bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eye care and ocular findings at the Olympic and Paralympic Games Rio 2016
Authors: Lima Vagner Loduca , Fernandes Arthur Gustavo , Viana Rodrigo Galvão , Feder David 
Published: April 2020

ObjectivesTo describe the attendance and ocular profile of competitors and members of delegations who attended the Polyclinic Ophthalmology Division during the Olympic and Paralympic Games Rio 2016.MethodsThe eye clinic was allocated in the purpose-built polyclinic opened for competitors and members of delegations from 24 July to 18 September 2016. All individuals who attended the service received a comprehensive ocular examination including biomicroscopy, subjective refraction and fundus evaluation. A main clinical finding was assigned for each eye by the ophthalmologist.Results5.6% of Olympic Games competitors and 8.9% of Paralympic Games competitors attended the Polyclinic Ophthalmology Division during the Rio Olympic and Paralympic Games. These rates compare with 2.6% and 6.5% at the London Olympic and Paralympic Games (2012). The main clinical finding was refractive error with 79.0% of the individuals receiving a glass prescription during the Olympic Games and 81.3% during the Paralympic Games.ConclusionOur outcomes highlight the importance of the eye service at the polyclinic as it may represent the only opportunity for many individuals involved with the Olympic and Paralympic Games to receive ocular evaluation. Our description of clinic structure, delivery of service and clinical results will be useful in the organisation not only for the Olympic and Paralympic Games Tokyo 2020 but also for any other large sporting events that involves medical attention in a polyclinic format.
Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?
Authors: Karelson Margit C , Jokihaara Jarkko , Launonen Antti P , Huttunen Tuomas , Mattila Ville M 
Published: April 2020

ObjectivesTo assess the rates and secular trends of different joint arthroscopies—shoulder, elbow, wrist, hip, knee and ankle—in Finland between 1997 and 2016.DesignRetrospective nationwide registry study.ParticipantsAll adults in Finland with any arthroscopic intervention procedure code for knee, shoulder, ankle, wrist, elbow or hip arthroscopy between 1 January 1997 and 31 December 2016 were included.Main outcome measuresIncidence rate of arthroscopic surgery per 100 000 person-years.ResultsThe rate of knee and shoulder arthroscopies declined after reaching a peak in 2006 and 2007, respectively. The rates of wrist, elbow and hip joint arthroscopies declined after their 2014 peak. At the same time, the median age of patients who had knee, ankle and hip arthroscopy decreased, whereas the age of patients who had shoulder arthroscopy increased.ConclusionsNumerous randomised controlled trials point to lack of efficacy of the most common knee and shoulder arthroscopic procedures. It should not be assumed that this has contributed to decreased rates of arthroscopic surgery. The concurrent decrease in most of the other joint arthroscopic procedures was unexpected.
Document analysis of exertional heat illness policies and guidelines published by sports organisations in Victoria, Australia
Authors: Gamage Prasanna J , Finch Caroline F , Fortington Lauren V 
Published: April 2020

ObjectivesTo conduct a document and content analysis of exertional heat illness (EHI)-related documents published by sports organisations in Victoria, Australia, in order to determine their scope and evidence base against current international best practice recommendations.MethodsA qualitative document and content analysis. Official documents relating to EHI were identified through a search of 22 Victorian sport organisation websites, supplemented by a general internet search. The content of these documents was evaluated against recommendations presented in three current international position statements on prevention and management of EHI.ResultsA range of document types addressing EHI were identified (n=25), including specific heat policies, match day guides, rules and regulations. Recommendations about prevention measures were the most common information presented, but these were largely focused on event modification/cancellation guidelines only (n=22; 88%). Most documents provided information on hydration as a preventive measure (n=20; 80%), but the emphasis on the importance of cooling strategies (n=7; 28%) and heat acclimatisation (n=5; 20%) was inadequate. Details on EHI, including its definition, symptoms/signs to look out for, and common risk factors (beyond humidity/high temperatures) were lacking in most documents.ConclusionThere is considerable variation in formal documents with regard to their content and quality of information. Continued efforts to bridge the evidence to practice gap in sports safety are therefore important. This study highlights the challenge for community sport, which relies on high-level policy and governance, across settings and populations that can differ substantially in their needs.
Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging
Authors: Yoshida Naohiro , Doyama Hisashi , Yano Tomonori , Horimatsu Takahiro , Uedo Noriya , Yamamoto Yoshinobu , Kakushima Naomi , Kanzaki Hiromitsu , Hori Shinichiro , Yao Kenshi , Oda Ichiro , Katada Chikatoshi , Yokoi Chizu , Ohata Ken , Yoshimura Kenichi , Ishikawa Hideki , Muto Manabu 
Published: April 2020

ObjectiveEarly detection of gastric cancer has been the topic of major efforts in high prevalence areas. Whether advanced imaging methods, such as second-generation narrow band imaging (2G-NBI) can improve early detection, is unknown.DesignThis open-label, randomised, controlled tandem trial was conducted in 13 hospitals. Patients at increased risk for gastric cancer were randomly assigned to primary white light imaging (WLI) followed by secondary 2G-NBI (WLI group: n=2258) and primary 2G-NBI followed by secondary WLI (2G-NBI group: n=2265) performed by the same examiner. Suspected early gastric cancer (EGC) lesions in both groups were biopsied. Primary endpoint was the rate of EGC patients in the primary examination. The main secondary endpoint was the positive predictive value (PPV) for EGC in suspicious lesions detected (primary examination).ResultsEGCs were found in 44 (1.9%) and 53 (2.3%; p=0.412) patients in the WLI and 2G-NBI groups, respectively, during primary EGD. In a post hoc analysis, the overall rate of lesions detected at the second examination was 25% (n=36/145), with no significant differences between groups. PPV for EGC in suspicious lesions was 13.5% and 20.9% in the WLI (50/371 target lesions) and 2G-NBI groups (59/282 target lesions), respectively (p=0.015).ConclusionThe overall sensitivity of primary endoscopy for the detection of EGC in high-risk patients was only 75% and should be improved. 2G-NBI did not increase EGC detection rate over conventional WLI. The impact of a slightly better PPV of 2G-NBI has to be evaluated further.Trial registration numberUMIN000014503.
Aberrant gut microbiota alters host metabolome and impacts renal failure in humans and rodents
Authors: Wang Xifan , Yang Songtao , Li Shenghui , Zhao Liang , Hao Yanling , Qin Junjie , Zhang Lian , Zhang Chengying , Bian Weijing , Zuo Li , Gao Xiu , Zhu Baoli , Lei Xin Gen , Gu Zhenglong , Cui Wei , Xu Xiping , Li Zhiming , Zhu Benzhong , Li Yuan , Chen Shangwu , Guo Huiyuan , Zhang Hao , Sun Jing , Zhang Ming , Hui Yan , Zhang Xiaolin , Liu Xiaoxue , Sun Bowen , Wang Longjiao , Qiu Qinglu , Zhang Yuchan , Li Xingqi , Liu Weiqian , Xue Rui , Wu Hong , Shao DongHua , Li Junling , Zhou Yuanjie , Li Shaochuan , Yang Rentao , Pedersen Oluf Borbye , Yu Zhengquan , Ehrlich Stanislav Dusko , Ren Fazheng 
Published: April 2020

ObjectivePatients with renal failure suffer from symptoms caused by uraemic toxins, possibly of gut microbial origin, as deduced from studies in animals. The aim of the study is to characterise relationships between the intestinal microbiome composition, uraemic toxins and renal failure symptoms in human end-stage renal disease (ESRD).DesignCharacterisation of gut microbiome, serum and faecal metabolome and human phenotypes in a cohort of 223 patients with ESRD and 69 healthy controls. Multidimensional data integration to reveal links between these datasets and the use of chronic kidney disease (CKD) rodent models to test the effects of intestinal microbiome on toxin accumulation and disease severity.ResultsA group of microbial species enriched in ESRD correlates tightly to patient clinical variables and encode functions involved in toxin and secondary bile acids synthesis; the relative abundance of the microbial functions correlates with the serum or faecal concentrations of these metabolites. Microbiota from patients transplanted to renal injured germ-free mice or antibiotic-treated rats induce higher production of serum uraemic toxins and aggravated renal fibrosis and oxidative stress more than microbiota from controls. Two of the species, Eggerthella lenta and Fusobacterium nucleatum, increase uraemic toxins production and promote renal disease development in a CKD rat model. A probiotic Bifidobacterium animalis decreases abundance of these species, reduces levels of toxins and the severity of the disease in rats.ConclusionAberrant gut microbiota in patients with ESRD sculpts a detrimental metabolome aggravating clinical outcomes, suggesting that the gut microbiota will be a promising target for diminishing uraemic toxicity in those patients.Trial registration numberThis study was registered at ClinicalTrials.gov (NCT03010696).
Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study
Authors: Chen Ru , Liu Yong , Song Guohui , Li Bianyun , Zhao Deli , Hua Zhaolai , Wang Xinzheng , Li Jun , Hao Changqing , Zhang Liwei , Liu Shuzheng , Wang Jialin , Zhou Jinyi , Zhang Yongzhen , Li Bo , Li Yanyan , Feng Xiang , Li Lin , Dong Zhiwei , Wei Wenqiang , Wang Guiqi 
Published: April 2020

ObjectivesTo estimate the effectiveness of endoscopic screening programme in reducing incidence and mortality of upper gastrointestinal cancer in high risks areas of China.DesignThis multicentre population-based cohort study was conducted in six areas in China from 2005 to 2015. All permanent residents aged 40 to 69 years were identified as target subjects. We refer to those who were invited for screening collectively as the invited group. Of these, we classify those who were invited and undertook endoscopic screening as the screened group and those who were invited but did not accept screening as the non-screened group. Target subjects who were not invited to the screening were assigned to the control group. The effectiveness of the endoscopic screening and screening programme were evaluated by comparing reductions in incidence and mortality from upper gastrointestinal cancer in the screened and invited group with control group.ResultsOur cohort analysis included 637 500 people: 299 483 in the control group and 338 017 in the invited to screening group, 113 340 (33.53%) of whom were screened eventually. Compared with subjects in the control group, upper gastrointestinal cancer incidence and mortality decreased by 23% (relative risk (RR)=0.77, 95% CI 0.74 to 0.81) and 57% (RR=0.43, 95% CI 0.40 to 0.47) in the screened group, respectively, and by 14% (RR=0.86, 95% CI 0.84 to 0.89) and 31% (RR=0.69, 95% CI 0.66 to 0.72) in the invited group, respectively.ConclusionAmong individuals aged 40 to 69 years in high risk areas of upper gastrointestinal cancer, one-time endoscopic screening programme was associated with a significant decrease in upper gastrointestinal cancer incidence and mortality.
Digestive system is a potential route of COVID-19: an analysis of single-cell coexpression pattern of key proteins in viral entry process
Authors: Zhang Hao , Kang Zijian , Gong Haiyi , Xu Da , Wang Jing , Li Zhixiu , Li Zifu , Cui Xinggang , Xiao Jianru , Zhan Jian , Meng Tong , Zhou Wang , Liu Jianmin , Xu Huji 
Published: April 2020

ObjectiveSince December 2019, a newly identified coronavirus (severe acute respiratory syndrome coronavirus (SARS-CoV-2)) has caused outbreaks of pneumonia in Wuhan, China. SARS-CoV-2 enters host cells via cell receptor ACE II (ACE2) and the transmembrane serine protease 2 (TMPRSS2). In order to identify possible prime target cells of SARS-CoV-2 by comprehensive dissection of ACE2 and TMPRSS2 coexpression pattern in different cell types, five datasets with single-cell transcriptomes of lung, oesophagus, gastric mucosa, ileum and colon were analysed.DesignFive datasets were searched, separately integrated and analysed. Violin plot was used to show the distribution of differentially expressed genes for different clusters. The ACE2-expressing and TMPRRSS2-expressing cells were highlighted and dissected to characterise the composition and proportion.ResultsCell types in each dataset were identified by known markers. ACE2 and TMPRSS2 were not only coexpressed in lung AT2 cells and oesophageal upper epithelial and gland cells but also highly expressed in absorptive enterocytes from the ileum and colon. Additionally, among all the coexpressing cells in the normal digestive system and lung, the expression of ACE2 was relatively highly expressed in the ileum and colon.ConclusionThis study provides the evidence of the potential route of SARS-CoV-2 in the digestive system along with the respiratory tract based on single-cell transcriptomic analysis. This finding may have a significant impact on health policy setting regarding the prevention of SARS-CoV-2 infection. Our study also demonstrates a novel method to identify the prime cell types of a virus by the coexpression pattern analysis of single-cell sequencing data.
Audio and panoramic video recording in the operating room: legal and ethical perspectives
Authors: Gabrielli Mauricio , Valera Luca , Barrientos Marcelo 
Published: April 2020

IntroductionThe idea of video recording (VR) in the operating room (OR) with panoramic cameras and microphones is a new concept that is changing the approach to medical activities in the OR. However, VR in the OR has brought up many concerns regarding patient privacy and has highlighted legal and ethical issues that were never previously exposed.AimTo review the literature concerning these aspects and provide a better ethical and legal understanding of the new challenges concerning VR in the OR.ConclusionsThere is a disparity between the two main legal models concerning VR in the OR, namely the European legal system (General Data Protection Regulation (GDPR)) and the American legal framework (Health Insurance Portability and Accountability Act (HIPAA)). This difference mainly deals with two distinct bioethical paradigms: GDPR places a strong emphasis on protecting patients’ privacy to improve the public health system, whereas HIPAA indicates the need to generate protocols to safeguard the risks connected to medical activity and patient privacy. Following from this point, we may argue that, at the ethical and bioethical level, GDPR and HIPAA depend mainly on two different ethical models: a perspective based on moral acquaintances and weak proceduralism, respectively. It is worth noting the importance of developing additional guidelines concerning different world regions to avoid the ethical problems that may emerge when simply applying a foreign paradigm to a very different culture.
Safety and effectiveness of non-vitamin K oral anticoagulants versus warfarin in real-world patients with non-valvular atrial fibrillation: a retrospective analysis of contemporary Japanese administrative claims data
Authors: Kohsaka Shun , Katada Jun , Saito Kumiko , Jenkins Aaron , Li Benjamin , Mardekian Jack , Terayama Yasuo 
Published: April 2020

ObjectiveTo assess the safety (ie, risk of bleeding) and effectiveness (ie, risk of stroke/systemic embolism (SE)) separately for four non-vitamin K oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) versus warfarin in Japanese patients with non-valvular atrial fibrillation (NVAF), including those at high risk of bleeding and treated with reduced doses of NOACs.MethodsWe conducted a retrospective analysis of electronic health records and claims data from 372 acute care hospitals in Japan for patients with NVAF newly initiated on NOACs or warfarin. Baseline characteristics were balanced using inverse probability of treatment weighting with stabilised weights (s-IPTW). Bleeding risk and stroke/SE risk were expressed as HRs with 95% CIs. Two sensitivity analyses were conducted.ResultsA total of 73 989 patients were eligible for analysis. Notably, 52.8%–81.9% of patients received reduced doses of NOACs. After applying s-IPTW, patient characteristics were well balanced across warfarin/NOAC cohorts. The mean within-cohort age, CHADS2score and CHA2DS2-VASc score were 76 years, 2.2–2.3 and 3.8, respectively. In all age categories, the majority of the HRs for major bleeding, any bleeding and stroke/SE were equal to or below 1 for all NOACs versus warfarin. Apixaban was the only NOAC associated with a significantly lower risk of any bleeding. There was a trend towards increased risk reduction with NOACs versus warfarin in patients with body weight ≥60 kg. In patients with renal disease, the HRs for apixaban versus warfarin were below 1 for major bleeding, any bleeding and stroke/SE, with statistical significance observed for the risk reduction in stroke/SE versus warfarin. In the sensitivity analysis, there were no large differences in HRs between the two observational periods.ConclusionsIn patients with NVAF primarily treated with reduced-dose NOACs, the risks of stroke/SE and major bleeding were significantly lower with NOACs versus warfarin.
Identification of DeleteriousNOTCHMutation as Novel Predictor to Efficacious Immunotherapy in NSCLC
Authors: Zhang Kai , Hong Xiaohua , Song Zhengbo , Xu Yu , Li Chengcheng , Wang Guoqiang , Zhang Yuzi , Zhao Xiaochen , Zhao Zhengyi , Zhao Jing , Huang Mengli , Huang Depei , Qi Chuang , Gao Chan , Cai Shangli , Gu Feifei , Hu Yue , Xu Chunwei , Wang Wenxian , Lou Zhenkun , Zhang Yong , Liu Li 
Published: April 2020

AbstractPurpose:NOTCH signaling is associated with tumorigenesis, mutagenesis, and immune tolerance in non–small cell lung cancer (NSCLC), indicating its association with the clinical benefit of immune checkpoint inhibitors (ICI). We hypothesized that NOTCH mutation in NSCLC might be a robust predictor of immunotherapeutic efficacy.Experimental Design:Multiple-dimensional data including genomic, transcriptomic, and clinical data from cohorts of NSCLC internal and public cohorts involving immunotherapeutic patients were analyzed. Polymorphism Phenotyping v2 (PolyPhen-2) system was performed to determine deleterious NOTCH mutation (del-NOTCHmut). Further investigation on molecular mechanism was performed in The Cancer Genome Atlas (TCGA) data via CIBERSORT and gene set enrichment analysis.Results:Our 3DMed cohort (n = 58) and other four cohorts (Rizvi, POPLAR/OAK, Van Allen, and MSKCC; n = 1,499) uncovered marked correlation between NOTCH1/2/3 mutation and better ICI outcomes in EGFR/ALKWT population, including objective response rate (2.20-fold, P = 0.001), progression-free survival [HR, 0.61; 95% confidence interval (CI), 0.46–0.81; P = 0.001], and overall survival (HR, 0.56; 95% CI, 0.32–0.96; P = 0.035). Del-NOTCHmut exhibited better predictive function than non-deleterious NOTCH mutation, potentially via greater transcription of genes related to DNA damage response and immune activation. Del-NOTCHmut was not linked with prognosis in TCGA cohorts and chemotherapeutic response, but was independently associated with immunotherapeutic benefit, delineating the predictive, but not prognostic, utility of del-NOTCHmut.Conclusions:This work distinguishes del-NOTCHmut as a potential predictor to favorable ICI response in NSCLC, highlighting the importance of genomic profiling in immunotherapy. More importantly, our results unravel a possibility of personalized combination immunotherapy as adding NOTCH inhibitor to ICI regimen in NSCLC, for the optimization of ICI treatment in clinical practice.
Coronary Disease Surveillance in the Community: Angiography and Revascularization
Authors: Gerber Yariv , Gibbons Raymond J. , Weston Susan A. , Fabbri Matteo , Herrmann Joerg , Manemann Sheila M. , Frye Robert L. , Asleh Rabea , Greason Kevin , Killian Jill M. , Roger Véronique L. 
Published: April 2020

Background
Temporal declines in cardiac stress tests results, coronary revascularization, and cardiovascular mortality have suggested a decline in the population burden of coronary disease until the 2000s. However, recent data indicate these favorable trends could be ending. We aimed to assess the evolution of the population burden of coronary disease in the community by examining trends in angiography and revascularization.

Methods and Results

We analyzed age‐ and sex‐adjusted trends from all coronary angiographic diagnostic procedures and revascularizations performed in Olmsted County, MN from 2000 to 2018. A total of 12 981 invasive angiograms were performed among 9049 individuals (64% men; 55% aged ≥65 years). Adjusted angiography rates decreased by 30% (95%
CI
, 25%–34%) between 2000 and 2009 and leveled off thereafter. Including
computed tomography,
angiography uncovered an increase in angiography use in recent years (risk ratio=1.15 [95%
CI
, 1.07–1.23] for 2018 versus 2014) and a decline in the prevalence of anatomic
CAD
from 2000 to 2018.
CAD
severity declined substantially from 2000 to 2009, followed by a plateau. Among 6570 revascularizations (72% men; 57% aged ≥65 years), 77% were percutaneous coronary interventions and 23% coronary artery bypass graft surgeries. The adjusted revascularization rates declined by 34% (95%
CI
, 27%–39%) from 2000 to 2009, followed by a plateau (risk ratio=1.10 [95%
CI
, 1.00–1.22]).

Conclusions

Between 2000 and 2018 in the community, coronary angiography use declined initially, leveled off, and then increased. Trends in
CAD
severity and revascularization use decreased then plateaued. The most recent trends are concerning as they suggest the burden of coronary disease is no longer declining. This warrants reinvigorated primary prevention and population surveillance.
Forensic identification of CITES Appendix I Cupressaceae using anatomy and mass spectrometry
Authors: Carmona Rene J. , Wiemann Michael C. , Baas Pieter , Barros Cristobal , Chavarria Gabriela D. , McClure Pamela J. , Espinoza Edgard O. 
Published: April 2020

Abstract
Alerce (Fitzroya cupressoides (Mol.) Johnst.) and Guaitecas cypress (Pilgerodendron uviferum (Don) Florin) are two of the three closely-related species of conifers in the Cupressaceae that are endemic to southern Chile and Argentina. Both are listed in Appendix I of the Convention on International Trade in Endangered Species of Fauna and Flora (CITES). The presence or absence of nodular (conspicuously pitted) end walls in the parenchyma cells provide good diagnostic characters to separate the two species wood anatomically, but the latter is sometimes difficult to distinguish. Therefore, a collaborative project was designed to study the chemical-molecular expression of these species by analyzing the heartwood using DART TOFMS (Direct Analysis in Real-Time (DART) Time-of-Flight Mass Spectrometry (TOFMS). This study compares the anatomical features of heartwood for both species and demonstrates that anatomy in conjunction with chemistry can separate them. DART TOFMS analysis combined with PCA was able to unequivocally determine taxonomic source with a statistical certainty of 99%. The mass spectra results obtained from heartwood demonstrated that identification is feasible after a few seconds, using a very small sample. DART TOFMS is a robust tool for reliable species identification and is useful to identify the taxonomic source of finished products or timber that are suspected of being illegally harvested.