bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of fatal and non-fatal cardiovascular events in young and middle-aged healthy workers: The IberScore model
Authors: Fernández-Labandera Carlos , Calvo-Bonacho Eva , Valdivielso Pedro , Quevedo-Aguado Luis , Martínez-Munoz Paloma , Catalina-Romero Carlos , Ruilope Luis M , Sánchez-Chaparro Miguel A 
Published: December 2019

Abstract

Aims
Our primary objective was to improve risk assessment for fatal and non-fatal cardiovascular events in a working population, mostly young and healthy.

Methods
We conducted a prospective cohort study to derive a survival model to predict fatal and non-fatal 10-year cardiovascular risk. We recruited 992,523 workers, free of diagnosed cardiovascular disease at entry, over six years, from 2004–2009. We divided the sample into two independent cohorts: a derivation one (626,515 workers; from 2004–2006) and a temporal validation one (366,008 workers; over 2007–2009). Then, we followed both cohorts over 10 years and registered all fatal and non-fatal cardiovascular events. We built a new risk calculator using an estimation of cardiovascular biological age as a predictor and named it IberScore. There were remarkable differences between this new model and Systematic Coronary Risk Evaluation (SCORE) (in both the specification and the equation).

Results
Over the 10-year follow-up, we found 3762 first cardiovascular events (6‰) in the derivation cohort. Most of them (80.3%) were non-fatal ischaemic events. If we had been able to use our model at the beginning of the study, we had classified in the ‘high-risk’ or ‘very high-risk’ groups 82% of those who suffered a cardiovascular event during the follow-up. All the post-estimation tests showed superior performance (true positive rate: 81.8% vs 11.8%), higher discrimination power and better clinical utility (standardised net benefit: 58% vs 13%) for IberScore when compared to SCORE.

Conclusion
Risk assessment of fatal and non-fatal cardiovascular events in young and healthy workers was improved when compared to the previously used model (SCORE). The latter was not reliable to predict cardiovascular risk in our sample. The new model showed superior clinical utility and provided four useful measures for risk assessment. We gained valuable insight into cardiovascular ageing and its predictors.
Use of healthcare services by patients with multiple sclerosis in France over 2010–2015: a nationwide population-based study using health administrative data
Authors: Roux J. , Guilleux A. , Lefort M. , Leray E. 
Published: December 2019

Background Most of the knowledge about people with multiple sclerosis (PwMS) in France comes from cohorts, which may suffer from recruitment bias or from the unique registry located in Lorraine, East France. Objective To describe use of care in the French population of PwMS, over 2010–2015. Methods All PwMS in the French national health data system (97% of the general population covered) were included. Demographics, and use of care were described (visits with general practitioners (GPs), neurologists, nurses, physiotherapists and hospitalisations). A focus on the neurological follow-up was also conducted. Results A total of 112,415 PwMS were identified (sex ratio F:M = 2.4, median age 46), of whom 5005 died during follow-up. The median numbers of visits with GPs and neurologists were 6.6 and 1.3 respectively per patient-year. Moreover, 53,457 (47.6%) received multiple sclerosis (MS) treatments; about 13% of patients had no neurological follow-up, and 81.8% had at least one hospitalisation. Conclusions For the first time in France, this exhaustive dataset offered the opportunity to provide objective figures regarding care practices for MS at the national level, without any selection bias. It also allowed description of patients with MS according to their neurological follow-up, especially those who were absent from cohorts led by neurologists.
Self-Perceptions of the Impact of Oral Problems on the Social Behavior of Preschoolers
Authors: Perazzo M.F. , Gomes M.C. , Neves É.T.B. , Firmino R.T. , Barros A.A. , Silva L.C. , Martins C.C. , Paiva S.M. , Granville-Garcia A.F. 
Published: December 2019

Introduction: Investigating preschool children’s social behaviors and the association with oral health variables helps to understand child development. Besides that, different perceptions need to be explored regarding the impact of oral problems on the social behavior between the child’s self-report and parent’s/caregiver’s proxy report. Objective: To determine which socioeconomic and oral factors are associated with difficulty sleeping and playing and the avoidance of smiling in preschoolers. Methods: A cross-sectional study was conducted with a representative random sample of 769 pairs of parents/caregivers and 5-y-old preschoolers. The preschoolers answered a questionnaire on difficulty sleeping, difficulty playing, and the avoidance of smiling for reasons related to oral problems. The parents/caregivers answered a questionnaire addressing socioeconomic characteristics as well as the use of dental services. Two calibrated dentists examined the children for the determination of dental caries, traumatic dental injury (TDI), malocclusion, and bruxism. Descriptive and Poisson regression analysis for complex samples with robust variance was used to test the associations (α = 5%). Results: The variables associated with difficulty sleeping were low household income (confidence interval [CI]: 1.40–3.01), number of untreated dental caries (CI, 1.02–1.04), dental pain (CI, 1.76–3.59), TDI (CI, 1.08–2.11), and anterior open bite (CI, 1.11–2.20). Difficulty playing also was associated with the low household income (CI, 1.34–3.15), number of untreated dental caries (CI, 1.01–1.04), dental pain (CI,1.42–3.61), and TDI (CI, 1.13–2.33). The number of untreated dental caries (CI, 1.02–1.05), dental pain (CI, 1.03–2.88), anterior open bite (CI, 1.30–3.26), and not using dental services (CI, 1.13–2.73) were determinant factors for the avoidance of smiling. Conclusion: Socioeconomic, symptomatic, and/or oral esthetic problems exerted an impact on the social behavior of the preschoolers analyzed, such as playing, sleeping, and smiling. Knowledge Transfer Statement: The results of the present study may help parents and clinicians to understand better the association of oral problems with the social behavior of preschool children. Moreover, this study shows the importance of listening to children in clinical decisions. These results also can help in the elaboration of oral health policies.
Genome-wide association study of morbid obesity in Han Chinese
Authors: Chiang Kuang-Mao , Chang Heng-Cheng , Yang Hsin-Chou , Chen Chien-Hsiun , Chen Hsin-Hung , Lee Wei-Jei , Pan Wen-Harn 
Published: December 2019

Abstract
Background
As obesity is becoming pandemic, morbid obesity (MO), an extreme type of obesity, is an emerging issue worldwide. It is imperative to understand the factors responsible for huge weight gain in certain populations in the modern society. Very few genome-wide association studies (GWAS) have been conducted on MO patients. This study is the first MO-GWAS study in the Han-Chinese population in Asia.

Methods
We conducted a two-stage GWAS with 1110 MO bariatric patients (body mass index [BMI] ≥ 35 kg/m2) from Min-Sheng General Hospital, Taiwan. The first stage involved 575 patients, and 1729 sex- and age-matched controls from the Taiwan Han Chinese Cell and Genome Bank. In the second stage, another 535 patients from the same hospital were genotyped for 52 single nucleotide polymorphisms (SNPs) discovered in the first stage, and 9145 matched controls from Taiwan Biobank were matched for confirmation analysis.

Results
The results of the joint analysis for the second stage revealed six top ranking SNPs, including rs8050136 (p-value = 7.80 × 10− 10), rs9939609 (p-value = 1.32 × 10− 9), rs1421085 (p-value = 1.54 × 10− 8), rs9941349 (p-value = 9.05 × 10− 8), rs1121980 (p-value = 7.27 × 10− 7), and rs9937354 (p-value = 6.65 × 10− 7), which were all located in FTO gene. Significant associations were also observed between MO and RBFOX1, RP11-638 L3.1, TMTC1, CBLN4, CSMD3, and ERBB4, respectively, using the Bonferroni correction criteria for 52 SNPs (p < 9.6 × 10− 4).

Conclusion
The most significantly associated locus of MO in the Han-Chinese population was the well-known FTO gene. These SNPs located in intron 1, may include the leptin receptor modulator. Other significant loci, showing weak associations with MO, also suggested the potential mechanism underlying the disorders with eating behaviors or brain/neural development.
The evolutionary history of the sucrose synthase gene family in higher plants
Authors: Xu Xiaoyang , Yang Yongheng , Liu Chunxiao , Sun Yuming , Zhang Ting , Hou Menglan , Huang Suzhen , Yuan Haiyan 
Published: December 2019

Abstract
Background
Sucrose synthase (SUS) is widely considered a key enzyme participating in sucrose metabolism in higher plants and regarded as a biochemical marker for sink strength in crops. However, despite significant progress in characterizing the physiological functions of the SUS gene family, knowledge of the trajectory of evolutionary processes and significance of the family in higher plants remains incomplete.

Results
In this study, we identified over 100 SUS genes in 19 plant species and reconstructed their phylogenies, presenting a potential framework of SUS gene family evolution in higher plants. Three anciently diverged SUS gene subfamilies (SUS I, II and III) were distinguished based on their phylogenetic relationships and unique intron/exon structures in angiosperms, and they were found to have evolved independently in monocots and dicots. Each subfamily of SUS genes exhibited distinct expression patterns in a wide range of plants, implying that their functional differentiation occurred before the divergence of monocots and dicots. Furthermore, SUS III genes evolved under relaxed purifying selection in dicots and displayed narrowed expression profiles. In addition, for all three subfamilies of SUS genes, the GT-B domain was more conserved than the “regulatory” domain.

Conclusions
The present study reveals the evolution of the SUS gene family in higher plants and provides new insights into the evolutionary conservation and functional divergence of angiosperm SUS genes.
Full-length transcriptome analysis of shade-induced promotion of tuber production in Pinellia ternata
Authors: Xue Tao , Zhang Han , Zhang Yuanyuan , Wei Shuqin , Chao Qiujie , Zhu Yanfang , Teng Jingtong , Zhang Aimin , Sheng Wei , Duan Yongbo , Xue Jianping 
Published: December 2019

Abstract
Background
Pinellia ternata is native to China and has been used as a traditional herb due to its antiemetic, antitussive, analgesic, and anxiolytic effects. When exposed to strong light intensity and high temperature during the reproductive growth process, P. ternata withers in a phenomenon known as “sprout tumble”, which largely limits tuber production. Shade was previously found to delay sprout tumble formation (STF); however, no information exists regarding this process at the molecular level. Hence, we determined the genes involved in tuber development and STF in P. ternata.

Results
Compared to that with natural sun-light (control), shade significantly induced chlorophyll accumulation, increased chlorophyll fluorescence parameters including initial fluorescence, maximal fluorescence, and qP, and dramatically repressed chlorophyll a:b and NPQ. Catalase (CAT) activity was largely induced by shade, and tuber products were largely increased in this environment. Transcriptome profiles of P. ternata grown in natural sun-light and shaded environments were analyzed by a combination of next generation sequencing (NGS) and third generation single-molecule real-time (SMRT) sequencing. Corrections of SMRT long reads based on NGS short reads yielded 136,163 non-redundant transcripts, with an average N50 length of 2578 bp. In total, 6738 deferentially-expressed genes (DEGs) were obtained from the comparisons, specifically D5S vs D5CK, D20S vs D20CK, D20S vs D5S, and D20CK vs D5CK, of which, 6384 DEGs (94.8%) were generated from the D20S vs D20CK comparison. Gene annotation and functional analyses revealed that these genes were related to auxin signal transduction, polysaccharide and sugar metabolism, phenylpropanoid biosynthesis, and photosynthesis. Moreover, the expression of genes enriched in photosynthesis appeared to be significantly altered by shade. The expression patterns of 16 candidate genes were consistent with changes in their transcript abundance as identified by RNA-Seq, and these might contribute to STF and tuber production.

Conclusion
The full-length transcripts identified in this study have provided a more accurate depiction of P. ternata gene transcription. Further, we identified potential genes involved in STF and tuber growth. Such data could serve as a genetic resource and a foundation for further research on this important traditional herb.
Ten-year experience with standardized non-operating room anesthesia with Sevoflurane for MRI in children affected by neuropsychiatric disorders
Authors: Mongodi Silvia , Ottonello Gaia , Viggiano Raffaelealdo , Borrelli Paola , Orcesi Simona , Pichiecchio Anna , Balottin Umberto , Mojoli Francesco , Iotti Giorgio Antonio 
Published: December 2019

AbstractBackgroundChildren require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population.MethodsRetrospective cohort study, university Hospital (January 2007–December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth’s penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis,p ≤ 0.05) and clinical judgment.ResultsOf 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%;p = 0.012). Complications’ rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score > 1 (OR 2.22, 95 CI% 1.30 to 3.77,p = 0.003), male sex (OR 1.73, 95% CI 1.07 to 2.81,p = 0.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06,p = 0.013). For respiratory complications, it increases with ASA score > 1 (OR 2.34, 95 CI% 1.19 to 4.73,p = 0.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78,p = 0.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41,p = 0.020). We had no major complications compromising patients’ outcome or requiring admission to ICU.ConclusionsSevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.
Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study
Authors: Hong Boohwi , Lee Sunyeul , Kim Yeojung , Lee Minhee , Youn Ann Misun , Rhim Hyun , Hong Seok-Hwan , Kim Yoon-Hee , Yoon Seok-Hwa , Lim Chaeseong 
Published: December 2019

Abstract
Background
Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital.

Methods
The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity.

Results
The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test (P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery.

Conclusions
There were no differences in 5-year overall survival between two groups in the cancer surgery.

Trial registration
Trial registration: CRIS KCT0004101. Retrospectively registered 28 June 2019.
Single-session esophagogastroduodenoscopy and endoscopic ultrasound using a forward-viewing radial scan ultrasonic endoscope
Authors: Uchida Daisuke , Kato Hironari , Matsumoto Kazuyuki , Ishihara Yuki , Matsumi Akihiro , Saragai Yosuke , Takada Saimon , Yabe Shuntaro , Muro Shinichiro , Tomoda Takeshi , Horiguchi Shigeru , Okada Hiroyuki 
Published: December 2019

AbstractBackgroundEndoscopic ultrasound is useful for obtaining high-resolution images of pancreaticobiliary diseases, but is not readily available for physical checkups. In this study, we evaluated the safety and efficacy of single-session esophagogastroduodenoscopy and endoscopic ultrasound in the detection of upper-gastrointestinal and pancreaticobiliary diseases using a forward-viewing radial scan ultrasonic endoscope.MethodsA total of 148 patients who were scheduled for upper-gastrointestinal screening using an endoscope were prospectively included. All patients were examined by EUS in combination with EGD using a forward-viewing radial scan ultrasonic endoscope. The primary endpoint was the safety of the procedures. The secondary endpoints were the prevalence of diseases, the basal imaging capability of EUS, the procedure time, total dose of propofol, and the correlation between background factors and the prevalence of pancreatic disease. The imaging capability at each region was scored as 0 (invisible) to 2 (sufficient visualization to evaluate the organs).ResultsIntraoperative hypotension occurred as an adverse event of intravenous anesthesia in one patient. There were 82 pancreaticobiliary findings and 165 upper-gastrointestinal findings (malignancy not included). Follicular lymphoma of the intra-abdominal lymph nodes was detected in one patient. The mean imaging scores of each section were 1.95 (pancreatic head and papilla), 2.0 (pancreatic body), 1.99 (pancreatic tail), and 1.89 (common bile duct and gallbladder). Age, history of diabetes mellitus, and smoking history were significantly associated with the prevalence of pancreatic diseases.ConclusionThe simultaneous performance of EGD and EUS using a new ultrasonic endoscope is tolerable and safe for upper-gastrointestinal and pancreaticobiliary screening.
The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea
Authors: Byun Seong-Eun , Kwon Kyeu Back , Kim Sang Ho , Lim Seung-Jae 
Published: December 2019

Abstract
Background
Dysphagia is prevalent in geriatric patients, such as elderly hip fracture patients, and is associated with a poor prognosis. This study investigated (1) the prevalence of dysphagia based on clinical screening and a video-fluoroscopic swallowing study (VFSS), (2) the risk factors of dysphagia, and (3) the prognostic implications of dysphagia in elderly patients (≥ 65 years) undergoing hip fracture surgery.

Methods
In this retrospective study, data from 393 female and 153 male patients ≥65 years of age who underwent surgery for a hip fracture between 2015 and 2018 were analysed. Patients who were considered at high risk of dysphagia after screening underwent a VFSS. To identify risk factors of dysphagia, demographic factors, the American Society of Anesthesiologists classification, past medical history, known risk factors of dysphagia, and factors associated with surgery were analysed using a binary logistic regression model. Odds ratios (ORs) of dysphagia for having poor prognosis including postoperative pneumonia, intensive care unit (ICU) admission, and death within 6 months after surgery were obtained by logistic regression. The association of postoperative pneumonia with poor prognosis was also analysed.

Results
Dysphagia was seen in 5.3% of hip fracture patients. In multivariate regression analysis, a serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia (OR [95%CI] = 3.13 [1.40, 7.01]). Dysphagia was identified as a risk factor for postoperative pneumonia in regression analysis after adjustment (OR [95%CI] = 3.12 [1.05, 9.27]). Postoperative pneumonia was significantly associated with ICU admission (OR [95% CI] = 4.56 [1.85, 11.28]) and death within 6 months after surgery (OR [95% CI] = 2.56 [1.03, 6.33]).

Conclusions
Dysphagia in elderly hip fracture surgery patients was associated with postoperative pneumonia, a risk factor for poor outcomes including ICU admission and death within 6 months after surgery. A serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia. Therefore, diagnostic testing should be performed to detect dysphagia, especially in patients with a low serum albumin level. Finally, particular care should be taken to prevent postoperative complications in patients with dysphagia.