mydriatics in 24 (96.0%; modified-ITT set) patients in the ICMA Group and 26 (89.7%) in the Topical Group. These proportions were similar in non-diabetics. No diabetic patient [1 (0.5%) non-diabetics] in the ICMA Group had a significant decrease in pupil size (≥3 mm) intraoperatively compared to 4 (16.0%; modified-ITT set) diabetics [16 (7.3%) non-diabetics] in the Topical group. Ocular AE among diabetics occurred in 2 (8.0%; Safety set) patients in the ICMA Group and 5 (16.7%) in the Topical Group. Endothelial cell density at 1 month postoperatively was similar between groups in diabetics (P = 0.627) and non-diabetics (P = 0.368).

Conclusions
ICMA is effective and can be safely used in patients with well-controlled diabetes, with potential advantages compared to a topical regimen including reduced systemic risk, better corneal integrity and reduced risk of ocular complications.

Trial registration
The trial was registered at (reference # NCT02101359) on April 2, 2014.
Study protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger
Authors: Kalsbeek J. H. , Roerdink W. H. , Krijnen P. , van den Akker-van Marle M. E. , Schipper I. B. 
Published: March 2020

Abstract
Background
The Dynamic Locking Blade Plate (DLBP) was recently introduced for fixation of displaced femoral neck fractures (FNF) and has been well received. Although the results of this implant in young patients are promising, the DLBP has not yet been compared to a standard device such as the Dynamic Hip Screw (DHS). The aim of this study is to compare the clinical outcome and costs of displaced FNF treated with internal fixation by means of either the DLBP or the DHS in patients up to 65 years of age. We hypothesize that the DLBP is superior compared to the DHS in terms of revision surgery rate, union rate, incidence of avascular necrosis and implant related failure.

Methods
The DEFENDD (DisplacEd Femoral Neck fractures Dlbp versus Dhs) trial is a multicentre randomized controlled trial that will include 266 patients of 18–65 years with a displaced FNF. Patients will be randomized to receive either a DLBP or a DHS with a 1:1 allocation using a random block size, stratified for centre. Clinical follow up will last 1 year and questionnaires will be obtained up to 2 years. The main outcome parameter is the incidence of revision surgery within 1 year, due to either non-union, avascular necrosis (AVN) or cut out of the implant. Secondary study parameters are the incidence of avascular necrosis, non-union, (implant related) complications, functional outcome, elective removal of the implant and health-related quality of life and costs.

Discussion
The outcome of the DEFENDD trial will provide high-level evidence of which implant is favourable for the treatment of femoral neck fractures in young patients (≤65 years).

Trial registration
Netherlands Trial Register, NL7300 Registration date 25-09-2018.
Beta-catenin inhibits bovine parainfluenza virus type 3 replication via innate immunity pathway
Authors: Du Xinying , He Wenqi , He Hongbin , Wang Hongmei 
Published: March 2020

AbstractBackgroundBovine parainfluenza virus type 3 (BPIV3) is one of the important viral respiratory agents associated with the bovine respiratory disease complex (BRDC) in cattle. Previous study has demonstrated that infection of BPIV3 causes innate immune response within the host cell. β-catenin is a key component of the Wnt/β-catenin signal pathway which is involved in the regulation of interferon-beta (IFN-β) transcription. Some viruses can activate while others can inhibit the Wnt/β-catenin signaling pathway. However, the role of β-catenin in BPIV3 infection remains unclear.ResultsHere we found that the expression of β-catenin mRNA was up-regulated and β-catenin protein was down-regulated after BPIV3 infection in MDBK cells. Moreover, it was confirmed that overexpression of β-catenin suppressed BPIV3 replication and knockdown of β-catenin promoted viral replication, suggesting that β-catenin inhibits BPIV3 replication. Furthermore, IFN-β signal pathway and virus titer analysis using the GSK3β inhibitor (LiCl) revealed that Wnt/β-catenin can serve as a mechanism to suppress virus replication in infected cells. The results indicated that LiCl promoted the expression and accumulation in the nucleus of β-catenin, which further promoted the expression of IFN-β and OSA1 and suppressed BPIV3 replication. Most importantly, BPIV3 down-regulating β-catenin protein expression was due to degradation of GSK3β mediated proteasome pathway.ConclusionsIn summary, we discovered the relationship between β-catenin and BPIV3 replication. These results provided further insight into the study of BPIV3 pathogenesis.
The comparison of dyslipidemia and serum uric acid in patients with gout and asymptomatic hyperuricemia: a cross-sectional study
Authors: Liang Jing , Jiang Yutong , Huang Yefei , Song Wei , Li Xiaomin , Huang Yulan , Ou Jiayong , Wei Qiujing , Gu Jieruo 
Published: March 2020

Abstract
Background
Dyslipidemia often concurs with hyperuricemia. Our study was to discover different lipid levels of gout and asymptomatic hyperuricemia and the predictors of sUA (serum uric acid) levels.

Methods
A cross-sectional study was performed to collect demographic, clinical variables, comorbidities and laboratory testing in patients with gout and asymptomatic hyperuricemia. Group comparison was performed with Student’s t-test or Mann Whitney U test for continuous variables and chi-squared tests for categorical variables (Fisher’s exact test where appropriate) and to screen potential risk factors. Correlation of sUA levels with demographic and biochemical variables were performed by using correlation analysis. The variable with s p-value less than 0.20 during the group comparison or clinical relevance was introduced into the stepwise multiple regression model.

Results
Six hundred fifty-three patients with gout and 63 patients with asymptomatic hyperuricemia (> 420 μmol/L in male and > 360 μmol/L in female) were enrolled, including 553 (84.7%) males. The mean age was 47.8 ± 16.0 years old. Elevated total cholesterol (TC) was observed in 173 (26.5%) cases with gout. Increased triglycerides (TG) and low-density lipoprotein (LDL-C) levels were observed in 242 (37.1%) cases and 270 (41.3%) cases with gout, individually. In contrast, elevated TC, TG and LDL-C levels were observed in 10 (15.9%) cases, 30 (47.6%) cases and 22 (34.9%) cases with hyperuricemia, individually. Significant differences were found in age, serum creatine, TC and erythrocyte sedimentation rate (ESR) between gout and asymptomatic hyperuricemia groups (p < 0.05). In patients with asymptomatic hyperuricemia, 12 (19.0%) patients had hypertension and 5 (7.9%) suffered from coronary heart diseases. Male (B = -112.7, p < 0.001), high-density lipoprotein (HDL-C) (B = -60.797, p = 0.013), body mass index (BMI) (B = 5.168, p = 0.024), age (B = -3.475, p = 0.006), age of hyperuricemia onset (B = 2.683, p = 0.032), and serum creatine (B = 0.534, p < 0.001) were predictors of sUA levels in gout patients (adjusted R2 = 28.7%).

Conclusions
Dyslipidemia is more commonly seen in patients with gout, compared to asymptomatic hyperuricemia. HDL-C is a protective predictor of sUA levels in gout.