bluuebunny/crossref_metadata_2025_split huggingface dataset:
The eruptive history, magmatic evolution, and influence of glacial ice at long-lived Akutan volcano, eastern Aleutian Islands, Alaska, USA
Authors: Coombs Michelle L. , Jicha Brian R. 
Published: October 2020

AbstractNew 40Ar/39Ar and whole-rock geochemical data are used to develop a detailed eruptive chronology for Akutan volcano, Akutan Island, Alaska, USA, in the eastern Aleutian island arc. Akutan Island (166°W, 54.1°N) is the site of long-lived volcanism and the entire island comprises volcanic rocks as old as 3.3 Ma. Our current study is on the 225 km2 western half of the island, where our results show that the focus of volcanism has shifted over the last ∼700 k.y., and that on occasion, multiple volcanic centers have been active over the same period, including within the Holocene. Incremental heating experiments resulted in 56 40Ar/39Ar plateau ages and span 2.3 Ma to 9.2 ka.Eruptive products of all units are primarily tholeiitic and medium-K, and range from basalt to dacite. Rare calc-alkaline lavas show evidence suggesting their formation via mixing of mafic and evolved magmas, not via crystallization-derived differentiation through the calc-alkaline trend. Earliest lavas are broadly dispersed and are almost exclusively mafic with high and variable La/Yb ratios that are likely the result of low degrees of partial mantle melting. Holocene lavas all fall along a single tholeiitic, basalt-to-dacite evolutionary trend and have among the lowest La/Yb ratios, which favors higher degrees of mantle melting and is consistent with the increased magma flux during this time. A suite of xenoliths, spanning a wide range of compositions, are found in the deposits of the 1.6 ka caldera-forming eruption. They are interpreted to represent completely crystallized liquids or the crystal residuum from tholeiitic fractional crystallization of the active Akutan magma system.The new geochronologic and geochemical data are used along with existing geodetic and seismic interpretations from the island to develop a conceptual model of the active Akutan magma system. Collectively, these data are consistent with hot, dry magmas that are likely stored at 5–10 km depth prior to eruption. The prolonged eruptive activity at Akutan has also allowed us to evaluate patterns in lava-ice interactions through time as our new data and observations suggest that the influence of glaciation on eruptive activity, and possible magma composition, is more pronounced at Akutan than has been observed for other well-studied Aleutian volcanoes to the west.
Vitamin B12and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT)
Authors: Liu Lishun , Huang Xiao , Wang Binyan , Song Yun , Lin Tengfei , Zhou Ziyi , Wang Zhuo , Wei Yaping , Guo Huiyuan , Chen Ping , Yang Yan , Ling Wenhua , Li Youbao , Qin Xianhui , Tang Genfu , Liu Chengzhang , Li Jianping , Zhang Yan , Zalloua Pierre A , Wang Xiaobin , Huo Yong , Zhang Hao , Xu Xiping 
Published: October 2020

IntroductionPrevious studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12–diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.Research design and methodsThis report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.ResultsAt baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12measurements, we found a positive association between an increase in vitamin B12and an increase in FBG.ConclusionsIn this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12and its longitudinal trajectory in order to better elucidate the role of vitamin B12in the development of diabetes. Such findings would have important clinical and public health implications.
Examining the impact of an asynchronous communication platform versus existing communication methods: an observational study
Authors: Jhala Meenakshi , Menon Rahul 
Published: October 2020

Background
Healthcare systems revolve around intricate relations between humans and technology. System efficiency depends on information exchange that occur on synchronous and asynchronous platforms. Traditional synchronous methods of communication may pose risks to workflow integrity and contribute to inefficient service delivery and medical care.

Aim
To compare synchronous methods of communication to Medic Bleep, an instant messaging asynchronous platform, and observe its impact on clinical workflow, quality of work life and associations with patient safety outcomes and hospital core operations.

Methods
Cohorts of healthcare professionals were followed using the Time Motion Study methodology over a 2-week period, using both the asynchronous platform and the synchronous methods like the non-cardiac pager. Questionnaires and interviews were conducted to identify staff attitudes towards both platforms.

Results
A statistically significant figure (p<0.01) of 20.1 minutes’ reduction in average task completion was seen with asynchronous communication, saving 58.8% of time when compared with traditional synchronous methods. In subcategory analysis for staff: doctors, nurses and midwifery categories, a p value of <0.0495 and <0.01 were observed; a mean time reduction with statistical significance was also seen in specific task efficiencies of ‘To-Take-Out (TTO), patient review, discharge & patient transfer and escalation of care & procedure’. The platform was favoured with an average Likert value of 8.7; 67% found it easy to implement.

Conclusion
The asynchronous platform improved clinical communication compared with synchronous methods, contributing to efficiencies in workflow and may positively affect patient care.
Effect of a real-time feedback smartphone application (TCPRLink) on the quality of telephone-assisted CPR performed by trained laypeople in China: a manikin-based randomised controlled study
Authors: Dong Xuejie , Zhang Lin , Myklebust Helge , Birkenes Tonje Soraas , Zheng Zhi-Jie 
Published: October 2020

ObjectivesTo determine the effect of a free smartphone application (TCPRLink) that provides real-time monitoring and audiovisual feedback on chest compressions (CC) on trained layperson telephone-assisted cardiopulmonary resuscitation (T-CPR) performance.DesignA manikin-based randomised controlled study.SettingThis study was conducted at a multidisciplinary university and a community centre in China.ParticipantsOne hundred and eighty-six adult participants (age 18–65 years) with T-CPR training experience were randomly assigned to the TCPRLink (n=94) and T-CPR (n=92) groups with age stratification.InterventionsWe compared the participants’ performance for 6 min of CC in a simulated T-CPR scenario both at the baseline and after 3 months.Primary and secondary outcome measuresThe primary outcomes were the CC rate and proportion of adequate CC rate (100–120 min−1). The secondary outcomes included the proportion of participants counting the CC rhythm, time to first CC, CC depth, hands-off time and CC full-release ratio.ResultsParticipants in the TCPRLink feedback group more consistently performed CC with higher rate, both initially and 3 months later (median 111 (IQR 109–113) vs 108 (103–112) min−1, p=0.002 and 111 (109–113) vs 108 (105–112) min−1, p<0.001, respectively), with less need to count the rhythm (21.3% vs 41.3%, p=0.003% and 7% vs 22.6%, p=0.004, respectively) compared with the T-CPR group. There were no significant differences in time to the first CC, hands-off time or CC full-release ratio. Among 55–65 year group, the CC depth was deeper in the TCPRLink group than in the TCPR group (47.1±9.6 vs 38.5±8.7 mm, p=0.001 and 44.7±10.1 vs 39.3±10.8 mm, p=0.07, respectively).ConclusionsThe TCPRLink application improved T-CPR quality in trained laypersons to provide more effective CCs and lighten the load of counting out the CC with the dispatcher in a simulated T-CPR scenario. Further investigations are required to confirm this effectiveness in real-life resuscitation attempts.
Linking the Mini-Mental State Examination, the Alzheimer’s Disease Assessment Scale–Cognitive Subscale and the Severe Impairment Battery: evidence from individual participant data from five randomised clinical trials of donepezil
Authors: Levine Stephen Z , Yoshida Kazufumi , Goldberg Yair , Samara Myrto , Cipriani Andrea , Efthimiou Orestis , Iwatsubo Takeshi , Leucht Stefan , Furukawa Toshi A 
Published: October 2020

BackgroundThe Mini-Mental State Examination (MMSE), the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) and the Severe Impairment Battery (SIB) are widely used rating scales to assess cognition in Alzheimer’s disease.ObjectiveTo understand the correspondence between these rating scales, we aimed to examine the linkage of MMSE with the ADAS-Cog and SIB total and change scores.MethodsWe used individual-level data on participants with Alzheimer’s disease (n=2925) from five pivotal clinical trials of donepezil. Data were collected at baseline and scheduled visits for up to 6 months. We used equipercentile linking to identify the correspondence between simultaneous measurements of MMSE with ADAS-Cog, and SIB total and change ratings.FindingsSpearman’s correlation coefficients were of strong magnitude between the MMSE total score and the ADAS-Cog (rs from −0.82 to −0.87; p<0.05) and SIB total scores (rs from 0.70 to 0.75; p<0.05). Weaker correlations between the change scores were observed between the MMSE change score and the ADAS-Cog (week 1: r=−0.11, p=0.18; rs thereafter: −0.28 to −0.45; p<0.05) and SIB change scores (rs from 0.31 to 0.44; p<0.05). Linking suggested that the MMSE total scores were sensitive to moderate and severe cognitive impairment levels. Despite weak to moderate correlations for the change scores, moderate change levels linked well, indicating ceiling and floor effects.ConclusionsThe current results can be used in meta-analyses, data harmonisation and may contribute to increasing statistical power when pooling data from multiple sources.Clinical implicationsThe current study results help clinicians to understand these cognitive rating scale scores.
qSOFA as a new community-acquired pneumonia severity score in the emergency setting
Authors: Spagnolello Ornella , Ceccarelli Giancarlo , Borrazzo Cristian , Macrì Angela , Suppa Marianna , Baldini Enrico , Garramone Alessia , Alessandri Francesco , Celani Luigi , Vullo Francesco , Angeletti Silvia , Ciccozzi Massimo , Mastroianni Claudio , Bertazzoni Giuliano , D'Ettorre Gabriella 
Published: October 2020

BackgroundQuick Sequential Organ Failure Assessment (qSOFA) score is a bedside prognostic tool for patients with suspected infection outside the intensive care unit (ICU), which is particularly useful when laboratory analyses are not readily available. However, its performance in potentially septic patients with community-acquired pneumonia (CAP) needs to be examined further, especially in relation to early outcomes affecting acute management.ObjectiveFirst, to compare the performance of qSOFA and CURB-65 in the prediction of mortality in the emergency department in patients presenting with CAP. Second, to study patients who required critical care support (CCS) and ICU admission.MethodsBetween January and December 2017, a 1-year retrospective observational study was carried out of adult (≥18 years old) patients presenting to the emergency department (ED) of our hospital (Rome, Italy) with CAP. The accuracy of qSOFA, qSOFA-65 and CURB-65 was compared in predicting mortality in the ED, CCS requirement and ICU admission. The concordance among scores ≥2 was then assessed for 30-day estimated mortality prediction.Results505 patients with CAP were enrolled. Median age was 71.0 years and mortality rate in the ED was 4.7%. The areas under the curve (AUCs) of qSOFA-65, CURB-65 and qSOFA in predicting mortality rate in the ED were 0.949 (95% CI 0.873 to 0.976), 0.923 (0.867 to 0.980) and 0.909 (0.847 to 0.971), respectively. The likelihood ratio of a patient having a qSOFA score ≥2 points was higher than for qSOFA-65 or CURB-65 (11 vs 7 vs 6.7). The AUCs of qSOFA, qSOFA-65 and CURB-65 in predicting CCS requirement were 0.862 (95% CI 0.802 to 0.923), 0.824 (0.758 to 0.890) and 0.821 (0.754 to 0.888), respectively. The AUCs of qSOFA-65, qSOFA and CURB-65 in predicting ICU admission were 0.593 (95% CI 0.511 to 0.676), 0.585 (0.503 to 0.667) and 0.570 (0.488 to 0.653), respectively. The concordance between qSOFA-65 and CURB-65 in 30-day estimated mortality prediction was 93%.ConclusionqSOFA is a valuable score for predicting mortality in the ED and for the prompt identification of patients with CAP requiring CCS. qSOFA-65 may further improve the performance of this useful score, showing also good concordance with CURB-65 in 30-day estimated mortality prediction.
Interval cancer after colonoscopy in the Austrian National Screening Programme: influence of physician and patient factors
Authors: Waldmann Elisabeth , Penz Daniela , Šinkovec Hana , Heinze Georg , Rinner Christoph , Jiricka Lena , Majcher Barbara , Hinterberger Anna , Trauner Michael , Ferlitsch Monika 
Published: October 2020

ObjectivePostscreening colorectal cancer (PSCRC) after screening colonoscopy is associated with endoscopists’ performance and characteristics of resected lesions. Prior studies have shown that adenoma detection rate (ADR) is a decisive factor for PSCRC, but correlations with other parameters need further analysis and ADR may change over time.DesignCohort study including individuals undergoing screening colonoscopy between 1/2008 and 12/2019 performed by physicians participating in a quality assurance programme in Austria. Data were linked with hospitalisation data for the diagnosis of PSCRC (defined as CRC diagnosis >6 months after colonoscopy). ADR was defined dynamically in relation to the time point of subsequent colonoscopies; high-risk groups of patients were those with an adenoma ≥10 mm, or with high-grade dysplasia, or villous or tubulovillous histology, or a serrated lesion ≥10 mm or with dysplasia, or colonoscopies with ≥3 lesions. Main outcome was PSCRC for each risk group (negative colonoscopy, hyperplastic polyps, low-risk and high-risk group of patients) after colonoscopy by endoscopists with an ADR <20% compared with endoscopists with an ADR ≥20%.Results352 685 individuals were included in the study (51.0% women, median age 60 years) of which 10.5% were classified as high-risk group. During a median follow-up of 55.4 months, 241 (0.06%) PSCRC were identified; of 387 participating physicians, 19.6% had at least one PSCRC (8.4% two or more). While higher endoscopist ADR decreased PSCRC incidence (HR per 1% increase 0.97, 95% CI 0.95 to 0.98), affiliation to the high-risk group of patients was also associated with higher PSCRC incidence (HR 3.27, 95% CI 2.36 to 4.00). Similar correlations were seen with regards to high-risk, and advanced adenomas. The risk for PSCRC was significantly higher after colonoscopy by an endoscopist with an ADR <20% as compared with an endoscopist with an ADR ≥20% in patients after negative colonoscopy (HR 2.01, 95% CI 1.35 to 3.0, p<0.001) and for the high-risk group of patients (HR 2.51, 95% CI 1.49 to 4.22, p<0.001).ConclusionA dynamic calculation of the ADR takes into account changes over time but confirms the correlation of ADR and interval cancer. Both lesion characteristics and endoscopists ADR may play a similar role for the risk of PSCRC. This should be considered in deciding about appropriate surveillance intervals in the future.
High burden of acute kidney injury in COVID-19 pandemic: systematic review and meta-analysis
Authors: Oliveira Camila Barbosa , Lima Camilla Albertina Dantas , Vajgel Gisele , Campos Coelho Antonio Victor , Sandrin-Garcia Paula 
Published: October 2020

AimsHospitalised patients with COVID-19 have a variable incidence of acute kidney injury (AKI) according to studies from different nationalities. The present systematic review and meta-analysis describes the incidence of AKI, need for renal replacement therapy (RRT) and mortality among patients with COVID-19-associated AKI.MethodsWe systematically searched electronic database PubMed, SCOPUS and Web of Science to identify English articles published until 25 May 2020. In case of significant heterogeneity, the meta-analyses were conducted assuming a random-effects model.ResultsFrom 746 screened publications, we selected 21 observational studies with 15 536 patients with COVID-19 for random-effects model meta-analyses. The overall incidence of AKI was 12.3% (95% CI 7.3% to 20.0%) and 77% of patients with AKI were critically ill (95% CI 58.9% to 89.0%). The mortality among patients with AKI was 67% (95% CI 39.8% to 86.2%) and the risk of death was 13 times higher compared with patients without AKI (OR=13.3; 95% CI 6.1 to 29.2). Patients with COVID-19-associated AKI needed for RRT in 23.4% of cases (95% CI 12.6% to 39.4%) and those cases had high mortality (89%–100%).ConclusionThe present study evidenced an incidence of COVID-19-associated AKI higher than previous meta-analysis. The majority of patients affected by AKI were critically ill and mortality rate among AKI cases was high. Thus, it is extremely important for health systems to be aware about the impact of AKI on patients’ outcomes in order to establish proper screening, prevention of additional damage to the kidneys and adequate renal support when needed.
Effects of Wnt signaling on epithelial to mesenchymal transition in chronic rhinosinusitis with nasal polyp
Authors: Bae Jun-Sang , Ryu Gwanghui , Kim Ji Hye , Kim Eun Hee , Rhee Yun Hee , Chung Young-Jun , Kim Dae Woo , Lim Suha , Chung Phil-Sang , Shin Hyun-Woo , Mo Ji-Hun 
Published: October 2020

BackgroundEpithelial to mesenchymal transition (EMT) is associated with the pathophysiology of chronic rhinosinusitis with nasal polyp (CRSwNP). Wnt signaling is causative for EMT, whereas the mechanism in CRSwNP is not fully understood.ObjectiveWe sought to evaluate the role of Wnt signaling in EMT of CRSwNP using a murine nasal polyp (NP) model and human tissues.MethodsInflammatory markers and EMT-related molecules were evaluated in NP models using adenomatosis polyposis coli (Apc)Min/+ mice with activated Wnt signaling and NP models treated with Wnt signaling inhibitor, indocyanine green-001 (ICG-001). EMT markers and Wnt signaling-associated mediators were analysed using human sinonasal tissues from control subjects and CRSwNP patients.ResultsApcMin/+ mice-induced NPs exhibited more frequent polypoid lesions and upregulation of Wnt-related molecules, including nuclear β-catenin, WNT3A and cyclin D1. Markers of EMT were significantly overexpressed in the ApcMin/+ NP mice (p<0.001 for E-cadherin and α-smooth muscle actin), and interleukin (IL)-17A+ cells and neutrophilic infiltration were increased in ApcMin/+ NP mice (p<0.001). Inhibition of Wnt signaling via ICG-001 resulted in significantly decreased nasal polypoid lesions (p<0.001), EMT-related markers (p=0.019 for E-cadherin and p=0.002 for vimentin) and the mRNA levels of IL-4 (p<0.001) and IL-17A (p=0.004) compared with the positive control group. Finally, nuclear β-catenin (p=0.042) was significantly increased compared with the control, and the expression levels of Wnt ligands and receptors were upregulated in human NP tissues (p=0.045 for WNT3A and p=0.042 for FZD2), suggesting increased Wnt signaling and EMT in CRSwNP.ConclusionWnt signaling may contribute to the pathogenesis of NPs through EMT. Therefore, inhibition of Wnt signaling may be a potential therapeutic strategy for patients with CRSwNP.
Implementation of a targeted mastitis therapy concept using an on‐farm rapid test: antimicrobial consumption, cure rates and compliance
Authors: Schmenger Anne , Leimbach Stefanie , Wente Nicole , Zhang Yanchao , Biggs Andrew Martin , Kroemker Volker 
Published: October 2020

BackgroundAim of the present study was to investigate the implementation of a targeted therapy (tLCT) concept under real‐life circumstances, taking both pathogen‐related and animal‐related factors into account. The reduction of antibiotics without negative effects on cure rates was evaluated as well as the compliance by the farmers.MethodsAfter analysing the existing conventional therapy (CT) concepts of five farms, the tLCT concept and a novel on‐farm test were introduced. Three treatment groups were compared with respect to bacteriological cure (BC), cytological cure (CYC), full cure (FC), new infection rate (NIR), relapse rate and the treatment approach per mastitis case: the CT group, the tLCT group including all clinical mastitis (CM) cases treated according to the concept, and the modified tLCT group (tLCTmod), including the CM cases in which farmers deviated from the concept.ResultsEven so farmers deviated from the treatment concept in 506 out of 909 cases; belonging to one of the three treatment groups had no significant impact on BC, CYC, FC, NIR or relapse rate. The antibiotic usage in the tLCT as well as in the tLCTmod group was significantly lower in comparison to the CT group.ConclusionFrom this, it can be deduced that farmers will reduce antibiotic doses by implementing a tLCT concept.
Study of nuclear properties with muonic atoms
Authors: Knecht A. , Skawran A. , Vogiatzi S. M. 
Published: October 2020

AbstractMuons are a fascinating probe to study nuclear properties. Muonic atoms can easily be formed by stopping negative muons inside a material. The muon is subsequently captured by the nucleus and, due to its much higher mass compared to the electron, orbits the nucleus at very small distances. During this atomic capture process, the muon emits characteristic X-rays during its cascade down to the ground state. The energies of these X-rays reveal the muonic energy level scheme, from which properties like the nuclear charge radius or its quadrupole moment can be extracted. While almost all stable elements have been examined using muons, probing highly radioactive atoms has so far not been possible. The muX experiment has developed a technique based on transfer reaction inside a high-pressure hydrogen/deuterium gas cell to examine targets available only in microgram quantities.