bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are small renal masses all the same?
Authors: Tan Yu Guang , Khalid Mohamad Farhan Bin , Villanueva Andre , Huang Hong Hong , Chen Kenneth , Sim Allen Soon Phang 
Published: March 2020

ObjectivesTo evaluate variables that can predict synchronous metastasis in patients presenting with small renal masses.MethodsWe reviewed our institution’s prospectively maintained database of 565 patients diagnosed with small renal masses (≤4 cm) over a 16‐year period. Variables associated with synchronous metastasis and subsequent relapse were analyzed using χ2 and logistic regression models.ResultsA total of 16 patients (2.7%) presented with synchronous metastasis. Just three patients with tumor size <3 cm had metastatic disease at presentation. On multivariate analyses, tumor size >3 cm, symptomatic cancer, age >65 years and ipsilateral synchronous tumors were independent predictors of M1 renal cell carcinoma. A weighted predictive model (concordance index 0.786) showed that a score ≥2 significantly increases the risk of synchronous metastasis (7.9% vs <1% for score <2, P < 0.01, hazard ratio 12.56, 95% confidence interval 5.52–22.85). A total of 498 (90.7%) patients underwent nephrectomies, 27 (4.9%) had ablative therapies and 24 (4.4%) continued on active surveillance/watchful waiting. Over a median follow‐up period of 62.8 months, 30 patients (6.1%) had disease recurrence. On multivariate analyses, higher Fuhrman grade and lymphovascular invasion were independent predictors of recurrence. A separate predictive model (concordance index 0.723) showed that either pathological outcome increases recurrence risk up to 15% (P < 0.01, hazard ratio 11.83, 95% confidence interval 5.82–18.76).ConclusionsSeveral clinical variables can better identify the metastatic potential of small renal masses. The two proposed predictive models can be valuable tools in future clinical practice.
PTBP1 modulates osteosarcoma chemoresistance to cisplatin by regulating the expression of the copper transporter SLC31A1
Authors: Cheng Cheng , Ding Qiuyue , Zhang Zhicai , Wang Shangyu , Zhong Binlong , Huang Xin , Shao Zengwu 
Published: March 2020

AbstractChemoresistance is the main obstacle of treatment in patients with osteosarcoma. RNA‐binding protein PTBP1 has been identified as an oncogene in various cancers. However, the role of PTBP1 in osteosarcoma, especially in chemoresistant osteosarcoma, and the underlying mechanism remain unclear. In this study, we aimed to explore the functions of PTBP1 in chemoresistance of osteosarcoma. We found that PTBP1 was significantly increased in chemotherapeutically insensitive osteosarcoma tissues and cisplatin‐resistant osteosarcoma cell lines (MG‐63CISR and U‐2OSCISR) as compared to chemotherapy‐sensitive osteosarcoma tissues and cell lines. Knock‐down of PTBP1 can enhance the anti‐proliferation and apoptosis‐induced effects of cisplatin in MG‐63CISR and U‐2OSCISR cells. Moreover, PTBP1 knock‐down significantly up‐regulated the expression of the copper transporter SLC31A1, as indicated by transcriptome sequencing. Through RNA immunoprecipitation, dual‐luciferase reporter assay and RNA stability detection, we confirmed that PTBP1 binds to SLC31A1 mRNA and regulates the expression level of SLC31A1 by affecting mRNA stability. Additionally, SLC31A1 silencing abrogated the chemosensitizing effect of PTBP1 knock‐down in MG‐63CISR and U‐2OSCISR cells. Using a nude mouse xenograft model, we further confirmed that PTBP1 knock‐down enhanced chemoresistant osteosarcoma responsiveness to cisplatin treatment in vivo. Collectively, the present study suggests that PTBP1 is a crucial determinant of chemoresistance in osteosarcoma.
Construction project scheduling under workspace interference
Authors: Tao Sha , Wu Changzhi , Hu Shaolong , Xu Feng 
Published: March 2020

AbstractWorkspace interference in construction sites usually leads to work inefficiency, rework, and risk to the workforce. In this paper, we present a study on controlling and mitigating workspace interference in construction project scheduling. In particular, we consider two types of workspace interference: unacceptable workspace interference (USI) and acceptable workspace interference (ASI). During the scheduling process, if two activities cause USI, they must be scheduled for non‐overlapping execution periods. If the two activities that cause ASI are executed concurrently, it will lead to decrease in productivity. We first establish a mathematical model for construction project scheduling subject to these two types of workspace interference. This established model is a mixed‐integer, multiobjective optimization problem. Then, a two‐stage metaheuristic algorithm is developed to solve the problem. Two construction scenarios are selected to illustrate the effectiveness of the proposed method. By comparing with traditional forward scheduling method, the two‐stage metaheuristic algorithm can achieve solutions with, on average, shorter project makespan, less total cost as well as milder resource usage variation in execution.
Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature
Authors: Watanabe Mikiko , Tozzi Rossella , Risi Renata , Tuccinardi Dario , Mariani Stefania , Basciani Sabrina , Spera Giovanni , Lubrano Carla , Gnessi Lucio 
Published: March 2020

SummaryNonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, characterized by hepatic fat accumulation and possible development of inflammation, fibrosis, and cancer. The ketogenic diet (KD), with its drastic carbohydrate reduction, is a now popular weight loss intervention, despite safety concerns on a possible association with fatty liver. However, KDs were also reported to be beneficial on hepatic pathology, with ketone bodies recently proposed as effective modulators of inflammation and fibrosis. If the beneficial impact of weight loss on NAFLD is established, less is known on the effect of macronutrient distribution on such outcome. In a hypocaloric regimen, the latter seems not to be crucial, whereas at higher calorie intake, macronutrient ratio and, theoretically, ketosis, may become important. KDs could positively impact NAFLD for their very low carbohydrate content, and whether ketosis plays an additional role is unknown. Indeed, several mechanisms may directly link ketosis and NAFLD improvement, and elucidating these aspects would pave the way for new therapeutic strategies. We herein aimed at providing an accurate revision of current literature on KDs and NAFLD, focusing on clinical evidence, metabolic pathways involved, and strict categorization of dietary interventions.
Development and application of ‘systems thinking’ principles for quality improvement
Authors: McNab Duncan , McKay John , Shorrock Steven , Luty Sarah , Bowie Paul 
Published: March 2020

Introduction‘Systems thinking’ is often recommended in healthcare to support quality and safety activities but a shared understanding of this concept and purposeful guidance on its application are limited. Healthcare systems have been described as complex where human adaptation to localised circumstances is often necessary to achieve success. Principles for managing and improving system safety developed by the European Organisation for the Safety of Air Navigation (EUROCONTROL; a European intergovernmental air navigation organisation) incorporate a ‘Safety-II systems approach’ to promote understanding of how safety may be achieved in complex work systems. We aimed to adapt and contextualise the core principles of this systems approach and demonstrate the application in a healthcare setting.MethodsThe original EUROCONTROL principles were adapted using consensus-building methods with front-line staff and national safety leaders.ResultsSix interrelated principles for healthcare were agreed. The foundation concept acknowledges that ‘most healthcare problems and solutions belong to the system’. Principle 1 outlines the need to seek multiple perspectives to understand system safety. Principle 2 prompts us to consider the influence of prevailing work conditions—demand, capacity, resources and constraints. Principle 3 stresses the importance of analysing interactions and work flow within the system. Principle 4 encourages us to attempt to understand why professional decisions made sense at the time and principle 5 prompts us to explore everyday work including the adjustments made to achieve success in changing system conditions.A case study is used to demonstrate the application in an analysis of a system and in the subsequent improvement intervention design.ConclusionsApplication of the adapted principles underpins, and is characteristic of, a holistic systems approach and may aid care team and organisational system understanding and improvement.
DO HIGH-PERFORMANCE WORK PRACTICES INDUCE INNOVATIVE WORK BEHAVIOUR? THE CASE OF THE QATARI BANKING SECTOR
Authors: OBEIDAT SHATHA M. 
Published: March 2020

Purpose: This paper presents results from an empirical study in the banking sector in Qatar on the impact of high-performance work practices (HPWPs) on employee’s innovative work behaviour (IWB). In particular, the study seeks to examine the impact of HPWP on employees work attitudes of job satisfaction and organisational commitment, and of the possible mediating link of employees’ attitudes (i.e., satisfaction and commitment) on HPWPs and IWB link.Methodology: Data were collected from employees about their perception of the use of HPWPs in their banks and about their level of satisfaction at work, their perceived commitment, and their innovative work behaviour. The sample included 150 employees working in different banks at Qatar.Findings: The findings suggest that HPWPs are positively related to job satisfaction, organisational commitment, and IWB. Also, the study provides support for the mediating effect of organisational commitment on the HPWPs and IWB link.Practical implications: When trying to inspire employees IWB through managerial practices (like HPWPs) in Qatari banks, management needs to pay attention to employees work related attitudes such as job satisfaction and organisational commitment.Limitations: The unique characteristics of the Qatari banks limits the generalizability of the study findings.Originality: This is the first study that explores the mediating role of job satisfaction and organisational commitment on HPWPs-IWB link after conducting a comprehensive PLS analysis. Moreover, the study provides evidence of this possible link in what is believed to be unique study setting.
Participatory Design of a Personalized Genetic Risk Tool to Promote Behavioral Health
Authors: Ramsey Alex T. , Bray Michael , Acayo Laker Penina , Bourdon Jessica L. , Dorsey Amelia , Zalik Maia , Pietka Amanda , Salyer Patricia , Waters Erika A. , Chen Li-Shiun , Bierut Laura J. 
Published: March 2020

Abstract
Despite major advancements in genomic medicine, research to optimize the design and communication of genetically informed interventions in behavioral health has lagged. The goal of this study was to engage potential end users in participatory codesign of a personalized genetically informed risk tool to intervene on high-risk health behaviors. We used structured interviews to examine end-user attitudes and interest in personalized genetics, qualitative interviews to guide iterative design of a genetically informed tool, and questionnaires to assess acceptability and potential utility of the tool. Participants expressed strong demand for using personal genetics to inform smoking and alcohol-related disease risk and guide treatment (78%–95% agreed). Via iterative design feedback, we cocreated a genetically informed risk profile featuring (i) explanation of genetic and phenotypic markers used to construct a risk algorithm, (ii) personalized risks and benefits of healthy behavior change, and (iii) recommended actions with referral to freely available resources. Participants demonstrated sufficient understanding and cited motivating behavior change as the most useful purpose of the tool. In three phases, we confirmed strong desire for personalized genetics on high-risk health behaviors; codesigned a genetically informed profile with potential end users; and found high acceptability, comprehensibility, and perceived usefulness of the profile. As scientific discovery of genomic medicine advances in behavioral health, we must develop the tools to communicate these discoveries to consumers who stand to benefit. The potential of genomic medicine to engage populations and personalize behavioral health treatment depends, in part, on preparatory studies to design for the future implementation of genetically informed interventions.
Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure
Authors: O’Connor Kyle D. , Brophy Todd , Fonarow Gregg C. , Blankstein Ron , Swaminathan Rajesh V. , Xu Haolin , Matsouaka Roland A. , Albert Nancy M. , Velazquez Eric J. , Yancy Clyde W. , Heidenreich Paul A. , Hernandez Adrian F. , DeVore Adam D. 
Published: March 2020

Background:
Current guidelines recommend evaluation for underlying heart disease and reversible conditions for patients with new-onset heart failure (HF). There are limited data on contemporary testing for coronary artery disease (CAD) in patients with new-onset HF.

Methods:
We performed an observational cohort study using the Get With The Guidelines–Heart Failure registry linked to Medicare claims. All patients were aged ≥65 and hospitalized for new-onset HF from 2009 to 2015. We collected left ventricular ejection fraction (LVEF), prior HF history, and in-hospital CAD testing from the registry, as well as testing for CAD using claims from 90 days before to 90 days after index HF hospitalization.

Results:

Among 17 185 patients with new-onset HF, 6672 (39%) received testing for CAD, including 3997 (23%) during the index hospitalization. Testing for CAD differed by LVEF: 53% in HF with reduced EF (LVEF ≤40%), 42% in HF with borderline EF (LVEF, 41%–49%), and 31% in HF with preserved EF (LVEF ≥50%). After multivariable adjustment, patients who received testing for CAD, compared with those who did not, were younger and more likely to be male, have a smoking history, have hyperlipidemia, and have HF with reduced ejection fraction or HF with borderline ejection fraction (all
P
<0.05).

Conclusions:
The majority of patients hospitalized for new-onset HF did not receive testing for CAD either during the hospitalization or in the 90 days before and after. The rates of testing for CAD were higher in patients with LVEF ≤40% though remained low. These data highlight an opportunity to improve care by identifying appropriate candidates for optimal CAD medical therapy and revascularization.
Combating Crime in the Digital Age: a Critical Review of EU Information Systems in the Area of Freedom, Security and Justice in the Post-Interoperability Era
Authors: Giannakoula Athina , Lima Dafni , Kaiafa-Gbandi Maria 
Published: March 2020

Abstract
This article provides a systematic and critical account of EU information systems in the area of freedom, security and justice, with the aim of establishing the contemporary links between information sharing and criminal law in the EU and of evaluating its impact on individuals. To this end, Part 1 offers a systemisation and critical assessment of the essential elements of the pertinent systems (ECRIS, ECRIS-TCN, Prüm, PNR, Europol, SIS, Eurodac, VIS, EES, ETIAS) and of the new interoperability regime under Regulation (EU) 2019/818, from the perspective of their objective to prevent and combat serious crime and to ensure a high level of security in the EU. In Part 2 the article explores personal data protection law, police law and criminal procedure law, in order to propose safeguards and limitations for effectively regulating this rapidly evolving framework and addressing the growing challenges for fundamental legal principles and individual rights. In this respect, the authors put forward concrete views and ideas, on the basis of their central suggestion that the issue discussed falls within the context of an emerging precognitive paradigm of criminal law.
Geographic Heterogeneity in Otolaryngology Medicare New Patient Visits
Authors: Hur Kevin , Gibbons Joseph , Finch Brian Karl 
Published: March 2020

ObjectiveTo analyze the spatial variation of sociodemographic factors associated with the geographic distribution of new patient visits to otolaryngologists.Study DesignRetrospective cross‐sectional analysis.SettingUnited States.Subject and MethodsMedicare new patient visits pooled from 2012 to 2016 to otolaryngology providers were obtained from the Centers for Medicare and Medicaid Services, and county‐level sociodemographic data were obtained from the 2012‐2016 American Community Survey. The mean number of new patient visits per otolaryngology provider by county was calculated. The spatial variation was analyzed with negative binomial and geographically weighted regression. Predictors included various neighborhood characteristics.ResultsThere were 7,199,129 Medicare new patient visits to otolaryngology providers from 2012 to 2016. A 41.7‐fold difference in new patient evaluation rates was observed across US counties (range, 11‐458.8 per otolaryngology provider). On multivariable regression analysis, median age, sex, work commute time, percentage insured, and the advantage index of a county were predictors for the rate of new patient visits to otolaryngology providers. However, geographically weighted regression demonstrated that the association of a county’s disadvantage index, advantage index, percentage insured, and work commute times with new patient visits per provider varied across space.ConclusionsThere are wide geographic differences in the number of new Medicare patients seen by otolaryngologists, and the influence of county sociodemographic factors varied regionally. Further research to analyze the variations in practice patterns of otolaryngologists is warranted to predict future public health needs.
Prevalence of obstructive sleep apnoea in acute coronary syndrome patients: systematic review and meta-analysis
Authors: Le Grande Michael R. , Beauchamp Alison , Driscoll Andrea , Jackson Alun C. 
Published: March 2020

Abstract
Background
Obstructive Sleep Apnoea (OSA) has been recognised as a risk factor for cardiovascular diseases such as hypertension and cardiovascular events such as acute coronary syndrome (ACS). Since it is also known to reduce exercise tolerance, it is important to establish the prevalence of OSA in ACS patients, particularly in those who are commencing cardiac rehabilitation (CR) programs.

Methods
Using PRISMA guidelines a systematic search was conducted in order to identify studies that objectively measured (using polysomnography or portable monitoring) the prevalence of OSA in ACS patients following hospital admission. A data extraction table was used to summarise study characteristics and the quality of studies were independently assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analysis of the selected studies was conducted in order to estimate OSA prevalence as a function of the two main methods of measurement, the severity of OSA, and timing of the OSA assessment following ACS hospital admission.

Results
Pooled prevalence estimates of OSA using the “gold standard” polysomnography ranged from 22% for severe OSA to 70% for mild OSA, at any time after hospital admission. Similar prevalence estimates were obtained using portable monitoring, but interpretation of these results are limited by the significant heterogeneity observed among these studies.

Conclusions
Prevalence of OSA following ACS is high and likely to be problematic upon patient entry into CR programs. Routine screening for OSA upon program entry may be necessary to optimise effectiveness of CR for these patients.
Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition
Authors: Di Gennaro Giovanni Luigi , Stallone Stefano , Olivotto Eleonora , Zarantonello Paola , Magnani Marina , Tavernini Tullia , Stilli Stefano , Trisolino Giovanni 
Published: March 2020

AbstractBackgroundThe management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC.MethodsWe retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis.ResultsThirty-four children (47 ft) in the nonoperative group and twenty-one children (34 ft) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9–17): 11.6 (9–17) for the nonoperative group, 12.2 (10–15) for the operative group. The mean follow-up averaged 6.6 (3–12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years;p < 0.0005), since the operative procedure was increasingly practiced in the latest years.There were no complications in either groups, but 6 patients (7 ft) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables.ConclusionThe operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.
Perianal Paget’s disease: a clinicopathological and immunohistochemical study of 13 cases
Authors: Liao Xiaoyan , Liu Xiuli , Fan Xuemo , Lai Jinping , Zhang Dongwei 
Published: March 2020

Abstract
Background
Perianal Paget’s disease (PPD) is rare and mostly described in clinical literature as case reports or small series.

Methods
We investigated the clinicopathologic and immunohistochemical features of PPD in a total of 13 cases retrieved from multiple academic institutions.

Results
The median age at diagnosis was 75 (range 50–86) years. Males were predominant with a male to female ratio of 2.25:1. Four (30.8%) cases were classified as primary PPD due to lack of synchronous or metachronous underlying malignancies, while nine (69.2%) were classified as secondary PPD with concurrent invasive adenocarcinoma (n = 8) or tubular adenoma with high-grade dysplasia (n = 1). Immunohistochemically, there is no differential expression of CK7 or CK20 in Paget’s cells between primary and secondary PPD; however, GCDFP-15 was only positive in primary PPD (3/3 vs. 0/6, P = 0.012), while CDX2 was only positive in secondary PPD (0/3 vs. 7/7, P = 0.008), suggesting different cell origin. All patients received local surgical resection with or without adjuvant therapy. After a median follow-up of 47 months, one patient with secondary PPD (7.7%) died of disease progression from underlying adenocarcinoma.

Conclusions
PPD occurs in elderly patients with male predominance and is frequently associated with underlying malignancies. Differential expression of CDX2 and GCDFP-15 may help distinguishing primary vs. secondary PPD, which is important for management as the presence of an underlying malignancy impacts clinical course and prognosis. Surgical excision remains the major treatment strategy for PPD. Long-term follow-up is required to monitor the disease recurrence and metastasis.