bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pyloricolonisation of duodenal foveolar metaplasia requires concurrent gastric infection
Authors: Booth Adam L , Gonzalez Raul S 
Published: September 2020

AimsEvaluate the rate and significance ofHelicobacter pylori(H. pylori) involving duodenal foveolar metaplasia of chronic peptic duodenitis (CPD).MethodsWe identified 100 biopsy cases of CPD with synchronous stomach biopsies. All 200 were reviewed for histological changes (eg, chronic gastritis, acute inflammation) and underwent immunohistochemical staining forH. pylori. Results were correlated with patient age, sex, endoscopy indication and findings on stomach biopsy.ResultsCases included 49 men and 51 women, with a median age of 56 years. Reflux or dysphagia was the most common symptom. Chronic gastritis was present in 46 stomach biopsies, with 54 within normal limits. Twelve stomach biopsies showedH. pylori, all of which showed gastritis. Two duodenal biopsies (2%) demonstratedH. pyloriorganisms on immunohistochemistry, both from patients withH. pylorigastritis.ConclusionsRoutine examination of CPD samples forH. pyloriappears unnecessary if a stomach biopsy is available for review.
Parkinson’s disease determinants, prediction and gene–environment interactions in the UK Biobank
Authors: Jacobs Benjamin Meir , Belete Daniel , Bestwick Jonathan , Blauwendraat Cornelis , Bandres-Ciga Sara , Heilbron Karl , Dobson Ruth , Nalls Mike A , Singleton Andrew , Hardy John , Giovannoni Gavin , Lees Andrew John , Schrag Anette-Eleonore , Noyce Alastair J 
Published: September 2020

ObjectiveTo systematically investigate the association of environmental risk factors and prodromal features with incident Parkinson’s disease (PD) diagnosis and the interaction of genetic risk with these factors. To evaluate whether existing risk prediction algorithms are improved by the inclusion of genetic risk scores.MethodsWe identified individuals with an incident diagnosis of PD (n=1276) and controls (n=500 406) in UK Biobank. We determined the association of risk factors with incident PD using adjusted logistic regression models. We constructed polygenic risk scores (PRSs) using external weights and selected the best PRS from a subset of the cohort (30%). The PRS was used in a separate testing set (70%) to examine gene–environment interactions and compare predictive models for PD.ResultsStrong evidence of association (false discovery rate <0.05) was found between PD and a positive family history of PD, a positive family history of dementia, non-smoking, low alcohol consumption, depression, daytime somnolence, epilepsy and earlier menarche. Individuals with the highest 10% of PRSs had increased risk of PD (OR 3.37, 95% CI 2.41 to 4.70) compared with the lowest risk decile. A higher PRS was associated with earlier age at PD diagnosis and inclusion of the PRS in the PREDICT-PD algorithm led to a modest improvement in model performance. We found evidence of an interaction between the PRS and diabetes.InterpretationHere, we used UK Biobank data to reproduce several well-known associations with PD, to demonstrate the validity of a PRS and to demonstrate a novel gene–environment interaction, whereby the effect of diabetes on PD risk appears to depend on background genetic risk for PD.
Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice
Authors: Meyer Lukas , Broocks Gabriel , Bechstein Matthias , Flottmann Fabian , Leischner Hannes , Brekenfeld Caspar , Schön Gerhard , Deb-Chatterji Milani , Alegiani Anna , Thomalla Götz , Fiehler Jens , Kniep Helge , Hanning Uta 
Published: September 2020

Background and purposeTo investigate early clinical surrogates for long-term independency of patients treated with thrombectomy for large vessel occlusion stroke in daily clinical routine.MethodsAll patients with anterior circulation stroke enrolled in the German Stroke Registry-Endovascular Treatment from 07/2015 to 04/2018 were analysed. National Institute of Health Stroke Scale (NIHSS) on admission, NIHSS percentage change, NIHSS delta and NIHSS at 24 hours as well as existing binary definitions of early neurological improvement (ENI; improvement of 8 (major ENI)/10 (dramatic ENI) NIHSS points or reaching 0/1 were compared for predicting functional outcome at 90 days using the modified Rankin Scale (mRS). Excellent and favourable outcome were defined as 0–1 and 0–2, respectively.ResultsAmong 2262 endovasculary treated patients with acute ischaemic anterior circulation stroke, NIHSS at 24 hours had the highest discriminative ability to predict excellent (receiver operator characteristics (ROC)NIHSS 24 hoursarea under the curve (AUC) 0.86 (0.84–0.88)) and favourable long-term functional outcome (ROCNIHSS 24 hoursAUC 0.86 (0.85–0.88)) in comparison to NIHSS percentage change (ROC% changeAUC mRS ≤1: 0.81 (0.78–0.83) mRS ≤2: 0.81 (0.79–0.83)), NIHSS delta change (ROCΔ changeAUC mRS ≤1: 0.74 (0.72–0.77), mRS ≤2: 0.77 (0.74–0.79)) and NIHSS admission (ROCAdmAUC mRS ≤1: 0.70 (0.68–0.73), mRS ≤2: 0.67 (0.68–0.71)). Advanced age was the only independent predictor (adjusted OR 1.05, 95% CI 1.03 to 1.07, p<0.001) for turning the outcome prognosis from favourable (mRS ≤2) to poor (mRS ≥4) at 90 days.ConclusionThe NIHSS at 24 hours postintervention with a threshold of ≤8 points serves best as a surrogate for long-term functional outcome after thrombectomy for anterior circulation stroke in daily clinical practice. Only advanced age significantly decreases its predictive value.
Different strokes: differences in the characteristics and outcomes of BCVI and non-BCVI strokes in trauma patients
Authors: McNutt Michelle K , Slovacek Cedar , Rosenbaum David , Indupuru Hari Kishan Reddy , Zhang Xu , Cotton Bryan A , Harvin John , Wade Charles E , Savitz Sean I , Kao Lillian S 
Published: September 2020

BackgroundAlthough strokes are rare in trauma patients, they are associated with worse functional and cognitive outcomes and decreased mobility. Blunt cerebrovascular injury (BCVI)–related strokes and mortality have decreased, likely due to refined screening and treatment algorithms in trauma literature; however, there is a paucity of research addressing non-BCVI strokes in trauma. The purpose of this study is to evaluate the incidence, etiology, and risk factors of stroke in our trauma population in order to identify preventive strategies.MethodsThis study was a retrospective review of all adult trauma patients admitted to a level 1 trauma hospital who suffered a stroke during trauma admission from 2010 to 2017. Data were collected from the prospectively maintained trauma and stroke databases. Stroke etiology was determined by a vascular neurologist.ResultsOf the 43 674 adult trauma patients admitted during the study period, 99 (0.2%) were diagnosed with a stroke during the index admission. Twenty-one (21%) strokes were due to BCVI. Seventy-eight (79%) strokes were due to non-BCVI etiologies. Patients with non-BCVI strokes were older, less severely injured, and had more medical comorbidities compared with patients with a BCVI stroke. While patients with a BCVI stroke were more likely to suffer multiple traumatic injuries from MVC (76% vs 28%, p<0.001), non-BCVI strokes had more isolated extremity injuries from fall mechanism (55% vs 10%, p<0.001). Over the study period, the age and incidence of stroke and BCVI (p<0.001) increased. However, the rate of BCVI strokes decreased while the rate of non-BCVI strokes increased.DiscussionThe incidence of stroke has increased despite aggressive screening and treatment of BCVI. This increase is primarily due to non-BCVI strokes which are associated with advanced age and medical comorbidities after low mechanism traumatic injury. Medical optimization of comorbid conditions during trauma hospitalization will become increasingly important for stroke prevention as the population ages.Level of evidence: Level III
Perspectives on perioperative management of children’s surgical conditions during the COVID-19 pandemic in low-income and middle-income countries: a global survey
Authors: Truche Paul , Bowder Alexis , Lalla Amber Trujillo , Crum Robert , Botelho Fabio , Rice Henry Elliot , Lopes Bellisa Caldas , Greenberg Sarah , Evans Faye , Meara John Gerard , Ameh Emmanuel Adoyi , Mooney David Patrick 
Published: September 2020

BackgroundMany organizations have issued recommendations to limit elective surgery during the coronavirus disease 2019 (COVID-19) pandemic. We surveyed providers of children’s surgical care working in low-income and middle-income countries (LMICs) to understand their perspectives on surgical management in the wake of the COVID-19 pandemic and how they were subsequently modifying their surgical care practices.MethodsA survey of children’s surgery providers in LMICs was performed. Respondents reported how their perioperative practice had changed in response to COVID-19. They were also presented with 26 specific procedures and asked which of these procedures they were allowed to perform and which they felt they should be allowed to perform. Changes in surgical practice reported by respondents were analyzed thematically.ResultsA total of 132 responses were obtained from 120 unique institutions across 30 LMICs. 117/120 institutions (97.5%) had issued formal guidance on delaying or limiting elective children’s surgical procedures. Facilities in LICs were less likely to have issued guidance on elective surgery compared with middle-income facilities (82% in LICs vs 99% in lower middle-income countries and 100% in upper middle-income countries, p=0.036). Although 122 (97%) providers believed cases should be limited during a global pandemic, there was no procedure where more than 61% of providers agreed cases should be delayed or canceled.ConclusionsThere is little consensus on which procedures should be limited or delayed among LMIC providers. Expansion of testing capacity and local, context-specific guidelines may be a better strategy than international consensus, given the disparities in availability of preoperative testing and the lack of consensus towards which procedures should be delayed.
Cancer in the Fourth Dimension: What Is the Impact of Circadian Disruption?
Authors: Pariollaud Marie , Lamia Katja A. 
Published: September 2020

AbstractCircadian rhythms integrate many physiological pathways, helping organisms to align the timing of various internal processes to daily cycles in the external environment. Disrupted circadian rhythmicity is a prominent feature of modern society, and has been designated as a probable carcinogen. Here, we review multiple studies, in humans and animal models, that suggest a causal effect between circadian disruption and increased risk of cancer. We also discuss the complexity of this connection, which may depend on the cellular context.Significance:Accumulating evidence points to an adverse effect of circadian disruption on cancer incidence and progression, indicating that time of day could influence the effectiveness of interventions targeting cancer prevention and management.
Blocking P2X7-Mediated Macrophage Polarization Overcomes Treatment Resistance in Lung Cancer
Authors: Qin Juliang , Zhang Xiaoyu , Tan Binghe , Zhang Su , Yin Chengcong , Xue Qi , Zhang Zhen , Ren Hua , Chen Jinlian , Liu Mingyao , Qian Min , Du Bing 
Published: September 2020

Abstract
P2X7, a crucial sensor of extracellular ATP, is widely distributed in different immune cells as a potent stimulant of inflammation and immunity. P2X7 is also highly expressed in immunosuppressive cells such as tumor-associated macrophages (TAM) and even tumor cells. However, the function and potential applications of P2X7-mediated immunosuppressive responses in the tumor microenvironment remain unclear. Here, we demonstrated that P2X7 was highly expressed in TAMs and that P2X7 deficiency impaired the “M2-like” polarization of TAMs via downregulation of STAT6 and IRF4 phosphorylation both in vivo and in vitro. P2X7 deficiency restricted the progression of urethane-induced lung carcinogenesis and Lewis lung cancer by decreasing tumor cell proliferation and angiogenesis, promoting T-cell mobilization, and reversing M2-like TAM polarization. Thus, deletion or blockade of P2X7 was therapeutic for lung cancer. Furthermore, resistance to both immunotherapy (anti–PD-1 antibody) and chemotherapy (cisplatin) was overcome by coadministration of the P2X7 inhibitors O-ATP, A-438079 hydrochloride, and A-740003. Therefore, our data revealed a vital role of P2X7 in tumor formation through regulating TAM polarization, suggesting the therapeutic potential of P2X7 blockade in patients with lung cancer.
Glycans as Immune Checkpoints: Removal of Branched N-glycans Enhances Immune Recognition Preventing Cancer Progression
Authors: Silva Mariana C. , Fernandes Ângela , Oliveira Maria , Resende Carlos , Correia Alexandra , de-Freitas-Junior Julio C. , Lavelle Aonghus , Andrade-da-Costa Jéssica , Leander Magdalena , Xavier-Ferreira Helena , Bessa José , Pereira Carina , Henrique Rui M. , Carneiro Fátima , Dinis-Ribeiro Mário , Marcos-Pinto Ricardo , Lima Margarida , Lepenies Bernd , Sokol Harry , Machado José C. , Vilanova Manuel , Pinho Salomé S. 
Published: September 2020

Abstract
Tumor growth is accompanied with dramatic changes in the cellular glycome, such as the aberrant expression of complex branched N-glycans. However, the role of this protumoral N-glycan in immune evasion and whether its removal contributes to enhancement of immune recognition and to unleashing an antitumor immune response remain elusive. We demonstrated that branched N-glycans are used by colorectal cancer cells to escape immune recognition, instructing the creation of immunosuppressive networks through inhibition of IFNγ. The removal of this “glycan-mask” exposed immunogenic mannose glycans that potentiated immune recognition by DC-SIGN–expressing immune cells, resulting in an effective antitumor immune response. We revealed a glycoimmune checkpoint in colorectal cancer, highlighting the therapeutic efficacy of its deglycosylation to potentiate immune recognition and, thus, improving cancer immunotherapy.
Prognostic Value of Secreted Frizzled-Related Protein 5 in Heart Failure Patients With and Without Type 2 Diabetes Mellitus
Authors: Wu Jiandi , Zheng Haoxiao , Liu Xinyue , Chen Peisong , Zhang Yunlong , Luo Jianjin , Kuang Jian , Li Jingwei , Yang Yu , Ma Tianyi , Yang Yanhua , Huang Xiaohui , Liang Guoquan , Liang Donglian , Hu Yunzhao , Wu Jason H.Y. , Arnott Clare , Mai Weiyi , Huang Yuli 
Published: September 2020

Background:
Patients with heart failure (HF) with diabetes mellitus have distinct biomarker profiles compared with those without diabetes mellitus. SFRP5 (secreted frizzled-related protein 5) is an anti-inflammatory adipokine with an important suppressing role on the development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the prognostic value of SFRP5 in patients with HF with and without T2DM.

Methods:
The study included 833 consecutive patients with HF, 312 (37.5%) of whom had T2DM. Blood samples were collected at presentation, and SFRP5 levels were measured. The primary outcome was the composite end points of first occurrence of HF rehospitalization or all-cause mortality during follow-up.

Results:

During median follow-up of 2.1 years, 335 (40.2%) patients in the cohort experienced the composite primary outcome. After adjustment for multiple risk factors, each doubling of SFRP5 level was associated with a 21% decreased risk of primary outcomes in the overall study population (
P
<0.001). Subgroup analyses showed that the association between level of SFPR5 and primary outcomes may be stronger in patients with T2DM (hazard ratio, 0.69 [95% CI, 0.61–0.79]) than in patients without T2DM (hazard ratio, 0.89 [95% CI, 0.79–1.01]; interaction
P
=0.006). Similar associations were observed when taking SFRP5 as a categorical variable. Addition of SFRP5 significantly improved discrimination and reclassification of the incident primary outcomes beyond clinical risk factors and N-terminal pro-B-type natriuretic peptide in all patients with HF and those with T2DM (all
P
<0.01).

Conclusions:
SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.
The Nontraditional Coriolis Terms and Tropical Convective Clouds
Authors: Igel Matthew R. , Biello Joseph A. 
Published: September 2020

AbstractThe full, three-dimensional Coriolis force includes the familiar sine-of-latitude terms as well as frequently dropped cosine-of-latitude terms [nontraditional Coriolis terms (NCT)]. The latter are often ignored because they couple the zonal and vertical momentum equations that in the large-scale limit of weak vertical velocity are considered insignificant almost everywhere. Here, we ask whether equatorial mesoscale clouds that fall outside the large-scale limit are affected by the NCT. A simple scaling indicates that a Lagrangian parcel convecting at 10 m s−1 through the depth of the troposphere should be deflected over 2 km to the west. To understand the real impact of NCT, we develop a mathematical framework that describes an azimuthally symmetric convective circulation with an analytical expression for an incompressible poloidal flow. Because the model incorporates the full three-dimensional flow associated with convection, it uniquely predicts not only the westward tilt of clouds but also a meridional diffluence of western cloud outflow. To test these predictions, we perform a set of cloud-resolving simulations whose results show preferential lifting of surface parcels with positive zonal momentum and zonal asymmetry in convective strength. RCE simulations show changes to the organization of coherent precipitation regions and a decrease in mean convective intensity of approximately 2 m s−1 above the freezing level. An additional pair of dry cloud-resolving simulations designed to mimic the steady-state flow of the model show maximum perturbations to the upper-level zonal flow of 8 m s−1. Together, the numerical and analytic results suggest the NCT consequentially alter equatorial mesoscale convective circulations and should be considered in conceptual models.
Anthropogenic Aerosols Dominate Forced Multidecadal Sahel Precipitation Change through Distinct Atmospheric and Oceanic Drivers
Authors: Hirasawa Haruki , Kushner Paul J. , Sigmond Michael , Fyfe John , Deser Clara 
Published: September 2020

AbstractSahel precipitation has undergone substantial multidecadal time scale changes during the twentieth century that have had severe impacts on the region’s population. Using initial-condition large ensembles (LE) of coupled general circulation model (GCM) simulations from two institutions, forced multidecadal variability is found in which Sahel precipitation declines from the 1950s to 1970s and then recovers from the 1970s to 2000s. This forced variability has similar timing to, but considerably smaller magnitude than, observed Sahel precipitation variability. Isolating the response using single forcing simulations within the LEs reveals that anthropogenic aerosols (AA) are the primary driver of this forced variability. The roles of the direct-atmospheric and the ocean-mediated atmospheric responses to AA forcing are determined with the atmosphere–land GCM (AGCM) components of the LE coupled GCMs. The direct-atmospheric response arises from changes to aerosol and precursor emissions with unchanged oceanic boundary conditions while the ocean-mediated response arises from changes to AA-forced sea surface temperatures and sea ice concentrations diagnosed from the AA-forced LE. In the AGCMs studied here, the direct-atmospheric response dominates the AA-forced 1970s − 1950s Sahel drying. On the other hand, the 2000s − 1970s wetting is mainly driven by the ocean-mediated effect, with some direct atmospheric contribution. Although the responses show differences, there is qualitative agreement between the AGCMs regarding the roles of the direct-atmospheric and ocean-mediated responses. Since these effects often compete and show nonlinearity, the model dependence of these effects and their role in the net aerosol-forced response of Sahel precipitation need to be carefully accounted for in future model analysis.
The Interdecadal Reverse of the Relationship and Feedback Mechanism between Sea Surface Temperature and Evaporation over the Indian Ocean during Boreal Autumn
Authors: Huang Bicheng , Su Tao , Wu Yongping , Feng Guolin 
Published: September 2020

AbstractThe linkage between sea surface temperature (SST) and evaporation (EVP) plays an important role in air–sea interactions. In this study, the interaction mechanism of SST and EVP during boreal autumn was studied using correlation analysis, composite analysis, the EVP decomposition method, and singular value decomposition. The results showed that the correlation between SST and EVP in the Indian Ocean was reversed from positive to negative in the late 1990s. The significant positive SST–EVP relationship was attributed to the Indian Ocean basin mode forcing upon EVP during 1980–90. The decrease in wind speed–induced EVP and SST warming led to a significant negative SST–EVP relationship during 2005–15. Moreover, the negative SST–EVP correlation occurred when the Indian Ocean dipole (IOD) and subtropical Indian Ocean dipole (SIOD) exhibited inverse phases. The low-level moisture–EVP–SST feedback dominated the negative SST–EVP correlation in the negative IOD and positive SIOD (nIOD–pSIOD) pattern, whereas the wind–EVP–SST feedback played the leading role in the positive IOD and negative SIOD (pIOD–nSIOD) pattern. The EVP anomalies induced by the low-level anomalous anticyclone and cyclone were the main causes of the SST anomalies with inverse phases of the IOD and SIOD. The correlation between the SST and EVP reversal from positive to negative implies that the effect of the atmosphere on the ocean is as important as the external forcing of the ocean on the atmosphere.
Moisture and Energy Budget Perspectives on Summer Drought in North China
Authors: Dai Lan , Wright Jonathon S. , Fu Rong 
Published: September 2020

AbstractWe investigate the physical processes behind summer drought in North China by evaluating moisture and energy budget diagnostics and linking them to anomalous large-scale circulation patterns. Moisture budget analysis reveals that summer drought in North China was caused dynamically by reduced vertical moisture advection due to anomalous subsidence and reduced horizontal moisture advection due to anomalous northeasterly winds. Energy budget analysis shows that reduced latent heating was balanced dynamically by decreased dry static energy (DSE) divergence in the middle-to-upper troposphere. Linking these results to previous work, we suggest that summer drought in North China was predicated on co-occurrence of the positive phases of the Eurasian (EU) and Pacific–Japan (PJ) teleconnection patterns, potentially modulated by the circumglobal teleconnection (CGT). In the typical case, the negative phase of the CGT intensified the positive EU-related upper-level cyclone. Resulting upper-level cooling and positive surface feedback imposed a cold-core surface anticyclone that weakened with height. By contrast, when the positive phase of the CGT occurred in tandem with the positive EU and PJ patterns, the anticyclone had a warm core and intensified with height. The two cases were unified by strong subsidence but exhibited opposite meridional advection anomalies. In the cold-core cases, meridional moisture inflow was reduced but meridional DSE export was enhanced, further limiting precipitation while maintaining negative thermal anomalies. In the warm-core case, which only occurred once, enhanced meridional inflow of water vapor supplied moisture for sporadic precipitation while reduced meridional DSE export helped to maintain strong static stability.