bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaporite weathering and deposition as a long-term climate forcing mechanism
Authors: Shields Graham A. , Mills Benjamin J.W. 
Published: November 2020

AbstractAlthough it is widely accepted that Earth’s long-term surface temperature is regulated by the mutual dependence of silicate weathering and climate on CO2, the root causes of some climatic events remain unresolved. We show here for the first time that imbalances between evaporite weathering and deposition can affect climate through the process of carbonate sedimentation. Calcium sulfate weathering supplies Ca2+ ions to the ocean unaccompanied by carbonate alkalinity, so that increased carbonate precipitation strengthens greenhouse forcing through transfer of CO2 to the atmosphere. Conversely, calcium sulfate deposition weakens greenhouse forcing, while the high depositional rates of evaporite giants may overwhelm the silicate weathering feedback, causing several degrees of planetary cooling. Non-steady-state evaporite dynamics and related feedbacks have hitherto been overlooked as drivers of long-term carbon cycle change. Here, we illustrate the importance of evaporite deposition, in particular, by showing how a series of massive depositional events contributed to global cooling during the mid–late Miocene.
Two-year outcomes after dextrose gel prophylaxis for neonatal hypoglycaemia
Authors: Griffith Rebecca , Hegarty Joanne Elizabeth , Alsweiler Jane M , Gamble Greg D , May Robyn , McKinlay Christopher Joel Dorman , Thompson Benjamin , Wouldes Trecia Ann , Harding Jane E 
Published: November 2020

ObjectiveTo determine the effect of prophylactic dextrose gel for prevention of neonatal hypoglycaemia on neurodevelopment and executive function at 2 years’ corrected age.DesignProspective follow-up of a randomised trial.SettingNew Zealand.PatientsParticipants from the pre-hypoglycaemia Prevention with Oral Dextrose (pre-hPOD) trial randomised to one of four dose regimes of buccal 40% dextrose gel or equivolume placebo.Main outcome measuresCoprimary outcomes were neurosensory impairment and executive function. Secondary outcomes were components of the primary outcomes, neurology, anthropometry and health measures.ResultsWe assessed 360 of 401 eligible children (90%) at 2 years’ corrected age. There were no differences between dextrose gel dose groups, single or multiple dose groups, or any dextrose and any placebo groups in the risk of neurosensory impairment or low executive function (any dextrose vs any placebo neurosensory impairment: relative risk (RR) 0.77, 95% CI 0.50 to 1.19, p=0.23; low executive function: RR 0.50, 95% CI 0.24 to 1.06, p=0.07). There were also no differences between groups in any secondary outcomes. There was no difference between children who did or did not develop neonatal hypoglycaemia in the risk of neurosensory impairment (RR 1.05, 95% CI 0.68 to 1.64, p=0.81) or low executive function (RR 0.73, 95% CI 0.34 to 1.59, p=0.43).ConclusionProphylactic dextrose gel did not alter neurodevelopment or executive function and had no adverse effects to 2 years’ corrected age, but this study was underpowered to detect potentially clinically important effects on neurosensory outcomes.
Gestational breast cancer: current challenges in staging and treatment of breast cancer
Authors: Schad Aimee , Slostad Jessica , Rao Ruta 
Published: November 2020

Gestational breast cancer (GBC) is the most common form of invasive cancer in pregnancy and has unique challenges in both staging and treatment given the dual goal of appropriate cancer management and minimising the risk of fetal toxicity. A 38-year-old woman with no significant medical history and 21 weeks pregnant presented with a palpable right breast mass. She was diagnosed with human epidermal growth factor receptor 2-positive infiltrating ductal carcinoma with advanced disease. The patient underwent treatment; however, unfortunately, she passed away after developing devastating distant disease recurrence.We highlight both the challenges and current guidelines for management of GBC. Our goal is to discuss the current limitations of GBC management and the necessity of further investigation for safe novel imaging and treatment modalities for pregnant women. It is crucial to increase awareness across multiple subspecialities, as a multidisciplinary team is necessary for proper treatment of GBC.
Burnout and work-related stressors in gastroenterology: a protocol for a multinational observational study in the ASEAN region
Authors: Ong John , Ong Andrew Ming Liang , Ong Sharon , Xin Xiaohui , Lee Yeong Yeh , Pausawasdi Nonthalee , De Lusong Mark Anthony , Makmun Dadang , Chong Vui Heng , Ho Shiaw Hooi , Lim Wan Yen , Koh Calvin Jianyi , Ong David , Khor Christopher , Dan Yock Young 
Published: November 2020

BackgroundClinician burnout is an important occupational hazard that may be exacerbated by the novel COVID-19 pandemic. Within Southeast Asia, burnout in gastroenterology is understudied. The primary objective of this study is to estimate the prevalence of burnout symptoms within gastroenterology, in member states of the Associations of Southeast Asian Nations (ASEAN), during and after the COVID-19 pandemic. The secondary objective is to identify work-related stressors that contribute to burnout in ASEAN gastroenterologists.Methods and analysisThis is an observational study that will use anonymised online surveys to estimate the prevalence of burnout symptoms at two time points: during the COVID-19 pandemic in 2020 and in 2022 (assumed to be after the pandemic). Gastroenterologists from Singapore, Malaysia, Thailand, Indonesia, Philippines and Brunei will be invited to participate in the online survey through their national gastroenterology and endoscopy societies. Burnout will be assessed using the Maslach Burnout Inventory-Human Services Survey tool. Supplementary questions will collect demographic and qualitative data. Associations between demographic characteristics and burnout will be tested by multiple regression.ResultsThe prevalence of burnout symptoms in gastroenterology during the COVID-19 pandemic, and the baseline prevalence after COVID-19, will be established in the above-mentioned countries. Work-related stressors commonly associated with burnout will be identified, allowing the introduction of preventative measures to reduce burnout in the future.Ethics and disseminationEthical approval was granted by the Singhealth Centralised Institutional Review Board (2020/2709). Results will be submitted for publication.
Prevalence and factors associated with overweight and obesity among patients with type 2 diabetes mellitus in Uganda—a descriptive retrospective study
Authors: Tino Salome , Mayanja Billy N , Mubiru Michael Charles , Eling Emmanuel , Ddumba Edward , Kaleebu Pontiano , Nyirenda Moffat 
Published: November 2020

ObjectivesTo assess the prevalence and risk factors of overweight and obesity among type 2 diabetes mellitus (T2DM) patients in Uganda.DesignRetrospective chart review.SettingThis study was conducted in the outpatient’s T2DM clinic in St. Francis Hospital—Nsambya, Uganda between March and May 2017.ParticipantsType 2 diabetes patients registered in the diabetes clinic between July 2003 and September 2016.Outcome measuresOverweight and obesity defined as body mass index (kg/m2) of 25.0–29.9 and obesity as 30.0 or higher.ResultsOf 1275 T2DM patients, the median age was 54 (IQR: 44–65) years, 770 (60.40%) were females, 887 (69.6%) had hypertension, 385 (28%) had controlled glycaemia, 349 (27%) were obese, while 455 (36%) were overweight. Overweight/obesity were lower among men (OR: 0.45, 95% CI: 0.340 to 0.593, p≤0.001) and among patients aged ≥65 years (OR: 0.52, 95% CI: 0.350 to 0.770, p=0.001); patients who rarely ate fruits and vegetables (OR: 0.66, 95% CI: 0.475 to 0.921, p=0.014) but higher among patients of middle (OR: 1.83, 95% CI: 1.320 to 2.550, p≤0.001) and upper (OR: 2.10, 95% CI: 1.450 to 2.990, p≤0.001) socioeconomic status; on dual therapy (OR: 2.17, 95% CI: 1.024 to 4.604, p=0.043); with peripheral neuropathy (OR: 1.40, 95% CI: 1.039 to 1.834, p=0.026) and hypertension (OR: 1.70, 95% CI: 1.264 to 2.293, p≤0.001).ConclusionsOverweight and obesity are high among T2DM patients in this population and may contribute significantly to poor outcomes of T2DM. Therefore, strategies to address this problem are urgently needed.
Exercise for people living with frailty and receiving haemodialysis: a mixed-methods randomised controlled feasibility study
Authors: Young Hannah M L , March Daniel S , Highton Patrick J , Graham-Brown Matthew P M , Churchward Darren C , Grantham Charlotte , Goodliffe Samantha , Jones William , Cheung Mei-Mei , Greenwood Sharlene A , Eborall Helen C , Conroy Simon , Singh Sally J , Smith Alice C , Burton James O 
Published: November 2020

ObjectivesFrailty is highly prevalent in haemodialysis (HD) patients, leading to poor outcomes. This study aimed to determine whether a randomised controlled trial (RCT) of intradialytic exercise is feasible for frail HD patients, and explore how the intervention may be tailored to their needs.DesignMixed-methods feasibility.Setting and participantsPrevalent adult HD patients of the CYCLE-HD trial with a Clinical Frailty Scale Score of 4–7 (vulnerable to severely frail) were eligible for the feasibility study.InterventionsParticipants in the exercise group undertook 6 months of three times per week, progressive, moderate intensity intradialytic cycling (IDC).OutcomesPrimary outcomes were related to feasibility. Secondary outcomes were falls incidence measured from baseline to 1 year following intervention completion, and exercise capacity, physical function, physical activity and patient-reported outcomes measured at baseline and 6 months. Acceptability of trial procedures and the intervention were explored via diaries and interviews with n=25 frail HD patients who both participated in (n=13, 52%), and declined (n=12, 48%), the trial.Results124 (30%) patients were eligible, and of these 64 (52%) consented with 51 (80%) subsequently completing a baseline assessment. n=24 (71% male; 59±13 years) dialysed during shifts randomly assigned to exercise and n=27 (81% male; 65±11 years) shifts assigned to usual care. n=6 (12%) were lost to follow-up. The exercise group completed 74% of sessions. 27%–89% of secondary outcome data were missing. Frail HD patients outlined several ways to enhance trial procedures. Maintaining ability to undertake activities of daily living and social participation were outcomes of primary importance. Participants desired a varied exercise programme.ConclusionsA definitive RCT is feasible, however a comprehensive exercise programme may be more efficacious than IDC in this population.Trial registration numbersISRCTN11299707; ISRCTN12840463.
Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey
Authors: Pedersen Courtney J , Uddin Mohammad J , Saha Samir K , Darmstadt Gary L 
Published: November 2020

ObjectiveDescribe the pattern of atopic disease prevalence from infancy to adulthood.DesignCross-sectional household survey.SettingCommunity-based demographic surveillance site, Mirzapur, Bangladesh.Participants7275 individuals in randomly selected clusters within 156 villages.Primary and secondary outcome measuresThe 12-month prevalence of atopic dermatitis (by UK Working Party Criteria (UK criteria) and International Study of Asthma and Allergies in Childhood (ISAAC)), asthma and rhinitis (by ISAAC); disease severity (by ISAAC); history of ever receiving a medical diagnosis.ResultsChildren aged 2 years had the highest prevalence of atopic dermatitis—18.8% (95% CI 15.2% to 22.4%) by UK criteria and 14.9% (95% CI 11.6% to 18.1%) by ISAAC— and asthma (20.1%, 95% CI 16.4% to 23.8%). Prevalence of rhinitis was highest among 25–29 year olds (6.0%, (95% CI% 4.5 to 7.4%). History of a medical diagnosis was lowest for atopic dermatitis (4.0%) and highest for rhinitis (27.3%) and was significantly associated with severe disease compared with those without severe disease for all three conditions (atopic dermatitis: 30.0% vs 11.7%, p=0.015; asthma; 85.0% vs 60.4%, p<0.001; rhinitis: 34.2% vs 7.3%, p<0.001) and having a higher asset-based wealth score for asthma (29.7% (highest quintile) vs 7.5% (lowest quintile), p<0.001) and rhinitis (39.8% vs 12.5%, p=0.003). Prevalence of having>1 condition was highest (36.2%) at 2 years and decreased with age. Having atopic dermatitis (ISAAC) was associated with significantly increased odds ratios (OR) for comorbid asthma (OR 5.56 (95% CI 4.26 to 7.26)] and rhinitis (3.68 (95% CI 2.73 to 4.96)). Asthma and rhinitis were also strongly associated with each other (OR 8.39 (95% CI 6.48 to 10.86)).ConclusionsAtopic disease burden was high in this rural Bangladeshi population. Having one atopic condition was significantly associated with the presence of another. Low incidence of ever obtaining a medical diagnosis highlights an important opportunity to increase availability of affordable diagnosis and treatment options for all age groups.
Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study
Authors: Vishnubala Dane , Marino Katherine Rose , Pratten Margaret Kathryn , Pringle Andy , Griffin Steffan Arthur , Finn Gabrielle , Bazira Peter , Edwards Kimberley 
Published: November 2020

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.
Buccolingual Inclination of Canine and First and Second Molar Teeth and the Curve of Wilson in Different Sagittal Skeletal Patterns of Adults Using Cone-Beam Computed Tomography
Authors: Golshah Amin , Rezaei Navid , Heshmati Sara 
Published: November 2020

Objectives. This study aimed to assess the buccolingual inclination of canine and first and second molar teeth and the curve of Wilson in different sagittal skeletal patterns in untreated adults using cone-beam computed tomography (CBCT). Materials and Methods. Sixty-six CBCT scans of adults (mean age: 28.74 ± 5.25 years) were evaluated in this cross-sectional study. The images were standardized using the Frankfurt horizontal plane and the interorbital line. The sagittal skeletal pattern was determined using the ANB angle and Wits appraisal. Inclination angles were measured by NNT Viewer and Mimics software. The curve of Wilson was measured by connecting the tips of mesiobuccal and mesiolingual cusps of maxillary first and second molars along the buccal groove and measuring the formed angle. Data were analyzed using ANOVA. Results. The intraobserver agreement was 0.969. The mean inclination of maxillary first and second molars in class I and III patients was significantly higher than that in class II patients

P
<
0.05

. The mean inclination of mandibular first and second molars in class II patients was significantly higher than that in class I and III patients

P
<
0.05

. The difference in inclination of maxillary and mandibular canine teeth was not significant

P
>
0.05

. The mean curve of Wilson in second molars of class II patients was significantly higher than that in class I patients

P
<
0.05

. Conclusion. In different sagittal skeletal patterns, a compensatory relationship exists between the opposing teeth, which, along with the standards of crowns, can be used to determine the appropriate position of teeth in dental arch.
Radiomic Detection of EGFR Mutations in NSCLC
Authors: Rossi Giovanni , Barabino Emanuele , Fedeli Alessandro , Ficarra Gianluca , Coco Simona , Russo Alessandro , Adamo Vincenzo , Buemi Francesco , Zullo Lodovica , Dono Mariella , De Luca Giuseppa , Longo Luca , Dal Bello Maria Giovanna , Tagliamento Marco , Alama Angela , Cittadini Giuseppe , Pronzato Paolo , Genova Carlo 
Published: November 2020

Abstract

Radiomics is defined as the use of automated or semi-automated post-processing and analysis of multiple features derived from imaging exams. Extracted features might generate models able to predict the molecular profile of solid tumors. The aim of this study was to develop a predictive algorithm to define the mutational status of EGFR in treatment-naïve patients with advanced non–small cell lung cancer (NSCLC). CT scans from 109 treatment-naïve patients with NSCLC (21 EGFR-mutant and 88 EGFR-wild type) underwent radiomics analysis to develop a machine learning model able to recognize EGFR-mutant from EGFR-WT patients via CT scans. A “test–retest” approach was used to identify stable radiomics features. The accuracy of the model was tested on an external validation set from another institution and on a dataset from the Cancer Imaging Archive (TCIA). The machine learning model that considered both radiomic and clinical features (gender and smoking status) reached a diagnostic accuracy of 88.1% in our dataset with an AUC at the ROC curve of 0.85, whereas the accuracy values in the datasets from TCIA and the external institution were 76.6% and 83.3%, respectively. Furthermore, 17 distinct radiomics features detected at baseline CT scan were associated with subsequent development of T790M during treatment with an EGFR inhibitor. In conclusion, our machine learning model was able to identify EGFR-mutant patients in multiple validation sets with globally good accuracy, especially after data optimization. More comprehensive training sets might result in further improvement of radiomics-based algorithms.

Significance:
These findings demonstrate that data normalization and “test–retest” methods might improve the performance of machine learning models on radiomics images and increase their reliability when used on external validation datasets.
Adaptação transcultural do Stroke Upper Limb Capacity Scale (SULCS): um instrumento de avaliação da capacidade manual em indivíduos com hemiparesia
Authors: Faria-Fortini Iza , Nunes Ciomara Maria Pérez , Bretas Gabriela dos Santos , Faria Christina Danielli Coelho de Morais , Scianni Aline Alvim , Teixeira-Salmela Luci Fuscaldi 
Published: November 2020

Após a ocorrência do Acidente Vascular Encefálico (AVE), é comum a presença de deficiências residuais, com potencial impacto na utilização dos membros superiores (MMSS) na realização de atividades cotidianas, consideradas essenciais para uma vida independente. O Stroke Upper Limb Capacity Scale (SULCS) avalia a função proximal e distal dos membros superiores de indivíduos pós-AVE por meio de 10 itens, hierarquicamente ordenados, que representam tarefas significativas relacionadas às atividades diárias realizadas em ambiente domiciliar. Objetivo: Adaptar transculturalmente o SULCS para uso no Brasil. Método: O processo de adaptação transcultural foi realizado em cinco estágios, seguindo procedimentos padronizados: tradução inicial, síntese das traduções, retrotradução, comitê de especialistas e aplicação da versão pré-final em 15 indivíduos pós-AVE. Resultados: As versões original e retrotraduzida apresentaram adequada equivalência semântica. O comitê de especialistas adequou a descrição dos itens às regras gramaticais da língua portuguesa. Em um item da escala, foi acrescentada observação sobre a forma de realização da tarefa, para equivalência experimental, e realizada adaptação do material de teste em três itens, para equivalência cultural. Não foram observadas dificuldades de compreensão dos itens no teste da versão pré-final. Conclusão: O SULCS-Brasil apresentou adequadas equivalências semântica, idiomática, cultural e experimental. Os resultados desse estudo viabilizam o uso do SULCS-Brasil como uma ferramenta para avaliação da capacidade dos membros superiores de indivíduos pós-AVE. Estudos futuros são necessários para continuidade do processo de validação da escala, a partir da investigação de outras propriedades de medida, tais como validade de construto e confiabilidade.
Loss of Endogenously Cycling Adult Cardiomyocytes Worsens Myocardial Function
Authors: Bradley Leigh A. , Young Alexander , Li Hongbin , Billcheck Helen O. , Wolf Matthew J. 
Published: November 2020

Rationale:
Endogenously cycling adult cardiomyocytes increase after myocardial infarction (MI) but remain scarce and are generally thought not to contribute to myocardial function. However, this broadly held assumption has not been tested, mainly because of the lack of transgenic reporters that restrict Cre expression to adult cardiomyocytes that reenter the cell cycle.

Objective:

We created and validated a new transgenic mouse,
αMHC
(alpha myosin heavy chain)
-MerDreMer-Ki67p-RoxedCre
(denoted
αDKRC
[cardiomyocyte-specific αMHC-MerDreMer-Ki67p-RoxedCre]) that restricts Cre expression to cycling adult cardiomyocytes and uniquely integrates spatial and temporal adult cardiomyocyte cycling events based on the DNA specificities of orthologous Dre and Cre recombinases. We then created
αDKRC::DTA
mice that expressed an inducible diphtheria toxin in adult cycling cardiomyocytes and examined the effects of ablating these endogenously cycling cardiomyocytes on myocardial function after ischemic-reperfusion (I/R) MI.

Methods and Results:

A tandem
αDKRC
transgene was designed, validated in cultured cells, and used to make transgenic mice. The
αDKRC
transgene integrated between
MYH6
and
MYH7
and did not disrupt expression of the surrounding genes. Compared with controls,
αDKRC::RLTG (Rox-Lox-tdTomato-eGFP
) mice treated with Tamoxifen expressed tdTomato+ in cardiomyocytes with rare Bromodeoxyuridine+, eGFP+ cardiomyocytes, consistent with reentry of the cell cycle. We then pretreated
αDKRC::RLTG
mice with Tamoxifen to activate the reporter before sham or reperfusion (I/R) MI surgeries. Compared with Sham surgery, the I/R MI group had increased single and paired eGFP+ (enhanced green fluorescent protein)+ cardiomyocytes predominantly in the border zones (5.8±0.5 versus 3.3±0.3 cardiomyocytes per 10-micron section, N=8–9 mice per group, n=16–24 sections per mouse), indicative of cycled cardiomyocytes. The single to paired eGFP+ cardiomyocyte ratio was ≈9 to 1 (5.2±0.4 single versus 0.6±0.2 paired cardiomyocytes) in the I/R MI group after MI, suggesting that cycling cardiomyocytes were more likely to undergo polyploidy than replication. The ablation of endogenously cycling adult cardiomyocytes in
αDKRC::DTA
(diphtheria) mice caused progressive worsening left ventricular chamber size and function after I/R MI, compared with controls.

Conclusions:
Although scarce, endogenously cycling adult cardiomyocytes contribute to myocardial function after injury, suggesting that these cells may be physiologically relevant.