bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to early pulmonary rehabilitation after COPD exacerbation and risk of hospital readmission: a secondary analysis of the COPD-EXA-REHAB study
Authors: Kjærgaard Jakob , Juhl Carsten Bogh , Lange Peter , Wilcke Torgny 
Published: August 2020

BackgroundEarly pulmonary rehabilitation after exacerbation of chronic obstructive pulmonary disease (COPD) has previously been shown to reduce the risk of hospital admission and improve physical performance and quality of life. However, the impact of attendance at early rehabilitation programmes has not been established.ObjectivesTo evaluate the impact of increasing attendance to pulmonary rehabilitation on the risk of hospital admission, physical performance and quality of life in patients attending an early rehabilitation programme after an exacerbation of COPD.MethodsThis study was a secondary exploratory analysis of the randomised controlled trial COPD-EXA-REHAB study, involving patients hospitalised with an exacerbation of COPD. The COPD-EXA-REHAB study compared early pulmonary rehabilitation, starting within 2 weeks after an exacerbation, with standard treatment, that is, the same programme starting 2 months later. The present analysis included only the 70 patients allocated to early pulmonary rehabilitation.ResultsAt 1-year follow-up, we found an association between the number of sessions attended and a reduction in hospital admissions (incidence rate ratio 0.93 (95% CI 0.88 to 0.99), p=0.02), corresponding to a 7% reduction for each session attended. Similarly, at 2-month follow-up, physical performance was positively associated with sessions attended: the mean Incremental Shuttle Walk Test result improved by 8 m with each session (95% CI 2.54 to 13.56, p=0.005) and the Endurance Shuttle Walk Test result by 44 s (95% CI 18.41 to 68.95, p=0.001). Quality of life, assessed using the COPD Assessment Test, was not significantly associated with the number of attended sessions, with the average score increasing by 0.15 points with each session (95% CI −0.35 to 0.65, p=0.55).ConclusionIncreased attendance at early pulmonary rehabilitation after exacerbation of COPD was associated with reduced risk of hospital admission and improved physical performance.
Study on the combination of brief psychodynamic psychotherapy with Viagra in the treatment of non-organic ED
Authors: Zhang Zhihang , Gao Xiang , Zhou Ying , Yu Chao , Pimolsettapun Jittikorn , Yang Libin , Zhao Youkang 
Published: August 2020

BackgroundErectile dysfunction (ED) has gradually become an important issue that seriously affects the quality of life of Chinese men. In addition to classic oral medications, psychotherapeutic interventions are increasingly being used in the treatment of ED.AimThis study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy (BPP) plus Viagra in the treatment of non-organic ED.MethodsWe initiated this study via a controlled, prospective experimental design with initial optimal efficiency standard greater than 10%. On the standard, 63 patients were enrolled who were assigned to control or treatment group. The control group (including 33 cases) received Viagra treatment for 2 months, and the treatment group (including 30 cases) was cured with BPP plus Viagra. After the treatments, the clinical efficacy was assessed using the International Erectile Function Index (IIEF-5) score, the Self-rating Anxiety Scale (SAS), Sexual Satisfaction (SS) score and Erection Hardness Score (EHS).ResultsIn the comparison of efficacy, pretreatment and post-treatment within each group, the two groups showed improvements in IIEF, SAS scores, SS, and EHS (treatment group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001; control group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001). Furthermore, the treatment group presented better performances in IIEF (p=0.040), SAS (p=0.006), SS scores (p=0.045) and EHS (p=0.041) than the control group.ConclusionThe combination of BPP with Viagra has positive effect on the treatment of non-organic ED.
Omega-3 supplementation and cardiovascular disease: formulation-based systematic review and meta-analysis with trial sequential analysis
Authors: Rizos Evangelos C , Markozannes Georgios , Tsapas Apostolos , Mantzoros Christos S , Ntzani Evangelia E 
Published: August 2020

BackgroundOmega-3 supplements are popular for cardiovascular disease (CVD) prevention. We aimed to assess the association between dose-specific omega-3 supplementation and CVD outcomes.DesignWe included double-blind randomised clinical trials with duration ≥1 year assessing omega-3 supplementation and estimated the relative risk (RR) for all-cause mortality, cardiac death, sudden death, myocardial infarction and stroke. Primary analysis was a stratified random-effects meta-analysis by omega-3 dose in 4 a priori defined categories (<1, 1, 2, ≥3 of 1 g capsules/day). Complementary approaches were trial sequential analysis and sensitivity analyses for triglycerides, prevention setting, intention-to-treat analysis, eicosapentaenoic acid, sample size, statin use, study duration.ResultsSeventeen studies (n=83 617) were included. Omega-3 supplementation as ≤1 capsule/day was not associated with any outcome under study; futility boundaries were crossed for all-cause mortality and cardiac death. For two capsules/day, we observed a statistically significant reduction of cardiac death (n=3, RR 0.55, 95% CI 0.33 to 0.90, I2=0%); for ≥3 capsules/day we observed a statistically significant reduction of cardiac death (n=3, RR 0.82, 95% CI 0.68 to 0.99, I2=0%), sudden death (n=1, RR 0.70, 95% CI 0.51 to 0.97) and stroke (n=2, RR 0.74, 95% CI 0.57 to 0.95, I2=0%).ConclusionOmega-3 supplementation at <2 1 g capsules/day showed no association with CVD outcomes; this seems unlikely to change from future research. Compared with the robust scientific evidence available for low doses, the evidence for higher doses (2–4 1 g capsules/day) is weak. The emerging postulated benefit from high-dose supplementation needs replication and further evaluation as to the precise formulation and indication.
Bilateral ultrasound-guided thoracic erector spinae plane blocks using a programmed intermittent bolus improve opioid-sparing postoperative analgesia in pediatric patients after open cardiac surgery: a randomized, double-blind, placebo-controlled trial
Authors: Macaire Philippe , Ho Nga , Nguyen Vien , Phan Van Hieu , Dinh Nguyen Thien Kim , Bringuier Sophie , Capdevila Xavier 
Published: August 2020

Background
Postoperative pain after pediatric cardiac surgery is usually treated with intravenous opioids. Recently, the focus has been on postoperative regional analgesia with the introduction of ultrasound-guided erector spinae plane blocks (ESPBs). We hypothesized that bilateral ESPB with a programmed intermittent bolus (PIB) regimen decreases postoperative morphine consumption at 48 hours and improves analgesia in children who undergo cardiac surgery.

Methods
This randomized, double-blind, placebo-controlled study comprised 50 children who underwent cardiac surgery through midline sternotomy. The patients were allocated randomly into two groups: ultrasound-guided bilateral ESPB at the level of T3–T4 transverse process then PIB with saline infusion (group 1, n=23) or PIB with 0.2% ropivacaine (group 2, n=27). Intravenous morphine at 30 µg/kg/hour was used as rescue analgesia. Postoperative pain was assessed using the COMFORT-B score for extubation, drain removal, and mobilization, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale at 0, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery. Adverse events were noted.

Results
The total dose of morphine in 48 hours was significantly decreased in patients receiving a bilateral ESPB with ropivacaine (120±320 µg/kg) compared with patients with saline infusion (512±560 µg/kg; p=0.03). Fourteen per cent of patients required rescue analgesia with morphine in group 2 compared with 41% in group 1 (p=0.05). The patients in group 2 demonstrated significantly reduced COMFORT-B scores at extubation, drain removal, and mobilization compared with those in group 1 and had reduced FLACC scale levels at 20 and 24 hours postoperatively (p=0.05 and p=0.001, respectively). No differences were reported for extubation and drain removal times or for length of hospital stay. In addition, vomiting episodes were decreased in group 2 (p=0.01).

Conclusions
In pediatric cardiac surgery, the results of this study confirm our hypothesis that bilateral ESPB analgesia with ropivacaine decreases the postoperative morphine consumption at 48 hours and demonstrates better postoperative analgesia compared with a control group.

Trial registration number
NCT03593642
.
Increased Cancer Risk in Families with Pediatric Cancer Is Associated with Gender, Age, Diagnosis, and Degree of Relation to the Child
Authors: Stjernfelt Karl-Johan , von Stedingk Kristoffer , Wiebe Thomas , Hjorth Lars , Kristoffersson Ulf , Stenmark-Askmalm Marie , Olsson Håkan , Øra Ingrid 
Published: August 2020

AbstractBackground:Studies of cancer risk among relatives of children with cancer beyond parents and siblings are limited. We have investigated the cancer risk up to the third degree of relation in families with pediatric cancer to reveal patterns of inheritance.Methods:A single-center cohort of 757 patients with pediatric cancer was linked to the Swedish National Population Register, resulting in 16,137 relatives up to the third degree of relation. All relatives were matched to the Swedish Cancer Register, and standard incidence ratios (SIR) were calculated to define relatives at risk.Results:Children and adults up to the third degree of relation had increased cancer risk, with SIRs of 1.48 (P = 0.01) and 1.07 (P &lt; 0.01), respectively. The SIRs for first- and third-degree adult relatives were 1.22 and 1.10, respectively, but no increased risk was observed in second-degree relatives. Male relatives had a higher risk than females, especially when related to a girl and when the child had leukemia. The risk was mainly increased for lung, prostate, and gastrointestinal cancer. When excluding 29 families of children with known pathogenic germline variants, the increased risk remained.Conclusions:Relatives to children with cancer up to third degree of relation have an increased cancer risk. Known pathogenic germline variants do not explain this increased risk.Impact:The overall increased cancer risk among relatives of children with cancer in this population-based cohort strengthens the importance of surveillance programs for families with pediatric cancer.
Effectiveness of Population-Based Service Screening with Mammography for Women Aged 70–74 Years in Sweden
Authors: Mao Zheng , Nyström Lennarth , Jonsson Håkan 
Published: August 2020

Abstract

Background:
Consensus has been reached on the effectiveness of inviting women aged 50 to 69 years to mammography screening, but for older women, the evidence is scarce. The aim of this study was to estimate the marginal effectiveness of inviting women to mammography screening with an upper age limit of 74 years versus stopping at age 69 using data from the Swedish service-screening program.

Methods:
A cohort design was used to compare the breast cancer mortality in the period 1986 to 2012 between geographic areas and periods where women were invited to screening up to the age of 74 years (study group) with those where women were invited up to age 69 (control group). The study group and the control group were compared using the incidence-based breast cancer mortality rate ratio where only breast cancer deaths in cases diagnosed at 70 to 74 years of age were counted.

Results:
After 20 years of follow-up, there were 1,040 and 1,173 breast cancer deaths in the study and the control group, respectively. The breast cancer mortality rate ratio for women invited up to age 74 versus women invited up to age 69 was 0.80 [95% confidence interval (CI): 0.75–0.85] after bias adjustments. The corresponding rate ratio for participating women was 0.73 (95% CI: 0.66–0.81).

Conclusions:
Continuing to screen women up to 74 years of age is effective compared with stopping screening at 69 years.

Impact:
This large long-term study will add to the knowledge of the effect of mammography screening for women 70 to 74 years.
Entospletinib in Combination with Induction Chemotherapy in Previously Untreated Acute Myeloid Leukemia: Response and Predictive Significance of HOXA9 and MEIS1 Expression
Authors: Walker Alison R. , Byrd John C. , Blachly James S. , Bhatnagar Bhavana , Mims Alice S. , Orwick Shelley , Lin Tara L. , Crosswell Howland E. , Zhang Danjie , Minden Mark D. , Munugalavadla Veerendra , Long Lauren , Liu Jinfeng , Pan Yang , Oellerich Thomas , Serve Hubert , Rao Arati V. , Blum William G. 
Published: August 2020

Abstract

Purpose:
Spleen tyrosine kinase (SYK) signaling is a proposed target in acute myeloid leukemia (AML). Sensitivity to SYK inhibition has been linked to HOXA9 and MEIS1 overexpression in preclinical studies. This trial evaluated the safety and efficacy of entospletinib, a selective inhibitor of SYK, in combination with chemotherapy in untreated AML.

Patients and Methods:
This was an international multicenter phase Ib/II study, entospletinib dose escalation (standard 3+3 design between 200 and 400 mg twice daily) + 7+3 (cytarabine + daunorubicin) in phase Ib and entospletinib dose expansion (400 mg twice daily) + 7+3 in phase II.

Results:
Fifty-three patients (n = 12, phase Ib and n = 41, phase II) with previously untreated de novo (n = 39) or secondary (n = 14) AML were enrolled (58% male; median age, 60 years) in this study. The composite complete response with entospletinib + 7+3 was 70%. Patients with baseline HOXA9 and MEIS1 expression higher than the median had improved overall survival compared with patients with below median HOXA9 and MEIS1 expression. Common adverse events were cytopenias, febrile neutropenia, and infection. There were no dose-limiting toxicities. Entospletinib-related skin rash and hyperbilirubinemia were also observed.

Conclusions:
Entospletinib with intensive chemotherapy was well-tolerated in patients with AML. Improved survival was observed in patients with HOXA9/MEIS1 overexpression, contrasting published data demonstrating poor survival in such patients. A randomized study will be necessary to determine whether entospletinib was a mediator this observation.
Hyperglycemia Induces Myocardial Dysfunction via Epigenetic Regulation of JunD
Authors: Hussain Shafaat , Khan Abdul Waheed , Akhmedov Alexander , Suades Rosa , Costantino Sarah , Paneni Francesco , Caidahl Kenneth , Mohammed Shafeeq A. , Hage Camilla , Gkolfos Christos , Björck Hanna , Pernow John , Lund Lars H. , Lüscher Thomas F. , Cosentino Francesco 
Published: August 2020

Rationale:
Hyperglycemia -induced reactive oxygen species are key mediators of cardiac dysfunction. JunD (Jund proto-oncogene subunit), a member of the AP-1 (activator protein-1) family of transcription factors, is emerging as a major gatekeeper against oxidative stress. However, its contribution to redox state and inflammation in the diabetic heart remains to be elucidated.

Objective:
The present study investigates the role of JunD in hyperglycemia-induced and reactive oxygen species–driven myocardial dysfunction.

Methods and Results:

JunD mRNA and protein expression were reduced in the myocardium of mice with streptozotocin-induced diabetes mellitus as compared to controls. JunD downregulation was associated with oxidative stress and left ventricular dysfunction assessed by electron spin resonance spectroscopy as well as conventional and 2-dimensional speckle-tracking echocardiography. Furthermore, myocardial expression of free radical scavenger superoxide dismutase 1 and aldehyde dehydrogenase 2 was reduced, whereas the NOX2 (NADPH [nicotinamide adenine dinucleotide phosphatase] oxidase subunit 2) and NOX4 (NADPH [nicotinamide adenine dinucleotide phosphatase] oxidase subunit 4) were upregulated. The redox changes were associated with increased NF-κB (nuclear factor kappa B) binding activity and expression of inflammatory mediators. Interestingly, mice with cardiac-specific overexpression of JunD via the α MHC (α- myosin heavy chain) promoter (α MHC
JunD

tg

) were protected against hyperglycemia-induced cardiac dysfunction. We also showed that JunD was epigenetically regulated by promoter hypermethylation, post-translational modification of histone marks, and translational repression by miRNA (microRNA)-673/menin. Reduced JunD mRNA and protein expression were confirmed in left ventricular specimens obtained from patients with type 2 diabetes mellitus as compared to nondiabetic subjects.

Conclusions:
Here, we show that a complex epigenetic machinery involving DNA methylation, histone modifications, and microRNAs mediates hyperglycemia-induced JunD downregulation and myocardial dysfunction in experimental and human diabetes mellitus. Our results pave the way for tissue-specific therapeutic modulation of JunD to prevent diabetic cardiomyopathy.
Taxonomic status of the Neotropical salamanders Bolitoglossa altamazonica and Bolitoglossa peruviana (Amphibia: Caudata: Plethodontidae), with the description of a new species from Northern Peru
Authors: CUSI JUAN C. , GAGLIARDI-URRUTIA GIUSSEPE , BRCKO ISABELA CARVALHO , WAKE DAVID B. , MAY RUDOLF VON 
Published: August 2020

We examine the phylogenetic relationships among salamanders of the genus Bolitoglossa (Eladinea) distributed in the Amazonian basin of northern Peru and southern Ecuador and assess species diversity based on morphological and phylogenetic analyses. We infer a molecular phylogeny using sequences from two mitochondrial (Cytb, 16S) and two nuclear genes (RAG–1, POMC). We find two well-supported subclades, one including [B. altamazonica + B. peruviana] + B. awajun sp. n., and the other including Bolitoglossa sp. Ituxi + Bolitoglossa sp. Jurúa. Ecuadorian lineages form divergent clades from the Peruvian lineages. Accordingly, Ecuadorian populations previously assigned to Bolitoglossa peruviana sensu lato are treated as members of a Bolitoglossa equatoriana species complex. A newly defined Bolitoglossa altamazonica species complex contains only populations from the Amazonian rainforest of Peru. Maximum likelihood and Bayesian Inference analyses confirm the phylogenetic placement of B. altamazonica and B. peruviana, and support recognition of a related new species of Bolitoglossa. The uncorrected genetic distances between the new species and B. altamazonica are 6.5% for Cytb and 4.9% for 16S; and the uncorrected genetic distances between the new species and B. peruviana are 8.0% for Cytb and 3.9% for 16S. Additionally, analyses of nuclear gene sequences show no haplotype sharing between the new species and closely related species. The new species is distinguished from its congeners by a combination of the following morphological characters: (1) Standard length mean 37.7 mm in males (range 32.0–42.2; n=5) and 41.4 mm in females (range 34.9–48.2; n=6); (2) in life, dorsal coloration uniformly brown with a dark brown triangular marking between the eyes or some irregular light cream spots or patches on the head, back and flanks; (3) iris pale golden; (4) in preservative, dark brown venter with cream mottlings or moderate-sized blotches on the gular region, belly, cloacal region and tail; (5) tips of third finger and third toe protuberant and pointed with nearly complete webbing on the hands and feet; (6) 11–26 maxillary teeth and 8–24 vomerine teeth. Given that the syntypes of B. altamazonica are lost, we designate a neotype for B. altamazonica from Allpahuayo Mishana National Reserve, Loreto department, Peru. Newly collected specimens from ~30 km NE from Moyobamba (type locality of B. peruviana) provide a better understanding of B. peruviana and enable us to show that it is the sister taxon of B. altamazonica. The new species is known from pre-montane forests in Cordillera Escalera Regional Conservation Area, Cordillera Azul National Park and Shucshuyacu, San Martin department, Peru at 485–1311 m elevation, ~75 km SE from Moyobamba. Bolitoglossa awajun sp. n. is the fourth endemic species of salamander from Peru.
Factors Regulating the Multidecadal Changes in MJO Amplitude over the Twentieth Century
Authors: Fu Zhen , Hsu Pang-Chi , Liu Fei 
Published: August 2020

AbstractThis study examined multidecadal changes in the amplitude of the boreal-winter Madden–Julian oscillation (MJO) over the twentieth century using two century-long reanalysis datasets (20CR and ERA-20C). Both revealed reasonable MJO variability compared to other state-of-the-art reanalysis datasets. We detected pronounced multidecadal variations along with an increasing trend in MJO amplitude during the period 1900–2009 in both datasets, although this linear trend was less significant in the reconstructed MJO index proposed by Oliver and Thompson. The two twentieth-century reanalysis datasets and the Oliver–Thompson MJO index consistently showed the intensified amplitude of MJO precipitation and circulation in the later decades (1970–99) compared to the earlier decades (1920–49). The most significant enhancement of MJO precipitation in the later decades appeared over the western Pacific warm pool. To understand the mechanisms controlling the changes in western Pacific MJO precipitation amplitude over the twentieth century, we diagnosed the moisture budget equation. The enhanced MJO precipitation variability in the later decades mainly came from increased moisture associated with a strengthened low-level convergence anomaly working on background mean moisture []. Further diagnosis showed that the effect of anomalous circulation (∇ ⋅ V′) change on the MJO precipitation amplitude change over the twentieth century was about an order larger than that of mean moisture () change, different from the mechanisms (i.e., increased gradient of ) responsible for the intensified MJO precipitation amplitude under future warmer climate. The enhanced MJO circulation anomalies during 1970–99 may be caused by an enhanced diabatic heating anomaly, offset partly by the increased mean static stability.
A Global Quasigeostrophic Diagnosis of Extratropical Extreme Precipitation
Authors: Dai Panxi , Nie Ji 
Published: August 2020

AbstractThis paper presents a global picture of the dynamic processes and synoptic characteristics of extratropical extreme precipitation events (EPEs), defined as annual maximum daily precipitation averaged over 7.5° × 7.5° regional boxes. Based on the quasigeostrophic omega equation, extreme precipitation can be decomposed into components forced by large-scale adiabatic disturbances and amplified by diabatic heating feedback. The spatial distribution of the diabatic feedback parameter is largely controlled by atmospheric precipitable water and captured by a simple model. Most spatial heterogeneities of EPEs in the middle and high latitudes are due to the spatial variations of large-scale adiabatic forcing. The adiabatic component includes the processes of vorticity advection, in which the synoptic vorticity advection by background wind dominates; temperature advection, in which the total meridional temperature advection by synoptic wind dominates; and boundary forcing. The synoptic patterns of EPEs in all extratropical regions can be classified into six clusters using the self-organizing map method: two clusters in low latitudes and four clusters in middle and high latitudes. Synoptic disturbances are characterized by strong pressure anomalies throughout the troposphere over the coastal regions and oceans and feature upper-level shortwave disturbances and a large westward tilt with height over land. Synoptic configurations favor moisture transport from ocean to land over coastal regions.