bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potentially over 3 million children in EU Europe believed not to be receiving needed medical and dental treatment—and parents' reasons why
Authors: Rigby Michael J. 
Published: February 2020

AbstractBackgroundChildren have the right to health and countries a duty under the United Nations Convention on the Rights of the Child to facilitate this. The European Union has emphasized the importance of investing in children, but at times this seems more wish than pragmatism. Furthermore, European statistical systems do not provide any relevant data, and the degree of unmet need has hitherto been unknown. However, new ad hoc household survey data have now been published by Eurostat showing the percentage of children with a purported unmet medical or dental need and the expressed reasons for this.MethodThis paper critically reviews these data on children with a reported unmet medical or dental need to create an indication of the number of European children with unmet medical and dental needs, and the contributory factors.ResultsThis paper calculates that some 1 million European children can be estimated to have an unmet medical need and 2 million children an unmet dental need, though the survey approach has some weaknesses. A probable overestimate of children affected in sample households offsets the likely failure to capture data about children in institutions, homeless, or in fractured families, or about multiple needs. The reported reasons for not obtaining treatments are a valuable first step in highlighting an important issue for Europe's children—measurement of service accessibility.ConclusionPotentially over 3 million European Union children are failing to have their health needs and their rights met. If the incoming European Commission is serious about its predecessor's promise to invest in children and to take seriously their rights, action is needed to improve quantification of unmet need and to reduce suffering and potential lasting damage.
Toll-like receptors in mediating pathogenesis in systemic sclerosis
Authors: Frasca L , Lande R 
Published: February 2020

Summary
Toll-like receptors (TLRs) are evolutionarily conserved receptors essential for the host defence against pathogens. Both immune and non-immune cells can express TLRs, although at different levels. Systemic sclerosis (SSc) is a chronic disease in which autoimmunity, dysregulated profibrotic mediator release and activation of fibroblasts lead to dysregulated collagen deposition and fibrosis. There is now increasing knowledge that the innate immune system and, in particular, TLRs take a part in SSc pathogenesis. The list of endogenous ligands that can stimulate TLRs in SSc is growing: these ligands represent specific danger-associated molecular patterns (DAMPs), involved either in the initiation or the perpetuation of inflammation, and in the release of factors that sustain the fibrotic process or directly stimulate the cells that produce collagen and the endothelial cells. This review reports evidences concerning TLR signalling involvement in SSc. We report the new DAMPs, as well as the TLR-linked pathways involved in disease, with emphasis on type I interferon signature in SSc, the role of plasmacytoid dendritic cells (pDCs) and platelets. The dissection of the contribution of all these pathways to disease, and their correlation with the disease status, as well as their values as prognostic tools, can help to plan timely intervention and design new drugs for more appropriate therapeutic strategies.
Building home on a fault line: Aging out of child welfare with a serious mental health diagnosis
Authors: Klodnick Vanessa V. , Samuels Gina M. 
Published: February 2020

AbstractYouth aging out of foster care are at high risk for homelessness. This research explains how and why homelessness occurs among youth with serious mental health struggles after aging out of residential and transitional living programmes. Using a longitudinal constructivist grounded theory design, we analyse 20 in‐depth interviews exploring youth's transition experiences and perceptions of transition success within 4 months of emancipation and at 6 and 12 months postemancipation. Monthly 15‐min check‐ins prevented attrition. A three‐phase transition process was observed driven by participant desires and actions to cultivate psychological home through establishing physical home alone away from social networks. Pre‐emancipation, the promise of home was privacy and opportunity for self‐redefinition. Shortly after emancipation, home became a physical and social space to be, a valuable resource to share and a demonstration of personal transition success. However, later in the year postemancipation, maintaining physical home proves nearly impossible given the risk context. Findings speak to how and why youth aging out appear overly self‐reliant upon emancipation. Cultivating a psychological sense of home has practice implications for child welfare providers who aim to prepare youth to live independently postemancipation.
Cardiovascular and kidney outcomes of linagliptin treatment in older people with type 2 diabetes and established cardiovascular disease and/or kidney disease: A prespecified subgroup analysis of the randomized, placebo‐controlled CARMELINA® trial
Authors: Cooper Mark E. , Rosenstock Julio , Kadowaki Takashi , Seino Yutaka , Wanner Christoph , Schnaidt Sven , Clark Douglas , Johansen Odd Erik ,   CARMELINA investigators
Published: February 2020

AbstractAimsIn CARMELINA®, linagliptin demonstrated cardiovascular and renal safety in patients with type 2 diabetes (T2D) with high renal and cardiovascular disease (CVD) risk. We investigated safety and efficacy of this dipeptidyl peptidase‐4 inhibitor in older participants.Materials and methodsSubjects aged ≥18 years with T2D and established CVD with urinary albumin‐to‐creatinine ratio (UACR) >30 mg/g, and/or prevalent kidney disease, were randomized to linagliptin or placebo added to usual care. The primary endpoint (time to first occurrence of 3P‐MACE: cardiovascular death, non‐fatal myocardial infarction or non‐fatal stroke) and other outcomes were evaluated across age groups <65 (n = 2968), 65 to <75 (n = 2800) and ≥75 years (n = 1211).ResultsMean age was 65.9 years (17.4% and 5.9% aged ≥75 and 80, respectively) and median follow‐up was 2.2 years. The hazard ratio (HR) for 3P‐MACE with linagliptin versus placebo was 1.02 [95% confidence interval (CI) 0.89, 1.17] with no significant interaction between age and treatment effect (P = 0.0937). HRs for participants aged <65, 65 to <75 and ≥75 years were 1.11 (95% CI 0.89, 1.40), 1.09 (0.89, 1.33) and 0.76 (0.57, 1.02), respectively. Linagliptin did not increase the risk of adverse kidney outcomes or hospitalization for heart failure across age groups. The incidence of adverse events, including hypoglycaemia, increased with age but was similar with linagliptin and placebo despite glycated haemoglobin A1c reduction with linagliptin.ConclusionsLinagliptin did not increase risk for cardiovascular events or hypoglycaemia and kidney function remained stable in older people with T2D and established CVD with albuminuria and/or kidney disease.
The evolving redox chemistry and bioavailability of vanadium in deep time
Authors: Moore Eli K. , Hao Jihua , Spielman Stephanie J. , Yee Nathan 
Published: February 2020

AbstractThe incorporation of metal cofactors into protein active sites and/or active regions expanded the network of microbial metabolism during the Archean eon. The bioavailability of crucial metal cofactors is largely influenced by earth surface redox state, which impacted the timing of metabolic evolution. Vanadium (V) is a unique element in geo–bio‐coevolution due to its complex redox chemistry and specific biological functions. Thus, the extent of microbial V utilization potentially represents an important link between the geo‐ and biospheres in deep time. In this study, we used geochemical modeling and network analysis to investigate the availability and chemical speciation of V in the environment, and the emergence and changing chemistry of V‐containing minerals throughout earth history. The redox state of V shifted from a more reduced V(III) state in Archean aqueous geochemistry and mineralogy to more oxidized V(IV) and V(V) states in the Proterozoic and Phanerozoic. The weathering of vanadium sulfides, vanadium alkali metal minerals, and vanadium alkaline earth metal minerals were potential sources of V to the environment and microbial utilization. Community detection analysis of the expanding V mineral network indicates tectonic and redox influence on the distribution of V mineral‐forming elements. In reducing environments, energetic drivers existed for V to potentially be involved in early nitrogen fixation, while in oxidizing environments vanadate () could have acted as a metabolic electron acceptor and phosphate mimicking enzyme inhibitor. The coevolving chemical speciation and biological functions of V due to earth's changing surface redox conditions demonstrate the crucial links between the geosphere and biosphere in the evolution of metabolic electron transfer pathways and biogeochemical cycles from the Archean to Phanerozoic.
Shifts in coralline algae, macroalgae, and coral juveniles in the Great Barrier Reef associated with present‐day ocean acidification
Authors: Smith Joy N. , Mongin Mathieu , Thompson Angus , Jonker Michelle J. , De'ath Glenn , Fabricius Katharina E. 
Published: February 2020

AbstractSeawater acidification from increasing CO2 is often enhanced in coastal waters due to elevated nutrients and sedimentation. Our understanding of the effects of ocean and coastal acidification on present‐day ecosystems is limited. Here we use data from three independent large‐scale reef monitoring programs to assess coral reef responses associated with changes in mean aragonite saturation state (Ωar) in the Great Barrier Reef World Heritage Area (GBR). Spatial declines in mean Ωar are associated with monotonic declines in crustose coralline algae (up to 3.1‐fold) and coral juvenile densities (1.3‐fold), while non‐calcifying macroalgae greatly increase (up to 3.2‐fold), additionally to their natural changes across and along the GBR. These three key groups of organisms are important proxies for coral reef health. Our data suggest a tipping point at Ωar 3.5–3.6 for these coral reef health indicators. Suspended sediments acted as an additive stressor. The latter suggests that effective water quality management to reduce suspended sediments might locally and temporarily reduce the pressure from ocean acidification on these organisms.
Prospective evaluation of visual function in patients with ocular diseases after robot‐assisted laparoscopic prostatectomy
Authors: Kakutani Shigenori , Asamoto Masaaki , Araki Fumiyuki , Chen Yi‐Ning , Shinokawa Miki , Okagami Yasuko , Ohata Takuya , Taguchi Satoru , Yamada Yuta , Takeshima Yuta , Kume Haruki , Yamada Yoshitsugu , Aihara Makoto , Ito Nobuko , Fukuhara Hiroshi 
Published: February 2020

ObjectivesTo investigate intraocular pressure and visual function in patients with ocular diseases undergoing robot‐assisted laparoscopic prostatectomy.MethodsWe carried out a prospective clinical study of patients undergoing robot‐assisted laparoscopic prostatectomy for localized prostate cancer at The University of Tokyo Hospital from December 2015 to March 2017. An ophthalmologist measured intraocular pressure, and carried out visual field testing at 0–2 months before and 7 days after robot‐assisted laparoscopic prostatectomy. During the surgery, an anesthesiologist measured intraocular pressure at specified time points.ResultsA total of 110 patients were enrolled and 98 eligible patients were analyzed; 37 were diagnosed with ocular diseases before robotic‐assisted laparoscopic prostatectomy (17 with glaucoma, 20 with other ocular diseases). Intraocular pressure significantly increased during robot‐assisted laparoscopic prostatectomy. Transient postoperative visual field defect was detected in 24 eyes of 17 patients, including six patients with ocular diseases at 7 days after surgery. At 3 months after surgery, one of 34 glaucomatous eyes and one of 40 eyes with non‐glaucomatous ocular diseases continued to show visual field defect, although visual field defect in the remaining patients recovered to preoperative conditions within 3 months.ConclusionsOur findings suggest that robot‐assisted laparoscopic prostatectomy can be safely carried out in patients with ocular diseases, even those with glaucoma, after precautionary consultation with an ophthalmologist.
Impact of pulmonary vein isolation on mechanisms sustaining persistent atrial fibrillation: Predicting the acute response
Authors: Dhillon Gurpreet S. , Schilling Richard J. , Honarbakhsh Shohreh , Graham Adam , Abbass Hakam , Waddingham Peter , Sawhney Vinit , Creta Antonio , Sporton Simon , Finlay Malcolm , Providencia Rui , Chow Anthony , Earley Mark J. , Lowe Martin , Lambiase Pier D. , Hunter Ross J. 
Published: February 2020

AbstractBackgroundNoninvasive mapping identifies potential drivers (PDs) in atrial fibrillation (AF). We analyzed the impact of pulmonary vein isolation (PVI) on PDs and whether baseline PD pattern predicted termination of AF.MethodsPatients with persistent AF less than 2 years underwent electrocardiographic imaging mapping before and after cryoballoon PVI. We recorded the number of PD occurrences, characteristics (rotational wavefronts ≥ 1.5 revolutions or focal activations), and distribution using an 18‐segment atrial model.ResultsOf 100 patients recruited, PVI terminated AF in 15 patients; 21.3% ± 9.1% (8.7 ± 4.8) of PDs occurred at the pulmonary veins (PVs) and posterior wall. PVI had no impact on PD occurrences outside the PVs and posterior wall (33.2 ± 12.9 vs 31.6 ± 12.5; P = .164), distribution over the remaining 13 segments (9 [8‐11] vs 9 [8‐10]; P = .634), the proportion of PDs that was rotational (82.9% ± 9.7% vs 83.6% ± 10.1%; P = .496), or temporal stability (2.4 ± 0.4 vs 2.4 ± 0.5 rotations; P = .541). Fewer focal PDs (area under the curve, 0.683; 95% CI, 0.528‐0.839; P = .024) but not rotational PDs (P = .626) predicted AF termination with PVI.ConclusionsPVI did not have a global impact on PDs outside the PVs and posterior wall. Although fewer focal PDs predicted termination of AF with PVI, the burden of rotational PDs did not. It is accepted though not all PDs are necessarily real or important. Outcome data are needed to confirm whether noninvasive mapping can predict patients likely to respond to PVI.
Sodium restriction improves nocturia in patients at a cardiology clinic
Authors: Monaghan Thomas F. , Michelson Kyle P. , Wu Zhan D. , Gong Fred , Agudelo Christina W. , George Christopher D. , Alwis Upeksha S. , Epstein Matthew R. , Mekki Pakinam , Flores Viktor X. , Bliwise Donald L. , Everaert Karel , Vande Walle Johan , Weiss Jeffrey P. , Lazar Jason M. 
Published: February 2020

AbstractThis study aims to determine whether dietary sodium restriction counseling decreases nocturnal voiding frequency in cardiology patients with concomitant nocturia. Patients who had established care at a cardiology clinic from 2015 to 2018 reporting ≥1 average nocturnal void(s) underwent a comprehensive sodium intake interview by their cardiologist, who provided them with individualized strategies for dietary sodium reduction and assessed adherence at follow‐up. Average nocturnal voiding frequency and dietary adherence were documented in the medical record. A nocturia database was compiled for retrospective analysis. A total of 74 patients were included. Patients considered to be adherent with dietary sodium restriction at follow‐up (n = 56) demonstrated a decrease in median nocturia frequency (2.5 [2.3‐3.0] vs 1.0 [1.0‐2.0] voids, P < .001). Among nonadherent patients (n = 18), median nocturia frequency did not significantly change from baseline to follow‐up (2.0 [1.5‐3.8] vs 2.0 [1.5‐4.8] voids, P = .423). Median changes were significantly different between the adherent and nonadherent groups (P < .001). Examination of second follow‐up available from 37 patients showed a continued effect. In conclusion, adherence with dietary sodium counseling appears to improve nocturia. Accordingly, dietary modification may represent an important adjunct therapy to lifestyle and pharmacologic interventions for decreasing nocturia frequency. Reduction in nocturnal voiding frequency may also reflect an additional benefit of dietary sodium restriction in accordance with best practice standards for cardiovascular disease.
Effectiveness of Active Learning that Combines Physical Activity and Math in Schoolchildren: A Systematic Review
Authors: Vetter Melanie , Orr Rhonda , O'Dwyer Nicholas , O'Connor Helen 
Published: February 2020

ABSTRACTBACKGROUNDDespite increased interest in combining learning and physical activity (PA), the academic and PA benefits of active learning are uncertain.METHODSA systematic search of 5 databases for studies combining learning math with PA in primary/elementary schools was conducted. Academic benefit was evaluated by pre‐post intervention math scores compared to a control group. Effect sizes (ES) were extracted/calculated when possible. Due to study heterogeneity, meta‐analysis was not conducted.RESULTSSix randomized controlled trials and 5 quasi‐experimental studies evaluating 4082 participants (53% girls; mean age 7.5‐11.1 years) were eligible. Math scores were significantly better in the intervention group in 6 of 11 studies on at least 1 test (ES: 0.42‐4.7; p ≤ .03). Other math tests either were not all statistically significant (2 studies) or the benefit varied across grades (1 study). No studies reported a decline in math scores. Of studies measuring PA with accelerometers, 4 of 5 reported significantly greater PA in the intervention group during the intervention (p < .05) or across the school day (p < .01).CONCLUSIONSUndertaking PA while learning was largely equivocal for math scores but showed promising results for increasing daily PA, without detrimental effects on math performance. The need for more rigorous studies with comprehensive assessment of academic performance and PA is highlighted.
ITTREAT (Integrated Community Test ‐ Stage ‐ TREAT) Hepatitis C service for people who use drugs: Real‐world outcomes
Authors: O'Sullivan Margaret , Jones Anna‐Marie , Gage Heather , Jordan Jake , MacPepple Ekelechi , Williams Hugh , Verma Sumita 
Published: February 2020

AbstractBackground/aimsDirect‐acting antivirals (DAAs) provide an unprecedented opportunity for a “find‐and‐treat strategy.” We aimed to report real‐world clinical, patient reported and health economic outcomes of community‐based hepatitis C virus (HCV) screening/treatment in people who use drugs (PWUDs).MethodsProject ITTREAT (2013‐2021), established at a drug and alcohol treatment centre, offered a comprehensive service. Generic (SF‐12v2 and EQ‐5D‐5L) and liver‐specific (SFLDQoL) health‐related quality of life (HRQoL) were assessed before and after HCV treatment. Costs/case detected and cured were calculated. Primary outcome measure was sustained virological response (SVR) (intention to treat).ResultsTill March 2018, 573 individuals recruited, 462 (81%) males, mean age 40.5 ± 10.0 years. Of the 125 treated, 115 (92%) had past/current history of injecting drug use, 88 (70%) were receiving opioid agonist treatment and 50 (40%) were homeless. Twenty‐six per cent received interferon‐based and 74% DAA‐only regimens. SVR (ITT) was 87% (90% with DAAs). Service uptake/HCV treatment completion rates were >95%, HCV reinfection being 2.63/100 person years (95% CI 0.67‐10.33). HRQoL improved significantly at end of treatment (EOT) in those with SVR: SFLDQoL (symptoms, memory, distress, loneliness, hopelessness, sleep and stigma) (P</ = .011); SF‐12 v2 physical and mental health domains (P < .001); and EQ‐5D‐5L composite profile score (P = .009) and visual analogue scale, P < .001. Cost (British pounds 2018) per case detected was £171; mean cost per cure (excluding medication) was £702 ± 188.ConclusionsExcellent real‐world SVRs in PWUDs with significant improvement in HRQoL can be achieved at modest costs. Project ITTREAT endorses community‐based integrated services to help achieve HCV elimination.
Genetic diversity, structure, and demography of Pandanus boninensis (Pandanaceae) with sea drifted seeds, endemic to the Ogasawara Islands of Japan: Comparison between young and old islands
Authors: Setsuko Suzuki , Sugai Kyoko , Tamaki Ichiro , Takayama Koji , Kato Hidetoshi , Yoshimaru Hiroshi 
Published: February 2020

AbstractPandanus boninensis, endemic to the Ogasawara Islands, Japan, is distributed on both the older Bonin and younger Volcano Islands. In this study, we conducted population genetic analyses of P. boninensis on these islands to examine the population diversity and structure across old and young islands, to assess potential differences in population demography with island age, and to collect any evidence of migration between old and young islands. We found that the genetic diversity of expressed sequence tag (EST)–based microsatellite (SSR) markers, the nucleotide diversity of nuclear DNA sequences, and the haplotype diversity of chloroplast DNA on young islands were lower than those on old islands. Clustering analyses of EST‐SSR indicated that populations on old islands were strongly diverged from those on young islands. Approximate Bayesian computation analysis of EST‐SSR suggested that population expansion occurred on old islands while population reduction occurred on young islands. We also found evidence of migration among old islands (mostly from south to north), while it appears that there have been very few migration events between old and young islands. These differences could be due to the fact that young islands tend to be geographically isolated and support smaller populations that began a shorter time ago from limited founders. The P. boninensis populations on the Volcano Islands are interesting from an evolutionary perspective as they constitute a classic example of the early stages of progressive colonization on oceanic islands with small effective population sizes and low genetic diversity.
Studies on Separation Efficiency and Energy Conservation Through Novel Finned Cyclone Separator
Authors: Dasar Mahesh , Patil Ranjit S. 
Published: February 2020

Abstract
In the present study, cylindrical portion of conventional (nonfinned) cyclone separator was reshaped by fixing triangular, semicircular, and rectangular cross section helical fins in order to make it as water wall having fin size 7 mm with fin pitch of 40 mm to improve its separation efficiency and to utilize the cyclone separator as heat exchanger. Fluid dynamic characteristics like axial velocity, tangential velocity, pressure drops were studied by varying the fin geometry (triangular/semicircular/rectangular). For the particles' size less than 3 μm, proposed cyclone separator with triangular helical fin was giving comparatively improved collection efficiency than other selected cyclone separators. Improvement in the collection efficiency of triangular fin-based cyclone separators was perceived from 5% to 10% over the conventional cyclone separator. Hence, helical fins with triangular in cross section were selected further for heat transfer and scale-up studies. It was observed that for the small barrel wall height (h = 400 mm) water temperature was enhanced by 4 °C, and with scale-up (making h = 800 mm) it was increased considerably around 15 °C. Thus based on improved separation efficiency to capture very-fine particulate matter (PM 2.5, which otherwise causes serious health issues) and considerable temperature gain of water noted at lab level scale-up study, triangular helical fins may be to fixed on the inner surface of barrel wall of conventional (nonfinned) cyclone separators in order to use them as heat exchanger for energy conservation in industrial applications.