bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parity, lactation, and long‐term weight change in Mexican women
Authors: Mazariegos Mónica , Ortiz‐Panozo Eduardo , González de Cosío Teresita , Lajous Martín , López‐Ridaura Ruy 
Published: March 2020

AbstractOne post‐partum behaviour that may be protective against post‐partum weight retention and long‐term weight gain among women of reproductive age is lactation because of its potential role in resetting maternal metabolism after pregnancy. However, most of the evidence focuses on weight retention at 6, 12, or 24 months post‐partum, and data beyond 2 years after birth are sparse, and findings are inconclusive. Therefore, our aim was to assess the association of parity and mean duration of lactation per child with long‐term weight change in Mexican women. We assessed the association of parity and mean duration of lactation per child with long‐term weight change in 75,421 women from the Mexican Teachers' Cohort. Several multivariable regression models were fit to assess these associations. We also examined the non‐linear association between duration of lactation and weight change using restricted cubic splines. We found that parous women (≥4 children) gained 2.81 kg more (95% CI [2.52, 3.10]) than did nulliparous women. The association between mean duration of lactation per child and weight change appeared to be non‐linear. Women who breastfed on average 3–6 months per child had lower gain weight (−1.10, 95% CI [−1.58, −0.47 kg]) than had women who did not breastfeed. This association was linear up to 6 months of lactation per child. Our findings suggest that parity alters weight‐gain trajectory in women and that lactation could reduce this alteration. These findings are important in the prevention of excessive weight gain through reproductive years and their future health implications.
Clinical management of very small pigmented lesions: Improved clinical outcome through dermoscopy and reflectance confocal microscopy combination
Authors: Persechino Flavia , Franceschini Chiara , Iorio Alessandra , Carbone Anna , Ferrari Angela , Buccini Pierluigi , Piemonte Paolo , Eibenschutz Laura , Sperduti Isabella , Cota Carlo , Frascione Pasquale , Ardigo Marco 
Published: March 2020

AbstractIntroductionSmall‐sized pigmented lesions (SSPL) <3 mm in diameter are common pitfall in the daily dermatology practice. Dermoscopy alone is hampered by the lack of specific features inversely proportional to the diameter of the lesions and its performance is highly operator‐dependent. Reflectance confocal microscopy (RCM) has been demonstrated to be effective in the diagnosis of several difficult lesions where dermoscopy lacks to provide conclusive information.Materials and MethodsA total of 179 lesions with uncertain or equivocal clinical and dermoscopy appearance were selected. Dermoscopist has been requested to express a diagnostic suspect when possible. Equivocal lesions underwent RCM performed by expert for second‐level evaluation before surgical excision for histological diagnosis. Results have been later statistically analysed.ResultsDermoscopy was not diagnostic in large number of lesions with low concordance histology (39.1%) instead of a much high concordance when combined with RCM (93.9%).ConclusionsSmall‐sized pigmented lesions were more likely to be located on the face area. Diagnosis of pigmented BCC was relatively easy on dermoscopy and also in the case of small lesions showing typical signs of BCC. LM and MM have been seen to be particularly difficult to be diagnosed using only dermoscopy. The combination of digital dermoscopy and RCM represents the correct approach of SSPL.
Temperature Dependence of the Friction Coefficient of Grease-Lubricated PTFE Linear Bushings Against Titanium Grade 5 Alloy (Ti6Al4V) and Life Tests Operating at High-Speed
Authors: Valiente-Blanco I. , Perez-Diaz J. L. , Perez-del-Alamo J. L. , Diez-Jimenez E. 
Published: March 2020

Abstract
Linear bushings are a compact and reliable solution for mechanisms requiring relative linear displacement between moving parts. In this paper, we report the dependence of the coefficient of friction (COF) of polytetrafluoroethylene (PTFE) grease-lubricated bushings against a Ti6Al4 V (grade 5) alloy shaft at high temperatures up to 200 °C, for a motion speed of up to 0.47 m/s and a load pressure of 0.8 MPa. A proportional sensitivity of the COF with temperature is observed due to the change in the viscosity of the grease lubricant. Results of survival tests are also reported demonstrating a total sliding distance of 3200 m without maintenance and a total a total sliding distance of 10,200 m without critical failure.
Protocol for a prospective, observational, longitudinal study in paediatric patients with moderate-to-severe atopic dermatitis (PEDISTAD): study objectives, design and methodology
Authors: Paller Amy S , Guttman-Yassky Emma , Irvine Alan D , Baselga Eulalia , de Bruin-Weller Marjolein , Jayawardena Shyamalie , Zhang Annie , Mina-Osorio Paola , Rizova Elena , Ozturk Zafer E 
Published: March 2020

IntroductionAtopic dermatitis (AD) is a chronic inflammatory skin disease often associated with atopic comorbidities and has significant impact on children and their families. There is a lack of robust and longitudinal long-term data on disease characteristics and typical clinical practice with currently available treatments in children with moderate-to-severe AD. Hence, an observational study is needed to evaluate AD characteristics and progression in paediatric patients with moderate-to-severe AD.Methods and analysisPediatric Study in Atopic Dermatitis (PEDISTAD) is a prospective, observational, longitudinal study in paediatric patients with moderate-to-severe AD who are currently receiving systemic or topical treatment and whose disease is not adequately controlled by topical prescription therapies or for whom those therapies are not medically advisable. 1300 children at 100–150 sites in approximately 20 countries worldwide will be enrolled and followed for 5 years. AD therapy is at the discretion of the investigator. Data collected will include: AD disease characteristics and comorbidities; current therapy for AD and initiation of new treatments/changes in current treatment; patient-reported/caregiver-reported outcomes; days missed from school/work for the patient/caregiver; healthcare professional visits; safety and biomarkers.Ethics and disseminationThis study is conducted in accordance with the principles established by the 18th World Medical Assembly and all subsequent amendments and the guidelines for Good Epidemiology Practice. Each individual country assures that ethics approval has been received and local regulatory requirements are met. Ethics approval has been obtained in all countries currently participating in PEDISTAD. Study data will be disseminated in manuscripts submitted to peer-reviewed medical journals as well as in abstracts submitted to congresses and in the resulting posters and presentations.Trial registration numberNCT03687359; pre-results.
Does Gleason score of positive surgical margin after radical prostatectomy affect biochemical recurrence and oncological outcomes? Protocol for systematic review
Authors: John Athul , O'Callaghan Michael , Catterwell Rick , Selth Luke A 
Published: March 2020

IntroductionPositive surgical margins (PSM) in cancer patients are commonly associated with worse prognosis and a higher risk of secondary treatment. However, the relevance of this parameter in prostate cancer patients undergoing radical prostatectomy (RP) remains controversial, given the inconsistencies in its ability to predict biochemical recurrence (BCR) and oncological outcomes. Hence, further assessment of the utility of surgical margins for prostate cancer prognosis is required to predict these outcomes more accurately. Over the last decade, studies have used the Gleason score (GS) of positive margins to predict outcomes. Herein, the authors aim to conduct a systematic review investigating the role of GS of PSM after radical prostatectomy in predicting BCR and oncological outcomes.Methods and analysisWe will perform a search using MEDLINE, EMBASE, SCOPUS and COCHRANE databases. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will screen titles and abstracts to select articles appropriate for full-text review. Studies discussing GS of PSM after RP will be included. Given the change in reporting of GS, only articles from 2005 to 2019 will be included. The quality of the studies chosen will be assessed using the Newcastle Ottawa tool for non-randomised and Cochrane risk of bias for randomised control studies. We will adopt the grading of recommendations, assessment, development and evaluation framework to comment on quality of cumulative evidence. The primary outcome measure will be time to BCR. Secondary outcome measures include secondary treatment, disease-specific survival, disease progression-free and overall mortality at follow-up period. We aim to perform a meta-analysis if the level of heterogeneity is acceptable (I2<50%).Ethics and disseminationThe review does not require ethics approval as it is a review of published literature. The findings of the review will be submitted for peer-reviewed publications and presented at scientific meetings.PROSPERO registration numberCRD42019131800.
Experiences of accessing and using breast cancer services in Vietnam: a descriptive qualitative study
Authors: Jenkins Chris , Ngan Tran Thu , Ngoc Nguyen Bao , Hien Ho Thi , Anh Nguyen Hoang , Lohfeld Lynne , Donnelly Michael , Van Minh Hoang , Murray Liam 
Published: March 2020

ObjectivesTo understand, describe and analyse the experiences of women with breast cancer in Vietnam when accessing and using breast cancer services.DesignDescriptive qualitative study. Women were interviewed about their experiences from the first time they became aware of symptoms or changes to their body through treatment and post-treatment. This study is the first descriptive study on breast cancer in Vietnam from the perspective of women with a breast cancer diagnosis.ParticipantsWomen (n=13) who had completed or were still receiving treatment for breast cancer, purposively recruited from the north and south of Vietnam.ResultsAn analysis of the experiences of women with breast cancer in Vietnam revealed a lack of awareness and knowledge about breast cancer and symptoms. Family and social support were described as key factors influencing whether a woman accesses and uses breast cancer services. Cost of treatment and out-of-pocket expenditures limited access to services and resulted in significant financial challenges for women and their families.ConclusionsVietnam has made huge strides in improving cancer care, and is tackling a complex and expanding public health challenge, however, there are a number of areas requiring strengthening and future research. While Vietnam has successfully expanded social health insurance coverage, changes that increase the percentage of costs covered for specific treatments, such as chemotherapy or radiotherapy, could benefit women and their families.
Accuracy of medical billing data against the electronic health record in the measurement of colorectal cancer screening rates
Authors: Rudrapatna Vivek A , Glicksberg Benjamin S , Avila Patrick , Harding-Theobald Emily , Wang Connie , Butte Atul J 
Published: March 2020

ObjectiveMedical billing data are an attractive source of secondary analysis because of their ease of use and potential to answer population-health questions with statistical power. Although these datasets have known susceptibilities to biases, the degree to which they can distort the assessment of quality measures such as colorectal cancer screening rates are not widely appreciated, nor are their causes and possible solutions.MethodsUsing a billing code database derived from our institution’s electronic health records, we estimated the colorectal cancer screening rate of average-risk patients aged 50–74 years seen in primary care or gastroenterology clinic in 2016–2017. 200 records (150 unscreened, 50 screened) were sampled to quantify the accuracy against manual review.ResultsOut of 4611 patients, an analysis of billing data suggested a 61% screening rate, an estimate that matches the estimate by the Centers for Disease Control. Manual review revealed a positive predictive value of 96% (86%–100%), negative predictive value of 21% (15%–29%) and a corrected screening rate of 85% (81%–90%). Most false negatives occurred due to examinations performed outside the scope of the database—both within and outside of our institution—but 21% of false negatives fell within the database’s scope. False positives occurred due to incomplete examinations and inadequate bowel preparation. Reasons for screening failure include ordered but incomplete examinations (48%), lack of or incorrect documentation by primary care (29%) including incorrect screening intervals (13%) and patients declining screening (13%).ConclusionsBilling databases are prone to substantial bias that may go undetected even in the presence of confirmatory external estimates. Caution is recommended when performing population-level inference from these data. We propose several solutions to improve the use of these data for the assessment of healthcare quality.
Relationship between regional left ventricular dysfunction and cancer-therapy-related cardiac dysfunction
Authors: Saijo Yoshihito , Kusunose Kenya , Okushi Yuichiro , Yamada Hirotsugu , Toba Hiroaki , Sata Masataka 
Published: March 2020

ObjectiveThe aim of our study was to assess the association between risk of cancer-therapy-related cardiac dysfunction (CTRCD) after first follow-up and the difference in echocardiographic measures from baseline to follow-up.MethodsWe retrospectively enrolled 87 consecutive patients (58±14 years, 55 women) who received anthracycline and underwent echocardiographic examinations both before (baseline) and after initial anthracycline administration (first follow-up). We measured absolute values of global longitudinal strain (GLS), apical longitudinal strain (LS), mid-LS and basal-LS at baseline and first follow-up, and per cent changes (Δ) of these parameters were calculated. Among 61 patients who underwent further echocardiographic examinations (second follow-up, third follow-up, etc), we assessed the association between regional left ventricular (LV) systolic dysfunction from baseline to follow-up and development of CTRCD, defined as LV ejection fraction (LVEF) under 53% and more absolute decrease of 10% from baseline, after first follow-up.ResultsLVEF (65%±4% vs 63±4%, p=0.004), GLS (23.2%±2.6% vs 22.2±2.4%, p=0.005) and basal-LS (21.9%±2.5% vs 19.9±2.4%, p<0.001) at first follow-up significantly decreased compared with baseline. Among the 61 patients who had further follow-up echocardiographic examinations, 13% developed CTRCD. In the Cox-hazard model, worse Δbasal-LS was significantly associated with CTRCD. By Kaplan–Meier analysis, patients with Δbasal-LS decrease of more than the median value (−9.7%) had significantly worse event-free survival than those with a smaller decrease (p=0.015).ConclusionsBasal-LS significantly decreased prior to development of CTRCD, and worse basal-LS was associated with development of CTRCD in patients receiving anthracycline chemotherapy.
Sibling history is associated with heart failure after a first myocardial infarction
Authors: Glinge Charlotte , Oestergaard Louise , Jabbari Reza , Rossetti Sara , Skals Regitze , Køber Lars , Engstrøm Thomas , Bezzina Connie R , Torp-Pedersen Christian , Gislason Gunnar , Tfelt-Hansen Jacob 
Published: March 2020

ObjectiveMorbidity and mortality due to heart failure (HF) as a complication of myocardial infarction (MI) is high, and remains among the leading causes of death and hospitalisation. This study investigated the association between family history of MI with or without HF, and the risk of developing HF after first MI.MethodsThrough nationwide registries, we identified all individuals aged 18–50 years hospitalised with first MI from 1997 to 2016 in Denmark. We identified 13 810 patients with MI, and the cohort was followed until HF diagnosis, second MI, 3 years after index MI, emigration, death or the end of 2016, whichever occurred first. HRs were estimated by Cox hazard regression models adjusted for sex, age, calendar year and comorbidities (reference: patients with no family history of MI).ResultsAfter adjustment, we observed an increased risk of MI-induced HF for those having a sibling with MI with HF (HR 2.05, 95% CI 1.02 to 4.12). Those having a sibling with MI without HF also had a significant, but lower increased risk of HF (HR 1.39, 95% CI 1.05 to 1.84). Parental history of MI with or without HF was not associated with HF.ConclusionIn this nationwide cohort, sibling history of MI with or without HF was associated with increased risk of HF after first MI, while a parental family history was not, suggesting that shared environmental factors may predominate in the determination of risk for developing HF.
Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database
Authors: Prionas Apostolos , Tsoulfas George , Tooulias Andreas , Papakoulas Apostolos , Piachas Athanasios , Papadopoulos Vasileios 
Published: March 2020

BackgroundAt present there is no organized trauma system in Greece and no national trauma database. The objective of this study was to record and evaluate trauma management at our university hospital and to measure the associated healthcare costs, while laying the foundations for a national database and the organization of regional trauma networks.MethodsRetrospective study of trauma patients (n=2320) between 2014 and 2015, through our single-center registry. Demographic information, injury patterns, hospital transfer, investigations, interventions, duration of hospitalization, Injury Severity Score (ISS), outcomes, complications and cost were recorded.ResultsRoad traffic collisions (RTC) accounted for 23.2% of traumas. The proportion of patients who were transferred to the hospital by the National Emergency Medical Services decreased throughout the study (n2015=76/1192 (6.38%), n2014=109/1128 (9.7%)) (p<0.05). 1209 (52.1%) of our trauma patients did not meet the US trauma field triage algorithm criteria. Overtriage of trauma patients to our facility ranged from 90.7% to 96.7%, depending on the criteria used (clinical vs. ISS criteria). Ninety-one (3.9%) of our patients received operative management. Intensive care unit admissions were 21 (0.1%). Seventy-six (3.3%) of our patients had ISS>15 and their mortality was 31.6%. The overall non-salary cost for trauma management was €623 140. 53% of these costs were attributed to RTCs. The cost resulting from the observed overtriage ranged from €121 000 to €315 000. Patients who did not meet the US trauma triage algorithm criteria accounted for 10.5% of total expenses.DiscussionOur results suggest that RTCs pose a significant financial burden. The prehospital triage of trauma patients is ineffective. A reduction of costs could have been achieved if prehospital triage was more effective.Level of evidenceLevel IV.
Variability in skeletal muscle fibre characteristics during repeated muscle biopsy sampling in human vastus lateralis
Authors: Nederveen Joshua P. , Ibrahim George , Fortino Stephen A. , Snijders Tim , Kumbhare Dinesh , Parise Gianni 
Published: March 2020

The percutaneous muscle biopsy procedure is an invaluable tool for characterizing skeletal muscle and capillarization. Little is known about methodological or biological variation stemming from the technique in heterogeneous muscle. Five muscle biopsies were taken from the vastus lateralis of a group of young men (n = 29, 22 ± 1 years) over a 96-h period. We investigated the repeatability of fibre distribution, indices of muscle capillarization and perfusion, and myofibre characteristics. No differences between the biopsies were reported in myofibre type distribution, cross-sectional area (CSA), and perimeter. Capillary-to-fibre perimeter exchange index and individual capillary-fibre contacts were unchanged with respect to the location of the muscle biopsy and index of capillarization. The variability in the sampling distribution of fibre type specific muscle CSA increased when fewer than 150 muscle fibres were quantified. Variability in fibre type distribution increased when fewer than 150 muscle fibres were quantified. Myofibre characteristics and indices of capillarization are largely consistent throughout the vastus lateralis when assessed via the skeletal muscle biopsy technique. Novelty Markers of muscle capillarization and perfusion were unchanged across multiple sites of the human vastus lateralis. Myofibre characteristics such as muscle cross-sectional area, perimeter, and fibre type distribution were also unchanged. Variation of muscle CSA was higher when fewer than 150 muscle fibres were quantified.
The Frequency of Ras Mutations in Cancer
Authors: Prior Ian A. , Hood Fiona E. , Hartley James L. 
Published: March 2020

AbstractRas is frequently mutated in cancer, however, there is a lack of consensus in the literature regarding the cancer mutation frequency of Ras, with quoted values varying from 10%–30%. This variability is at least in part due to the selective aggregation of data from different databases and the dominant influence of particular cancer types and particular Ras isoforms within these datasets. To provide a more definitive figure for Ras mutation frequency in cancer, we cross-referenced the data in all major publicly accessible cancer mutation databases to determine reliable mutation frequency values for each Ras isoform in all major cancer types. These percentages were then applied to current U.S. cancer incidence statistics to estimate the number of new patients each year that have Ras-mutant cancers. We find that approximately 19% of patients with cancer harbor Ras mutations, equivalent to approximately 3.4 million new cases per year worldwide. We discuss the Ras isoform and mutation-specific trends evident within the datasets that are relevant to current Ras-targeted therapies.
Optimization of T-cell Receptor–Modified T Cells for Cancer Therapy
Authors: Drakes Dylan J. , Rafiq Sarwish , Purdon Terence J. , Lopez Andrea V. , Chandran Smita S. , Klebanoff Christopher A. , Brentjens Renier J. 
Published: March 2020

AbstractT-cell receptor (TCR)–modified T-cell gene therapy can target a variety of extracellular and intracellular tumor-associated antigens, yet has had little clinical success. A potential explanation for limited antitumor efficacy is a lack of T-cell activation in vivo. We postulated that expression of proinflammatory cytokines in TCR-modified T cells would activate T cells and enhance antitumor efficacy. We demonstrate that expression of interleukin 18 (IL18) in tumor-directed TCR-modified T cells provides a superior proinflammatory signal than expression of interleukin 12 (IL12). Tumor-targeted T cells secreting IL18 promote persistent and functional effector T cells and a proinflammatory tumor microenvironment. Together, these effects augmented overall survival of mice in the pmel-1 syngeneic tumor model. When combined with sublethal irradiation, IL18-secreting pmel-1 T cells were able to eradicate tumors, whereas IL12-secreting pmel-1 T cells caused toxicity in mice through excessive cytokine secretion. In another xenograft tumor model, IL18 secretion enhanced the persistence and antitumor efficacy of NY-ESO-1–reactive TCR-modified human T cells as well as overall survival of tumor-bearing mice. These results demonstrate a rationale for optimizing the efficacy of TCR-modified T-cell cancer therapy through expression of IL18.See related commentary by Wijewarnasuriya et al., p. 732